questions on revision (mad at myself)
Hey all, I have a question. I just had surgery on 2/5/05. I think I have stretched my pouch. I am thoroughly disappointed in myself for this. I started at 283 and now I weigh about 200-204. I have stopped losing weight completely. In fact I have not lost any weight in a long time. I have been holding steady for about 6 months here. If I did stretch my pouch out, would I be able to get a revision or not since it is so soon after the surgery? If anyone could help I would greatly appreciate it. Please don't give me grief. I already feel crappy about this as it is.
Thanks for support and information,
Candice : ' (
My surgeon has suggested to me that if I didn't succeed to get to my goal weight
That I should consider then instead of a revision, to then add the Lap Banding.
Christmas '05 - 600 lbs., Surgery Day - 560 lbs., Today 47 Days - 500 lbs.
Only 300 more pounds to go. I'm sure I will make as soon as I can exercise again.
But still HomeBound due to Incission from Hernia Surgery, Opened up in two spots. Healing now from within. Doc saids it'll still be at least another month till healed up,
if nothing else happens. I really miss swimming now.
Mike
I just had my RNY, May 10th, 2006 with Dr.Rehnke in Pasadena/St.Petersburg, FL.
Had you've called your insurance company directly instead of hearsay from everyone else? Otherwise all I can direct you to do is above go to "Insurance", find your insurance company in Florida. Then read reviews and check out their profiles to see who they used and one in your area. The other option is still above under "Bariactric Surgeons" and again read reviews of surgeons in your area. Then it's up to you to decide who to use.
I hope this helps you, Mike
Aetna considers medically necessary surgery to correct complications from bariatric surgery, such as obstruction or stricture.
Although each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. Members and their providers will need to consult the member's benefit plan to determine if there are any exclusions or other benefit limitations applicable to this service or supply.
Aetna considers repeat bariatric surgery medically necessary for members whose initial bariatric surgery was medically necessary (i.e., who met medical necessity criteria for their initial bariatric surgery), and who meet either of the following medical necessity criteria:
- Conversion to a RYGB may be considered medically necessary for members who have not had adequate success (defined as loss of more than 50 percent of excess body weight) two years following the primary bariatric surgery procedure and the member has been compliant with a prescribed nutrition and exercise program following the procedure; or
- Revision of a primary bariatric surgery procedure that has failed due to dilation of the gastric pouch is considered medically necessary if the primary procedure was successful in inducing weight loss prior to the pouch dilation, and the member has been compliant with a prescribed nutrition and exercise program following the procedure.
Call Aetna for information on your exact policy.
HTH,
Kristen
I just broke and eight-month plateau last week. Since last September, I had wrestled with the same two pounds. Last week, I lost four pounds, even though I haven't done anything different since September! In the last eight months, I went from size 18W to 12P. So even though the scale didn't budge, I obviously lost fat (and probably replaced it with muscle).
Have you talked with your nutritionist? Are you still measuring food? Have your measurements/clothes sizes changed?
If you think that you have a mechanical failure, get a copy of your original op report and a recent UGI and visit with a surgeon who does revisions with these docs.
Hopefully, like me, you are on the mother of all plateaus and it will end soon.
Hugs to you,
Kristen
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