What if???????

[athykay 9]

I should have asked this before my surgery, but didn't. So now I am. What if for some reason you had to have the band removed? Would Insurance cover it? Anyone ever have this problem? Just curious since I self payed because of exclusions in my policies.

Doing great so far but you never know..

Dr. Lopez

May 21 2004

:Bunny

[Alexandra 55]

No one can answer definitively the question of whether a band removal would be covered by insurance. In my experience (which is fairly extensive, as I'm an insurance broker), and in my state, medically necessary procedures are covered regardless of what they're related to. So, for example, if someone who had cosmetic breast implants developed a problem with them, the treatment for the problem would be covered even though the original implants were elective and not covered.

But every state has different laws and every contract has different provisions. You'd have to check locally with your plan and state department of insurance to get the full story as it applies to you.

[athykay 9]

Thanks Alex that makes good sense. I just had never seen anyone post about this.

Thanks again.

Kathy

[claraluz 2]

I think what Alex said would probably be true almost anywhere. I know that my fill doctor, who has the band herself, said that her insurance paid when she had to have her band removed emergently. And they had not covered the band placement originally. I also am getting the impression, though - and it may be wrong - that bands are not as removed as often as they once were. The surgeons I heard speak at the Texas Bandster Bash said that even erosions usually require no treatment at all. Slippages are treated with a temporary unfill.

Nancy

[donali 57]

Erosions require no treatment? They just leave the eroded band in the stomach, where it does nothing?

I do not understand this. Besides the fact that there would be a new opening into the stomach (the band's tube) which surely could possibly leak stomach juices into the body cavity (?), there is the remaining problem that the patient now basically has no restriction, so in essence, no band.

If my band ever eroded, I'd certainly want the sucker out. And then, as soon as my stomach was ready, I'd want another one put on.

And as I understand it, only minor slippages can be effectively treated with an unfill. If the slip does not correct itself with an unfill, then a surgical repair must be done.

[Alexandra 55]

Donali, we just talked about this the other night at the support group. It's a common misunderstanding that I think it's really important to clarify.

"Erosion" refers to erosion of the STOMACH, not the band itself. The materials of the band are much more sturdy than the tissues of the stomach, and when there's friction and abrasion it's the stomach that gives first.

So: it's the band that is DOING the eroding, but the stomach that is BEING eroded. Relieving the pressure point where the erosion is happening can be enough to let the area heal. The band itself retains its structural integrity, and will long survive the soft tissues of our bodies.

Hope that helps! End of lesson.

[donali 57]

I did not write my question clearly - I know the BAND does not erode, but gets absorbed into the stomach. I just called it "eroded band" as a name for the process in which it came to be lying useless inside the stomach.

I have not heard of any test that can tell a doc when a band is beginning to erode, so that it could be prevented. I have only heard of people who suddenly no longer have restriction, and that is when it is discovered that the band is now INSIDE the stomach, instead of outside and around it.

[athykay 9]

Your kidding the band ends up in the stomach? How does that happen? Wow I am totally confused on this girls. :confused:

What ever, I don't want either of those things going on. I believe in the power of positive thoughts so that's what I got going on here.

Thanks again,

Kathy

Dr. Lopez

Heathly band:) :D :D :D :)

5/21/2004

[donali 57]

This article says that removal of the band after erosion is mandatory:

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15072660

This particular article is NOT about the adjustable gastric band, but the band used in other WLS. However, I thought the info was still valuable, and the pictures show basically the same thing that would happen with an AGB erosion. The attached picture is one of these non-adjustable bands.

http://www.cstobesity.com/articles/Fobi%2011(6).pdf

Here is an eroded AGB:

http://www.thieme.de/endoscopy/06_00/uctn_03.html

An FDA doc on the LapBand that I have not seen before:

http://www.fda.gov/cdrh/pdf/P000008b.pdf

Some articles with a little info about erosion:

http://clos.net/lib/02-wls/agb-comps.htm

http://www.contemporarysurgery.com/09_03/CS903Sym.pdf

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15056068

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15011918

[athykay 9]

Wow thanks for the links, I learned alot. I had read some of that prior to my surgery, these were very informative.

Thanks again,

Kathy

[hagerteresa 3]

I specifically called my insurance before I had my band put in (I was also self pay in Mexico) and asked them about emergency situations and they said that it would be covered even though they won't cover the band going in. We can only all hope and pray we are not one of the few that have these awful problems. By the way I live in Oregon. Not sure about individual states or companies. I was banded May 8th with Dr. Lopez and am doing great. Best wishes to you too, Teresa

[Alexandra 55]

Donali, I should have realized you of all people would understand the situation better than anyone. Thanks for the very informative links!!