VSG to RNY. 4 years post op. slight twist/fold in sleeve upper g.i. shows gerd and fluid ....

FDclerical
on 11/14/16 11:53 am
VSG on 11/06/12

coming right back up! and my sleeve is slightly twisted my new surgeon says. he also showed me the images and said it looks very big almost like a regular stomach.

my mental eval is this Thursday 11.17 and then submitting to insurance the day after! cant wait for the sharp pains to be gone and to hit my goal!

sickofrollercoaster
on 11/15/16 10:17 am - Katy, TX

Hi.  I am 6.5 years post-op from sleeve.  I have had progressively worsening reflux to the point that I just can't take it anymore.  I continue to increase medication but nothing seems to work. I saw my doctor yesterday and he is recommending revision to bypass.  I will of course be doing all of the evaluations and then they will send on to insurance.

Most worried about insurance denying.  I have United in Texas.

Would like to follow your story and see how things go for you.

FDclerical
on 11/15/16 10:30 am
VSG on 11/06/12

hey rollercoaster! hows your Bmi? stay positive we can def support eachother on this CRAZY journey!!! each insurance should have specific criteria for revision but mine just required a mental eval and a note of medical necessity. because my BMI is still high to qualify for surgery I have full confidence. stay positive and thank you for responding. my body responds to PPI but VERY minimally. and the pain is to much to take. an upper G.I. should clarify and show you everything going on.

sickofrollercoaster
on 11/15/16 11:00 am - Katy, TX

Thank you for responding!  My BMI is at 26 (not sure how because I am 145 lbs at 5'0").  So in that respect I would never qualify for WLS.  My surgeon is having me do bloodwork, Upper GI, EGD, a psych eval and a nutrition appointment before submitting to insurance.  He did say that there are ways to get it through insurance without calling it WLS so we will see.  I am trying to get Upper GI scheduled now and the EGD is set for November 28th.  Out of pocket with no insurance the cost is between $18-$20k.  My face fell to the floor when he told me that but he said do not let that worry me, we will somehow get it done.

sickofrollercoaster
on 11/16/16 10:54 am - Katy, TX

So they just verified that my insurance does not cover bariatric surgery.  What I am puzzled about is that technically doing the bypass is not for weight loss reasons, it is the only sure fire way with my current anatomy to cure my GERD.  I meet with my doctor on December 5th to discuss what our next steps are...  I am having Upper GI next Wednesday and the EGD the following Monday.  I need this to happen, I cannot continue living this way.

FDclerical
on 12/5/16 11:02 am
VSG on 11/06/12

hey rollercoaster just checking in with you. let me know how the appointment goes today! my revision date is set for dec 27th....

sickofrollercoaster
on 12/7/16 5:31 pm - Katy, TX

Hey, thanks for checking in.  I visited with the doctor on Monday morning.  They have submitted my case to insurance and left all bariatric type coding off.  Doctor is proposing to do a partial gastrectomy to correct my gastric sleeve and then do the bypass.  Paperwork went in yesterday.  They said it can take up to 14 business days to hear back.  Please say a prayer!

VSG: 5-10-10, Dr. Aceves, Mexicali; RNY: 1-17-17, Dr. Snyder, Houston

VSG SW 180, LW 118; RNY SW 150, GW 120

FDclerical
on 12/8/16 6:49 am
VSG on 11/06/12

awesome ill pray for you!!! hope it all works out and relief is right around the corner for both of us!!!

sweetnlo
on 12/21/16 7:54 am

Hi, I just had a "conversion" from the VSG to RNY. My insurance didn't cover baritric surgery either; however, my doctors office was able to get approved as medically necessary. I live in a small town about 20 miles from Katy. I had my procedure done at North Cypress, surgeon is Dr. St Laurent. 

    
sickofrollercoaster
on 12/22/16 7:18 pm - Katy, TX

I got my approval last week, took insurance one day!  Surgery is January 17th!!!  I cannot wait.  I live in Katy.  My doctor is Dr. Brad Snyder and surgery will be at Memorial Hermann in the Medical Center.  How are you doing?

VSG: 5-10-10, Dr. Aceves, Mexicali; RNY: 1-17-17, Dr. Snyder, Houston

VSG SW 180, LW 118; RNY SW 150, GW 120

Most Active
Recent Topics
×