Hello. I am new. Looking for advice/encouragement for revision VSG to RNY.

Hello. I am new here. I had my first visit to a bariatric dr today. I haven't seen a doc since I was discharged in 2012 with my sleeve.(long story short, my surgeon's office did Ins. fraud, I had litigation, resulting in me not able to return) I did all my aftercare, post-op and attempts at weight loss all by myself. I never lost much weight. I did the best I could. I started at 264lbs. Lost 80 lbs with the sleeve in 11 mo, but didn't keep it off. I only held onto that weight loss til around 1 year. post-op. That was around the time that my acid reflux began.

Now, it has gotten so much worse. My pcp took over my care & diagnosed me with GERD in 2013 and a hiatal hernia in 2017. I have been on 5 different meds. I am vomiting in the night and most days I am dehydrated from not eating and drinking properly . I have done a little research and think that maybe a revision to RNY is a good bet. I am 5'3", currently 254lbs. I have gained all but 10 lbs of the original weight before I got sleeved.

This doc I went to see is the ONLY doc in my town that is covered my Aetna HMO insurance that I can see. I was nervous seeing him since he had affiliations with my old surgeon. I had questions I was going to ask about revising to a bypass. But he did most of the talking. I do not know why I froze. He seemed to focus on the GERD. Which is great. That is what I want is to get rid of is acid reflux. But he seemed mostly interested in repairing the hernia and treating the GERD with a new procedure called LINX and getting me off the meds. I am not interested! I do not want that device inside of me. I am afraid of complications from that similar to what many experienced with Gastric Band. He didn't speak much about revision. He said that he noticed I have gained some weight back. He wants me to go to a seminar to get info about my options. Then we will follow that with another consult appt. ( another $50 co-pay) to discuss my options.

I am looking for some advice. I do not want to just go with the flow with this Dr suggesting the latest new thing. I have done some research and found that many who have the revision to rny get rid of their acid reflux and continue to loose weight.

I guess I am wondering if I should continue with what this Dr is suggesting me do, (seminar, another consult, etc.) or should I try to see if he will refer me out to another surgeon for a 2nd opinion?? The nearest surgeon from me is about 180 miles north and is a revision specialist. I just do not know if Insur will allow me to see him. How did the process go with your revision? Do I just demand a revision when you met with your surgeon? Or did you start with a seminar and then discuss options? I am worried maybe this Dr doesn't have my best interest or he doesn't do revisions. IDK!! Thanks for your help. I appreciate it.

You might want to try one more visit with that guy, I wouldn't waste my time but I have no idea what it's like to have no other real options nearby. Also, depending on your insurance you may require a referral and if he's the only one around you'll need to get that from him.

Before you do anything though call the 800 number on the back of your insurance card and get the details on what is and isn't covered by your policy. Have them mail you a hard copy or print a dated one to keep for your records. Unless you're planning on paying cash for a revision, what they tell you will determine your next steps.

I'm so sorry you are stuck with GERD of that magnitude. Even if your insurance doesn't generally cover revisions, it may cover medically necessary surgeries and I hope you find what you need to get that all taken care of.

Thank you. That is a good idea to have my complete policy on hand.

My conversion to RNY was done by the same surgeon who did my sleeve. I developed GERD about 8 months post surgery and revised slightly more than 2 years after my sleeve surgery. I didn't need to do any of the seminar things. We discussed Linx, but I wasn't a good candidate because I also have dysphagia (poor swallowing ability) and Stretta which was not covered by my insurance.

While the conversion to RNY did not cure my GERD 100% it's about 80% better. I was basically at goal (about 10lbs away) but my surgeon told me that while I'll continue to lose, it won't be as fast as with the first surgery.

I've learned through this whole process that you need to be your own best advocate. If you don't want either Linx or Stretta, you need to make your wants known. Your body, your decision. If he's not on board with a revision then find someone covered under your insurance who is. I know that's easy for me to say, given that I'm in Los Angeles and basically have my choice of bariatric surgeons, but if the one I was using wasn't listening to me or willing to work with me, I'd find someone else, even if it meant traveling 200 miles to do it.

This doctor is worried I may have dysphagia as well. He said he was ordering the Bravo test and a endoscopy.

So since revising to the RNY did not cure your GERD, what do you take to remedy it?

Thank you for sharing.

From my understanding from my surgeon, the Bravo testing won't diagnose dysphagia. It will diagnose the seerity of your GERD. Neither will the endoscopy. My dysphagia was diagnosed by a manometry test (which sucked).

I take prevacid.

be careful about the Linz procedure. I was looking into it and my surgeon told me there are NO studies that shoe it works at all for ppl with a sleeve.

i, personally hD a procedure called the Stretta which has helped some.

sorry to hijack this thread, but Hollykim, talk to me about Stretta. Even after my conversion to RNY, I still have reflux. Nowhere near as bad, but it's still there. At my last appt, my surgeon told me he had a plan and it included stretta. We tried to get it approved before my conversion, but my insurance provider said no, since they consider it experimental. I've since switched insurance companies.

Did you notice a difference? If so, how long did it take? Any side effects? If you knew then what you know now, would you do it again? Thanks!

I do notice a great improvement. Before Stretta,I would wake 5 out of seven nights a week, with acid coming up my throat,into my mouth and running out my nose,causing choking.coughing and 5hroat clearing.

about 2 months post Stretta the frequency is 2 out of 5 nights. nights,but the severity is not as bad. Sometimes I will onlyfeel a slight burning in the back of my throat and adding an extra pillow will resolve it.

Pre Stretta,I could not lie down at all,period. I had bricks under the feet of the bed at the head,pillows under the mattress and propped up on three pillows to,sleep. Post Stretta, the bricks remain,the under mattress pillows remain,but I can sleep on one pillow sometimes all night with no reflux. I consider that a huge improvement.

Sometimes I will be sitting straight upright on the couch watching tv and will have reflux coming up into my mouth but I consider the night time issue much improved.

My surgeon told me that I some ppl need two treatments to get the most results. At 5 months post ,I am mulling that over and trying to decide whether to have the second treatment or not.

They apparently have a terrible time getting insurance to pay as they do say it is experimental though it is not and was widely used 20years ago,before the Nissan. Became available. My insurance also wouldn't pay so I chose to,self pay. It cost me a little over $7000.00 at Vanderbilt.

I am leaning toward having 5ensecond treatment cause why just go halfway? I will self pay if I have to and am great full I can, but at my next appt I am going to ask if Medicare will cover it ,as I will go on Medicare in 18 months and if they cover it ,I might wait till then.

i noticed only positive side effects . Even immediately post op,there wasn't a lot of pain.though he gave me and I used ,that Magic Mouthwash stuff that has Mallon and lidocaine in it. That was all I needed for the slight pain I had and only needed it for a few days.

I am am glad I did it and am pleased with the improvement. If more improvement could be had with a second treatment,I think why should I no go for the second treatment and get the most results possible.

Thanks. My conversion to RNY basically stopped me from spitting up acid, or having it come out my nose. However, I still have acid burning the back of my throat, I still have coughing that's acid related and pressure in my chest. Also, I have a very weak LES, so if I bend over too soon after eating, food will come back up. He told me he thinks the stretta will work. The plan right now is to do stretta at the same time I undergo a hernia repair. I think i'll do it even if we can't convince insurance to cover it. Either that, or I'll take the insurer to the Department of Insurance and try to force them to pay. I'm glad it worked for you. It gives me hope!!!