Band slipped...removal and possible bypass..Insurance? Next Steps?

[Heather_8.1.14 65]

*This is a copy and paste of what I wrote in the Lapband complications thread*

Long time bandster, mostly now a creeper lol.

A quick back story. I was banded in 2010, I had lost 70lbs and with my surgeons blessing got pregnant with my 3rd child (1st "band baby") 9 months post op. Had a successful pregnancy/delivery with an empty band. A few months after my surgery my gall bladder went bad and had it removed. Didn't do a whole lot of "maintence" with my band between 2011 and 2013. After my 4th child (2nd band baby) was born this past October I was noticing that even with an empty band I was still getting the stuck feeling and having difficulty eating and many times I found myself vomiting.

Fast forward to now. Being a mom of 4 I was putting myself on the back burner for my heath, finally I called my dr Monday and today I had an upper GI done to find my worst fear had come true, my band slipped. It isn't severe enough to need to be removed right this second but they are already working on getting everything needed to go back to the insurance company. My doctor does not feel putting another band in would be the best option since this one failed and suggested bypass. My practice does the sleeve but the PA said that because of my history with reflux I wouldn't make the best candidate and because I was so successful with my band he believes I can be with the GB as well.

I'm just afraid of that whole surgery, which is why I chose the band. But I have heard people say they've had the exact experience and ended up going the bypass route and they were happy. I had chose the band because it was less invasive and I had planned on having more kids, but now we're done and maybe this isn't a bad option.

I guess I'm just looking for others who experienced/experience this and some guidance and support

I have Keystone BCBS insurance. Any idea on how long this process will take? What hoops I may have to jump through?

[MimIN 19]

Hi Heather,

You are not alone! I was terrified to go through with RNY, same as you I chose the band because it was less evasive and not "permanent"

I underwent revision on May 21st after 7.5 years with the band. Absolutely best decision I have ever made. My band experience was great for the first year or so, I lost more than 100lbs and felt great. Slowly, I started having all of the problems others report and it escalated from there. After the birth of my first (and only atm) daughter, I had a band revision because it slipped while I was pregnant. I had a little relief but as soon as I got a fill, I had issues. By this time, I was over it.

My new surgeon believed I was a great candidate for RNY but with a bmi of 33, it was unsure if it would be approved. Well, it was and within days. I have BCBS of Michigan and the approval was easy. So easy that I was sure it was a mistake. It was not and insurance has paid.

My recovery wasn't awesome but I'm a big baby and ended up with an infection in my port site. I'm sure it was my fault as I don't know well enough to relax and follow the rules. All is well now and 5 weeks later I have lost 33lbs.

Good luck in your journey, it will be worth it!

[Heather_8.1.14 65]

Hi Mim thank you! My BMI was 34.66 and my insurance denied it at first and I was devastated since I was less then a %, but my surgeon kicked it back and they approved. I go in for surgery on August 1st! I've got a ton of testing to complete but Im looking forward to finally finishing my WL journey

Hi Heather,

You are not alone! I was terrified to go through with RNY, same as you I chose the band because it was less evasive and not "permanent"

I underwent revision on May 21st after 7.5 years with the band. Absolutely best decision I have ever made. My band experience was great for the first year or so, I lost more than 100lbs and felt great. Slowly, I started having all of the problems others report and it escalated from there. After the birth of my first (and only atm) daughter, I had a band revision because it slipped while I was pregnant. I had a little relief but as soon as I got a fill, I had issues. By this time, I was over it.

My new surgeon believed I was a great candidate for RNY but with a bmi of 33, it was unsure if it would be approved. Well, it was and within days. I have BCBS of Michigan and the approval was easy. So easy that I was sure it was a mistake. It was not and insurance has paid.

My recovery wasn't awesome but I'm a big baby and ended up with an infection in my port site. I'm sure it was my fault as I don't know well enough to relax and follow the rules. All is well now and 5 weeks later I have lost 33lbs.

Good luck in your journey, it will be worth it!