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Looking for revision advice



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I had the gastric sleeve surgery in February of 2018. I lost 100lbs and was feeling wonderful. I got pregnant with my son in June of 2019 and gained about 55lbs and cannot for the life of me lose the weight.

I reached out to my surgeon as at the time of my surgery he told me to "get the sleeve because it is more safe if I plan on getting pregnant" and if I wasn't happy with the results after my pregnancy I could "always come back and get bypass". Well I reached out to my surgeon after about a year of me doing multiple failed diets and said I wanted to make an appointment for a revision surgery. My surgeon then responded with "You have the tool you need to work it". That was that, I feel very discouraged however, am looking into a different surgeon in another town.

I guess my real question here is: Has anyone else had to deal had a hard time being approved for revision?? Did your surgeons frown upon it? Is it possible they will turn me down for surgery because I previously had the sleeve already?

If you made it this far, thank you for reading my rant!

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Surgeon approval is generally easy, but insurance approval (at least for me) came with complications such as Gerd/Esophagitis. I would seek a second opinion. There are surgeons that only do sleeve and there are those that are comfortable with revisions, RNY, DS... Etc. Good luck.

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Revision is not that uncommon according to my surgeon. My surgeon's office pushes for patients to choose a surgery that will help them lose the most weight they can because they have people coming back for revisions due to choosing a less aggressive surgery the first time or weight regain because they feel that people don't factor that in. They have no problems with doing revisions, but warn that sometimes you won't lose as much as your first surgery or if you do then you'll lose it a lot slower. And, revision also relies very much upon insurance approval if you can't afford it out of pocket so they always advise people to check what their insurance allows before deciding on a final surgery. Originally, I was looking into Gastric Bypass, but my surgeon pushed for me to have the DS or SADI-S because of me being super morbidly obese with a BMI of over 50. My insurance wouldn't have approved of a revision if I didn't like where my weight settled so I ended up going with my doctor's advice. So when it comes to revision I understand that it very much depends upon the insurance. Some will only approve a revision if you develop complications such as GERD, while others will allow it if you've had significant weight regain and can't lose. So it's really just dependent upon what your insurance allows. If it does allow a revision then it comes down to what you want. A revision to Gastric Bypass or the Duodenal Switch (for reference the first part of the DS is the gastric sleeve. Also, there is the SADI-S version which has a longer intestinal length then the original DS, but you'd have to find a surgeon who even does the DS or SADI-S as not every surgeon does). I hope that your insurance will cover your revision and if it doesn't then I hope you find a place that is affordable for out of pocket costs.

Sorry that your surgeon was so unhelpful and I hope you have better luck with the next one!

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My original surgeon was with kaiser, and he wouldn't give me a revision surgery. I changed to PPO and found a surgeon who said he would give me the surgery but didn't think it would help. I eventually found the bariatric institute in Utah, and Dr. Medlin gave me my yes. Getting approved was a BREEZEEEEEE. I guess it depends on your insurance.

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On 10/13/2021 at 1:57 PM, Tomo said:

Surgeon approval is generally easy, but insurance approval (at least for me) came with complications such as Gerd/Esophagitis. I would seek a second opinion. There are surgeons that only do sleeve and there are those that are comfortable with revisions, RNY, DS... Etc. Good luck.

I'm looking at revision. I'm seeing a doctor in Dallas. Insurance doesn't cover WLS at all, but this is medical due to severe reflux. At first they wouldn't even look at the clinicals from a new endoscopy and barium burger, but after getting the HR person with the company my husband works for involved, the doctor now has a fax number to send results. How long did it take for them to decide it was necessary medically? Where are you in TX? We're in east TX so Dallas isn't too far away.

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On 11/3/2021 at 9:23 AM, StratusPhr said:

I'm looking at revision. I'm seeing a doctor in Dallas. Insurance doesn't cover WLS at all, but this is medical due to severe reflux. At first they wouldn't even look at the clinicals from a new endoscopy and barium burger, but after getting the HR person with the company my husband works for involved, the doctor now has a fax number to send results. How long did it take for them to decide it was necessary medically? Where are you in TX? We're in east TX so Dallas isn't too far away.

Took the surgeon, one visit. After he submitted paperwork, it took my insurance about 3 weeks.

I messaged you ^^

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11 hours ago, Tomo said:

Took the surgeon, one visit. After he submitted paperwork, it took my insurance about 3 weeks.

I messaged you ^^

Thank you. My husband has gotten their HR lady involved. She messaged him late this afternoon, someone from HealthLink (pre-certification people) wanted to know who to contact at the doctor's office. I hope this is a good sign! Fingers crossed! Again, thank you!

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