BMI of 28 and need a revision!

Beachbumm
on 2/19/08 4:08 am - Someplace, LA
Hi I had my RNY in 2002.  I lost all of my weight, but now I am gaining.  I am up to 165 but I had gone down to 119.  My BMI does not qualify  me for surgery, BUT the fact that I am gaining makes me want to have something done at least to stop this!  I am currently doing the 5 day pouch test (one day 2) and I am trying to lose the extra weight! AAAHHH My insurance won't pay for a revision because my BMI is too low........must be 40 and 5 years of morbid obesity, which I have not been obese for 5 years as I had RNY in 2002.  I hate insurance companies and I work for one!!!!! Lorri
Lorri
RNY 5/27/2002
249/119/160
skinny_cyndi
on 2/19/08 4:33 am - Mahwah, NJ
My insurance is United Helathcare HMO and my BMI is 32.6, but I had a mechanical failure and was hospitalized for 5 days due to an ulcer. I also was having trouble eating. You're right, they may not approve but unless there is an exclusion if you can prove the first surgery failed, you may be able to get the revision approved. My friend had a revision done at 170 because she could prove failure of the first surgery.
Beachbumm
on 2/19/08 5:04 am - Someplace, LA
Cyndi REALLY?  I have United Healthcare and I totally had mechanical failure and was in the hospital for 2 weeks after the surgery!  I went through hell and so did my family.  I would not bring my dog to my WLS doctor....sorry to sound ugly but he left me high and dry after the complications started. I am going to see a surgeon tomorrow to talk to him about options.....I would even be happy to have sclerotherapy or stomaphyx if he would be willing to do that......I just need help to stop my constant hunger/head hunger/whatever.....I know I am a food addict.  I will take food over anything and I hate that!  I feel like the biggest failure and loser. Oh well, maybe I will hear something tomorrow from the doctor that I haven't thought of yet. Thanks for your post!
Lorri
RNY 5/27/2002
249/119/160
liquidl
on 3/8/08 3:10 am
Have you looked into stomaphyx? It doesn't have a BMI requirement (which is so stupid of them to require from a post WLS patient!!! do they want us to gain it all back before they help us!! DUH!!). I've heard that sometimes insurance will cover the Stomaphyx but its a really new procedure so you might have to educate them on it. I'm considering getting it myself but i'm a self pay. I'm 8 years post op GRDS. My goal was 115 but I never made it. I got to 129 and maintained that weight for about a year but I have been increasing slowly and steadily and I am now up to 150 and still gaining. I'm scared out of my mind! Another 40 pounds and I'll be right back where I started from. What's up with that? Stomaphyx is done through the mouth and is minimally invasive. My doc will do it for $7000, all inclusive. If I was in your situation, I'd try to pay for it myself if my insurance turned me down. There's nothing more important to me than maintaining a reasonable weight and having a normal life.
Beachbumm
on 3/9/08 11:12 pm - Someplace, LA
Hi! You sure said it! It seems like they do want us to gain the weight back before they will help us!!!! I have actually started looking into Stomaphyx.  I found a doc here in LA that will be doing the procedure in April, but that sort of worries me having a doc that just learned the procedure working on me.... see, my RNY was done by a doc that was still "learning" and my surgery was messed up from the start.....so, I don't know what to do. I am really really trying to watch what i eat...... Thanks for the info though!!! Lorri
Lorri
RNY 5/27/2002
249/119/160
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