Question:
Apparently I have a failed surgery with no insurance need advice?

I had a VBG in June of 2002. I weighed in at 303 and now weigh 250, thats a loss of about 50lbs in 1 1/2 years. I am beginning to see the scale creep up. My states Vocational Rehabilitaion paid for my surgery, I have no insurance. I started complaining to my surgeon about the excessive amounts of food I could eat within weeks of surgery. He blew me off until about May of this year. He said it sounds like a staple line disruption and wants me to have an upper GI. Voc Rehab will not pay for the test and I can't pay for anything out of pocket! My surgeon said "don't bother paying for the test yourself if you can't pay to get restapled". I just feel like I'm getting screwed and I don't know if there is anything I can do about it. What would you do? I'm not asking for diet or exercise plans, if I could do that I would've never needed surgery. My surgeon told me I have a failed surgery.    — LaKeAffy (posted on December 29, 2003)

December 28, 2003
Dont feel bad, my surgeon says the VBG failure rate is 80% over 5 years:( I fail to understand why surgeons continue doing this surgery since it has such a bad track record. How about getting a job that has insurance that pays for WLS? Like home depot? Its sad your surgeon is setting up people for failure.
   — bob-haller

December 28, 2003
LaKeitha, I've got several friends who were conversion surgeries from VBG to DS for this very reason. There's a Yahoo group where you may find some support and information - the URL is: http://groups.yahoo.com/group/DS_Revision/ If you need email addresses of people who have gone the same route you have, let me know, okay? Is self-paying for a conversion surgery a possibility for you? You'd be amazed at how affordable it is - particularly if you own a house or have a retirement savings - it's tax-deductible, as well, and if retirement funds are used, they can be taken without tax penalty in many cases. For more info, see www.bodybybaltasar.com Many blessings, dear one! dina
   — Dina McBride

December 29, 2003
But if the test were to come back would they pay for the surgery? I would see if Medicaid or some other agency can help also.
   — snicklefritz

December 29, 2003
It should fall back on Voc. Rehab. Contact them
   — sherri parker

December 30, 2003
I just had to answer Bob Haller on this one. Even "if" she got a job with insurance, there are VERY few who would do a revision for her and approve it after another insurance company paid in the first place. First of all, she has obviously seen her doc about this in the past year so there will most likely be a year wait for the insurance to even cover office visits for this. It's pre-existing. Again, this is why I stay online and answer some questions (aren't you all just so lucky lol). There are so many people who had the surgery, be it VBG, RNY or DS and then for one reason or another, have had post op problems with their surgeons. Many of the docs just don't want to deal with them. There are soooo many good docs out there who care, but some of us, me included, ended up with duds. Just to let you know, mine was on the board of EVERYTHING, well known and well respected when I went to him 4 years ago. His aftercare program though, was a joke. At that time, I honestly didn't know the right questions to ask before surgery. Now I do and I stay to make sure that preops ask them and research first and formost. Even with research, these problems can happen and some people just don't know where to turn like this poor woman. To me, voc rehab should be footing the bill. They okayed the surgery and they need to pay for problems post surgery. I, personally, would find a lawyer for this. It's not right to just throw this poor woman to the wolves and say "oh well" we did the surgery for you, now if you get sick or it doesn't work it's not our fault". That's ridiculous! If they thought she needed this surgery, then she certainly needs to stay healthy for it to succeed. If it's not succeeding, they need to correct the problem. I wish this woman nothing but luck and blessings and I hope that you find an answer for this. Hugs
   — Barbara H.

December 30, 2003
Barb I couldnt agree with you more. I was only trying to be helpful suggesting how she could get insurance. But personally I think the VBG should be replaced by the lap band. Its easier, reversible, and adjustable. I also think docs should all transect because of the number of posters here whos VBG or staple line fails. BTW these opinons are my surgeons as well. Voc rehab should foot the cost. or the surgeons insurance since it appears the surgery had troubles from the begining.
   — bob-haller

January 2, 2004
I have been inactive on this site for quite awhile, so probably won't see any replies or corrections to my post if anybody makes any, but I did want to briefly respond regarding Barbara and Bob's issue, just in case there are interested parties out there. I don't claim to be be an insurance expert anymore, but worked at Humana for 10 years in the past so have a little background. In most states, as long as you've had continuous coverage (without a gap in coverage for, say 90 days or something like that), 'pre-existing' does NOT apply as long as you enrolled for coverage with your new employer within the open enrollment period (usually within a specified number of days of employment, such as 30). However, this doesn't hold true if you at first deny coverage with a new employer and then decide 6 months later that you want it. Then, all bets are off and pre-existing conditions are not covered. Unfortunately, since the original poster of this post didn't have coverage to begin with, this probably won't apply.. So sorry, but keep your chin up!! I had to pay for my surgery out of pocket due to a written exclusion in my policy. I'm happily still paying for it each and every month, because I know it was worth it and I found ways to finance it. Where there's a will, there's a way!!
   — gina C.