Revision - Optimistic w/ Dr. but Insurance Unsure!
Well I went to my new Dr. yesterday regarding my reflux. He did a complete unfill (which scares me with no restriction). He was optimistic about wanting to do a revision - he said for sure if there is a slip I can either revise to another surgery or fix the band. I told him fixing the band was not ideal for me since I had so much weight to lose and he was adamant about revising to RNY. He also said that if there is not a slip and the reflux was that severe with only 4cc in the band then the band mechanics is just not ideal for my body and I can't keep having such severe reflux and in that case it should still come and be revised.
I'm currently on meds for reflux and scheduled for a barium swallow and blood work.
He is hoping to be able to use the last year of medical history and visits to my previous surgeon as "attempted" weight loss. The issue with the insurance may be that regardless if there is a problem with the band, they may require another 6 months of presurgery diet/weightloss history attempts. The office in fact told me that if the band has to come out for medical reasons, potentially based on the insurance that I would FIRST have to have it removed and then wait the six months and go through nutrition counseling AGAIN and then have to get approved AGAIN from my insurance. I don't even have the same insurance policy as I had when my first surgery was approved. I'm already frustrated.
Wondering if anyone else went through this with a revision and their insurance?
Trying to take one day at a time but that is easier said than done especially with the fear of weight starting to come back on while things are figured out.
I'm currently on meds for reflux and scheduled for a barium swallow and blood work.
He is hoping to be able to use the last year of medical history and visits to my previous surgeon as "attempted" weight loss. The issue with the insurance may be that regardless if there is a problem with the band, they may require another 6 months of presurgery diet/weightloss history attempts. The office in fact told me that if the band has to come out for medical reasons, potentially based on the insurance that I would FIRST have to have it removed and then wait the six months and go through nutrition counseling AGAIN and then have to get approved AGAIN from my insurance. I don't even have the same insurance policy as I had when my first surgery was approved. I'm already frustrated.
Wondering if anyone else went through this with a revision and their insurance?
Trying to take one day at a time but that is easier said than done especially with the fear of weight starting to come back on while things are figured out.
I was considered a lightweight when I had my revision. I had been 218 for almost a year with no weight loss. i did not want the band out and then the bypass because I was afraid the insurance would not pay.
I had major heart burn issues. Even had heart burn when the band was empty.
My dr ended up eating the cost because the insurance paid for the bypass but not the band to be removed. Wierd ughhh.
I did have to do the pre op class, psych visit with psychologist on staff. I had to have all the blood work and EKG, chest x ray.
I was having major anxiety issues because I was afraid insurance would not pay after I had my band removed. THe insurance person wanted me to have 2 surgeries and my heart was beating very low because of the band so I did not want to have the band out and have another surgery.
I know this does not help much but this was my experience.
I had major heart burn issues. Even had heart burn when the band was empty.
My dr ended up eating the cost because the insurance paid for the bypass but not the band to be removed. Wierd ughhh.
I did have to do the pre op class, psych visit with psychologist on staff. I had to have all the blood work and EKG, chest x ray.
I was having major anxiety issues because I was afraid insurance would not pay after I had my band removed. THe insurance person wanted me to have 2 surgeries and my heart was beating very low because of the band so I did not want to have the band out and have another surgery.
I know this does not help much but this was my experience.
On March 11, 2011 at 6:46 AM Pacific Time, Nikki C. wrote:
Well I went to my new Dr. yesterday regarding my reflux. He did a complete unfill (which scares me with no restriction). He was optimistic about wanting to do a revision - he said for sure if there is a slip I can either revise to another surgery or fix the band. I told him fixing the band was not ideal for me since I had so much weight to lose and he was adamant about revising to RNY. He also said that if there is not a slip and the reflux was that severe with only 4cc in the band then the band mechanics is just not ideal for my body and I can't keep having such severe reflux and in that case it should still come and be revised. I'm currently on meds for reflux and scheduled for a barium swallow and blood work.
He is hoping to be able to use the last year of medical history and visits to my previous surgeon as "attempted" weight loss. The issue with the insurance may be that regardless if there is a problem with the band, they may require another 6 months of presurgery diet/weightloss history attempts. The office in fact told me that if the band has to come out for medical reasons, potentially based on the insurance that I would FIRST have to have it removed and then wait the six months and go through nutrition counseling AGAIN and then have to get approved AGAIN from my insurance. I don't even have the same insurance policy as I had when my first surgery was approved. I'm already frustrated.
Wondering if anyone else went through this with a revision and their insurance?
Trying to take one day at a time but that is easier said than done especially with the fear of weight starting to come back on while things are figured out.
A revision to what? Your surgeon appears to be a band mill, that's the only surgery he does.
If you are revising to anything with a staple line you'll want to make very sure you to go a revision surgeon with bunches of staple line experience. Your surgeon has 1550 bands and that's it, no revisions, no sleeves, no bypass, no DS.
A revision from band to anything with a staple line carries 3x the risk for bleeding, leaks, and perforations. A leak could change your life in ways you didn't know existed.
Previously Midwesterngirl
The band got me to goal, the sleeve will keep me there.
See my blog for newbies: http://wasabubblebutt.blogspot.com/
The band got me to goal, the sleeve will keep me there.
See my blog for newbies: http://wasabubblebutt.blogspot.com/
The surgeon on my profile is my original surgeon who is a big advocate of the band. He is not the Dr. I was referring to in my post. Not to mention these profiles on OH for surgeons are contingent upons someone updating them frequently which I doubt they are.
I have not changed anything on my profile regarding a revision surgery or new surgeon info. I saw the new Dr. once. It's too early on to even know what is going to happen from here on out.
The new surgeon predominently does bypass, but also does VSG, bands and revision. Bands are the least % of surgery in his practice. His practice is all bariatrics and has been doing "staple line" surgeries for more than 10 year. I'm not going to a chop shop or some surgeon who decided to get on the bariatrics bandwagon to make some money. Experience and reputation is very important for me.
I still think my original surgeon is a great Dr. He also did the follow up surgery of my gall bladder removal. I have no complaints about him or his practice. But I'm doing what is best for me both physically and financially and that is moving on to an in-network surgeron who is giving me other options. If I had the money to self pay and went back to my original surgeon and asked him to revise to VSG tomorrow, he would do it. Unfortunately, I dont have that choice.
I have not changed anything on my profile regarding a revision surgery or new surgeon info. I saw the new Dr. once. It's too early on to even know what is going to happen from here on out.
The new surgeon predominently does bypass, but also does VSG, bands and revision. Bands are the least % of surgery in his practice. His practice is all bariatrics and has been doing "staple line" surgeries for more than 10 year. I'm not going to a chop shop or some surgeon who decided to get on the bariatrics bandwagon to make some money. Experience and reputation is very important for me.
I still think my original surgeon is a great Dr. He also did the follow up surgery of my gall bladder removal. I have no complaints about him or his practice. But I'm doing what is best for me both physically and financially and that is moving on to an in-network surgeron who is giving me other options. If I had the money to self pay and went back to my original surgeon and asked him to revise to VSG tomorrow, he would do it. Unfortunately, I dont have that choice.
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