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I got a letter from my insurance stating they will not authorize a revision. They didn't talk much about the revision but states they would not cover anything unless the band had eroded or slipped or there was a port infection. I am so disappointed but i am not giving up . I wish there was class action law suit for this piece of crap !!!!! I sincerely hope no one out there is putting them in people anymore .
I had the same issue as the poster above. I didn't have a problem with GERD/Reflux prior to VSG, but it started about 8 months post surgery. By the time of my revision, I was choking on stomach acid, had a DeMeester score of 78.23 which translates to acid about 409% higher than normal. Mine was not controlled by medication even though I was on PPI x2 daily as well as Zantac. Knowing what I know now, if I had GERD prior to surgery I would never have gone with the sleeve.
I have recently had a revision and to answer your question will be hard. Every doctor and center has their own criteria then you have to add in your insurance as well. I have tried to get a revision since 2000 but my insurance never had the bariatric rider. About three years ago it was added to our policy but they verbally told me no since I had already had one in a lifetime. I decided to go through the process and make them formally turn me down so I could get a lawyer. Yup I had one in a lifetime but not from them. I had to go through everything a new surgery would but more. I had to first have an endoscopy to see if there was a failure. I had a complication two years after my original and a general surgeon saved my life but while doing so changed my bypass. So for thirty years I had been dealing with that change. However my weight gain was still on me. My eating habits and what I ate was an issue. So during the endoscopy they found GERDS. All these years I thought I had bad sinuses that caused me to throw up every single morning till I could clear my stomach out. I even had sinus surgery trying to fix it. After a six month diet which I took full advantage of and changed every bad habit I had losing on my own 143 pounds that insurance company approved me. I was in shock. I had the original gastric bypass and revised to the same RNY procedure with long limb but a revision has a very low weight loss success. So that changing of every bad habit I have maintained during this surgery. I figured the success of the honey moon period was not so great for revisions I was going to have to buckle down. I am six months out and have surpassed statistics for revisions and even surpassed weight loss for a original RNY. I can say it is because I made the changes not all the surgery. So what the others have said is right.
Some insurance will fight you over already having it.
Most insurance will expect there to be a reason.
Some doctors do not believe in revisions unless life saving.
Some doctors are experienced and others are not. Never choose a doctor lightly I went out of town to ensure someone knew what they were doing.
You will need to work harder this time then last. So find a place for yourself mentally or you will go through this for nothing.
I am not familiar with the sleeve other than what it is as a surgery so I don't know much about it. I do know some people have had success in resetting a RNY pouch. My surgeon gives you free lifetime dietitian consultations for this very thing. If you have trouble losing the weight or start gaining it back you can return to the dietitians for free support. I have a friend that is struggling over gaining some back after having one long ago. She is going to bariatric support groups with me but she is doing the food changes on her own instead of seeking a revision. There are many ways to approach this. You first need to find out if your surgery is in tact or something has changed to fight against the weight loss.
Good luck!
Hello there!
I follow some people's post on YouTube who has had revisions due to GERD, and then some has been denied as well. The ones that have been denied has been though an appeal process. The doctors they have used knew the process very well, so I would suggest getting a doctor that knows the process and is willing to do appeals if necessary. I see that bypass has healed others. I too have horrible heartburn. Look on YouTube for others who had similar revisions. This forum does not get many replies. But I thought I would post because that is a concern for me as well
Well lets be sure to help each other in this journey!
I go in this Thursday to determine if I have a hiatal hernia, if I have GERD, and how much my pouch has stretched. I think its called an EGD? But I will keep you posted.
I have United Health Care insurance and they waive the 6 month supervised diet requirement for revisions.
I needed my sleeve converted to a bypass. Truth be told, I wish I had never done the sleeve and gone with the bypass, as the bypass would have been a better fit for me. Prior to the sleeve, I never had problems with acid reflux/GERD. By the time I had my revision, I was choking on fluid every night and waking up gasping for air. I took prescribed medications twice a day and it barely touched my nighttime problems. Everyone is different and you may not have a problem with reflux. It's hard to say.
Hi there Kay,
you can succeed with a rny. Just to let you know Ive been looking into a revision to my RNY in 2009. Its been gradual but weight is creeping back up. how are you getting your surgery approved.