former_vbg

I can so relate to the fears and issues over family / friends not being supportive. When I had my VBG 13 years ago, I only told about 2 or 3 friends, no family members- none, nadda, zip and to this day they do not know I had the surgery. They just figured I lost a bunch of weight the "old fashioned way". I'm SOOOOO glad I didn't because it would make it even harder going into having a revision knowing they would be even more judgmental this time. I favor more of my father's side of the family, although both my parents have weight issues as well as one of my brothers. I won't be telling anyone at work and it goes without saying, no family will be told either. I have only told 3 of my closest friends, people I felt pretty certain they would be supportive or at least willing to listen to me without being judgmental. Even when I go for short term disability from work, my boss will likely try to get me to tell him- but all he will get is that I am having surgery to fix a past surgery that has been causing some complications". That's all he needs to know, if that even. But, to avoid being completely rude and cause an uncomfortable conversation by just flat out saying I won't say, this will be my approach. You have made a sincere attempt to include your family. You have done what you can do and now the rest is up to them to meet you in the middle on this. Like the others have said, this is about YOU- not about THEM. Just keep focused on the goal and you will be fine. The others will have to figure out how to deal with their own insecurities on their own time.

You might ask him about how many Sleeves he has done, where he got his training. Then, personally I would want to know what size bougie he uses. Size 32 to 36 seems to be the standard from everything I have researched. I'm going through the insurance hurdles now and the surgeon I am using uses 32.

That's the one that does TONS of t.v. advertisements isn't he? And, I think almost every night at like 2AM he has the same 30 minutes with the same people who are singing the glory of the lapband perhaps? When is your surgery? Are you having the Sleeve or the lapband?

Do you mind if I ask why you changed and went to Mexico?

Good luck w/getting the Aetna customer service to advise you. They will likely only refer you to their online policy bulletin. They kept telling me to work through my surgeon's office. See what the lady who does the insurance says, hopefully they will help advise you on that.

Thanks. Your employer must have customized this part of the insurance because the policy bulletin says they normally require a 6 mth supervised diet. I even ended up speaking with a supervisor today in customer service and they said they are not allowed to advise what I am supposed to do, just to have the surgeon's office submit for a pre-certification, that I can always appeal if it gets denied. Boy...that was helpful. Not! Tomorrow morning, I go in for an Upper GI/ End which needs to be done anyways. I have a Nut appt next Tuesday, had an appt w/my PCP today. I have an appt w/a head shrink next Tuesday- but he asked me what kind of testing I need done cuz there are many types of psych evals. I told him I wasn't really sure, that the policy bulletin doesn't say. I emailed the insurance gal at the surgeon's office tonight to see what she says. I don't see any reason to go through multiple visits and fill out some long test. Depending on how many visits I have to go through for the psych eval, I could have everything I need to submit for a pre-certification by mid to late next week. Then, wait.... My PCP is very much in favor of me having a revision and said he would put some documentation and a letter together to help show the medical necessity.

Boy, I can relate to many of these posted on this thread- but ESPECIALLY the one about not being worried about visiting people I haven't seen for a long time like relatives and old friends. I dread visits "back home", sometimes I've been way down on my weight and then other times I have gone way up. I have a few relatives that are so critical even if they don't say anything directly to me, I can tell in some of their comments what they really mean. My father's side of the family is scattered with many overweight folks, my mom's side not as much- but what is amazing is I get this criticism even from some of the overweight people. You can bet I will not be sharing that I had any type of WLS.

Just adding my 2 cents for what my surgeon told me. He said that he doesn't want his patients to smoke for at least 3 weeks post-op because it can delay the healing process and if you are in a high risk category anyways for leaks either due to other health conditions or being a revision patient it only compounds the possibilities for complications/ delay in healing. What is odd is he only requires patients to quit 7 days pre-surgery. I do not have a surgery date, but plan to quit 3 or 4 weeks pre-surgery.

I'm assuming you were a first time surgery approval? I also have Aetna PPO Choice and just learned today that I may have to go through a 6 mth supervised diet- but that's not what they told me when I first checked on this 2 months ago. There is a section for "Repeat Bariatric Surgery" that says nothing about that. Normally, I have found their customer service to be helpful, but when I called today to get clarification I just got the runaround saying they couldn't explain their policy bulletins. I would have to go through my Dr. to get explanation. I'm like, WTF... Section III of this Aetna Policy Bulletin, for revisions- it says: Repeat Bariatric Surgery: Aetna considers medically necessary surgery to correct complications from bariatric surgery, such as obstruction, stricture, erosion, or band slippage. Aetna considers repeat bariatric surgery medically necessary for members whose initial bariatric surgery was medically necessary (i.e., who met medical necessity criteria for their initial bariatric surgery), and who meet either of the following medical necessity criteria:Conversion to a RYGB or BPD/DS may be considered medically necessary for members who have not had adequate success (defined as loss of more than 50 percent of excess body weight) two years following the primary bariatric surgery procedure and the member has been compliant with a prescribed nutrition and exercise program following the procedure; or Revision of a primary bariatric surgery procedure that has failed due to dilation of the gastric pouch is considered medically necessary if the primary procedure was successful in inducing weight loss prior to the pouch dilation, and the member has been compliant with a prescribed nutrition and exercise program following the procedure; or Replacement of an adjustable band due to complications (e.g., port leakage, slippage) that cannot be corrected with band manipulation or adjustments. I qualify under Number 2. It doesn't say in the section about the supervised diet section if that is for first time patients or everyone. I can't imagine it would as I have complications from the original surgery. Does anyone have any input on this?

Ok, I had a phone consult with Dr. Husted today and I have no concerns about his surgical abilities and overall the call went fine- but I am struggling with one important thing.....the size of the bouget (sp?). He says he uses a size 42 whether its a virgin or revision sleeve. He further went on to talk about how he aligns it with the anatomy inside (arteries or something). Basically that he doesn't like the idea of doing a sleeve too tight due to getting the hour glass syndrome. I'm not sure whether I'm going to be able to get past this. I am glad for the 2nd chance opportunity and I know Dr. Husted is known for his surgical abilities, but I am very concerned with having too large of a stomach left and the opportunity for re-gain. Could you share your thoughts please? In particular, what size bouget was used, how much you can eat right after surgery and then later down the road?

Who was your surgeon?

Hi Deb, No, Dr. Husted is in Phoenix, AZ http://www.johnhustedmd.com/ There are no expert revision surgeons in the Kansas City area, including Dr. Hoehn. He has a good reputation for virgin surgeries, but that's where his expertise ends unfortunately. I had hoped to find a qualified revision surgeon in the Midwest but so far nothing. That's how I came across Dr. Husted.

I spoke to a Penny (customer service Rep) today, had some more specific questions on my financial responsibilities, and also asked her where I could find information on the requirements for qualifying for this surgery. I thought I would share this here in case anyone else might have an interest/ need. http://www.aetna.com/healthcare-professionals/policies-guidelines/medical_clinical_policy_bulletins.html Then, just type in the type of procedure you want information on. Type in Obesity Surgery and it will come up. You can also type in Gastric Sleeve and it will bring up pretty much the same search information. Hope this helps others. It read a little confusing to me. I get the jist of it, but there are a few things I'm not quite clear on. We'll just have to see. I'll bring this with me when I get to see the surgeon....

He's probably fine for virgin surgeries, but has little experience with revisions. Their office also is more geared for getting through as many people as possible, like assembly lines IMO.

Well, I thought I might have finally found an experienced and competent revision surgeon within a 100 mi radius of Kansas City. His staff is so friendly, don't try to chase you off the phone the moment you talk to one of them, but most of all HELPFUL and FORTHCOMING of information unlike another experience I had recently from a well known Dr. in Kansas City. Anyways, I spoke to one of the ladies in his office (not sure if she is a nurse or what), but I talked to her yesterday and explained a little about my history and what I was looking to accomplish. She asked me to fax over my medical records and ins. card and they would review my paperwork. Get this- I only faxed it over at 9:30am this morning and she called me back later to let me know she had everything she needed, that the lady who processes the paperwork was checking w/my ins and she would get back in touch with me as soon as she heard more. By 3:30pm this afternoon, she called me back to tell me the following: Well, the good news which I kind of already knew anyways because I had done my own homework on what my ins. covered but hearing it from a Dr's office made it more real. My revision surgery WILL be covered. But, the bad news is that she said that the Dr. said that he did not think he could convert the VBG to a sleeve, but could do it to an RNY. She said I would need to talk to the Dr. in person to get more details about why he didn't think he could convert the VBG to a sleeve. He is having a seminar in 2 weeks and so she suggested I go and talk to him there which I will do. From all of my research, I was really getting good vibes about this doc and so I really want to listen to what his concerns are about converting me to a sleeve because I'm sure if I "shop" long enough I can find SOMEbody to do the revision, but it may come at a huge cost to me by a botched surgery. I don't have any health issues, no medications, and so there must be something he is concerned about the VBG surgery itself. Anybody have any suggestions? Thoughts?

I'm sorry to hear this. So, are you able to do the self-pay route then? I feel fortunate that I have Aetna, they seem to have a rather generous WLS part of their coverage. I know that my revision will be covered when I decide on the right doctor for me. Although, I don't take anything for granted with the changes with the Healthcare reform- who knows what benefits will be cut next year so I will get the revision done this year one way or another.

I googled your Dr.'s name only because I have been looking for an experienced and reputable revision surgeon, and was surprised when this article came up among the first 3 listings in the search. http://tyler.injuryboard.com/miscellaneous/death-in-gastric-bypass-surgery-results-in-wrongful-death-medical-malpractice-lawsuit.aspx?googleid=214112 Just kind of surprised me I guess.... Sounds like you had a good experience, but he has a few skeletons in his closet.

I have seen others mention this too. What I wonder is I am already the one who is always cold when others are hot, so I can't imagine being more cold natured. I will have to add that to my list of questions for my surgeon (if I can ever find one who is experienced with revisions).

A question, how many of you that have had revision surgeries smoke? If so, how much? I got an interesting letter today from a surgeon's office and wanted others input on this subject. I'll share more after I see what people's responses are. Thanks.

I don't think anyone was trying to make snide comments. You asked for feedback, and you got it from veterans further out than you. It's ultimately your choice what you want to do.

First, know that you have rights under the Fair Credit Reporting Act. I understand you applied with them, but they obviously did not follow your instructions (unless there was fine print that allowed them to do what they did and you didn't see it). An excellent website for people who need help fighting against malicious creditors is http://www.debtorboards.com/ If you want to read up on your rights under the Fair Credit Reporting Act, go here: FCRA: http://www.ftc.gov/os/statutes/fcra.htm For a list of other very good links at the debtorsboards.com site, go here: http://www.debtorboards.com/index.php/topic,7211.0.html

Ok, just trying to get recommendations for WLS surgeons who have extensive experience with revisions. I can't seem to get any response from the office of one well known surgeon in the KC area. Another surgeon has little experience with Sleeves or Revisions. The other surgeon I know of in the KC area I'm not sure I trust due to his NON-STOP t.v. advertisements and infomercials that run every night in the middle of the night with the same people praising high glory to this surgeon's practice. That is a huge turn off for me because since I can't seem to find a way to verify the number of procedures they have done from an objective party, I don't know that I would trust what they did tell me even if it was what I wanted to hear. This could be Lawrence, KS, Sedalia, MO, Columbia, MO or KC of course. Suggestions/ Referrals appreciated.

I understand the COE isn't really that big of a deal, I had just hoped they would be able to release those numbers to me. There are 2 other Bariatric surgeons in the KC area, but one of them does NON-STOP commercials and that is a huge turnoff to me. The other one has not done very many sleeves and although the lady I talked to at that office was very forthcoming in sharing specifics on the surgeon's experience, she said she wasn't sure he had done very many revisions, much less a VBG to a Sleeve. So, he is out... Guess I will start a new thread asking for anyone who knows a Revision Experts in the KC or surrounding area and see what comes back. I need to stay in-network though too. Thanks for the feedback.

I see various threads a times where people give the advice to "find a surgeon who is an expert with revisions". So, there is a surgeon in my area that I have found many speak very highly of, however, I can't get his office to give me any specifics on the number of each of the procedures he has done, including revisions and what type of revisions he has done. I sent another email Friday asking what the status was of getting me this information. In the meantime, I have contacted Medical Records for the hospital he works for (considered a COE), they said it was confidential information. I also called the COE affiliation and they said that the only thing they could tell me was that in terms of procedures that one of the minimum requirements was that they perform at least 50 WL surgeries per year and that they do on-site inspections every 3 years....but that was about it. Same basic story with the state medical board..... Soooo.... as I continue my Quest for a revision I am now at a point where I need to find a surgeon who is an expert with revisions. I feel its a red flag if I can't get a straight answer from this surgeon's office even if there are others who speak highly of him. It makes me concerned that they either A) they are simply too busy to be bothered with such questions Maybe also understaffed in the office or C) maybe they don't really want to release that information - for WHATEVER reason. Either way, I need to feel that my surgeon and his office are forthwith and responsive to questions. It's been a week this Monday since I asked this question from his office and NOTHING, not even a follow up. Ok, so back to my original question- how does one find an expert / competent surgeon, and in my case a revision WLS surgeon?!?!?!????? Thanks for any/ all suggestions.