adshabrack

Members
  • Content count

    2
  • Joined

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About adshabrack

  • Rank
    Newbie
  • Birthday

Profile Information

  • Gender
    Female
  • Location
    Raleigh, NC

Information

  • Surgeon
    McPhail
  • Hospital
    Wakemed
  • Height (ft-in)
    5-03
  • Start Weight
    340
  • Current Weight
    285
  • Goal Weight
    200
  • Body Mass Index (BMI)
    53
  • Surgery Type
  1. Aussie H - That's like saying, "Have you tried Weight Watchers?" I have done EVERYTHING correctly. The lapband accounts for only 5% of the surgeries done here in the US now. When I had it done in 2008, it was 54%. Almost half of the patients who have had the lapband have it removed within 5 years or have it revised. It's simple. The procedure does not work for many people. My physician does not offer it as an option anymore in her practice. I am glad it works for you, but it did not for me. In my case, it is not helping my diabetes, even at the tightest setting. I need a more restrictive procedure, and the gastric sleeve and bypass have shown to dramatically reduce the effects of diabetes, or even send it into remission. As far as I am concerned, and my physicians as well, this is medically necessary. If I do not have this done, my health will continue to decline.
  2. I have been fighting my insurance company for 3 months now over my revision. I had lapband in 2008, and lost 80lbs in 6 months. However, my weight loss stopped there, and I have regained 40lbs (which fluctuates), and my surgeon recommended having a revision. My endocrinologist also recommended it since the initial surgery was done to alleviate issues/complications with my type 2 diabetes, for which I am now taking 5 medications for, including a TON of insulin each day. The insurance is saying that since there is no device failure, then they should not have to approve an additional procedure and that it's not medically necessary. However, their definition of medically necessary is to improve or treat a disease that affects the overall health and life span of the patient. I also have developed sleep apnea and arthritis in my knees since the first surgery. I have appealed twice, and they are still saying no. What can I do to convince them that this is medically necessary???