Recent Posts

shae37
on 6/15/19 6:27 pm - tampa, FL
Topic: Proximal vs distal

Has anyone either been told you couldn't get the duodenal switch due to your pouch not be long enough? And if you would still be able to get the rny revision? I had my egd done and he said my pouch is measuring 5cm and should be 7cm. Di I'm quite upset because i really wanted the ds. Wondering if I should do a second opinion with another doctor.

Looking4home
on 6/14/19 11:31 am
Revision on 04/05/19
Topic: STILL Waiting

Rejected twice. My revision is pending and expected to be approved by 6/21/2019. Having over $50,000 worth of testing to prove GERD, gastritis, esophagus lesions, and a medium size hernia. So basically my insides are being destroyed. I don't have cancer at this point. This sucks. However, there is hope. Revision is medically necessary. I am just waiting on paperwork or a medical fight w

Amy R.
on 6/14/19 12:34 am
Topic: RE: New Insurance - wanting a revision

What Julie said about insurance, especially Tricare. Call them and if they do say they pay for revisions I'd have them send you something in writing verifying that. Policies change all of the time and can be misinterpreted even by a companies own agent.

Do you know if you've got anything mechanically wrong up in there? Like a stretched stoma or some such that would support your request for a revision? And do you have any idea what you'd be revising to? As Julie also said, revision options are limited after an RnY. You've basically got the Distal RnY which is a scary bad surgery in my opinion. Or you've got the stoma-tightening type surgeries like the ROSE procedure which basically produce an average loss of about 30 pounds. And I guess I shouldn't forget Band-over-Bypass.

In the end though, no matter how many revisions a person has, we are always going to get to a point where we have to face down that regain monster. Regains happen with ALL surgeries, even with the DS. Eventually we are back the starting point: calories in vs. calories out.

Good luck to you in finding your insurance coverage and making your decision. You're in a tough spot for sure and I wish you the best.

Sparklekitty, Science-Loving Derby Hag
on 6/13/19 9:05 am
RNY on 08/05/19
Topic: RE: New Insurance - wanting a revision

Every insurance company and plan is different, so none of us can know what your plan covers. Call the customer service number on the back of your card to ask them.

If your plan has a "one surgery rule" and no coverage for "medically necessary" revisions, you're likely out of luck. You can look into self-pay for a revision surgery, including lower-cost options in Mexico.

What type of revision would you want? There's not much of anywhere to go with an RNY without running into some pretty serious risks. Some people have had their stoma stitched more tightly, but that doesn't often result in much weight loss.

You can also try going back to basics-- logging food, limiting calories and carbs-- to use the pouch that you already have.

Sparklekitty / Julie / Nerdy Little Secret (#42)
Roller derby - cycling - triathlon
VSG 2013, RNY conversion 2019 due to GERD. Trendweight here!

krisinga
on 6/13/19 7:39 am
Topic: New Insurance - wanting a revision

I had a gastric bypass in 2009 (starting weight was 330 and lost down to 150). 10 years later and several illnesses as well as chronic pain (and let's face it... LIFE) and I'm almost 30 pounds heavier than my surgery sw.

Question: I had CareFirst for my original surgery. I am now with TriCare Select. Does anyone know if TriCare would cover the revision even though they have a "1 surgery rule"?

I have a consult with a surgeon (I'm in Augusta, GA) and they are going to do the legwork on the insurance; however, I'm trying to find out if someone has had this situation before I get my hopes up.

Any help would be greatly appreciated.

marlab64
on 6/12/19 2:12 pm - Bucks County, PA
Topic: RE: Lap Band Revsion insurance approval/appeal

This is me EXACTLY!!!!!!! I have gone year after year to get denied. I am NOT giving up this time and taking it as far as I have to.

Thank you for giving me hope!

sparty
on 6/11/19 2:52 pm
Revision on 08/16/18
Topic: RE: Lap Band Revsion insurance approval/appeal

I would work with your surgeon's office and getting them to make the case that the revision is medically necessary. They really need to know all of the side effects and complications you're experiencing ****pt a list on my phone since it was easy to forget about all the little things I have just learned to live with over the years that were not normal). Make sure they understand how miserable you are, how it's affecting your life, emphasize how your current tool isn't working as designed and that you need a solution to the issues and complications you are experiencing. They should be your advocate and help with your insurance company.

I had the same insurance requirement and I had similar issues with frequent stuck, vomiting and GERD. Year after year I would go in and they would run tests, confirm I didn't have a slip or any mechanical issues so I figured there was no chance to revise. I finally gave up and had just had them empty my band, even though that did not resolve my issues. I went back after 3 years since I was still having issues stuck issues daily and really pushed for them to help me. I made it clear I wasn't going anywhere and that I wasn't going to just deal with these issues for the rest of my life. They helped me pursue a revision and when my insurance initially denied it they did a "peer to peer" with my insurance company and it got approved.

Good Luck!

Band to RNY 8/16/18

Age: 33, Height: 5'4"

HW: 299 (Pre-LB), RNY Consult: 260, SW: 248, GW: 145 (reached 3/31), New Goal: 130, CW: 133.0

Pre-op: -13, M1: -20, M2: -15, M3: -15, M4: -15, M5: -13, M6: -13, M7: -9, M8: -9, M9: -3, M10:

FeFi
on 6/10/19 4:35 pm - GA
RNY on 04/24/14
Topic: RE: RNY Revision Question/Concerns

Thank you very much for your feedback this is what I was looking for!

I've elected not to move forward until I research a little bit more.

Again, thank you so much for your valuable feedback!

Felecia

rocky513
on 6/10/19 3:42 pm - WI
Topic: RE: RNY Revision Question/Concerns

The procedure you are describing is a Distal RNY. There are lots of studies about this revision online.

You may lose weight with this revision, but many people have issues with chronic diarrhea and vitamin deficiency from malabsorption.

If you go through with this surgery you will need to be hyper-vigilant with taking your vitamins and having frequent blood work.

HW 270 SW 236 GW 160 CW 145 (15 pounds below goal!)

VBG Aug. 7, 1986, Revised to RNY Nov. 18, 2010

Sparklekitty, Science-Loving Derby Hag
on 6/10/19 8:37 am
RNY on 08/05/19
Topic: RE: RNY Revision Question/Concerns

If you don't know if this is "OK," you need to have a conversation with your surgeon ASAP, or get a second opinion.

They should be able to talk to you about potential side effects as well.

Sparklekitty / Julie / Nerdy Little Secret (#42)
Roller derby - cycling - triathlon
VSG 2013, RNY conversion 2019 due to GERD. Trendweight here!

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