No revision for this girl..booooo!

 I received the same denial. But I'm still working on it and documenting and researching. My question is in the way they did the upper GI... I'm assuming that they used the barium contrast on you like they did me? Okay.... They claim mine is regular size, a 3, if it was a 6 or 8, then it be grounds for revision... But here's the question, the barium is a liquid, it doesn't exactly do a good job at stretching orpossibly showing the stretching of the stomach or the stoma from the pouch to the intestine. Would the machine or the X-ray technician be able to pick up on a pouch being stretched in "live mode"? And on another site, the revision was one of the logical corrective treatments for the situation due to pouch or stoma stretching.... And of course it says on a separate line, revisional surgery is called for if the pouch has become enlarged, which in your case and mine, the surgeons claims we are normal roux en y size. I have brought up the whole stretching thing showing up on the upper GI test to the consulting physician, not the surgeon himself,  and I never got a reaction to it but when I pushed on about getting a revision and continued to ask to be referred back to the consulting ohysician, he finally gave me the option to speak to the surgeon (whom i see on August 30th) in person but of course he was confident enough to tell me that I will be proven wrong and of course was ****y and rude about saying it... Of course he also said that a lapband surgery could not be performed on a former roux en y patient as revision, he said that I was given false information when I relayed this information to him, even after I told him that I found the paperwork he still stuck to his guns. My doctor happens to also be my insurance carrier here in California, might have heard of it, Kaiser Permanente, so this is a doctor that has the insurance benefits and well being in mind first and the patients last. I have managed to get them to do reconstructive surgery that they were adamant about claiming as cosmetic, it was all in the wording I used and the serious amount of documentation. I know this is a long response ( totally incapable of summarizing my thoughts or simply just keep my word useage down to a minmum) and i know it doesn't really answer your questions or give much advice but I do want you to know you are not alone at this very moment in fighting the doctors under same cir****tances. But perhaps this will help, if any progress I make, I will let you know. Just don't give up. I don't like the depression I get when they tell me no, therefore i keep moving on like a stubborn mule that i am. I know I'm a grown woman but I gotta stomp my foot on the ground sometimes to get some attention, especially at Kaiser.

Well I had an EGD done with the first surgeon I had selected to discuss my possible revision with and his results showed a definitely enlarged/dilated stoma & pouch and his suggestion was bc of insurance purposes I would most likely be required to do another 6-month supervised diet, but he did say that a revision is what was needed in order to correct the stoma/pouch.  This 2nd surgeon I chose to see (he's way close in location) said that whether the stoma/pouch are stretched really has no bearing on whether a revision is the right way to go or not??  Thats how he made it sound to me anyway.  This surgeon also wanted to do an upper GI to check and see the limb that was created..and if anything is going on with that??  So I have no idea, although its not looking good!  I guess I could go back to this other doctor and do a 6-month supervised diet.  I'm just very confused.  And its so hard to actually talk to these surgeon's themselves..you always have to talk to a nurse or something, but rarely even them without an appointment.  I do understand they are very busy, but anyway..lol I'm just rambling on here..you'll have to forgive me.  I wish you much luck and success on your revision!

so far I have found that I have to talk to a NUT then an NP before I can get to the surgeon to talk to them.(twice now) Bunch of crap when all you want is an answer on whether they will do it or not. I would like to not waste my time and money on seeing a NUT and a NP to go to surgeon and then be told, NO we don't do that here.

In my case, I had a CT with IV and oral contrast, and it did show the pouch to be enlarged. I'm not sure with the upper GI what they could do to extend the pouch unless they put in an NG tube and instilled the barium really quickly. I'm wondering if you might have an upper GI endoscopy, if anything could be determined that way? They use air to distend the colon, so if they could carefully inflate the pouch, they might be able to see something of the pouch's "distensability" (HAHA, I made that up) .
I have no idea if that is a viable approach, but you could ask about it if you could get your PCP to refer you to a GI. I know sometimes they don't want to send you (because of insurance costs as you discussed) but if you had a problem, like "bad reflux", that would be a reason for the referral...nudge ndge wink wink...
Good luck and keep pushing! You will get it done eventually if you can get the right answer.