I want a sleeve revision will Kaiser cover it if my initial surgery was in Mexico?

[SoCalGal77 7]

I am new to this site and im not sure where to post this. I had my sleeve done in Mexico in Nov 2012. I had a BMI of 40 and weighed 215 pounds. The surgery went good I think. I had nothing eventful that happened. The surgeon was ok, but nothing to brag about. The process was strange but I suppose the norm for mexico. I did not have any complications like others I have read about. In fact I was able to eat fairly fast after surgery and I only did a week of liquids and soft foods. I never felt very restricted from the very beginning. I think I could have done much better had I researched what steps to take after the surgery. But my reality is I never felt like it was a success because I could eat quite a bit from the beginning. When I first started eating soft foods I was able to eat 2-3 measuring cups before getting full, and a couple months out from surgery and I was eating a whole steak like 10 ounces. I did lose some weight but I think thats because I only ate Protein and took Vitamins and drank Water. I was always able to lose weight on all protein diets before but they are hard to maintain. I only lost 35 pounds total after the surgery. Fast Forward 4 years later and Im right back at the exact weight I was on surgery day 215. So it took 4 years to gain back 35 pounds but I exercise a lot and I am a major water drinker. I have also done this pouch reset thing several times and I used HCG and Atkins and B12 shots and other methods to try to get back some control and lose weight. I never lost anymore but all that effort slowed down the gaining. In the beginning I tried hard to stick with what I learned on my own like protein first and not drinking while eating. Thats a hard one because I had no restriction. I now drink sodas and beers and anything I want while eating. I graze all day and I have major major hunger pains. Not acid but hunger pains just like before especially after eating empty carbs. I wake up starving and I feel like I could eat all day long. I have pretty much given up and back to my old habits. I can eat a whole Big Mac Meal if I want to. I may not be able to eat 100% as much as I used to but damn near 85%. Like I said from day one when I didn't feel the restriction or anything that I read about and researched, I already considered my sleeve a failure from the get go. Once I stopped losing weight after the 3 months it really started to sink in maybe I didn't get a small enough pouch, maybe the Dr messed up, maybe I messed up.. either way I lost all motivation. anyway..

I now have a new job starting next month and they offer some pretty good insurance plans. I want to try this thing again the right way, with doctors to help me, and I want to do it in the U.S. According to the Kaiser info I meet the BMI and comorbidity requirements. I have not chosen my insurance plan yet but when I do I will make sure that Bariatric Surgery is on the list. I guess my concern is getting someone to do a revision if the original surgery was in Mexico. My other issue is I now have some left side pain that comes and goes and it hurts right over the main incision scar. It definitely feels like its my stomach area. I need a doctor to check me out and see if something is wrong. I have not once been seen by a Dr. or had any follow up care what so ever. Does anyone have advice or experience in getting a check up at a bariatric center and a revision to a smaller pouch if the original surgery was in Mexico. I live in southern California and I would like a place near by in the OC or LA area. Is my first step going to a general doctor and having a referral to a bariatric place? Does anyone have any advice on a specific Dr that I should try to see? Will I get turned down since I had a previous surgery in Mexico? I have zero documents or paperwork provided to me by the Mexico Dr. No matter how many times I emailed and called I got no where on that subject. I even sent money for a so called video of my surgery and never received anything. The only proof is my surgery scars. What are the steps should take to work towards a revision in the U.S. I would even take advice on which plan to choose. Any help at all.. Thanks in advance.

[KristenLe 5,980]

@@SoCalGal77 First of all, sorry you are going through this. I would definitely find a Primary Care Provider who follows you for general care. They will probably want to refer you to a GI doctor to have them run some tests to see what might be going on (endoscopy, etc.) - find out what the situation is with your sleeve before considering further bariatric surgery.

Best of luck! Hope they can help you!

[reducer623 137]

How horrible! So sorry that this has happened to you. Based on the information about your health you seem qualified but not sure how that would work w/ the previous Mexico surgery.

I recommend that you call bariatric surgeons within your town (or close) and explain your situation. They can give you the best advice & also as the previous person suggested, please do set up an appointment w/ a primary physician if you haven't done so. I'm sure you're due for blood work to make sure all of your levels are on target if you haven't been.

Best of luck to you!

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[SoCalGal77 7]

Thanks for the kind words. My insurance wont kick in for another 2 months. After that my main goal is going to be my medical needs. I haven't been to a doctor in almost 10 years besides for the 2 days I got Gastric Sleeve Sugery and he said my labs were just fine at that time and of course the dreaded Gyno which I pay out of pocket for.. Oh and one $15k trip to the ER from a Gall Bladder attack, that was before the Sleeve. Believe it or not I have not had a single gall bladder issue ever since the surgery and I was having regular attacks before that. The sleeve surgeon said he looked at my gall bladder and said it looked good so he left it in. Im 39 and I feel 59. I am miserable back at this weight, my ankles, and back from such heavy breasts, and my blood pressure feels like its through the roof. I am short 5'1" and I feel like a beach ball with legs. The depression took an all time low this year. Ive had so many issues starting with my fathers death, my aunts death, my step dads death, and coming to realization I was raised by a narcissistic mother who is also an alcoholic, all of this happening in one year. I also have this overwhelming feeling of guilt I spent the only savings I had to get the Sleeve surgery in Mexico and lost my job over it too when I had to take too many days off work for recovery time. I haven't had a decent full time job in 4 years and im now broke as a joke. That surgery money could have came in handy right now and it was a failure adding to my guilt. I have felt the depths of depression this year that I don't wish on anyone. This new job and insurance is my saving grace. That and I am moving 1600 miles away from the negative family members. I hope this is a new start for me and I really hope I can get some decent insurance coverage out of this. Even if I cannot get covered on a sleeve revision at least I can have all my other issues looked into. But I would really love a sleeve revision so I can have a chance to do it right.

[daniotra 298]

I agree with the person that said to ask for a referral to have your anatomy looked at. If there is something wrong, that can likely be fixed. I'm Kaiser NorCal, and they generally do not do revisions due to lack of weight loss or regain. Get checked out, but don't count on it.

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[emme.vee 142]

From what I read Kaiser doesn't cover revisions. BUT I also know that every Kaiser is different and every situation is different. It sounds like you had an entirely different procedure . I don't know if I would even mention WLS to the doctor but I guess you kind of have to to figure out what really happened.

I'm so sorry you're going thru all this. I am with Kaiser OC & I see a doctor in Santa Ana. Only seen her once and I'm pre-op right now, so I don't have much advice. Let me know if you want her info.

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[cindyw41 761]

Do you by chance have acid reflux? I know in some cases insurances will cover a revision from sleeve to gastric bypass If there is issues.

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[SoCalGal77 7]

I have mild reflux but im not sure if its significant. I take nexium in two week intervals when I feel it coming on strong. usually about every 3- 4 months I take a two week dose and it goes away for a long while. I have actually heard that a revision or a resleeve can make the reflux worse but I suppose it depends on whats wrong in the first place. I am hoping to get a doctor that notices the first surgery wasnt done properly and I get resleeved. Yes it is a revision but kaiser didnt have to pay for it the first time and this second time would to repair. But if the doctor doesnt find anything wrong with me then there may be no hope for insurance to cover it.

emme.vee - I would live to take your info from the Santa Ana doctor as soon as I can figure out how to message you.. , Thanks so much

[emme.vee 142]

I have mild reflux but im not sure if its significant. I take nexium in two week intervals when I feel it coming on strong. usually about every 3- 4 months I take a two week dose and it goes away for a long while. I have actually heard that a revision or a resleeve can make the reflux worse but I suppose it depends on whats wrong in the first place. I am hoping to get a doctor that notices the first surgery wasnt done properly and I get resleeved. Yes it is a revision but kaiser didnt have to pay for it the first time and this second time would to repair. But if the doctor doesnt find anything wrong with me then there may be no hope for insurance to cover it.

emme.vee - I would live to take your info from the Santa Ana doctor as soon as I can figure out how to message you.. , Thanks so much

I sent you a PM.

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[cindyw41 761]

A revision from sleeve to bypass will get rid of the reflux according to my surgeon. It's a possibility for me because I had a hiatal hernia wild moderate reflux. He said that he still recommended the sleeve but that a revision could be in my future.

A re-sleeve may not be possible. Once your insurance kicks in they'll be able to do a Upper Gi to see how big/small your stomach is

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