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Post by goodkel on Sept 27, 2012 4:08:49 GMT -5
The VERY first thing that you need to do is read this and watch the video. weightlosssurgery.proboards.com/index.cgi?board=speaker&action=display&thread=3804&page=1This is not your fault. At a BMI of 35, you will need two co-morbidities for insurance to qualify you for a revision. Without that, the cut off point is usually a BMI of 40 unless there are other compelling reasons that would require a revision. A discussion with an experienced revision surgeon, and there are only a small handful of them, would be your next step. You don't have any info on your profile, but I would call or email Dr. Roslin if you are on the East coast and Dr. Keshishian if you are on the West. |
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Post by msbatt on Sept 27, 2012 8:43:48 GMT -5
Since you're in Texas, I also suggest you check with Dr. Daryl Stewart in Denton. I'm not sure if he does RNY to DS revisions, but you can ask. He's considered a very good DS surgeon for 'virgin' procedures.
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Post by larra on Sept 27, 2012 9:58:35 GMT -5
Definitely check your insurance policy for yourself, both regarding how many comorbidities you need AND their policy on revisions, which may be different. Some policies have criteria for revisions, some allow them only for documented anatomic complications of the original procedure (which can mean different things to different insurers), and some don't cover them at all. Check for yourself, do not trust any info someone gives you over the phone.
In the meantime, there is no reason not to get your vitamin levels back up with strong D supplementation (we DS'ers take the dry D that you can get from Vitalady, 50,000 units/dose) and see if you can't arrange for some B12 injections along with the oral stuff to get you back up to par and feeling better. The other B vitamins you can probably do orally, and some iron supplementation is also in order from the sound of things. Again, Vitalady has good products for both RNY and DS patients.
And definitely contact Dr. Stewart in Denton. I think he's doing RNY to DS revisions though I'm not 100% sure. If not, you have the other names.
Larra
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Post by mark540 on Sept 27, 2012 12:21:24 GMT -5
Watch out to find if the insurance company requires a supervised diet for a period of time before approval. If your BMI is 35 and you lose enough to get to a BMI of say 32, they might pull the old trick of your BMI is not high enough. Drink a gallon or so of water before weighing in if this is the case and toss a few rolls of quaters in your pockets for good measure. Go for a weigh in in the latter part of the afternoon if possible, after lunch for the first weigh in and then get morning weigh ins after that.
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Post by Deleted on Oct 13, 2012 21:08:24 GMT -5
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Post by msbatt on Oct 13, 2012 21:31:21 GMT -5
I'm pretty sure we've had some folks revise at a 'normal' BMI due to medical problems, too.
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Post by zoetrope on Oct 22, 2012 12:48:22 GMT -5
Many insurances now have an (unfair) one surgery per lifetime clause, whether or not that insurance company paid in the first place.
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Post by Deleted on Oct 28, 2012 16:32:56 GMT -5
HI I have a BMI of 38 and was approved for RNY to DS revision in 10 days. I dump have pain in feet, knees, and hips. Can you see a different surgeon? I flew to SoCal to see Dr. Keshishian in Mid Septebmer and am scheduled for surgery 12/10. I truly feel his office staff (Sandra) made all of the diference. I think they have super human mind melding powers..
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Post by Deleted on Nov 2, 2012 22:17:08 GMT -5
Whit- Do you mind if I ask if you have any comorbidities? I don't know if I have anything serious enough (for the insurance company) yet.
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Post by Girlrocker on Nov 3, 2012 8:12:10 GMT -5
Whit- Do you mind if I ask if you have any comorbidities? I don't know if I have anything serious enough (for the insurance company) yet. Hi, I live in LA and have UHC PPO through work. I had my revision with Dr. Keshishian and was considered a lightweight as well at 240 with a BMI of 39. Other than my regain, which exacerbates the degenerative arthritis, anemia, I didn't have any co-morbidities. My RNY failed me in terms of weight loss, but I was healthy. I'm not sure where you live, who your insurance carrier is? Since Dr. K is one of handful of vetted surgeons (about six in this country) who can actually perform this surgery, it's worth more research and investigating. If I've missed your back story, apologies! You can also put basic stats (RNY surgery date, your city/state, weight stats) in your signature, helps us to help you. |
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Post by Deleted on Nov 4, 2012 17:06:23 GMT -5
Hi,
I have dumping syndrome, pain in feet, knees, and hips. I also had documentation of steady weight gain over the past 10 years. I had an UGI which showed a very small rapidly empting pouch. I had 3 surgical consults before I knew RNY to DS would have best long term results. I have Anthem BCBS Plus through UC Berkeley.
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