Accidentally reverse an approval by changing surgeries?

[ready4it 8]

Am I freaking out too much?

In June my dr's office submitted a request to my insurance for the lap band. I'd requested the RNY, but they thought I would have a better chance of approval based on my lower BMI and lack of co-morbidities. I was denied. On 11/27 my insurance approved me because my BMI was now 40. I hate to admit it, but I'd gained the weight I lost during the medical center's approval process (+ more) and was now eligible for the 3 main surgeries. The nurse coordinator asked what surgery I wanted and I said the sleeve because I thought it was the right choice for me. She said she wasn't sure because I'd had a history of gerd. I hadn't been having issues recently so I stood by my choice. I was scheduled for 12/10, then rescheduled for 1/10/13 due to conflicts in the surgeons schedule. However; in the last week and a half, my gerd has started really acting up again. I started getting nervous about it and kept going back to research the sleeve. Called the surgery coordinator this week to discuss if I should go sleeve or RNY-the nurse told me that any patient of theirs suffering with gerd only got worse after getting sleeved. They were not sure my insurance would cover the RNY, so they had to submit it back to insurance again. Now I'm super nervous that I shot myself in the foot, won't be approved for the RNY and then can't get the sleeve either because they won't do it on me. I feel like for me, the band would be a big waste of my time-but am affraid that will be the only option. Did I screw this up for myself?

[atelux17 135]

It is a very personal choice, but I would not get an RNY. As a nurse, RNY Patients come back in with. dehydration, nutrient deficiencies, fistulas. If u are addicted to sweets, then maybe.

[IsB 209]

My surgeon told me that he will not do the sleeve for anyone with gerd and that he always tells them to get the RNY instead.

As for the insurance you should wait and see what happens before freaking out. 40 BMI is the magic number. From my experience it doesn't matter which procedure you chose if you are over 40. Good luck

[fonally 107]

I'm approved for sleeve on 1-9-12 but now the cardiologist brought up my gerd. Does anyone with GERD have a sleeve ? Is it bad?

[ashleymullen 1]

I can understand your anxiety. I am in a similar situation myself. When I originally met with my surgeon I was planning to get the Lap Band. However, during my meeting the nurse I spoke with suggested that I get the sleeve instead because they felt it would be more beneficial to me. When the office submitted my info to insurance, they had submitted for the Lap Band even though I had decided to have the sleeve instead. Two weeks later I received my approval letter but my surgeons office had to resubmit since I was no longer having the lap band. I was told by the coordinator that it shouldn't take as long for the second approval (for the sleeve) since I was already approved for a similar procedure, that they would basically just change the procedure code in the system. However, it has been a month since they resubmitted and neither I nor the surgeon's office has received any reply from the insurance company (Anthem BCBS of GA). So, now I'm worried that I've put myself in a bind and insurance won't come through before my January 14th surgery date!

[GeorgiaLady 4]

I have GERD and I got the sleeve. I even had gastric polyps from PPI use. I have not had any problems except when I forget to take my PPI. My reflux was and is controlled on Protonix. I was never told that there would be/ might be a problem. I am 5 1/2 weeks post op.

[missymellie33 1]

It is a very personal choice, but I would not get an RNY. As a nurse, RNY Patients come back in with. dehydration, nutrient deficiencies, fistulas. If u are addicted to sweets, then maybe.

I agree! I have researched that GERD can still be a problem with RNY, so why deal with malabsorption, dehydration and all that plus still possibly struggle with GERD?

From what I understand you take a chance having GERD no matter what wls you choose. I have it and neither my surgeon nor my cardiologist was worried, as I really don't have symptoms now. I may have to take something post-op according to my surgery packet. Any who, you might want to find out why your surgeon will or will not before the sleeve on you because of GERD, getting a second opinion probably wouldn't hurt. Sometimes we have to fight for what we want/need. Please keep us posted. I am sure everything will go well with you.

Kind regards,

Missymellie33

[ShrinkyDinkMe22 376]

I to had Gerd prior to sleeve. My, surgeon did an egd to make sure there was no damage to my esophagus, stomach, and duodenum. Once that was ok it was submitted to insurance for sleeve and got approved. I have to take a ppi for 3-4 months post op and then maybe try to get off them a d see how I do. Hope you get it figured out.

[thenewme@32 40]

Can someone tell me what is a gerd?

[GeorgiaLady 4]

Can someone tell me what is a gerd?

Gastroesophageal Reflux Disease