Looking to see if my Dr. Will do the revision because of my Gerd

[lavette43 75]

Didn't most of yall go with the same dr.when you had your Revision?

Sent from my SM-G991U using BariatricPal mobile app

[I♡BypassedMyPhatAss♡ 804]

My original surgeon moved farther away, so with traffic it would have been a four hour round trip. So I found a new surgeon. She removed my band last year and will be doing my revision next month.

[lavette43 75]

My original surgeon moved farther away, so with traffic it would have been a four hour round trip. So I found a new surgeon. She removed my band last year and will be doing my revision next month.

I'm hoping my Dr will give it to me .This Gerd gets on my last nerves. I DIDN'T HAVE BEFORE THE SURGERY.

Sent from my SM-G991U using BariatricPal mobile app

[Tomo 1,193]

I went to a different surgeon. Before I chose him, I consulted with my original and a couple of other surgeons.

[beardog66 1]

What is the name of your surgeon. I'm needing revision surgery.

[RickM 1,747]

Going to your original surgeon, if you are still in the same town, is a good start, but that should only be a start. As Tomo suggests, getting a second (and third, even,) opinion is a good idea, particularly for a revision where the needs and solutions are more varied than the original surgery. Talking to a non-surgeon or two (such as a gastroenterologist) is also a good idea as there may be some non-surgical interventions that can do the job, and it is usually preferable to start there anyway, and then consider surgery if those don't work.

Be suspicious of a surgeon who immediately tells you that if you have a sleeve, with GERD, that you need a bypass revision, without first doing some tests to find out what's really going on inside you. It may be a hiatal hernia which commonly causes GERD in WLS nd non WLS people alike, and that can be repaired without going through a revision (though some surgeons may not be comfortable or capable of doing so, or it can be a poorly shaped sleeve that inhibits good flow, and that can often be resleeved to correct that (though I probably wouldn't be depending upon the original surgeon to fix that, as it implies technique issues with the original surgery.)

In short, don't be too quick to self diagnose - let the professionals do that (though it pays to be well educated on it,) and play the field to get multiple opinions - they all can have somewhat different background and experiences, and that drives their opinions; don't settle for the first one that you come across.

goo luck in sorting this out....

[Daja 48]

I went with a different surgeon due to insurance issues. Had major GERD issues with Barrett’s esophagus, my GI had me maxed out on PPI’s and did PH monitoring, EGD, and Barium’s swallow tests. All of this is usually required by insurance companies before they will pay for the revision. Sometimes GERD is caused by a change in the anatomy of the original sleeve (which was not the case for me) my Dr told me if that is the case they can use a ballon to change it to what it should be or try to resleeve rather than a revision to RNY. It’s definitely worth a consult before such a major surgery. Wishing you all the best…

[jenuinelygenuinely 81]

I went with a totally different hospital/program after having a bad nutritionist. Like @Daja I had to get an upper endoscopy and a barium swallow test done which was required. My first consult the doctor told me a revision would be best if I had severe GERD but they weren't going to approve me for surgery without doing tests...LOL

During my tests they found the reason for my GERD and deemed it medically necessary. The surgeon did tell me if they found a HERNIA he would've performed SAD-IS procedure or a DS.

[lolarose13 147]

On 08/03/2022 at 15:13, jenuinelygenuinely said:

I went with a totally different hospital/program after having a bad nutritionist. Like @Daja I had to get an upper endoscopy and a barium swallow test done which was required. My first consult the doctor told me a revision would be best if I had severe GERD but they weren't going to approve me for surgery without doing tests...LOL

During my tests they found the reason for my GERD and deemed it medically necessary. The surgeon did tell me if they found a HERNIA he would've performed SAD-IS procedure or a DS.

I will have to talk to my surgeon about this. My insurance just denied my revision because they wanted to prove my GERD with a 24hr PH monitoring test! I already had an endoscopy and the doctor found a large hernia, but now they want me to prove my GERD with a super expensive/extensive test? I’m upset that my doctor wants to go ahead with this.

[lolarose13 147]

On 08/02/2022 at 16:09, Daja said:

I went with a different surgeon due to insurance issues. Had major GERD issues with Barrett’s esophagus, my GI had me maxed out on PPI’s and did PH monitoring, EGD, and Barium’s swallow tests. All of this is usually required by insurance companies before they will pay for the revision. Sometimes GERD is caused by a change in the anatomy of the original sleeve (which was not the case for me) my Dr told me if that is the case they can use a ballon to change it to what it should be or try to resleeve rather than a revision to RNY. It’s definitely worth a consult before such a major surgery. Wishing you all the best…

Can you tell me more about the PH monitoring? I don’t know what to expect if we go ahead with this. I thought finding a hernia would be enough, but my doctor submitted me a GERD revision.

[Daja 48]

There are a couple different kinds of pH monitoring. Neither of them are pleasant, quite frankly. One of the tests involves that the tube ( an ng tube) be placed down your esophagus into your stomach via your nose and stay there for 24 hours. It monitors the acid that you have and your doctor will read the monitor afterwards; you’ll eat with it, shower with it, everything. The other PH monitoring test is usually done in the hospital and they also place an ng tube into your stomach via your nose and they spray some salt Water into the back of your mouth and you are asked to swallow and then not swallow and it measures how strong or weak the lower esophageal juncture is. That is the test that I had done. For me, The machine also broke in the middle of the test. When I asked the doctor if I had to repeat it and he said no, I was so happy I almost cried, as it was one of the most horrible tests I’ve ever experienced in my life. The test they choose depends on insurance company requirements as well as what they think is the cause of your reflux is. Just excess acid or is there a possibility of an anatomical issue. For me it was both. And a paraesophageal hernia that was strangulating my stomach though that didn’t show up on any of the tests they did in advance, it was like surprise lol!

Edited August 23, 2022 by Daja
Spelling errors

[lolarose13 147]

14 hours ago, Daja said:

There are a couple different kinds of pH monitoring. Neither of them are pleasant, quite frankly. One of the tests involves that the tube ( an ng tube) be placed down your esophagus into your stomach via your nose and stay there for 24 hours. It monitors the acid that you have and your doctor will read the monitor afterwards; you’ll eat with it, shower with it, everything. The other PH monitoring test is usually done in the hospital and they also place an ng tube into your stomach via your nose and they spray some salt Water into the back of your mouth and you are asked to swallow and then not swallow and it measures how strong or weak the lower esophageal juncture is. That is the test that I had done. For me, The machine also broke in the middle of the test. When I asked the doctor if I had to repeat it and he said no, I was so happy I almost cried, as it was one of the most horrible tests I’ve ever experienced in my life. The test they choose depends on insurance company requirements as well as what they think is the cause of your reflux is. Just excess acid or is there a possibility of an anatomical issue. For me it was both. And a paraesophageal hernia that was strangulating my stomach though that didn’t show up on any of the tests they did in advance, it was like surprise lol!

Thank you! this is incredibly useful information. My doctor suggested filing an appeal just for the unnecesary burden of going through this test since the symptoms have been documented for years. Did you have to stop your meds before the procedure? I cannot even imagine trying to do this if I can barely make it without them; I want to cry!

Edited August 23, 2022 by lolarose13

[Daja 48]

I did not have to stop my reflux meds, ( thank goodness, as I was on 4). Quite frankly, a barium swallow will also tell them if you have Reflux, though it’s not always 100% accurate (but if your GERD is bad enough and the tech and radiologist is good it should show) and it not nearly as bad a test. If you appeal, definitely add in the poor quality of life, how much medication you are taking, and reiterate that it’s not for weight loss. If your dr is willing to do a peer to peer with the insurance company, that also helps. I included that my GI suggested surgery and told me there were no more medical management options available left to me, therefore, undergoing more tests to prove what we already knew undermined his professional opinion as well as that of the surgeon who agreed with him. I also insisted that a GI Dr review my case not any dr (insurance companies will use any dr available and I’ve had podiatrists and ob-gyn’s deny me because they are going by a list of requirements as opposed to knowing a disease condition)

These are things that helped me get approved. Best to you and hope all goes well..