Process for revision

I come here looking for answers for my principal. With my recent surgery, he has really made up his mind that he would like to try and get a revision. I told him about our lovely boards here but he is so busy he really doesn't have time to stop by, so I said I would for him. He had rny about 4 years ago. He started out at a little over 500. He got down to 350, but within the last year he has put back 80 of those pounds. He really wants to get this revision, but does not know how to go about getting it. What are your suggestions? What was the process for you? Do you ask to see the surgeon, do you speak to your primary doc first, is the procedure just like trying to get approval for surgery? Any advice and suggestions would be greatly appreciated. Thank-you.

Hello I just got my revision approved so I thought I could help you out. I first talked to my primary physician. At the time I was having trouble with keeping food down and so my PCP gave me a referral to my origional surgeon. I highly recommend going to the surgeon that did your first surgery, many surgeons will not revise another surgeons work. Plus each surgeon does things a little different so the surgeon will know what he origionally did. For me the revision was not just a matter of no longer losing weight but had to prove (like the first time) that it was medically neccessary. Also most surgeons will not do a revision unless there has been a staple line disruption or a medical reason why the weight has come back on. The best advise I can give you is to get a refferral to the surgeon and talk about the options available. With your friend above 400 I can't imagine there would be too much of a problem getting it approved. Especially if he has any medical co-morbidities. Another thing to consider is to find out if his insurance even covers revisions. Some insurances will only cover it first time around. The office staff can help get the paperwork together and also may know off hand what the specific company covers and doesn't. The biggest thing is to be patient and work the process one step at a time. For me waiting for the revision approval was more stressful than it was the first time around. However with a second chance I am 100% more committed to making this work. I have done a ton of research on revisions so if you have any more questions feel free to e-mail me at [email protected]. Also your friend will want to research the newest procedure called the billiopancreatic deversion with deudenal switch. It has been very successful with getting large amounts of weight off and keeping it off. It is risky but I do know that the RNY can be revised to the BPD/DS. Good luck Micah

First and formost he needs to know why there is a weight gain. He needs to see his PCP. Also know that not all physicians will perform revisions. I am trying to get the insurance straightened out but my surgeon said he would do it. Just know that a revision is dangerous. His PCP will order some tests like an upper GI, Ct Scan and endoscopy. Once the results are in the surgeon will discuss with him if it is doable. Not all surgeions will do a revision Tina

hi, Just got home from the hospital. Had my revision on the 11th. Luckily I made out okay. I have a tremendous amount of pain. They rushed me in for an x-ray and upper GI. Luckily all okay. I have a drain in for 3 weeks so that is probably causing the pain. Thank goodness for pain meds. I originally lost 165 pounds. I gained about 40 back. In the beginning my stoma had closed and I had to keep getting it stretched. Then it was too big. So I was hungry all the time and ate all the time. I know I ate too much and that is where it all went bad. The surgeon originally used staples for the stoma. He said they found it didn't work and the result was stretching. My pouch was much bigger then tests showed. I had an endoscopy and upper GI. I didn't see my primary first because the surgeon is now out of network. The insurance denied back in January. I appealed and finally won in July. They couldn't get me in until October. So, have your friend get back to the surgeon. At my support group they said us older WLS patients don't come back because we are embarassed. I went back because I knew I needed help. Wish him good luck.

What do you mean we don't come back. Heck... I did not pay a boat load of copays to be fat again. Heck yea... I went back. I wanted to know why I was starting to look like a line backer when all the rest of my friends were thin. I found out soon enough. As soon as I can get insurance to cover the revision I am in. I got denied for policy exclusion not medical necessity. So my surgeon said that was a good sign. I just need to get it covered and I there. congrats on your revision. Tina

At my support group they don't come back. I think I am the only one that has come back. One woman said she ran into someone who told he she was too embarassed. I'm like you. I didn't know go through all that the first time to gain the weight back. I don't think it was my fault anyway. If the older post ops in my group came back they may see that maybe the procedure at the time was the problem. Take care