Why me????

Sorry for the length of the post.  I got my lap band in June 2009.  Every time I had a fill I had nothing but problems.  Not only was it either so tight that I couldn't swallow water or it was so loose that I could eat at a buffet.  I would yo yo with fills and then I got to where I had them unfill my band and I waited about 7 months and thought that I needed to go ahead and try it again.  Yet again I had nothing but problems and this time it physically hurt my stomach.  It was so frustrating for me.  I had thought about getting the gastric bypass but the thought of "re-routing" my intestines and having some of the potential side effects were just too much for me so I just left it alone.  So this past May I got a trainer and joined the gym.  I also started Weigh****chers.  My daughter and a friend of hers would come over EVERY day and we did zumba on the wii.  After about approximately a month my knees just couldn't do it.  They would swell after each work out and then the right knee started to sound like rattling paper when I bend it.  Then I saw one of my friends who had lost A LOT of weight and I began to talk to her about what she did to loose weight.  She told me she had gotten the VSG.  I was so excited when I heard about this that I raced home and read everything I could on i****ched every youtube video I could, and joined OH.  I had my lapband removed 1/4/13.  We then applied for the VSG.  Today I called the insurance, like I have done every day for the last 8  business days, and was told that it was denied.  They transferred me and stated that they have requested more information from my physicians office for medical necessity.  I called my doctors office who stated they would submit more information but I feel like everything HAS to be so difficult for me.  (I know I am having a pity party right now).  I guess the reality is that I am scared.  I have NO co-morbidities and my BMI is 43.2.  The reality is that I have horrible joint and back pain but I haven't run to the doctor because I know I need to lose weight and these symptoms will improve.  I feel frustrated and anxious.  Has anyone been in a similar situation and been successful?  Any advice, help, or reality checks will be really appreciated. 

Don't be too afraid. Joint/back pain IS a comorbidity. Your bmi is enough. Being unable to lose weight with your band or being unable to tolerate it are definite reasons for revision. Your knees are a good reason, too. Let the insurance guru do their thing, with the surgeon adding reasons why they think you should revise. If it gets denied again holler out here for some of the people who excel in getting approvals. Don't give up and accept no for an answer. If there wasn't a reason for you needing wls you wouldn't have qualified before. There are ways to get around the one wls per lifetime, too.

Hon you and probably 1/4 of this forum have been in the very same spot you are right now. The band was a horrible joke for the majority of us, it is a bad product hat needs to be recalled and we need to be compensated for our pain, but that's another long story! There are many, many exbandsters here and I only wish I were able to join them, my insurance doesn't cover bariatrics. I'm sure you'll get many more replies from others just like you. We all know insurance is a pain in the rear and we just have to jump thru their hoops,they run the show. All you can do is push the doc to send them the info they want and hope for an approval and remember you can appeal a denial. Keep pushing till you get what you want!

Thank you for the responses.  I had so much drive when getting the lap band approved and in the last 3.5 yrs. I have lost so much hope of losing weight and feeling healthy.  I agree with the comments regarding the lap band.  IT IS A HORRIBLE PRODUCT!!!!!!  I know I need to see this through and I will it is just feeling a bit much tonight.  I tried to see if I could speak with someone at my insurance company and they said that only the doctor or a doctors representative would be allowed to speak with someone.  Say what!!!!!!!!!   Just frustrating.  I am only 37 years old and my joints feel horrible which in turn creates this horrible cycle of not exercising, feeling depressed, eating.  I just need to suck it up and get ready to fight. 

Thank you for reading and giving support.  It means A LOT to me. 

"I am only 37 years old and my joints feel horrible which in turn creates this horrible cycle of not exercising, feeling depressed, eating."

I feel you. Don't beat yourself up for getting frustrated--it can be a frustrating process but you're arming yourself with knowledge and support and I believe you'll get where you need to be.
 

I was denied 3 times and had to wait almost 2 years for my surgery.  I switched doctors too.  I had a horrible time and had to drop my primary insurance so my secondary would pay.  The pins and needles are awful!  I was given a date 3 times just to be denied a few weeks before for different reasons.  Such a hassle.  I cried a lot!  But now I am four months out and can't believe it actually happened.  I'm sure you'll be approved sooner than I was.  Be vigilant!

Oh my, 2 years!!!!  I don't know what I would do.  Honestly, I am going to keep pushing with the insurance but in the end if it takes to long I will head on down to Mexico.  Either way.  Of course it would be much more convenient and cost effective to do it locally.  I just don't understand how I could qualify for the lap band and not qualify for the vsg.  Doesn't make sense at all to me.

I'm glad that you finally got yours done though.  Congratulations!!  :)

You could have typed this post directly from my "band story"!!  We sound EXACTLY the same!!  I saw the surgeon today.... starting this process for sleeve and praying this time things go better!!!

Good Luck!!

Good luck with your visit today.  Make sure you lock someone down to tell you EXACTLY what you should start working on to get it approved through your insurance so you can start doing it now.  Call your insurance and try to get someone to give you an exact of what you need to do. 

You will feel much better physically when the band is out but for me it also made me feel vulnerable.  It was gone.  But the good has outweighed the bad with having it removed.  It was too embarrassing, painful, and pointless.

Do you have your sleeve yet?? How are u doing?