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I've been in the process of having revision to my 2012 mini-incision RNY to biliopancreatic diversion with duodenal switch (BPD/DS). I started the process December 2019. On the phone, Aetna is cir****pect when it comes to giving the impression they'll approve any procedure in the future. The process has been circuitous because of COVID and because Aetna pretty much wouldn't give me a straight answer. I have many comorbidities that have recurred, including insulin-dependent diabetes. I qualify for the surgery. My surgeon (who I really like) has been great but seems like he doesn't want to deal with insurance. I get it but I must have Aetna insure this revision. I finally got all the pre-surgery tests completed and submitted to my surgeon. He has a policy that if the surgery isn't paid in full a week before the surgery date, it's a $1,000 charge. I DO NOT want to pay that. But I am desperate to have this revision. I am so completely unhappy with my weight and health issues. Get busy living, or get busy dying. So day before yesterday my surgeons office contacted me and said they'd submitted his pre-evaluation letter to Aetna on my behalf, and that they set my surgery date for October 22, 2020! OH JOY! I applied for CareCredit and was approved for 2/3 of the cost of the surgery. So damn the torpedoes, I'm going to have it regardless. I'll let you know what Aetna says. Best wishes! Warmly, Kathie
Have you thought of going in, and having the SADI-S revised to the DS?
i had an RNY in 1999 at 25 years old. 328 was my SW, and got to 170. 2012 I revised from RNY to DS. My pouch was made bigger than normal, and although I did get to 150 I am now back to 213. Im currently in the beginning stages of a resleeve. The weight gain is killing my body, and I'm starting to have health problems
First thing you need to do is make sure your policy covers WLS. Then you need to see if they cover WLS revisions. Most only cover them if there was a mechanical issue with the original surgery. If you gained weight due to poor eating and there is nothing wrong with the original surgery then they may not approve a revision.
What was your original surgery? Also revisions have a lot lower weight loss than a virgin WLS surgery. Meaning you will most likely only lose 20-30lbs with the revision.
Best of luck to you.
Dr. Sanchez Lapband 9/12/2003
hw305/revision w280/cw197/gw150
Revision from Lap Band to Bypass on 2/4/2015 by Dr. Pohl
I concentrate on calories. With Weigh****chers, I do their points system, but it is roughly 50 calories per point. So 20 points is about 1000 calories a day.
Go to the RNY board and there will be a new post every day.
This is some information about the extended RNY that he was going to do. After you read it, you might be glad you did not get it. I have heard it described as the worst possible RNY.
Extended RNY
Real life begins where your comfort zone ends
Thanks for your reply?. Yes I know about the malabsorption. The doctor was going to try and bypass more of my intestines to give me the malabsorption. Unfortunately it was to dangerous as I was already under anesthesia 6 hrs. I had a tremendous amt of scar tissue. He felt I could end up with infections and severe malabsorption issues. So it was disappointing, but he had to do the right thing and not proceed with that part.What is the name of the blog to list your foods. I'm still on soft/ full liquid but would like to check it out. Also do you just count calories? Or do you count fat and carbs as well? Thanks again
The 100 pound weight loss after RNY is due to the restricted size of the stomach and to the malabsorption caused by bypassing the intestines.
That is a once in a lifetime experience. Once your body has figured out how to absorb food again and you have learned to outeat your surgery, then excess weight is extremely hard to lose. The average revision, even if it goes perfectly, will result in a 20 pound weight loss.
And much of that is from the liquid diet before and after surgery. The only way to ever lose weight again is to do it with calorie restriction. Trimming the pouch and tightening the stoma will help if you eat small meals and never drink with your meals. When you drink with a meal, the food runs right out and does not keep you full.
Take a look at this video Drinking with meals
I follow the Weigh****chers plan when I need to drop some pounds. Many people use Keto.
The things you must do for life are limit calories, never drink with meals, take vitamins, and get blood work done at least yearly. I also must have a smart scale and must weigh myself every day. If I stop doing that, I gain very quickly.
It is very possible to lose the weight again, but you have to be realistic and do it the same way as people who never had surgery. It will take about a year of hard work. Many people find it helps them to stay accountable if they plan and post their meals for the day.
We have a daily thread on the RNY board where we do that. Please join us there.
Real life begins where your comfort zone ends
Thank you for your quick response! I see now I looked at the date posted incorrectly! LOL
I have only now just begun to look into getting a revision. But during my last 9 years I have NEVER spoke with another general doctor who has even heard of Gastric Plication! I hope I have better luck when I begin looking for a doctor to do my revision. LOL
I did recently have an endoscopy procedure done to check on GERD and that GI doctor she could tell my stomach was still stitched, but since she was unfamiliar with the procedure she didn't know if it was stretched or not.
Guess my main fear is that it will be denied by insurance due to MY failure not the procedure's failure. But only way to know for sure is to try. Fingers crossed.
I hope you continue to post so I can follow along with your journey. Wishing you best of luck and health!
Thank you so much!!
post isn't that old! lol
have you had any testing done since surgery? like an upper GI or barium swallow?
I had both done in 2018 and have confirmed that I have stretched out my stomach. I have since repeated the EGD last week and will be scheduling revision surgery soon.
I have consulted with four bariatrics surgeons. It was easy for me to pick which surgeon to go with because I ultimately picked the surgeon that had experience revising a gastric plication and is confident in his ability to convert me to a sleeve and do a loop ds/modified DS.
His practice has a lot more experience dealing with revision patients and will be submitting my case as a technical failure and as such I don't need to jump through so many hoops like a new patient. The other practices had less experience with revision surgeries and were willing to operate on me but for insurance purposes were treating me as a new patient.
Overall my options were; gastric sleeve, gastric bypass, duodenal switch, loop DS.
Happy to answer any questions you may have.
Does anyone know if there are different insurance requirements when doing a revision? I paid cash for my original surgery back in 2011. Lost all my weight and kept it off until about 1-2 years ago. Now I am hoping insurance will pay for a revision surgery but don't know if I will be held to different standards seeing as I 'failed' my original surgery? Any help or others with experience with this would greatly be appreciated.
I know this is an old post, but I am curious how things went for you? I had Gastric Plication back in 2011. Lost all my weight and kept it off until almost 2 years ago. Now I have gained it all back and quickly headed to more. I had my G.P. done in Michigan and paid cash for it. I am just wondering now if my insurance will cover a revision surgery for me since I have 'failed' at my first surgery. And if Dr.'s are still willing to take you on as a patient knowing you failed in the past? Probably questions you can not help me with, but if you can give me any info in what you dealt with it would greatly be appreciated!
Thank you!!
