Approved after Peer to Peer

Thankfully I've been approved to have my revision.

I originally had my VSG on OCT 2011. I lost almost 100 lbs. My only complaint was the acid reflux. I thought it was just something I was going to have to live with.

My weight is also still an issue as it had crept back up even with my intake being so limited.

My insurance coordinator worked very hard to get me approved. I am elated to be moving forward.

The initial denial was due to the location selected. It didn't have a special certification that my health insurance required.

The second time it was denied because the insurance wanted it coded as a first time gastric bypass, not a revision.

In the peer 2 peer , my surgeons team was able to explain why it has to be coded as a revision.

I will have my 2nd consultation on June 19th to schedule my surgery!

Here I go!!!! AGAIN!!!!

I am waiting to hear about approval for revision from VSG to RnY for reflux/GERD. I have erosion in my esophagus, and I had polyps in my stomach from the PPI use. I had VSG in 2009 and lost 70 pounds at my lowest (about six months out). (Surgery fixed my stomach but not my head.) If I had known about the GERD problem, I would have had RnY to begin with! I had GERD before my sleeve and the first morning after my sleeve, I thought I was going to die the acid was so bad. It was a sign, I suppose.

I met with my surgeon week before last. The insurance company has to respond within two weeks, so I assume I'll hear about a denial on Monday and then we'll take the next step. (Yes, I am not optimistic it will be approved.)

I've spent the last six or so months having all kinds of test ordered by my gastro. Gastric emptying (normal), EGD (erosion found and polyps removed), a very nasty BRAVO study in which I had to spend days and days off my PPI (very abnormal result) etc. So maybe that will convince the insurance company. I dunno.

At this point, I just want the acid GONE. My grandmother died of esophageal cancer. Six weeks from diagnosis to deceased. It was terrible. I wouldn't wi**** on my worst enemy, and I certainly don't want it to happen to ME!

Good luc****ep me posted.

I'm hoping for the best for you.

And you also put it best. The VSG fixed my stomach and not my head. I to would have gone for the RnY if I would have known the reflux would have been such and issue.

Keep me posted!

All the WLS fix the stomach and non fix the head.

Yeah I would say I had a 6 month adjustment period with my brain post op

I'm 1.5 years out with the sleeve and 6 years of with the whole WLS thing and am still seeing a therapist to try to get the head right.

I have been thinking I might need to see a therapist. What kinds of issues do they explore? (If you don't mind answering. If it's too personal, that's okay.) I definitely eat my emotions instead of feeling them. It's a thing I've been paying attention to recently. Frustrated? Eat something. Bored? Eat something. Mad? Eat something. Etc. But I really don't know WHY I do that. So I've been wondering if seeing a psychologist could help me figure that out.

Regardless of how fixing the GERD works out, I need to fix my head. And my surgeon said that I wouldn't lose that much anyway with a second surgery (because I asked him about losing TOO much) so revising the sleeve to RnY is not about weight loss for me; it's about fixing my acid issues so my esophagus does not erode any more than it has.

I was reading this thread because it interested me.  And I learned some things too so thank you. I wanted to put my 2 cents in about seeing a therapist. 

When I had the band put in, I spent about 2 hours with a therapist.  Did it address the reasons why I eat or DID eat the way I did all my life? No.  It got me the surgery.  Do I think I need a therapist to find this out.  Yes!  We do need to figure out what triggers us, why it triggers us and how to stop it from triggering us.  But unless we know why we are being triggered, how can we find out the rest?

For the most part, I already know where my bad habits came from and I never learned how to stop it because I never related the reason to the action of eating stupidly.  It never came up until I realized I had been putting on about 10 pounds a year.  That started when I was 26 and has ended here.  I would say seeing a therapist is something that can only benefit us in this issue.  But we all have to make up our own minds.

Personally I don't enough emphasis is put on the "whys" of overeating before surgery.  Perhaps if it was there wouldn't be so much regain.  I feel as though I have my head together now and wish I had gotten therapy before my surgery....

Karen's post was a good answer to your question.  My therapist had WLS and had issues growing up similar to mine which is why she decided to get in to this field late in life after two other careers.  The figure is as high as 90% of obese people looking for WLS had major issues that lead them to overeating.  Many have been sexually, physical or mentally abused growing up or later in life also.

Some people are from controlling partner situations and overeating is the thing they have control over.  I always thought I was a strong person and had a great job.  But, what I had gone thru as a child and in my first marriage contributed to my issues.  Even with dealing with the issues, I still need to go in and say I know why and what I need to do but I am not doing it and talking it out really help keep my head in the game.

Like Karen I did the two hour eval to get the band.  But, I choose to start seeing the therapist while getting the band removed and starting the process to try to get the center and insurance to OK the sleeve.  This time I am getting the help I need.  I too was told to expect to lose slower and less this time.  I am 50/60 pounds less than with the band.  I was lucky, I had the gerd with the band, stopped when I got the band out.  Than with the sleeve I was able to control it with the ppi's for the first year as is our centers standard.  Than after going thru the ppi withdrawal which is really hard and many mistakenly go back on them, I am off the ppi's and gerd free with my sleeve.

If you want to talk more about the therapy just pop me a pm.