Daja

I did not have to stop my reflux meds, ( thank goodness, as I was on 4). Quite frankly, a barium swallow will also tell them if you have Reflux, though it’s not always 100% accurate (but if your GERD is bad enough and the tech and radiologist is good it should show) and it not nearly as bad a test. If you appeal, definitely add in the poor quality of life, how much medication you are taking, and reiterate that it’s not for weight loss. If your dr is willing to do a peer to peer with the insurance company, that also helps. I included that my GI suggested surgery and told me there were no more medical management options available left to me, therefore, undergoing more tests to prove what we already knew undermined his professional opinion as well as that of the surgeon who agreed with him. I also insisted that a GI Dr review my case not any dr (insurance companies will use any dr available and I’ve had podiatrists and ob-gyn’s deny me because they are going by a list of requirements as opposed to knowing a disease condition) These are things that helped me get approved. Best to you and hope all goes well..

There are a couple different kinds of pH monitoring. Neither of them are pleasant, quite frankly. One of the tests involves that the tube ( an ng tube) be placed down your esophagus into your stomach via your nose and stay there for 24 hours. It monitors the acid that you have and your doctor will read the monitor afterwards; you’ll eat with it, shower with it, everything. The other PH monitoring test is usually done in the hospital and they also place an ng tube into your stomach via your nose and they spray some salt water into the back of your mouth and you are asked to swallow and then not swallow and it measures how strong or weak the lower esophageal juncture is. That is the test that I had done. For me, The machine also broke in the middle of the test. When I asked the doctor if I had to repeat it and he said no, I was so happy I almost cried, as it was one of the most horrible tests I’ve ever experienced in my life. The test they choose depends on insurance company requirements as well as what they think is the cause of your reflux is. Just excess acid or is there a possibility of an anatomical issue. For me it was both. And a paraesophageal hernia that was strangulating my stomach though that didn’t show up on any of the tests they did in advance, it was like surprise lol!

I went with a different surgeon due to insurance issues. Had major GERD issues with Barrett’s esophagus, my GI had me maxed out on PPI’s and did PH monitoring, EGD, and Barium’s swallow tests. All of this is usually required by insurance companies before they will pay for the revision. Sometimes GERD is caused by a change in the anatomy of the original sleeve (which was not the case for me) my Dr told me if that is the case they can use a ballon to change it to what it should be or try to resleeve rather than a revision to RNY. It’s definitely worth a consult before such a major surgery. Wishing you all the best…