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Revision Denied by BCBS of North Carolina
catwoman7 replied to Liv_94's topic in Revision Weight Loss Surgery Forums (NEW!)
I don't know about this company or policy in particular, but many won't approve revisions for weight gain. Some, however, approve them if there are medical issues. Since you've had issues with GERD and high blood pressure, that *might* be enough for some companies -but again, not all companies approve revisions. I wonder if a doctor could have a peer-to-peer review with them. Although your current surgeon isn't in your network, so that might be an issue - is there a bariatric surgeon who's in your network that you could do a consultation with? -
Revision Denied by BCBS of North Carolina
Liv_94 posted a topic in Revision Weight Loss Surgery Forums (NEW!)
Hello everyone, I’ve gone through the long process of trying to get a revision surgery after gaining most of the weight back after having the sleeve in 2014. I’ve had mental health issues in the years following and also developed GERD and High blood pressure in the recent years since. The insurance company (BCBS of North Carolina) has been giving me issues from the start first saying that my surgeon wasn’t in network so they wouldn’t cover the surgery. Upon further investigation from my doctors office the real issue was them denying my claim for a revision because there was a lack of evidence showing that I followed proper diet and exercise after my first surgery. Has any experienced something similar? I have the two comorbidities and my bmi is currently 45 so I’m just kinda in shock they denied me especially without even informing me. -
Anyone have the Mini gastric bypass (MGB)
Isabel1246 replied to LMorales's topic in Gastric Bypass Surgery Forums
Thanks! I was a sleeve revision to mini bypass at 286 and thankfully its really moving so far -
Weight loss meds after surgery!
Tomo replied to carpeediem's topic in POST-Operation Weight Loss Surgery Q&A
I was given one month of Lomaira at about 6.5 years after vsg, right before my revision for gerd. I was worried about the side effects of phentermine. I was supposed to take it 3x a day. I took half of a pill (it worked) in the afternoon, not every day, when I got cravings. I have heard good things about Ozempic. I bet it is a lot safer than phentermine which is the common go-to drug they give wls. Glad you found something that works for you. -
Anyone have the Mini gastric bypass (MGB)
Isabel1246 replied to LMorales's topic in Gastric Bypass Surgery Forums
I was a revision which means weight loss is slower, but I am 5'4" and started my journey at 286 lbs and today I am 246.3. I am 1-month post-op. I'm using the 3 patches that the bypass patients use plus one multivitamin. -
Having GERD. Will insurance cover revision if BMI IS 31?
Tomo replied to NewlySleeved12282020's topic in Revision Weight Loss Surgery Forums (NEW!)
Having gerd was enough for me to get the revision covered. When I first went in to speak to my current surgeon, I had a bmi of 28. He advised to get the revision ASAP. Unfortunately, I didn't. I was so scared to get the bypass. Also, I was content with my weight loss (bmi 60+ to 28, steady for many years) and thought I could control the gerd with PPIs. I couldn't. I suffered terribly for years after that. Looking at it in retrospect, I was silly. Best thing I ever did. -
Looking for a November surgery pal
JamieKatrina replied to Needtogethealthy's topic in Gastric Bypass Surgery Forums
@Barihopeful- sorry for the late response. I’ve been sooo tired. Haven’t been feeling my normal energy or self lately. I’m loosing inches. Afraid to get on the scale just yet. When I went to my post op appointment I was down 16 lbs including preop lost. I will weigh in on the 9th. Exactly one month. How’s everyone doing with their liquids? I’m not hungry and finding it to be a chore to eat and drink lol oh btw this is a revision from Sleeve to Bypass with a hernia repair. -
I just had my revision surgery from a Lapband to a Gastric Bypass. I am 11 days out and have lost 8 pounds. Is this normal?
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March 2022 Surgery Buddies
Kimsmom replied to LilaNicole20's topic in PRE-Operation Weight Loss Surgery Q&A
Doing great. Down 40 pounds. Since Im a revision.. weight loss a little slower but all is well -
Having GERD. Will insurance cover revision if BMI IS 31?
Dee Steppe replied to NewlySleeved12282020's topic in Revision Weight Loss Surgery Forums (NEW!)
I had the same thing, acid reflux terribly, weight gain just all around miserable. I had had the roux-n-y 15 years ago. I had called to check into the revision surgery and the first thing they did was an upper barium test. Low and behold I have a 2 1/2 cm fistula attaching my pouch to my remnant stomach. At that point, it became a repair of a complication instead of a revision. My surgery is coming up and I am so excited. Sent from my SM-G973U using BariatricPal mobile app -
November 2022 surgery support!
MrsRock5 replied to feisty one's topic in Gastric Sleeve Surgery Forums
How much did you lose your first surgery? What year was it? I’m post op day 7 today & am down 5. I kind of expected more also but I had a rough recovery, two units of blood & tons of IV fluids. I’m not surprised it’s taking so long for fluid to shift & things to get going but it’s still frustrating. My husband is a “trust the process” type of person & I’m more of a “beat the process into submission even if it kills me & my entire hometown”. That’s fantastic you had no pain. Did your same surgeon do this revision? -
Gastric Bypass Revision
catwoman7 replied to Ljthatguy's topic in Revision Weight Loss Surgery Forums (NEW!)
are you on purees now? If so, that could explain it. I'm have a "virgin" bypass, not a revision, but i didn't start feeling restriction until I moved on to solid food. Also, they likely cut some nerves when they were in there - it takes awhile for them to regenerate. -
On November 14th I had a gastric bypass revision. I had one incision that brought more pain than the others. Days later I found out that it was infected which led me now having to pack the wound daily. During the revision the surgeon told me he got rid of a lot of scar tissue from the previous surgery and fixed a hernia. The one thing I’ve have an issue with now is that I don’t feel the same restriction I felt during the first surgery and that scares me. It’s starting to make me feel like the revision didn’t happen. Has anyone experienced this ?
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Hi all, first time posting, a vet GBS 8 years out, on track for a revision to DS. Last time around I was part of a forum called “Thinner Times”. I see it when I google it but unable to get in. Did this forum cease to exist? Loving this forum but also wanted to check out a few others!
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Today is month 3 since surgery. All together I have lost 55 lbs and 36 inches. I need to start an exercise routine. I think that’s my biggest growth area. But I am definitely happy with my progress. Very excited about this. This is a revision for me and this time it feels very different. My surgeon said my weight loss will be slow but I don’t find that to be the case. I think I’m progressing just fine😊.
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Cardiac patients?
Starwarsandcupcakes replied to Capri81's topic in PRE-Operation Weight Loss Surgery Q&A
I’m almost 3 years post first WLS (and a little over 2 after revision because of gerd). I have a small PFO and a bicuspid aortic valve (diagnosed while getting cleared for WLS). I have PVCs and SVT in my medical chart due to sepsis from a bowel obstruction. I can’t take metoprolol because my resting blood pressure is too low to support it so I get yearly echos and see my cardiologist twice a year. -
Having GERD. Will insurance cover revision if BMI IS 31?
NewlySleeved12282020 posted a topic in Revision Weight Loss Surgery Forums (NEW!)
I have been having terrible reflux. The dentist says I have corrosion on my back teeth… I have an appointment with my bariatric doctor to discuss an endoscopy to take a look at things in there. I’m hoping a revision will fix it. I have Blue Cross Blue Shield. On their website it says BMI of 40 or 35 and higher with medical conditions. I’m at a 31. I’m worried that they won’t cover the revision. Does anyone else have BCBS and needed a revision due to reflux with my BMI? I just want relief!- 15 replies
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Tips for getting into the revision mindset
GreenTealael replied to ryan_86's topic in Revision Weight Loss Surgery Forums (NEW!)
I’m not a good reference for weighloss after revision because I had the revision when I was at goal but the preop and stress of surgery led me to lose 10-15lbs. (I worked to regain that weight as my surgeon did not want me to lose any additional weight) -
Postop
SeattleLady replied to incredibleshrinkingnurse's topic in Revision Weight Loss Surgery Forums (NEW!)
I am trying to read everything about revision. It's not 100% every time according to some accounts. However, most likely it will be better than before. Good luck to you and keep us updated! Sent from my SM-G996U1 using BariatricPal mobile app -
Tips for getting into the revision mindset
SeattleLady replied to ryan_86's topic in Revision Weight Loss Surgery Forums (NEW!)
Did you lose weight after revision, (if yes) how much and how long did it take? Thanks so much! Sent from my SM-G996U1 using BariatricPal mobile app -
Postop
incredibleshrinkingnurse replied to incredibleshrinkingnurse's topic in Revision Weight Loss Surgery Forums (NEW!)
My father never had surgery but suffered from GERD as long as I can remember. He was diagnosed with esophageal cancer last year. That’s what motivated me to get this done. Before surgery I was also on pantoprazole twice daily and still taking tums and GasX daily too. I also wear a CPAP and had unbearable aerophagia every morning. That’s ultimately why I chose to go through with it. My sleeve didn’t help me much with weight loss but I lost 70 lbs earlier this year between the nausea and vomiting! As I type this I just woke up with similar but milder symptoms and I’m 10 days post op. I really hope it’s just due to the healing process! Everyone I’ve read about says all symptoms of GERD disappear after revision -
I think some policies will cover revisions if there are medical reasons - and GERD would be a medical reason. You'll have to check with your insurance company, though, to see if it'll be covered.
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Just curious if insurance will cover you if they want to do a revision from a sleeve to a bypass. 18 months out no weight gain buy having unbelievable GERD affecting my health.
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Worsening GERD do I need Bypass
liveaboard15 replied to Abbynormal4875's topic in Revision Weight Loss Surgery Forums (NEW!)
if you had GERD before. I am unsure why a surgeon would allow you to go thru sleeve and the sleeve can make that worse. getting a endoscope may be a good thing to get done that can see the acid and how your esophagus is. But those with GERD/heartburn tend to get better with bypass. That is why most that get the sleeve end up getting a revision to bypass because of GERD issues. -
Unfortunately what you experienced is exactly why few surgeons do lap band surgery anymore. A bad result does not necessarily mean medical malpractice. You had bad luck, just as I did. I had RNY>RNY revision last December 21. Ten days later I was airlifted back to the hospital with peritonitis and sepsis. My small intestine had split post surgery and everything I consumed was entering my abdominal cavity. I spent 7 weeks in hospital, had 3 endoscopy procedures, two open surgeries, and then spent 3 more weeks in a rehab facility. This was just about as bad as it could get: I was near death. However, I recovered without loss of any organs, limbs, or mental capacity. I never blamed my surgeon or the hospital.