Qualifications for insurance to cover revision...

I am 7 years post op from a Proximal RNY in Seattle.  I have lived in Fla now for 6 years and have never had a need to see a surgeon again. But I have gained like almost 60 pounds and am running scared. Was wondering if insurance usually covers a revision? I am looking for a surgeon inn Gainesville. Thanks for your help. Patti

Hi Patti, You might check out Dr. Jawad.  He does his surgery in Ocala, but has two other offices that might be closer to meet with him.  He is an expert in this field, and his reputation speaks for itself. http://www.bariatriccenterofocala.com/ Home - JawadMD.com (Not sure which link will work, so I gave both). I would rather drive an hour for the best, than settle for someone close.  Best of luck for your revision!!!!!!!!!!  Keep us posted.

Chantrel, Thank you so much for your reply. Unfortuneately Dr. Jawad doesn't accept Medicare anymore. SOmeone else had recommended him as well. He does seem to have a very good reputation.  Patti

Patti- Do you want to be revised to a different procedure or do you want to have an RNY to RNY revision.  There are several people on the DS board that have had RNY to DS revisions.  I think the insurance coverage will depend entirely on the reason for the revision ie mechanical failure  and what your current BMI is.  Your best bet is to contact a surgeon that is very experienced in revisions and get their take on the situation.  I have always heard that revisions are technically more complicated than first surgeries, so be sure you go to someone who is very experienced in revisions.  Just because a surgeon is a great first surgery surgeon -- it does not mean he/she has the technical knowledge or experience to do a revision. Red

Red, I think I just want to stay with the RNY. My BMI is 36. There isn't any mechanical failure I don't think. It just doesn't work. I can't go back to what I was and I feel like I am headed that way.  I know this is all my fault, I just cannot seem to control it on my own. Patti

Patti- Do not be so hard on yourself.  It may not be your fault.  There are any number of reasons the RNY (or any WLS) can fail and many times it has nothing to do with compliance.  If your pouch is too large or your stoma has enlarged you may not be getting the restriction you need to feel satisfied without eating too much.  Also there is the issue of malabsorbtion.  There is some malabsorbtion with the RNY and you may need more malabsorbtion of the calories you consume.  This would mean being revised to a more distal RNY or to the DS.  But you really will not know until someone does some testing and looks to see the current state of your insides. Red

Dr Cendan is in Gainesville and never for a second did I even think I was settling by using him. I work in the Surgical ICU at the hospital he operates at and know first hand of his outcomes and reputation. I'd have gladly driven to Orlando if I thought things would have gone better. He's been doing bariatric surgery for over 10 years, has done over 500 surgeries. One patient with a leak in five years. In ten years he's had two patient deaths. One was someone with a PE and the other was a man who ate a meatball sub at one week post op and burst his pouch. I know his office takes medicaid too as he's not in private practice, but rather operates  through the university of FL. He was in private practive for his first five years though until UF @ Shands wooed him over from where he was at. His office number is 352-265-0604

Thanks alot, I really appreciate it. I will give him a call tomorrow and ask a few questions.

One more thing on Dr. Cendan, he patented an endoscopic stapler that many surgeons use for their laproscopic surgeries nationwide.  It puts in microsized rows of triple staples to virtually eliminate leaks. He took great care of me and I personally wouldn't have wanted to go anywhere else. Didn't even cross my mind. I honestly felt like I was putting myself in the hands of surgical expert.