NEED ADVICE....and any revisions covered by Kaiser?

offthewall34
on 7/12/09 5:21 pm - Bakersfield, CA
Hello,
I have posted my current issues on the RNY failure board, but i thought this group might have a lot of answers as well.
I am a 37 yo female that underwent RNY three years ago.  It was successful and I lost and maintained a 125# weight loss for over 2 years.  About a year ago, I slowly gained 15 pounds, but I wanted to do this due to the fact that my face was really "gaunt".  I was still well within my normal weight range.  Well, From November to February, I gained 47 pounds.  Needless to say I was freaked out!  I started being even more careful with my diet, and I even did the 5 day pouch test several times without any weight loss or feeling of pouch shrinkage.  Since then, I have gained another 15 pounds, and this is when I was eating even more strictly!  What could be going on and what do I do about it?  I feel very depressed, defeated, and like a failure!  I feel so much shame that I am afraid to contact my surgeon.  I really need help on what to do, and figuring out what this could be. 
Oh, and as a side note...have any of you had Kaiser and had them cover a revision?  What are the criteria for the second surgery?
Thank you all for "listening"!
D
starrgirrl
on 7/13/09 9:52 am - los angeles, CA
From what I've been able to discern each Kaiser bariatric office has their own criteria for determining if they'll do revisions. For instance the Richmond office in Northern CA has a blanket policy that they will not do revisions. The Harbor City office in Southern CA will consider revisional surgery - they are currently doing the RNY and VSG & on occassion the Band. My understanding is that the South San Francisco office will consider it on a case-by-case basis. Therefore, you may want to call a the Kaiser bariatric centers in your network to see if they will consider doing a revision. That way you can determine which office to target for your referral.

Lots of light to your journey!
Amy Farrah Fowler
on 7/16/09 7:46 am
I'm not sure what you are wanting to revise to, but there are many revisions on the DS board, and some who are very informed about the different insurance companies, and how to deal with them.
offthewall34
on 7/16/09 8:26 am - Bakersfield, CA
I'm not sure what I want to revise to.  I have no idea what my options are.  I just know that what I have is not working anymore and it's really getting me down! 
I will take a look at the DS board and see if I can find out any info.  Thank you!
D
Amy Farrah Fowler
on 7/16/09 8:35 am
Well, you should look at the surgery choices first, then select a surgeon that is skilled in that area.

Many of us have had surgeons steer us toward what they happen to perform, not necessarily what would be best for us, and I'm a big advocate of doing what is best for ME, and making my doctors and insurance respect that. They're main interest is their bottom line, and they've tried to cheap out on my health too many times for me to trust them.

I wanted the DS because it had the best statistics as far as weight loss, and maintenance of that loss, as well as the highest cure of co-morbidities. If you have any questions I might be able to answer, I'd be happy to.
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