Lap Band Vs. sleeve gastectomy?

[MacMadame 81]

I keep going back and forth. Plus I did a spreadsheet and if I switch insurance my out of pocket expenses will be double what they are now. If I don't switch, I have to self-pay and if I self-pay, then a sleeve seems like a better deal as I don't have to worry about erosion or slippage and having to pay again to take it out. But if I switch, the band will be paid for 90% after my deductible is met.

They also made some changes in the plan this year but won't post the Plan Summaries with all the exclusions.

Man, this insurance stuff is so complicated and unpleasant!

[WASaBubbleButt 41]

I keep going back and forth. Plus I did a spreadsheet and if I switch insurance my out of pocket expenses will be double what they are now. If I don't switch, I have to self-pay and if I self-pay, then a sleeve seems like a better deal as I don't have to worry about erosion or slippage and having to pay again to take it out. But if I switch, the band will be paid for 90% after my deductible is met.

They also made some changes in the plan this year but won't post the Plan Summaries with all the exclusions.

Man, this insurance stuff is so complicated and unpleasant!

I was self pay for the band and it was pretty expensive. The aftercare was very expensive when you consider the fills, unfills, testing, diagnostics, upper GIs, upper endoscopy, transportation non stop to my doc, prescriptions, the works then a revision for $12,5 on top of it. This has all been verrrry expensive. In my case it would have been soooo much cheaper to do a sleeve in the very beginning. The band does require a great deal of aftercare and it's for life. It's not a couple of fills and you are done. It's much more than that. With a sleeve I get the surgery and I'm done. A lifetime of restriction, no stoma, no restriction issues due to weather, stress, hydration, TOM, and all the other factors that deal with restriction such as fills and unfills, no slips, erosion, and no more liquids after the post op diet.

If you go to a sleeve board and see banded folks that have converted to sleeves they are the only folks not whining about the liquid post op diet. Know why? They are used to liquids, a few more weeks of it doesn't phase them. With banding you are on liquids after surgery, after each fills, after each stuck episode, during each day when restriction is too tight for a variety of reasons. It bothers me that I am sooo used to liquids. It's just not a healthy route to go for some of us.

I wouldn't depend on cost when deciding on a surgery type, look far far beyond that one. But if you are going to depend on cost in deciding a surgery type, look at ALL the costs, and that is a lifetime of aftercare.

[MacMadame 81]

II wouldn't depend on cost when deciding on a surgery type, look far far beyond that one. But if you are going to depend on cost in deciding a surgery type, look at ALL the costs, and that is a lifetime of aftercare.

You misread me, I think. I am looking at costs of one insurance vs. another. I know the sleeve is a little more than a band, but that's not my big issue. My big issue is that I don't want to change my insurance. The one I have works really well for me and the one I have to switch to isn't a good choice for me overall, but will cover a band.

So is it worth it to switch in the long run? That's what I'm struggling with. If it's not worth it and I have to pay myself, then I'm going to get what I want when I want it. I can't see saving a few thousand and not getting what I want when I'm spending 8 to 20 thou. (depending on where I go and what I get). That's just not my approach to money.

But if I decide to stick with insurance, I have limitations. My best guestimate is that even with insurance, I will still be out-of-pocket $4200 this next year. I can lower the damages by using a FSA for that amount. But if I'm going to spend $4200 and then have higher out-of-pocket expenses every year for years, why not spend $8000 and get my band in Oct. when I want it without having to do a 6 month diet and other things that I find to be silly? Or get a sleeve if that is what I want?

This is how my mind works... I know other people have a different approach to finances and for some people $4000 is a lot of money to be saving. But for me, it's about not having to pay much at all vs. paying a lot but getting exactly what I want.

[WASaBubbleButt 41]

You misread me, I think. I am looking at costs of one insurance vs. another. I know the sleeve is a little more than a band, but that's not my big issue. My big issue is that I don't want to change my insurance. The one I have works really well for me and the one I have to switch to isn't a good choice for me overall, but will cover a band.

So is it worth it to switch in the long run? That's what I'm struggling with. If it's not worth it and I have to pay myself, then I'm going to get what I want when I want it. I can't see saving a few thousand and not getting what I want when I'm spending 8 to 20 thou. (depending on where I go and what I get). That's just not my approach to money.

But if I decide to stick with insurance, I have limitations. My best guestimate is that even with insurance, I will still be out-of-pocket $4200 this next year. I can lower the damages by using a FSA for that amount. But if I'm going to spend $4200 and then have higher out-of-pocket expenses every year for years, why not spend $8000 and get my band in Oct. when I want it without having to do a 6 month diet and other things that I find to be silly? Or get a sleeve if that is what I want?

This is how my mind works... I know other people have a different approach to finances and for some people $4000 is a lot of money to be saving. But for me, it's about not having to pay much at all vs. paying a lot but getting exactly what I want.

Okay, I did misunderstand. Sorry, I see what you are saying now.

Six month diet, start it now and if you need it you'll almost be done by the time Oct rolls around. I agree, it's a stupid requirement.

Something to consider... just throwing out prices here. I don't know band prices in the US for specific doctors, so just throwing out Mexican prices to make a point.

Band: $7000

Sleeve: $9500

Revision from band to sleeve $12,500 (plus $7000 band surgery)

Revision from band to band $12,500 (plus $7000 band surgery)

Correction of a slip: $3500 - $5000 (plus $7000 band surgery)

[PamRN 0]

I was banded for 2 years. I chose the band because it was reversible in the event of a problem, and less invasive than the RNY. There was a problem...erosion - 80% was inside my stomach...so much for less invasive huh?

2 years ago I had it removed/reversed, and it reversed me all right...right back up the scale, and I'm now scheduled in Aug for the VSG.

I've spent the last 2 years researching, reading, and waiting before finally deciding what to do. I've finally decided to do the VSG.

The studies say it's as effective or better at 5 years out than the RNY in weight loss and maintaining. Wasabubblebutt is right, they use an improved technique to prevent stomach stretching. I've read that you may gain a 3 to 5 % stretch over time. That's still a very tiny stomach.

I've read that some patients do experience a bit of a dumping feeling. A discomfort if they intake the wrong food, generally sugar alcohols... or eat too fast, described as a feeling of discomfort in the chest and or abdomen, lightheadedness, feeling faint, and sweats. It eventually passes, you have to wait it out.

Many do not experience any kind of dumping feeling. I would think it would be a good thing to train us avoid foods that arent good for us.

I've also read that the body compensates over time and generates a new location in the intestine for grehlin production, but it's never at the former levels that the stomach produced, so it's still a reduced level of hunger.

It's permanent. Just like the band you can eat around your sleeve with high calorie liquids. We still have to monitor what we fuel ourselves with.

I've read that much like the band causes the slimes, VSG can cause 'foamies' brought about by eating too fast, not chewing well or eating too much.

I like the newest VSG studies for 5 years out. I like that this time it will be permanent. No risk of erosion, no risk of slippage, no port, no fills, a constant sweet spot not affected by TOM, stress, time of day... I'm having difficulty locating any post up VSG'ers who regret the sleeve, but am finding lots and LOTS of banders that regret banding.

Edited July 24, 2008 by PamRN

[SHAND 0]

I regret my lap band and i want to get the sleeve. Anybody else got anything to say about taking out the band and getting the sleeve.

[MacMadame 81]

Talk to WASaBubbleButt. She already did it.

[HeatherO 7]

I regret my lap band and i want to get the sleeve. Anybody else got anything to say about taking out the band and getting the sleeve.

Why did you decide you wanted to convert? I know I struggled in the beginning deciding between the two. If you explain it might be useful information for those of us still trying to make a decision.

WasABubbleBut is indeed an excellent resource. You should look up some of her posts.

[verticlelap 0]

try no weight loss after six months!

[youknowit 11]

PAMRN - Did you go through with getting the sleeve, and how is everything going? :Dancing_biggrin:

[WASaBubbleButt 41]

I regret my lap band and i want to get the sleeve. Anybody else got anything to say about taking out the band and getting the sleeve.

I did it and love my sleeve. It is soooo much easier than banding!

[funfamilyfun 2]

I had a sleeve on August 11.

I have lost 58 pounds! Your stomach does not stretch with a sleeve. The doctors remove the part of your stomach that stretches. It may seem as if it stretches but actually, your stomach is just healing the first few montsh.

At first I considered the band, but then read the complications and decided on the sleeve. I'm not saying that it is easy, but I feel so much better without 58 pounds!

I was self pay. Good luck with your decision.

[youknowit 11]

if you don't mind me asking... who did you go to, and what did you pay? :biggrin:

[4meonly 4]

YouKnowIt,

I had a revision from band to sleeve on Oct. 20th.

I had Dr. Aceves do the revision. He is in Mexicali, Mexico. Great doctors, great staff, great hospital, and great care.

The revision is a tougher surgery than a straight sleeve because they are removing the band and port as well as doing the sleeve. You spend 3 nights in the hospital. You spend 1 night (before the surgery) in a beautiful hotel (included in the cost).

Let me know if you have any questions.

Cheryl