Revision question

Hello, I had Rny surgery in 2007, I was 366 pounds, the lowest I got was 239. I have been fine until I got pregnant in 2011 and gained about 35 pounds. Then last year in had foot surgery and have gotten back to 301. I've been wanting to get a revision. But am unsure if medicaid will pay for it. I'm a student so that's the only insurance I have. Does anyone know if they give people a hard time approving the revisions.  Also, I do not have any health issues like high BP or diabetes. Does thaatter?

Thanks

A great deal depends on what, specifically, is mechanically wrong with your bypass.  If it is merely a matter of eating the wrong foods then no, medicaid is not going to pay for a revision.  You need to prove via diagnostics what is wrong with your bypass.

What diagnostics have you had?  What do they show?

I haven't had any tests done so I'm not sure. What do I need to have done? I have an appt Thursday with a doctor for a consult. 

An upper GI is probably a good place to start.  Is it a dietary issue? If so, no revision in the world is going to fix that.  If it is a mechanical issue that is a different story.

What is your diet like?

I am a state employee and I also have Medicaid.  My revision was recently approved not sure if it varies state by state by NM Medicaid will only cover for one bariatric surgery per lifetime.  I had private insurance the first time around.  My first surgery was done in 2009 weighing 358 at the start of the process and I lost 138 pounds. About a year and a half out of surgery I got pregnant and gained some back maybe 10 pounds.  Unfortunately when my daughter was a little over a year I got pregnant again and it was downhill from there my highest weight was 280.  I had revision surgery on May 2nd.  I was approved after the first submission both times as I have high blood pressure and a family history of heart disease along with an extreme BMI.  You just need to do some research into your Medicaid coverage.  I can tell you my pouch was stretched and my intestine connection as well. All which was strictly my doing. As far as my diet I was still going along the right path I just was able to eat more.  Once again dieting and exercising on my own got me no where.  I am so thankful for the help I have received one again and I have vowed to reach my goals!  No distractions no BS and definitely NO babies!! lol. Good Luck.

Christine, did u have to go through the 6 month diet again since it was a revision? Also, what tests do they do to see if the pouch stretched?

No my insurance did not require that I go through the diet again but my surgeon did have me work with the nutritionist to get a clear picture on my eating habits.  I had to keep a real and honest food journal.  I found that although I was structuring my meals correctly they were somewhat carb heavy.  I had to do the drink test where they watch the passage of the liquids from the stomach to the intestines (not sure of the proper term) and I also had to have the test where they go through your mouth with a camera to view the stomach.  I began the process in November but for every test I had to had a follow up visit.  My doctor is 200 miles away so the process was pretty drawn out.  My doctor explained to me that he must show that he is actively working with you to ensure success hence the dietary visits. It was also discovered that I had a hiatal hernia (which means part of my stomach was sitting up over my diaphragm causes heartburn etc).  I don't know if the insurance was more willing to approve it due to the fact that I was going to have the surgery to correct the hernia either way and he would be working in the same area.  Definitely a possibility but I am not sure what they are looking at when making these kinds of decisions.  I should have had surgery in March sometime but staff dropped the ball on insurance paperwork.  I was approved within 2 weeks no issues at all.