Anyone Ever Heard of This?

I had my "initial" RNY on June 5, 2007.  The surgery took longer than usual and the doctor told me while I was in recovery that my liver was too big and he could not get around it but "I would be fine".  One month later I had lost 9lbs....huh??!  I go to his office for my follow up and he tells me that it was my fault.  That basically my fat ass had already learned how to eat around my pouch.  Meanwhile time goes on.  I stay sick and lose no significant weight.  The most I lost was 13lbs in month.  In November of 2007 I stopped losing at all.  So In Feb. of 2008 I get a trainer who worked with me till I lost 27 lbs.  In between that time I had to have another EGD, and Upper GI and a colonoscopy to see why I was sick all the time.  The radiologist just said, "you pouch is huge, does your doctor know about this?"  I told him I didn't know.  Anyway, I was eventually approved for a revision less than a year after having had the first surgery but the doctor requires that his patients participate in a pre-surgical weight loss program that costs $1200.00  Well I did not have that so I just gave up. 

Ok now on to the really good stuff.  I have been suffering with muscle spasms, pain and just plain ol discomfort since then so this year I start seeing a gastroenterologist who then refers me to have an Upper GI done again.  I do this and take my report to another Bariatric surgeon who informs me on yesterday that I have multiple surgery clips still in my stomach and that the surgeon who attempted my first surgery apparently could not get to the top of my stomach, therefore he could not complete my surgery.

I googled the surgery clip thing and I found that it is not uncommon but I should have signed something giving my consent and stating that I had been notified.  Well, since I just found out about them yesterday, I did not give my consent.

So now, I have been walking around here for 3 years now mad at myself for not trying harder or doing more and I come to find out, I only had half of the surgery done......

What do I do???  The insurance I have (Aetna) says they will pay for my surgery to have the clips removed but the only way they will cover the "revision" or completion/correction to the prior surgery is if my doctor convinces them that I can not go through the rest of my life with half of a gastric bypass done.

Help!    I don't know what to do...


Thanks in Advance,

Angela

If I were you, I'd find a good revision surgeon and have him clean up the mess the other hack made and have him do a proper procedure while he was there.  I'm sure if you see a reputable revision surgeon that he'd have no problem doing a write up for Aetna to get approval.
Best of luck,
Debbie M.

I agree with Debbie 100%. And then, I'd sue your orginial surgeon - what an A$$!!!!!

How horrible - but good luck!!!

Thanks Ladies!  I am in the process of seeking legal help.  I left a message with an attorney and I am waiting to hear back from him.  As far as the revision, my company does not cover anything related to bariatric surgery.  I asked them to add the rider since I am having complications but they only told me that they would "take it into consideration"......so we shall see.

Just want to wish you good luck.  I do know some surgeons use different codes to bill the surgeries.  Maybe if you have complications that could be fixed by "bariatric" surgery they can code it as some other similar surgery but still in essence you'd have the WLS.  Does that make sense?  Sorry - I'm rather incoherant tonight, worked a long day!