Amerihealth for revision?

I really need a revision. I have Amerihealth, and they are being a big problem.
Does anyone out there have Amerihealth and has had a revision.
I can't live with my RNY anymore and they don't want to cover a reversal or a revision to something else.

(Your mileage with your RNY may vary. Mine is causing problems.) 

I guess the big question right up front is 'what is going on with your RNY that you feel you need a revision'? Is it causing you health problems/issues? Is it not working anymore? I would think that if its causing you distress/pain/discomfort or those types of things insurance would work with you if you have it documented by doctors?

Just wondering...

I vomited a lot at the beginning. I think it messed up my stoma. My stoma is 4 cm; original surgeon abandoned me.

It just has not worked for me. I would trade for my original anatomy back.

They say that these are not serious enough complications.

Complications from the surgery:

•    Frequent diarrhea
•    Fecal incontinence, “which is defined as the loss of anal sphincter control or the inability to defer the call to defecate to a socially acceptable time and place, resulting in the release of gas, liquid, or solid stool." [Rockwood TH, Church JM, Fleshman JW, et al. Fecal Incontinence Quality of Life Scale: quality of life instrument for patients with fecal incontinence. Dis Colon Rectum. 2000;43(1):9–16.  This scale has been shown to be produce reliable and valid measurements in Oliveira L, Wexner SD. Anal incontinence. In Wexner SD, Beck DE (eds). Fundamentals of Anorectal Surgery, 2nd ed. London, UK: WB Saunders; 1998.]
•    6-8 bowel movements a day, a number clearly out of line with a normal population
•    Nutritional Deficiencies, despite taking the required supplements (D)
•    Excessive Vomiting, especially at the beginning. I believe that this vomiting disrupted the proper healing of the stoma in the first place, as it was demonstrated that the stoma was not right just twelve months after surgery.
•    Hiatal Hernia

I am so sorry to hear you are experiencing all of these complications and it isn't right that the insurance company won't do something to help you get a revision or some type of surgical help. Your surgery was 4 years ago - is a reversal possible? I'm fairly new out and I know they said it could be done with mine but I'm sure it would require a lot of surgery if I needed it.

Are you consulting your PCP or another surgeon regarding your health issues from this? I don't know if a surgical team would pull more weight with the insurance company or not.

I wish I had some advice for you but I haven't heard of anyone having such major complications as you have, and it doesn't seem right that someone won't help you. Don't give up - keep looking. You shouldn't have to live with these health problems.

Best of luck to you...Kathy

If all else fails, consider suing the original surgeon.

I've thought about suing, but it sounds like such a long and expensive road.

The original surgeon is really famous, wealthy, and well-connnected and at one of the best hospitals in the U.S. I removed his name from my profile on purpose. I was too nice in my follow ups and kept just doing what the nutritionists said ("Eat more protein!") and not complaining.

So, I ate more, didn't lose weight, and eventually I was allowed to get a test that showed that the stoma was wide open. At that point, he abandoned me. He's got great reviews on here and is even more famous now.

I'm envious of people who had a good experience, because I didn't, and I went to "one of the best." 

I think it's probably better to move on and figure out how to get this fixed.

You're probably right about moving on. You should post your experiences honestly thought for future patients and to hold him/her accountable.  I was just thinking that if insurance would not cover a revision or reversal, that may be an option. I really hope you get some resolution that satisfies you.