It's official. I'm probably going to lose my band.

[losing_the_band 133]

I had my first appointment with my new surgeon today. Since it had been two and a half years since I'd seen my original one, he did a fluoroscopy on me. We saw that my band was extremely tight and that my pouch was extremely dilated/stretched. The tight band was news to me, since I hadn't felt much restriction in a long time and could eat close to a full meal. The band was so tight that we couldn't see the barium emptying out of the pouch at all. He said that my opening between pouches was probably about the size of a pencil eraser, and that he was amazed that I'd lived with it for as long as I did. He did an immediate complete unfill, since he said that it was pretty dangerous. He said that eventually it would migrate and close off my stomach entirely and I'd have to have emergency surgery to remove it.

He gave me three options, all of which are surgery. Remove the band and leave my stomach alone, go in and reposition the band, or do a revision to a sleeve. Right now, I don't meet the BMI requirements for revision, but he thinks we may be able to make an argument that it's a medically necessary surgery anyway. Ideally, we'll revise, if that isn't possible, I'd rather have the band repositioned than removed.

I admit that I was kind of hoping to have something wrong with the band in order to justify revising to a sleeve, but actually KNOWING that something is wrong bothers me more than I thought it would. I almost started crying at the surgeon's office.

Now it's time to hurry up an wait while we get everything together and submitted to insurance. It's going to be at least a week until anything gets done, since the insurance coordinator is on vacation this week.

[Tiffykins 673]

Fingers crossed you can get the sleeve. From my understanding, dilation is reason for them to approve the full revision. At least that's what I've seen on the various forums.

Best wishes on insurance submission and keep us posted ! ! !

[losing_the_band 133]

I'm hoping that's true in my case. I'm just worried because my insurance policy states that a second bariatric surgery requires a 2-year history of morbid obesity. It's ironic that if I hadn't ever been successful with the band, they'd gladly pay for the sleeve, but because I actually was successful, they might not want to pay for the sleeve, even though I'm regaining. Hopefully, they'll consider the dilation to be a good enough reason to justify revision, though.

[Wheetsin 714]

Typically criteria for approval does not include losses from the immediately prior WLS. For example, my father had a slipped band removed, and a few months later was re-banded. Although the criteria for band approval includes a BMI over 40, he was excluded from this due to his past.

I am a soon to be band to sleeve revision (I'm mostly decided sleeve is what I want). My BMI is under 40 and I don't have comorbidities, but that will not be grounds for denial.

However, if I had my band out 5 years ago, and had stayed at a normal weight since, and now wanted to be sleeved, I would most likely not be approved.

(That's as my ins. co. explained it to me)

I don't know what the statute of limiations, so to speak, is on duration you can go "unassisted" and maintain your BMI, and disqualification because of a low BMI.

[CowgirlJane 14,259]

Insurance is a puzzle. I knew that my insurance covers WLS and I met all the criteria, but we had a few extra hoops to jump through to get approval for a revision. That extra hoop was easy once I was diagnosed with a slip. Basically, if you had a "failure" of the previous surgery like a slippage it didn't matter your BMI or co-morbidities. Even so, they wanted my NUt and psych assessment to approve the band removal... I think they got wires crossed because that makes no sense. The insurance person said, oh we needed it anyway for the sleeve procedure approval.

Anyway, my doc was alarmed by my slip too because even though all Fluid is out he said the band was too tight and it had slipped alot. It is strange because I feel basically no restriction. He too warned me that I could suddenly be totally blocked and require emergency surgery. Tomorrow, I have my EKG which is the last step before the removal - I somehow missed that I needed to do that. Only after the EKG is done will they schedule the removal.

Ask your doctor how often the "repositioning" actually works or if it is likely to slip again.

[Wheetsin 714]

Slips are weird in that way. I have restriction. I'm not going to say a LOT, when I can eat I can eat about as much as I want, but there are still plenty of times when I'll just skip meals b/c it's too uncomfortable to eat. And I'm still full a LOT sooner than I would be with nothing ("as much as I want" is still under a full portion).

Yesterday I ate a small plate of Cheez-Its just fine. About 45 mins later went to drink some apple juice and ended up sliming over it. I came |----| close to having to having to yak, which I haven't had to do in months & months & months. That's a slip, and no fill, and not TOM.

I haven't heard anything about my removal since the EGD was scheduled. I need to call. I'm really not impressed with the way this is being handled. I know my surgeon's office is busy, but I don't think my expectations are too high when I saw that I just want to know what comes next... and maybe a guess as to when.

[Rev Me Up! 75]

Good luck with your insurance and I hope you get some relief soon. Be prepared to stand up for what you want - you are your own best advocate. It seems like lots of people have denials and then win on appeal, you just have to be persistent.

Good luck!