broken - need suggestions

I had surgery in 2003 and I lost 115 pounds = I was about 150 pounds.  I did really well for several years.  Recently I have had problems with my intestines and stomach hurting (last year and a half)  I also would eat then about 30-40 minutes later I was hungry again.  I thought I was going crazy.  But I checked it out.  I had a scope and my stoma is large.  My surgeon wanted to put a lap band over my stoma/intestine  to make it tighter. I was getting ready and I found out that the insurance codes it as a new obesity surgery.  My BMI isn't large enough to qualify for a NEW surgery.  I just want it fixed!!  I asked the doctor if he could do that plus alter my pouch or do something so it could be coded as a "Revision".  Revisions are covered no problem under my insurance.  I am currently contacting a couple of clinics about the Rose procedure.  But the last surgeon said that the Rose will just streach again and there will be problems later on.  I just want to be FIXED.   Thanks so much for all your suggestions.  I appreciate it.

I would recommend doing your own research.  YOU will be your own best medical advocate.  Unfortunately many physicians would rather put down a procedure than admit they do not know everything about it.  The ROSE procedure is very new - very new.  I believe he would be incorrect to say that the ROSE procedure won't last, since they JUST started doing them in Feb. of THIS year.  I am scheduled to have it done next tuesday.  I read that another person (on this site) had in done in Feb and has lost 30 pounds so far.  http://www.forbes.com/prnewswire/feeds/prnewswire/2008/03/17 /prnewswire200803171210PR_NEWS_USPR_____NYM089.html CINCINNATI, March 17 /PRNewswire/ -- Cincinnati Weight Loss Center, a member of the Synchrony Health Network, is one of the first weight loss surgery centers in the U.S. -- and the first in Ohio -- to offer a new Incisionless surgical procedure to reverse weight regain after gastric bypass surgery. Surgeons Brad Watkins and John Mobley started performing the procedure on March 7. The incision-free procedure, which physicians have coined "ROSE" (Restorative Obesity Surgery, Endolumenal), reduces the size of a patient's stomach pouch and stoma to the original post-gastric bypass proportions to help them back onto the path of weight loss. Gastric bypass surgery (GBS or RYGB) offers an effective means to lose significant weight. It is not, however, always a permanent fix. Up to 44 percent of patients who undergo gastric bypass begin to regain weight -- and the dangerous health problems associated with it -- a few years after their initial operation. Studies show that post-gastric bypass weight regain sometimes occurs because the stomach pouch and the opening to the small intestine slowly stretch out, allowing the patient to eat more without feeling full. To perform the ROSE procedure, the Cincinnati Weight Loss Center surgeons utilize a small flexible endoscope and a new EndoSurgical Operating System(TM) (EOS) developed by USGI Medical Inc. (http://www.usgimedical.com). The scope and the EOS are inserted through the mouth and into the stomach pouch. The EOS tools are then used to grasp tissue and deploy suture anchors to create multiple, circumferential tissue folds around the stoma, reducing the diameter of the opening to original post-gastric bypass proportions. If needed, additional anchors are then placed in the stomach pouch to reduce its volume capacity. No cuts are made into the patient's abdomen during the procedure, so the patients report little or no postoperative pain.

From what I have read on this board, you might find a revision surgeon who can bill the insurance company like a regular medical expense and go in to find out why you have pain in your intestines and stomach and repair any adhesions/scar tissue - and while the surgeon is in here, they can revise whatever you need for your WLS. Other's have had it done that way. Or you can have the StomaphyX which is self-pay or Rose which is under study at present and you may qualify as a study participant.

There is a woman who just posted on the DS board who is an expert in insurance and willing to help those who need it.

Here's the link to the thread she posted:

http://www.obesityhelp.com/forums/DS/a,messageboard/action,r eplies/board_id,5357/cat_id,4957/topic_id,3585831/

Thank you all for your advice.  I took matters into my own hands and sought out another surgeon.  I have an appointment the end of the month. I sent all my med records to him yesterday.  I also checked on the stophamax - there is a great place about 3 hours from me that does it.  I also found that they participate with BCBS PPO.  I will just have to pay 20%.  I have a little more hope today that I'll get myself fixed up.  Its just frustrating that my original surgeon is just unwilling to help.  I guess I should have known better based on his attitude that I did something to make my stoma streach.  I tried to tell him that I've never had any issues with things getting stuck despite sometimes not chewing well enough.  I know in my heart I wouldn't purposefully try to ruin this opportunity I've been given.