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How to win an insurance appeal?
Cabelltech replied to Cabelltech's topic in Revision Weight Loss Surgery Forums (NEW!)
Unfortunately, I think having a revision does seem to make a difference even though I had weight loss success with the band. I always vomited with the band but I was twelve years out before the vomiting was happening during the night while I was sleeping. That is very scary and the main reason I chose to have it removed. -
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15+ Years with the band - Sleeve revision scheduled - What do I need to know?
liveaboard15 replied to WillyC's topic in Revision Weight Loss Surgery Forums (NEW!)
Foamies is more of a gastric bypass thing. I had sleeve 2 months ago. idk what restrictions you have on the band. but for us mainly small meal sizes... Protein is first and most important, waiting 30+ minutes after eating to drink anything. taking the multivitamins, calcium for life, and the possibility of developing severe GERD and needing a revision to bypass is a big thing and something i worry about. If you have GERD or heartburn then bypass will be what you need to get. -
Hi All - I'm sure this has been asked and answered - but here goes: I was banded in January of 2007 and had pretty good success with it. I lost 140lb - and maintained my weight at around 230-240lbs (I'm 6'2") for many years but after COVID lockdowns my weight started to creep back up to around 260lbs and I developed night coughs/reflux. I went to my surgeon a couple of months ago and he unfilled me which cured the reflux, but I immediately gained 10 lbs. He also did an endoscopy to make sure nothing was wrong. During the endoscopy he discovered I had a hiatal hernia and minor slippage with no erosion but he recommended that I consider removing the band and revision to a gastric sleeve (which I've agreed to do in order to be proactive and avoid any emergency complications if I do develop any erosion or other issues in the future). So my question is - what do I need to know about the differences between the two? I'd managed the band pretty well - occasionally dealing with PB's, sliming, and other fun - inconvenient but nothing I couldn't handle. I've read a couple of comments talking about foaming (or something)? Just want to make sure I'm going into this with my eyes wide open. Thanks in advance for any helpful hints! -
November Surgery Buddies!!!
Neubian60466 replied to Tristenhilpert97's topic in Gastric Sleeve Surgery Forums
Congrats on your wl, you are doing great. I’m 7 months post bariatric revision and have lost 79lbs to date. I’m officially stalling been 180-181 for almost 3 weeks now. This is longest stall I’ve had and starting to wonder if I’m done losing?? Got a couple more months to go to reach a year and my projected wl is 100lbs.. I hope this stall breaks this week!!! -
Once per lifetime max on anthem bcbs
liveaboard15 replied to shiannajohnson's topic in Revision Weight Loss Surgery Forums (NEW!)
Probably not going to get around that. I have thought about that too since my state excludes all bariatric surgery. and i am hoping i never have heart burn issues but if i ever needed a revision to bypass my plan would be to move to another state temporarily, Set up residency, Get insurance, Get the procedure done and move back. Yea lots of work but $20K+ for revision is too high for most people to pay out of pocket. I paid $19K for my sleeve out of pocket andi am out of money lol -
Need hiatal hernia repair and RNY revision
RickM replied to comtemplating's topic in Revision Weight Loss Surgery Forums (NEW!)
You are right to be looking around for second and third opinions when contemplating a repair and possible revision with a higher than average complexity. If indeed you are in the "gained it all back, plus" camp, then the traditional RNY fixed probably won't be strong enough to do the job, and adding in the hernia and additional scaring compounds things. The surgeon I would suggest looking into would be Ara Keshishian, who is in the Glendale/Pasadena area of So Cal. He is one of the handful of surgeons who can do the complex RNY/DS conversion, should that me necessary, and I have seen some on these forums who have had some fairly involved RNY reworks from him (though his preference is usually to go for the DS if it makes sense.) Rumor has it that he isn't dealing with insurance anymore (haven't verified that, though,) so if that is an issue, another good choice to talk to would be John Rabkin in SF, who is similarly qualified in complex procedures., As both have long drawn patients from around the country (and beyond) they have long routinely been able to do their early screening discussions and longer term follow ups remotely. Another doc I would talk to if you want to look East would be Mitchell Roslin in NYC; he also seems to have a very deep toolkit, capable of doing a number of different procedures as appropriate Most bariatric surgeons are pretty good at doing RNYs and variations of that, but don't go very far beyond that, and it sounds like you need someone with rather broad (and deep) skills to get what you need. Good luck,,,, -
How to win an insurance appeal?
Recidivist replied to Cabelltech's topic in Revision Weight Loss Surgery Forums (NEW!)
My insurance company initially denied coverage for my RnY. I had my surgeon contact the company directly to explain why I needed the surgery and that did the trick. (Mine was not a revision, which might make a difference.) -
Not sure if this helps but I had VSG in Feb 2020 and never had any problems with GERD prior to surgery. Since my surgery I have terrible GERD and am now getting ready to have a revision to a bypass. Also, I only lost 40 lbs after my VSG. Wish I had just had the bypass to start with!
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How to win an insurance appeal?
Cabelltech posted a topic in Revision Weight Loss Surgery Forums (NEW!)
I have been denied coverage from BCBS insurance company for requesting lapband to bypass revision. Because they can find nothing wrong with my band, they won’t do the surgery. Even though the band is okay, I’m not. It has caused esophageal dilation and dysmotility. I lost weight with the band but I was vomiting a lot at night. Id wake up from a dead sleep vomiting out of my nose and mouth at least three nights a week. Very scary due to possibly getting that into my lungs. Has anyone else filed an appeal that was accepted by insurance? -
Need hiatal hernia repair and RNY revision
comtemplating posted a topic in Revision Weight Loss Surgery Forums (NEW!)
Just found out I need a hiatal hernia repair surgery. Had an upper Gi and the dr said stomach is very small and had a hard time "finding it". Also a lot of scar tissue. I am 6 years post RNY (12 yrs post gastric banding). I kept my 75 lb weightloss off until covid. I lost additional weight during covid due to stress and trauma and now I have gained it all back and then some. So in addition to needing the hernia repair surgery, I want to discuss revision surgery. I am having trouble swallowing pills without them getting stuck, have GERD, and have pain when eating. I am trying to find some names of surgeons to research. I am in Arizona but will travel. The surgeon that I have met with has said this isn't going to be an easy surgery and they won't know exactly what they are dealing with until they get a full look. Anyone been through something similar and have a dr. they can recommend? -
Weight loss expectations VSG to RNY??
mi75 replied to mi75's topic in Revision Weight Loss Surgery Forums (NEW!)
yes planning on it. see my GI doc in a week. I haven't seen my original surgeon in 7 years- I had to switch to another clinic because of insurance purposes and will discuss with my GI doc which surgeon would be better for the revision (now that i've switched to a BCBS plan they both take).... GERD is still terrible. -
It's been a little over 7 months from my surgery (revision from sleeve to bypass) and this morning I stepped on the scale and saw I made it down to 1derland! This comes after a bit of a stall for a week or so, so I just wanted to share and encourage those who are either considering the surgery or are struggling to get through a stall that this does work and if you keep up with your tracking and weighing food and watching what you're putting in your body, it will work for you too!
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RNY to Sleeve or revision of RNY
catwoman7 replied to Tarah Roy's topic in Revision Weight Loss Surgery Forums (NEW!)
yes - you can reverse an RNY. However, they usually only do it for serious medical issues that can't be resolved any other way. I'm not sure why you'd want to go from RNY to sleeve, though, since RNY is a stronger surgery. Unless you don't really want to lose more weight (you said you've put on 60 lbs) and are more concerned about getting stomach acid back (not sure why you'd want this - plus GERD is a potential risk of sleeve). I've heard of people having RNY revised to DS, when they reverse the RNY, create a sleeve, and then do the intestinal bypass part of the DS - but very few surgeons are qualified to do this. I would probably consider some of those surgeons, though, since they'd have the most experience (even if you just want the sleeve part). -
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RNY to Sleeve or revision of RNY
Tarah Roy posted a topic in Revision Weight Loss Surgery Forums (NEW!)
I had RNY over 12 yrs ago and lost all of my weight due to surgery. Lost so much that I looked horrible, I was down to 130 and my body frame cant be that low. I had to force myself to gain, I got to a good weight 145-155 is my best range. I had gained about 60 lbs, then lost 20-30 lbs. and plato. I want to get back to a healthier weight, would like to have a revision if possible. Can you go from RNY to the Sleeve or only do a revision of the RNY. I would prefer to do a sleeve to get the stomach acid and nutrition back. I know at one time they said once you get RNY there was no way to reverse it, well that was 12 years ago. My surgeon unfortunately I am no longer with that Medical group. So need to find a great one in Georgia (Emory, Northside Hospital). Any Info would be great, I have also read some people have gotten a burning sensation; which recently started for me however, have been dealing with some stress. thank you. :) -
As @catwoman7 said some of those changes you mentioned are just temporary. Like hair loss usually persists for about 3 months & your hormones settle once you’ve lost most of your weight (oestrogen is stored in fat so as you lose all the excess oestrogen is released into blood stream). Large weight regain can occur because of complacency & people slipping back into old eating habits. It can occur because how they were eating wasn’t sustainable &/or was too restrictive. It didn’t allow them to live their life as they wanted & hindered them doing what they enjoyed. Or they didn’t do the head work to understand & learn to manage their old eating behaviours & what drove them to eat. All things the surgery doesn’t do anything about. But it does give you the time to explore these factors. Also remember the average weight loss at about the three year mark is 60% of the weight that had to be lost. This can include the bounce back ‘resettling’ weight gain, complacency & adjusting to a more flexible eating plan. Or it could just be the weight your body is happier at. Sure there is always a chance to develop an issue that has to be monitored but it’s rare. Comparatively, there are very few complications from weight loss surgery. Some of the issues may not have anything to do with the surgery. I have a protein malabsorption issue. Not from my 3 yr old sleeve but from my gall being removed last year. (Malabsorption issues are very rare with sleeve.) I have low BP. I had a genetic predisposition before surgery now it’s all the time because of my lower weight not the surgery. Gerd is probably the highest risk after sleeve - about 15-20% I believe. But it can be managed or treated by a revision to bypass. Some issues may be revealed because you likely are being monitored medically more closely now then before or your weight & associated comorbidities may have been masking what were pre existing conditions. You’ll likely read & hear about people with problems because they they post to seek help & support. They don’t often post about what the cause was or the remedy. In comparison, people tend not to post or talk about their successes. I know many people who’ve had the surgery. No one has experienced long term or developed new issues because of the surgery. A couple regained most of their weight because they went back to their old eating habits. Certainly the benefits far outweigh any temporary side effects or the very rare problem.
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I have always had high blood pressure, but after my recent revision in August of last year, about two months in, my blood pressure dropped. Stopped taking Lisinopril. 8 months after that my BP is still on the low side. I hope it stabilizes after I go full maintenance because sometimes when I stand I feel dizzy. Sent from my SM-S908U using BariatricPal mobile app
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Ugggg, I forgot how much the preop diet sucks. I'm being revised from a lapband to gastric bypass on July 6. My band has been unfilled since December, so I've been able to eat normally since then. My current surgeon has me doing two weeks of shake for breakfast, shake for lunch, healthy choice steamer for dinner. Last time I did all liquids, staying under 20 grams of carbs, but it was only for a week. From what I remember, the first days of the preop diet are the worst and then I kinda got numb and it wasn't so bad. But I'm in the thick of it now. And staring down two full week of this is daunting. I made it last time, I'll make it this time, but just uggg.
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My VSG revision to GBP went smoothly. Arrived at 8:45 am and went home at 6 pm. I was happy not to stay overnight because it’s hard to sleep and every time you do sleep, the nurses want to wake you up. Unfortunately sleeping at home wasn’t much better. I couldn’t get comfortable. Pain is tolerable, more uncomfortable. Gas seems barely there. I was able to belch a bunch before I left to hospital. Goal today is to get my liquids in. Hope everyone is else is doing well.
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Weight loss expectations VSG to RNY??
SOHLCRU replied to mi75's topic in Revision Weight Loss Surgery Forums (NEW!)
Well I had my nutrionist appointment yesterday and there is a different process for revisions. So from my understanding I'll have to have an EGD done to see the effects of the GERD. Then I have to meet with the surgeon and see if I qualify. So far since I have written the original post I have lost 10lbs and will just keep on trying my best. So hopefully I'll get some more clarity within the next few weeks. -
Rny patients....& Taste change
Starwarsandcupcakes replied to KatyC2922's topic in Gastric Bypass Surgery Forums
At almost 2 years post revision I still can’t walk down the baking aisle or the candy aisle at the grocery store because the smell of sugar really bothers me so anything I need for baking I have to order for pickup. After my sleeve I couldn’t drink anything besides protein shakes and grape powderade zero and I hated anything artificial grape before surgery. After my revision from GERD thankfully that went away and I could enjoy actual water again! Everything else though was just temporary but I do find I enjoy baby kale now. -
Same here. My revision was Dec. 3. I have only lost a total of 41 lbs. I eat right, etc. I had a appointment with my nutritionalist. She said I was fine. Try and eat a bit more but I drink and eat at least 50-70g protein a day. Go figure.
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Lap band Revision to GSV- painful open wound
JFizzle posted a topic in Revision Weight Loss Surgery Forums (NEW!)
Hi All, I had a lap band removal and revision to the GSV on 6/6/22. The GSV laparoscopic scars healed/ scabbed over quickly, but the large cut/ open wound left to heal after the lap band removal is super painful and gross. It is deep, has to be packed with sterile gauze and dressed every 1-2 days. My doctor says it’s healing nicely and that pain is just part of the process. I have googled and not found any information on this process. Has anyone else had the revision and had to deal with the open wound? Are there any other options like wearing a drain? This pain is worse than my 2 C-sections! I feel like this part was glossed over and not even addressed in my pre-op visits! It feels so weird and disgusting walking around with an open wound. Any tips or suggestions would be greatly appreciated.- 2 replies
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- Lap band revision
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Can someone recommend a good doctor for revision of gastric sleeve here in Dubai please.
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It’s definitely tough but you can do it! There is so much variation among practices and even case by case. I was given clearance to eat/drink at the same time after I asked for a definitive answer. For my specific circumstance it was ok because I had a stricture dilated (after VSG to RNY revision) and my anastomosis wasn’t going to stretch any further than they forced it during the procedure. I was told that the concern is sleeve/pouch stretching earlier than it would take to naturally relax.
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Looking to see if my Dr. Will do the revision because of my Gerd
RickM replied to lavette43's topic in Revision Weight Loss Surgery Forums (NEW!)
Going to your original surgeon, if you are still in the same town, is a good start, but that should only be a start. As Tomo suggests, getting a second (and third, even,) opinion is a good idea, particularly for a revision where the needs and solutions are more varied than the original surgery. Talking to a non-surgeon or two (such as a gastroenterologist) is also a good idea as there may be some non-surgical interventions that can do the job, and it is usually preferable to start there anyway, and then consider surgery if those don't work. Be suspicious of a surgeon who immediately tells you that if you have a sleeve, with GERD, that you need a bypass revision, without first doing some tests to find out what's really going on inside you. It may be a hiatal hernia which commonly causes GERD in WLS nd non WLS people alike, and that can be repaired without going through a revision (though some surgeons may not be comfortable or capable of doing so, or it can be a poorly shaped sleeve that inhibits good flow, and that can often be resleeved to correct that (though I probably wouldn't be depending upon the original surgeon to fix that, as it implies technique issues with the original surgery.) In short, don't be too quick to self diagnose - let the professionals do that (though it pays to be well educated on it,) and play the field to get multiple opinions - they all can have somewhat different background and experiences, and that drives their opinions; don't settle for the first one that you come across. goo luck in sorting this out....
