Low BMI but want revision

[Purplrose323 32]

Hi all, I'm new here and just looking for every and anything I can absorb with regards to this surgery. I'm super anxious as I saw one of the PA's in my surgeon's office today to discuss removal of my 9 year old lap band and a possible revision. I see my surgeon on Monday but I'm scared to death that even after seeing him he may tell me I'm not a candidate. My BMI is 34 and for the first time in my life today I was told I needed to gain weight for the insurance to cover the revision. I've had my band since September of 2004 and I absuloute hate it. The most I lost was 50lbs or so. Long story short I'm now 212 and steadily gaining again. My band made me feel like a forced bulimic and there was constant reflux. We fiddled with for awhile this year and still there is no sweet spot. That being said, I'm just wondering about insurance coverage? If anyone was able to have this done with low BMI and no comorbidities, or any other thing that helped with insurance covering this. I know every insurance plan is different but just looking for some input. My band is now at 2cc (I have a 4cc band) and I have an endoscopy scheduled for 5/16. I absolutely wish this surgery was available in 2004. I'm also curious as to what you can and can't eat once you are past the post op period, etc., or if anyone had any major complications? Thanks in advance. Kelly

[kakaw 33]

You sound like me, only I had my band for half the time you did. I too was told I would need to gain to have the revision. I did, 14.5 lbs and it was so hard since my band made me puke things up all the time. I ended up going to Dr.Aceves in Mexicali for my revision. I also had a wide Hiatal Hernia and some other issues. I am so amazed how great it is to have my band out and not constantly be sick! I am struggling a bit not to lose more, never thought Id say that! I lost the weight I gained wiin 10 days of surgery. I had my revision March 22. Feel free to PM me, Im not on here a whole lot

[kshallow 9]

It may make a difference in regards to insurance if there is a problem with your band that can be medically diagnosed ( slip, prolapse, erosion,etc.) If they will cover the revision. I was very sick with a slipped band, a "mechanical failure" See what your endo test comes back with. If there isn't a clear problem with the band itself, start contacting your insurance company, plead your case complete with documentec doctors visits, fills, UGI'S, ER visits, testing, etc. Any substantiated way you can document that a covered revision will save them money in the long run could help. As far as low BMI, mine was 27 at time of revision.I made my case to ins co. this wasn't about me losing a tremendous amount of weight, it was about lifelong weight maintenance (again, cost effective for them if I avoid any weight-related medical issues) good luck

[marfar7 1,533]

Medicare will pay for the revision, no matter what your bmi is (mine is 28) if there are complications with your band. Your dr could say that you have a band intolerance, excessive vomiting both of which are true. Mine slipped (have had it for 3 1/2 yrs) and was totally unfilled last month. Waiting till all the inflammation to go down so I can have the revision all in 1 surgery. Like I said, my insurance covers it with complications, even with my bmi at 28. I only need to lose 30 lbs but I know I caould never keep off the 100 I've already lost without a tool.

Good luck!

[Purplrose323 32]

Thank you for all your responses and weIl wishes! I have empire bcbs, however it's thru my husbands union, and I'm not sure how it works. Says you need to call the union for precertification, and I know for a fact they are pain in the ass with most anything at least before it was bcbs they went thru. So I'm trying to stay hopeful and positive, which this last year has been so difficult. I haven't been to the ER with regards to the band at all. I'm sure though if I kept living with it I'd end up there at some point. I was honestly living silently with the band problem, afraid there was no other tool for me to keep the weight off. No one knew not even my husband how bad the vomiting and stuff had become until I had my son and it was back to have the thing filled again. I practically broke down. So here's to hoping I can have this done without having to gain back all the weight lost from the band and it's complications!

[sherrypep 91]

I am having a revision on Monday after being banded on 12/21/11. My band has a slow leak, and I have reflux, heart burn, and throwing up if this band is tightened at all. My BMI is only about 29 but my insurance approved it right away. I am having my revision on Monday and can't wait to get that band out of me. Best of luck with your decision.

[stefaniwg 172]

I went to two different doctors who told me to gain 30 pounds before they would even submit to insurance which would put me back at my starting weight. Ummm no! I'm going to Tj Mexico on May 22nd to have my revision with Dr. Garcia! No hoops to jump thru there! Good luck to you!

[Fixerupper 335]

I have bcbs of Michigan and.they are covering based on the BMI I had when I got my band. Mine is due to band intolerance but I now have a hernia, gastritis, and esophogitis from the constant vomiting. Those conditions will worsen if hhe band is left in place and can have some pretty scary consequences.

[tlah 40]

You sound like me' date=' only I had my band for half the time you did. I too was told I would need to gain to have the revision. I did, 14.5 lbs and it was so hard since my band made me puke things up all the time. I ended up going to Dr.Aceves in Mexicali for my revision. I also had a wide Hiatal Hernia and some other issues. I am so amazed how great it is to have my band out and not constantly be sick! I am struggling a bit not to lose more, never thought Id say that! I lost the weight I gained wiin 10 days of surgery. I had my revision March 22. Feel free to PM me, Im not on here a whole lot[/quote']

I have bcbs federal basic had band for 3.5 years. Bad reflux esophagus dilation although im at 34.1 now I was at 36 when I started the use first weight vits c usually vonly 10 lbs. Eats carbs and Desserts. Best of luck to b you I know your pain I was husr sleeved may 2

[imbabiluv 20]

I had my sleeve done 6 days ago. I had in put in 10/24/10. It was slow I did lose a lot of weight but I developed diabetes. My band was removed and the sleeve was done the same day. I made the choice march 18th and just had my surgery. I am coping with the liquids and I'm happy that my diabetes are gone as of the surgery. It's your preference but I regret my lap band.

[tlah 40]

Me too had a revision. May 2. And doing great

[teach830 1]

I had a band to sleeve revision on March 29, 2013. I had the band put in in Spetember 2010. Started at 250, lost 92 lbs. I had a slip which caused severe acid reflux. The revision was not covered because my BMI was normal. I found a doctor who only charged me $5000 if the band removal could be done at the same time and was covered. All went well and I am loving my sleeve.

[ppqjones 7]

I am in a similar situation. I am awaiting my EGD this week then will be submitted for removal either for medical reasons or intolerance which ever path best fits. Then hoping my ins will approve revision even though my BMI is only 35 now without any co-factors. If not ill see what I can do for self pay. And if that doesn't work I'll start all over I refuse to give up at the first "no". Good luck & keep pushing for your health!

[amy73 0]

Hi, I also had my lap band surgery in 2004. I had moderate weight loss due to restriction and vomiting. I had only one fill the smallest amount they could do. I never went back for help because I felt like a failure and I was not willing to give up the band out of fear of gaining even more weight. Earlier this year I had the band emptied. Now I have gained 20 plus pounds. I want a revision but I'm worried they will not approve it because I have a bmi of 30. Do you have any advice?

Starting 230lbs

After band 155lbs

1 year 165

2nd 175

now 197

[SuNMooNStaRS816 423]

Hi' date=' I also had my lap band surgery in 2004. I had moderate weight loss due to restriction and vomiting. I had only one fill the smallest amount they could do. I never went back for help because I felt like a failure and I was not willing to give up the band out of fear of gaining even more weight. Earlier this year I had the band emptied. Now I have gained 20 plus pounds. I want a revision but I'm worried they will not approve it because I have a bmi of 30. Do you have any advice?

Starting 230lbs

After band 155lbs

1 year 165

2nd 175

now 197[/quote']

In Mexico they will do the surgery at a BMI of 30.