Is regain alone enough for revision?

Mommy O.
on 12/15/17 8:42 pm

I have regained roughly 2/3 of my weight loss after haveing two kids. I have tried to get back to a healthy weight for the past 6 years. I'm in a support/ weight loss program now. I don't know what else to do.

My question is, if I go to a surgeon to be evaluated for a revision, do most require additional medical things like GERD, Hernia, ulcers?

Also, I need to find a good surgeon here in AZ. It has been difficult to get anybody to see me even for an evaluation because most doctors will not see patients who have had surgery by another doctor.

thanks!

  

hollykim
on 12/17/17 8:47 am - Nashville, TN
Revision on 03/18/15 with
On December 16, 2017 at 4:42 AM Pacific Time, Mommy O. wrote:

I have regained roughly 2/3 of my weight loss after haveing two kids. I have tried to get back to a healthy weight for the past 6 years. I'm in a support/ weight loss program now. I don't know what else to do.

My question is, if I go to a surgeon to be evaluated for a revision, do most require additional medical things like GERD, Hernia, ulcers?

Also, I need to find a good surgeon here in AZ. It has been difficult to get anybody to see me even for an evaluation because most doctors will not see patients who have had surgery by another doctor.

thanks!

regain alone is usually not a reason for revision.

You would need to show , by having an Egd, that there is something mechanically wrong with your pouch or sleeve.

If there is nothing mechanically wrong, they attribute Weight gain to user issues, I.e not following your post op diet, overeating, not following the rules.

I am not saying you are doing these things, just that it is what the insurance assumes. If you are following the plan, not overeating ,not eating the wrong foods, then there is no reason you can't list the weight and keep it off.

 


          

 

Donna L.
on 12/18/17 12:27 pm - Chicago, IL
Revision on 02/19/18

You need to read the evidence of coverage for your insurance to see if they even cover revisions (many do not) and what the requirements are. Some will not even revise for GERD, actually, and many are notoriously picky. I'd start by reading that document. Often it's on their website.

I follow a ketogenic diet post-op. I also have a diagnosis of binge eating disorder. Feel free to ask me about either!

It is not that we have so little time but that we lose so much...the life we receive is not short but we make it so; we are not ill provided but use what we have wastefully. -- Seneca, On the Shortness of Life

H.A.L.A B.
on 12/20/17 7:42 am

some insurance have rule "one WLS per lifetime". Even if the first one was self paid, or another insurance paid for it - they still count that.

Hala. RNY 5/14/2008; Happy At Goal =HAG

"I can eat or do anything I want to - as long as I am willing to deal with the consequences"

"Failure is not falling down, It is not getting up once you fell... So pick yourself up, dust yourself off, and start all over again...."

azmichy
on 1/2/18 9:40 am
VSG on 10/24/17

First of all Dr. Jason Reynoso at Honor Health in Scottsdale will see you. I had lapband in 2003 by Dr. Juarez and St. Luke's. I lost 110 lbs and then one kid and 13 years later had regained about 50% of my excess weight. I had pre-diabetes and had been on medications a few years. I had no complications from the band other than I just got sick of paying for fills/unfills, etc.

My husband had sleeve surgery in April and I went in and spoke to Dr. Reynoso. He personally is removing 4-5 bands a week and converting the patients to other surgeries.

I was revised on 10/24 in one operation. My insurance (BC/BS) approved the conversion with no real hurdles to jump through.

I have several friends who have tried to have revisions but their insurance would not cover it. However, Dr. Reynoso will take you on as a patient, no problem.

Best of luck.

mc

Lap Band 09/17/2003 HW-276 SW-225 LW-167

Revision to VSG 10/24/17 HW-244 SW-217.8 CW-179.6

Pre-op:0~M1:17~M2: 6.6~M3: 7.8~M4: 6.7

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