NEXT STEP???

DeeDeeLynne60
on 10/11/13 6:01 am - Massillon, OH
Hi! Ok I'm feeling confused as to what to do next! Here's my story.... I had an old style VGB(the kind they do not perform anymore) 27 years ago. I had regained my weight many years ago. This last year I have had lots of problems GERD, Hiatal hernia, severe pain and distention, vomiting and nausea, increasing back and hip problems. Went to my reg GI Dr and he did an emptying test and basically said fluids are passing but solids are causing problems. So he sent me to Dr Kroh for further testing which was done at the Cleveland Clinic. After having those tests performed he sent me back to my reg GI Dr. I saw him yesterday and was so frustrated and upset afterwards. Basically he said those tests showed the same thing.......narrowing around the site of the band (again) and bad gastritis. He said there was nothing he could do so I just need to learn to live with it!! He said I just have to push lots of liquids after I do eat a meal...even if it takes days of liquids...till everything passes!! Also eat soft, easily digested foods that will pass easily! (Yeah that's been my life for how long...trying not too eat much veggies, fruit, meat...wonder why I can't lose weight??) I told him I wanted to have the band removed and he said "well that will only cause you to GAIN more weight!" I explained to him that obviously the band isn't really working and only causing me MORE problems when I do try to diet and lose weight! So he suggested I called Dr Kroh back!! Shhhheez...back to square one! I did so and they scheduled me for an appt Nov 18th and said they checked mi insurance and it does not cover any Bariatric surgery but to come in for my appt ant they would write up an appeal to the ins co. Because of my medical issues. Then she told me not to get my hopes up because they are almost always denied! I then asked her about the DS surgery and she knew nothing about it! (??) She said they would appeal for a band removal into a RNY! Now here are my questions........
-What do I do now??
-Should I let them continue with the appeal?? And is that appeal specific to only that Dr and the RNY??
-Or do I try to find a DS surgeon that does revisions?? And HOW do I do that??
-And is the DS harder to get approved then the RNY??
-Also do I let the Dr appeal or go thru an ADVOCATE myself...or both??
Sorry foy the loooong post and all the questions....just don't know what to do next?? Thanks....DIANE
kitkat88
on 10/17/13 10:12 am - Metairie, LA
RNY on 11/18/13

Not many doctors or insurance do DS anymore not sure why but sleeve and rny are the most popular. I would liet the center go ahead and file an appeal, mainly because its more likely to get denied. Just let them appeal it and get an answer before doing work to find DS revisions. That can be a lot of work for nothing, unless your going to self pay.

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