Does Medicaid cover revisions?? Help!!

Hi everyone, I haven't been on here for so long... I had an open RNY on 03/04/04 and I lost 60 pounds in three months. Then slowly I gained 13 of it back, so I only lost 47 in 18 months. Shocking, huh? How could I fail what is supposed to be the last resort? Anyway the last time I saw my surgeon, Dr. Rossi, he wanted me to see a dietician. I tried to tell him it wasn't behavioral because I was doing everything I was suppsosed to do, but he didn't believe me. So I never went back. Haven't been there in at least 6 months. But I had an upper GI in March of this year because I wanted to know why I hadn't lost any more, and it showed that my pouch was enlarged, to at least 5 cm in maximum dimension. That's about the size of an orange, instead of the egg it's supposed to be! Then, I just had an upper GI again today because I'd been having pain (that I thought was a hernia), and it shows that the contrast flowed through my defuntionalized stomach!!! So first of all, should I see Dr. Rossi again and tell him about this? Second, do you think he would do a revision? Third, I'm on Medicaid now - does anyone know of anyone being approved for a revision by Medicaid? I'm really worried about this. I have tons of health problems, including insulin-dependent diabetes, hormone deficiencies (I have to take Activella and Prometrium, and I'm only 27! long story) and hypothyroidism, which I think all contributed to my screwy innards and nothing staying where it was supposed to. But I'm really worried now. I want the revision, but will he do it? And will Medicaid cover it? I have a husband and an almost-4 year old to be healthy for. Please, any advice or thoughts at all are appreciated!! If you don't post here, please email me at [email protected]. Thank you so much!!!

I believe I've heard of Medicaid covering revisions in IL but every state is different. There are a couple of surgeons that accept Medicaid and are known for revisions at the University of Chicago. Dr. Alverdy and Prachard. They perform both the RNY and DS but since you've had a failed RNY you might want to look into a revision to a DS. If you're interested in researching more information about the ds you can read about it at www.duodenalswitch.com as well as finding the phone numbers to the Dr.s listed above. Good Luck

Okay, wonderful!!! Thank you so much!! I will definitely read about this!!! I have an appt. with the surgeon tomorrow morning at 10:45, please pray for me!!!

Everything said about Univsersity of Chicago Hospital is correct, and medicaid will cover the surgery but one thing that is incorrect is about is a Revision to a DS is always not always option. I wanted the DS and Dr Prachand say NO!!!!!!!!! based of operative notes he felt that the lap band was best for me. People had me hyped about the DS, and I was a little disappointed at first, until I called him and talked to him in length about his decision to do the Lap Band. I'm glad I did Lana

I would be willing to do the lap band, but before I got the RNY they told me I couldn't do the lap band because I require insulin for my diabetes. I don't really understand the correlation - is it something to do with poor wound healing in IDDM patients and so a foreign body would not be accepted by the body? Anyway I would be willing to do whatever it took! I have an appt. with the surgeon tomorrow morning at 10:45, so please be praying for me!!! THANK YOU!!!

How long did your process take with the surgeon???

Hello I am on medicaid and just got approved for a distal RNY. This is also a revision for me, I had a VBG in '98. I think I was pretty lucky I have a very small staple line disruption, acid reflux, but no other real co-morbidities. I made sure my doctor's office kept on top of them (medicaid won't talk to patients). They claimed not to recieve my paperwork three different times even though my doctor had the fax confirmations. So I think they may play some games but if you don't let them up for air they eventually give in. The contact from the medicaid office said he approved it because he knew if he denied it we would just appeal it. He was right, saved us all some stress. I made sure I had my ducks in a row. I had all the paperwork including the psych eval all sent in at the same time the first time. They never even made me do the eight months physician supervised diet, but I had been doing it anyway just in case that would be required. That would give them a reason to deny me and I didn't want that. So in short work hard and it will pay off. I'm still waiting for a surgery date but it should be around Christmas. Good luck to you. P.S. yours may be different since you are in Illinois. Keep us posted micah

You are the answer to my prayers!! I am on the board myself looking to see if medicaid covers the revision. I am also from IL. And could you believe Dr. Gupta did my surgery. He won't consider a revision so I am looking elsewhere. He says the risk is too high. I was able to eat a lot more than expected from the start. I never threw up or anything. He kind of dismissed ny concerns because I was loosing. I wasn't hungary at the time so I was able to limit the amount of food I ate. Now I am starving all the time!! I unfortunately (to my wt loss) got pregnant soon after surgery and he thinks that things were streched. I lost about 110 lbs. and have gained 10 back. I still weigh 230 lbs and am afraid I will gain back due to hungar. I am loosing sleep over this. Another issue for me is that my medicaid will probably end soon because I am back to work now and my year is almost up. My job does not offer insurance. Well you have to medically quailify. Ha Ha. Ive been sooo embarassed and dissapointed in myself that I'd kind of given up. Thanks for your post. Please update me on any info that you find out. [email protected] Good Luck to you Angela