curlyRNYgirl999

@daynauky1... we have similar start weights. OMG you look amazing and it doesn't look like it has even been a year post op yet right? How often and how long are you working out?

So I had a consult with my surgeon on Monday who told me we should go ahead and convert to the RNY. He told me we could do the surgery all at once, remove the band and do the bypass. Today I get a call from his billing office saying that they cannot submit for the band removal and conversion to be done at the same time and I would need to have two separate surgeries. This surprised me and when I questioned them they did not really seem to have a good reason as to why. So I called up Anthem BCBS (California) and asked them if for a bariatric conversion they require two separate surgeries and they told me 'No'. She even checked with her supervisor and told me they said 'No'. I call back my surgeon's office and tell them I spoke with insurance and they do not have any policy against doing the removal of the band and conversion to RNY at the same time. She claims it is what some Director at Anthem told their office and that they have been denying their requests for the surgeries at the same time for other patients. I don't know about you guys but I call B.S. If it's not in my insurance policy and I meet all the requirements for the conversion then why would they deny it? So she tells me I can either submit for approval for the two surgeries now or go get the Psych, NUT and PCP referral done now and submit for the one surgery later. I put everything on hold and am going to have them submit a request for the single surgery. I do NOT want to have to go through two surgeries. I mean, I will if that's what I have to do but I really just feel like they are trying to milk my insurance. I even called another bariatric surgeon's office in the same town and they said that it was at the surgeon's discretion and they do it either way depending on the patient. What do you guys think? Am I being jerked around? Did you have to go through two surgeries or one? Did you have any trouble getting approved for the band to RNY conversion??

I wanted to share some of my fears with revision surgery. I am only two weeeks away from my operation and I am starting to get nervous about my life afterwards. I figured I could share my fears along with others and hopefully get some support as well. So here goes. These are my top fears about revision surgery: I wont lose any weight or hardly any. I wont be able to follow doctor orders and may cause myself complications. I will come out of surgery only to find they couldn't do it after all. I will not feel as much restriction as I did with the band. I will only lose weight for a short time like with the band, and then start gaining it all back I have more fears but these are the most prominent. I guess this whole journey with the band has just scarred me in some ways and made me doubt the power of surgery, even though I know from seeing my friends and family who have done it that it works. I guess I worry since I chose the band first, things wont be the same for me and it wont work as well. Share your fears with me.

Good luck today lapnicky!!!! You are in my thoughts! I wish you a speedy recovery. Let us all know how you're doing once you're well enough.

I am over the moon with excitement about my band to RNY revision! I just wanted to share my joy with all of you! After dealing with all the ups and downs and run arounds with my former surgeon's office (Dr. Daniel Swartz) and moving to a new surgeon (Dr. Kelvin Higa) to start all over, I could not be happier with how quickly and efficiently I have my new surgery scheduled!! I feel so wonderful. I am ready to start prepping my body and life for this change and finally see the results I had hoped for when I first went under the knife. Wish me luck!!

Day 5. Doing well. Only stayed one night in the hospital, surgery was about 2 hours long, haven't needed to take my pain meds since Friday. I have a drain in, which I didn't expect. Its kind of annoying to deal with but it comes out on Thursday. I can't wait. I'm soooo bored of broth and sugar free whatever at this point and I find myself preoccupied with thoughts of food but I hear that's normal and goes away after you can start to eat more normal again. Been walking a lot and taking it slow. FHSH was a great hospital and my nurse, Hai, the first night was great. You'll do well. Just follow doctors orders, try to walk as much as you can and get your fluids. You're in good hands with ALSA.

Waiting in the hospital as I type. IV in and ready to go. See you all on the other side. ????

I will be having it all done in one surgery. That is the way my surgeon prefers to do it. He specializes in revisions so I am confident all will go smoothly. I am trying to get myself in the mindset already and lose what I can before hand to give it a head start.

Update: My new surgeon Dr. Kelvin Higa is going to do just one surgery. I had no problems with the office at my new surgeon getting insurance approval. I wish I would have gone to them from the start! I just got the call today that I am scheduled for January 29th! I cannot wait! It has been quite the journey to get here but I am so glad to be moving on from the band!

I finally met with my new surgeon! This new office is lightyears ahead of my old surgeon. Well organized, technologically advanced and patient focused. It made my old doctor's office look like a back alley chop shop. He spent about 20 minutes with me, talking and answering my questions. It was great! He is also all for doing it in one surgery (pending any complications during of course) and says that he almost always does them in one! I have a few things to do before scheduling but I am well on my way. Hoping for a Feb./Mar. surgery date! Just want to say to anyone who feels like their doctors office might be trying to make an extra buck on their health...do your research and don't give up, even if it means going to a different surgeon. I couldn't be happier and wish I would've come to this office sooner!! Also...my old doctor's office. They NEVER called me back, EVER. It was very clear that they didn't care about me at all and I would NOT recommend them. Anyone in the Fresno, CA area stay clear of Dr. Swartz and go to Boone and Higa at ALSAMG instead. Your health is too important to spend it with people who just want money!

So an update today...the doctor's office is officially full of B.S. I am switching offices now. Despite all of my efforts to speak with insurance and them and get this all sorted out they are standing on the side of money, delaying my care and compromising the health of other patients who aren't as willing to question them. I am actually not mad about having to switch because the other Surgeon's office I have chosen is one of the best in the state and is very well known for its patient care and follow-up care. It still digusts me though that some WLS Offices out there are just looking to manipulate and take advantage of desparate people in need. I should have known when they first charged me a "program fee" but offered no additional services to justify it as well as having a 1-800-blah blah THIN phone number. Ugh. I feel so stupid for chosing them in the first place but glad the agony is over.

Spoke to the pre-authorization review folks at Anthem BC/BS today and they told me that the cpt code for the band removal was denied but the code to do the bypass was approved. Say what? Hmm...waiting for the doctor office to call me and see what they say. Anthem said they probably just need to adjust their coding for the request. At least I know what insurance said before the doctor's office if they try to tell me differently.

I suppose it doesn't matter either way. I just don't feel like they are being honest about the reason for having two. Especially since the surgeon himself wanted to do it in one. I will put my request forward for the one surgery and if it gets denied then I have everything already done to request it in two. Either way, this band is coming out.

I had a slip back in May. It felt a lot like what SoccerMomma described. Bad reflux and spitting up just about everything you try to eat. I actually had surgery to "fix" it and have been doing horrible since. I just talked to my surgeon yesterday about switching to RNY as I just don't think the band is right for me and my reflux is coming back. He's all for it so we will see. I'll be happy to be done with the band.