Feeling confused about next step!!
Thanks! Can you tell me where those two Drs are located??
They are located in California. I am a revision myself from RNY/ERNY to DS. I ended up going to Dr. Keshishian. I live in MI so had to travel myself. They are both excellent surgeons, especially for revisions. You can't go wrong with either.
Hope you find your answers. Never give up!
SH
Lowish BMI? See Lightweights Board! Lightweight Creed For more on DS see www.DSfacts.com
If you don't have peace, it isn't because someone took it from you; you gave it away. You cannot always control what happens to you, but you can control what happens in you John C Maxwell 
Sleeve 2010 Dr López Corvala, Mexico. DS 2012 Dr Himpens, Belgium
I 
my DS 
Get a different dr, first and foremost. you have suffered long enough with that band, time to actually live!!
If your insurance has an exclusion for bariatric surgery, no appeal will win that, none.. BUT that is something YOU must know, I would trust no one and especially not the dr's office. What does your contract say? if you dont' know what your contract says especially for covered benefits and exclusion, you are a lamb walking into the lion's den.
sounds like that dr will put in for a RNY, and YES that appeal will be for RNY NOT DS, unless the dr requests DS, you will never be denied, so you can never appeal, forget that dr...run as fast as you can.
how are you going to get a DS approval with bariatric exclusion on your policy?.....you have to know you policy, don't let anyone pressure you on getting something you don't want. getting the DS means you have to advocate for yourself, time to start.
1. know your subscriber agreement, read the covered and exclusions especially well, look at the appeals process, paying close attention to details, like dates, contacts etc
2. if you want a DS contact a ds revision dr ....having the band for that long, you will be a difficult revision patient.
3. if you are denied after your appeal, and for heaven's sake don't have the dr's office appeal for you... suggest going out of the country to Brazil, Spain or Mexico, there are vetted DS surgeons there.
keep asking questions, you deserve to be healthy, get rid of that band, you have lost your sense of normalcy, don't accept anything but DS...keep advocating for yourself you are worth it....keep fighting to get healthy
Thank you so much! I will check further into my ins guidelines and exclusions but from what I have read it says no Bariatric benefits available! But would that apply if there are medical problems going on?? That's where I'm unsure! So I'm kind of confused as to why several people have suggested out of the country a Dr???
Thank you so much! I will check further into my ins guidelines and exclusions but from what I have read it says no Bariatric benefits available! But would that apply if there are medical problems going on?? That's where I'm unsure! So I'm kind of confused as to why several people have suggested out of the country a Dr???
again you will have to check your subscriber agreement, but an exclusion is just that, no matter if you have medical issues, see you accepted that insurance policy knowing it had an exclusion, if you didn't know then you essentially "bought" a policy without knowing what it covers and doesn't cover.
People are suggesting out of the country because like college education, surgery in the USA is the most expensive anywhere, doesn't mean it is better...If i couldn't get health ins in the USA i would go to Ungsong in Mexico, Marchesian in Brazil, Baltasar in Spain, or Gagner if you can find him, he is a slippery one. You can also try to find a competitive rate in the US....good luck to you
You are a perfect example of why that operation is rarely done anymore. It caused many problems, and had many failures. It is the operation that failsl, not you, so don't kick yourself.
What to do next...first, get your hands on your policy and read the exact wording for yourself. Keep in mind that you are not requesting bariatric surgery, but rather, treatment of your medical problems that the anatomy you presently have has caused. There may well be a difference in your policy. Even if not, you can and should appeal, and even if someone requesting a standard bariatric surgery might lose that appeal, your situation is different and you might win. You won't know unless you try.
Next, you need to contact one of more of the best revision surgeons in the country, accepting that you will need to travel. There is one surgeon at the Cleveland Clinic who has started doing the DS, but I don't know his criteria, or whether or not he's done the kind of revision you need. The best names have already been provided for you. Start emailing them.
Next, know that that band that you have, which is a piece of mesh, is not at all the same as the lap band that everyone talks about, and is often extremely didfficult or impossible to remove because of scar tissue it generates. Whether or not a DS will be possible for you, I have no way of knowing. You might end up with RNY, which IMHO is not as good an operation as the DS but would be far, far better than what you have now. It may depend on what your surgeon finds when he gets in there, because scar tissue can't be assessed with any x-ray or scan. Even so, you are having such a bad time now that going into surgery without knowing what you will come out wiht may be worth it. Your decision, of course, not mine.
Larra
