Thursday, December 1, 2011

Frustrated.

After another barium swallow, there was no change in my LapBand's brokenness...next plan?  Surgery.  While I'd contemplated, researched and discussed the sleeve with others, I had decided that I would prefer to stick with LapBand revision surgery, knowing that the quality of after care I have now is what's necessary to be successful in the end of my journey.  I waited for a week to hear from the dietitian/nurse who would be contacting me with more information, but finally called her to find out what was going on...

...and, of course, the insurance I have doesn't cover anything.  Nothing.  I knew it didn't cover bariatric services (I've been paying out of pocket for all of these barium swallows and adjustments), but we assumed that since I am at the point where this brokenness is affecting my ability to eat, sometimes drink, live, etc...insurance would cover either the revision or removal.  Nope!  She told me that she even pleaded with the insurance nurse, telling her that I've been surviving mostly on liquids since they took over my case in August - nothing.  At this point, my doctor is going to do a "peer to peer" with the insurance doctor...basically, a last ditch effort conversation where my doctor has to convince the insurance doctor that surgery is essential for me.  They've told me so far that, if anything, the insurance would probably only agree to removal...definitely not a sleeve, and more than likely not revision.  When asked if I was okay with that option?  I have no choice.  I'm not independently wealthy, nor do I have the minimum $10,500 I was quoted...so, if my doctor can convince the insurance company to cover removal...my LapBand days are over.

While it makes me nervous, anxious, frustrated, etc. to live without the LapBand after having preliminary success with it, I'll admit that it'll be nice to return to a life of normalcy where I can eat without vomiting, pain, etc.  I'll have to summon all of the courage inside of me to finish this journey on my own, but I'll have to be confident that I've learned enough about myself to do this.  Guess I'll have to change the title of my blog, eh?

Flip side...if insurance won't cover it?  Ugh.  I can eat nowadays, but my food choices and portion sizes are very limited...otherwise, vomit ensues.  I stick to mostly liquids for safety reasons (although, hell, the doc said if I were admitted under emergency care and had to get the band removed, insurance would probably cover that - but I'm not interested in going there), but I'll have to do a better job at those food choices and portion sizes if I have to live with this slipped band.

F.
M.
L.

3 comments:

  1. Oh my...you poor girl! I'm so sorry you're going through all this.

    I'm sure your doc would have told you, but is it possible that if your insurance covers the removal that you could get a new Band or sleeve at surgery...you could just pay for that portion of the surgery (ie. for the Band; just the 30-45 min. of surgery time and cost of the Band itself)? Just a thought. ((hugs)) -BG

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  2. Thanks for the suggestion! I'll see what the "peer to peer" result is, then ask :)

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  3. I'm so sorry you're going though this! I'm confident that you can achieve your goals with or without the band!

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