Another new same old question about revisions
chellyalb
on 1/1/09 2:05 am, edited 1/1/09 5:29 am - Raleigh, NC
on 1/1/09 2:05 am, edited 1/1/09 5:29 am - Raleigh, NC
Hello all and Happy New Year,
My name is chelly and I am on and off this sight from time to time. I have been gain weight since april of 2008 I have gone from 165 to 195 I have take the pouch test and it did not work. I have been on a diet and working out since then and it seems all I do is gain weight. The weight gain has put me in a depression which I have gone to the doctor and got on meds and they make every thing even worse. I know what is wrong with me it is that I am FAT again and just keep get fatter. I beleive I need a revisions but, I do not think my insurance would pay for it they pay for NO THING. I do have B-12 and Iron deficiencies so that I have to get a B-12 shot every week and I am allgeric (sp) to Iron which I have to have it infused every month. Don't think self hating and those defiencies and having a bmi of 32 would be enough to get a revision. So if you have an idea's please let me know that would be great. also I have Blue Cross Blue Shield PPO. Thanks again Chelly
My name is chelly and I am on and off this sight from time to time. I have been gain weight since april of 2008 I have gone from 165 to 195 I have take the pouch test and it did not work. I have been on a diet and working out since then and it seems all I do is gain weight. The weight gain has put me in a depression which I have gone to the doctor and got on meds and they make every thing even worse. I know what is wrong with me it is that I am FAT again and just keep get fatter. I beleive I need a revisions but, I do not think my insurance would pay for it they pay for NO THING. I do have B-12 and Iron deficiencies so that I have to get a B-12 shot every week and I am allgeric (sp) to Iron which I have to have it infused every month. Don't think self hating and those defiencies and having a bmi of 32 would be enough to get a revision. So if you have an idea's please let me know that would be great. also I have Blue Cross Blue Shield PPO. Thanks again Chelly
mew6495
on 1/1/09 11:21 pm - MI
on 1/1/09 11:21 pm - MI
Hi Chelly,
First, I am sorry to hear of your struggles. It is so scary to watch the pounds coming back on!
I would suggest contacting your insurance and finding out what exactly they cover and what the requirements are. I also have BCBS and they covered mine. I know every plan is different so you should check with them. One of the issues I had with my insurance was that there was some confusion between revision requirements and original wls requirements. For me it finally came down to if it was "medically necessary". So make sure you are very clear on what you are looking for and don't give up if they don't give you the answer you want.
I, like you, did not have the higher BMI. When I first started researching revision my BMI was 31. I was dieting and being very careful on what my food intake was and I could not loose a pound. I started researching the different types of revisions and revision doctors to see what I could live with and even if I was willing to undergo another surgery. There will be doctors who will refuse to even listen to you because your BMI is not over 40. There will be doctors office staff who will not even let you get past them to discuss it with the doctor to see what your options are. Just be patient and diligent and you will eventually find someone who is willing to work with you whether it be for revision surgery or another weight loss plan. I knew for myself, if I did not take action that I would have all my weight back and then some. I did not want to go the route of gaining more weight just to have the surgery. So I made a decision on what type of revision would fit with me and my needs and then I found doctors who was willing to listen to me as a person rather then just a "BMI" number. Once I chose my surgeon I went from there.
My suggestions;
1. Be very sure another surgery is what you want and that you have done everything possible to take off the weight without surgical intervention. ALWAYS remember that wls is a TOOL. It is not a fix all and behavior modification will be necessary.
2. Keep a food journal. This will help see exactly what you are doing and may be needed as back up for your revision approval if you go that route. (fitday.com offers a good online journal)
3. Ask your PCP to schedule a Upper GI (pouch condition) and a EGD (stoma size) to determine if you have a mechanical failure.
4. There are many types of revisions out there and even more "opinions" on which ones are the "best". Do your research. Some carry a higher complication risk factor then others. Pick the one that best suites your lifestyle and one you feel you can stay the most compliant with.
5. Finding an experienced revision surgeon is very important as revisions have a much higher risk factor. There are some good revision surgeons out there make sure to do your research on them as well.
Good Luck to you.
First, I am sorry to hear of your struggles. It is so scary to watch the pounds coming back on!
I would suggest contacting your insurance and finding out what exactly they cover and what the requirements are. I also have BCBS and they covered mine. I know every plan is different so you should check with them. One of the issues I had with my insurance was that there was some confusion between revision requirements and original wls requirements. For me it finally came down to if it was "medically necessary". So make sure you are very clear on what you are looking for and don't give up if they don't give you the answer you want.
I, like you, did not have the higher BMI. When I first started researching revision my BMI was 31. I was dieting and being very careful on what my food intake was and I could not loose a pound. I started researching the different types of revisions and revision doctors to see what I could live with and even if I was willing to undergo another surgery. There will be doctors who will refuse to even listen to you because your BMI is not over 40. There will be doctors office staff who will not even let you get past them to discuss it with the doctor to see what your options are. Just be patient and diligent and you will eventually find someone who is willing to work with you whether it be for revision surgery or another weight loss plan. I knew for myself, if I did not take action that I would have all my weight back and then some. I did not want to go the route of gaining more weight just to have the surgery. So I made a decision on what type of revision would fit with me and my needs and then I found doctors who was willing to listen to me as a person rather then just a "BMI" number. Once I chose my surgeon I went from there.
My suggestions;
1. Be very sure another surgery is what you want and that you have done everything possible to take off the weight without surgical intervention. ALWAYS remember that wls is a TOOL. It is not a fix all and behavior modification will be necessary.
2. Keep a food journal. This will help see exactly what you are doing and may be needed as back up for your revision approval if you go that route. (fitday.com offers a good online journal)
3. Ask your PCP to schedule a Upper GI (pouch condition) and a EGD (stoma size) to determine if you have a mechanical failure.
4. There are many types of revisions out there and even more "opinions" on which ones are the "best". Do your research. Some carry a higher complication risk factor then others. Pick the one that best suites your lifestyle and one you feel you can stay the most compliant with.
5. Finding an experienced revision surgeon is very important as revisions have a much higher risk factor. There are some good revision surgeons out there make sure to do your research on them as well.
Good Luck to you.
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