Had Surgical Consult Yesterday - (sorry, I write novelettes)
Ramla_J
Posts: 14 Member
My surgeon signed off and is preparing the letter to the insurance company. I'm scared to death that I will be denied again....
In 2000, I had my stomach stapled. Back then, the only education I had was a 20-minute video. I did great. I lost 158 pounds. I actually kept it off for six years. But then I started gaining and gaining. As of today, I have gained back 80 pounds. For 11 years, I have felt like a failure and that I blew a "gift" that was given to me.
In 2010, I sought out a surgeon for a revision. I went through the entire 9-month process only to be denied by my insurance company. I was devasted. We appealed, but the insurance company held their ground. The last thing the doctor told me was "You would have only lost 50 pounds anyways." I will never forget that.
I started having issues with my stomach two years ago. Twice, I landed in the hospital with psuedo heart attacks. No one could tell me what was wrong with me. I knew it was my stomach because before each episode, I had an evening of intense throwing up. But I couldn't make anyone believe me because all they saw was a middle aged fat woman complaining that she couldn't breath and was having pains in her chest.
I kept insisting to my doctor that it was my stomach, but she wanted to rule out my heart first. I had the radio active heart test and guess what? I have a very healthy heart...duh...I could have told them that. So finally, my doctor listens to me. I had TWO upper GIs done. The doctors there were dumbfounded with the anatomy of my stomach and they diagnosed me with a esophageal hernia.
I continued to have issues and my doctor ordered a cat scan to dig a little deeper. It was discovered that I have four abdominal hernias. So off to a hernia specialst. The hernia specialist also is a bariatric surgery specialist (a fact I didn't know until he told me). He said he had reviewed my cat scan and I have a big hole in my staple line. It wasn't me who failed, it was my surgery. So, food slips down into the hole and has no where to go. It sits there and stagnates until I'm in a physical positon where it can "leak" back into the part of the stomach that will process it. He also said that he would never repair hernias on someone that is as overweight as I am. The doctor told me that I would be an excellent candidate for a conversion. I explained that I had been denied and I don't want to go through that heartbreak again. He explained with the cat scan evidence of my old surgery failure, that it wouldn't be that difficult to get this surgery approved.
So, another round of counseling phone calls, dietician visits, psych evaluation, swallow test, and losing the required amount of weight...here I am today. Waiting for the phone call.
I did get good news yesterday. First off...the doctor told me there is no reason I can't lose up to 100 pounds. He said that 50 pound limit was *kitten*. Then he told me that if I wait two years after surgery, where my weight loss has stablized, he can do the hernia repairs. Oh and guess what?? He will have to remove all of my excess skin to make this a safe procedure.
So, please say prayers and keep your fingers crossed that I will be approved. I was told it would take up to two weeks before I found out.
Thank you!!
In 2000, I had my stomach stapled. Back then, the only education I had was a 20-minute video. I did great. I lost 158 pounds. I actually kept it off for six years. But then I started gaining and gaining. As of today, I have gained back 80 pounds. For 11 years, I have felt like a failure and that I blew a "gift" that was given to me.
In 2010, I sought out a surgeon for a revision. I went through the entire 9-month process only to be denied by my insurance company. I was devasted. We appealed, but the insurance company held their ground. The last thing the doctor told me was "You would have only lost 50 pounds anyways." I will never forget that.
I started having issues with my stomach two years ago. Twice, I landed in the hospital with psuedo heart attacks. No one could tell me what was wrong with me. I knew it was my stomach because before each episode, I had an evening of intense throwing up. But I couldn't make anyone believe me because all they saw was a middle aged fat woman complaining that she couldn't breath and was having pains in her chest.
I kept insisting to my doctor that it was my stomach, but she wanted to rule out my heart first. I had the radio active heart test and guess what? I have a very healthy heart...duh...I could have told them that. So finally, my doctor listens to me. I had TWO upper GIs done. The doctors there were dumbfounded with the anatomy of my stomach and they diagnosed me with a esophageal hernia.
I continued to have issues and my doctor ordered a cat scan to dig a little deeper. It was discovered that I have four abdominal hernias. So off to a hernia specialst. The hernia specialist also is a bariatric surgery specialist (a fact I didn't know until he told me). He said he had reviewed my cat scan and I have a big hole in my staple line. It wasn't me who failed, it was my surgery. So, food slips down into the hole and has no where to go. It sits there and stagnates until I'm in a physical positon where it can "leak" back into the part of the stomach that will process it. He also said that he would never repair hernias on someone that is as overweight as I am. The doctor told me that I would be an excellent candidate for a conversion. I explained that I had been denied and I don't want to go through that heartbreak again. He explained with the cat scan evidence of my old surgery failure, that it wouldn't be that difficult to get this surgery approved.
So, another round of counseling phone calls, dietician visits, psych evaluation, swallow test, and losing the required amount of weight...here I am today. Waiting for the phone call.
I did get good news yesterday. First off...the doctor told me there is no reason I can't lose up to 100 pounds. He said that 50 pound limit was *kitten*. Then he told me that if I wait two years after surgery, where my weight loss has stablized, he can do the hernia repairs. Oh and guess what?? He will have to remove all of my excess skin to make this a safe procedure.
So, please say prayers and keep your fingers crossed that I will be approved. I was told it would take up to two weeks before I found out.
Thank you!!
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Replies
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Sending lots of prayers your way...I suffered with a paraesophageal hernia for years, they fixed mine when they did my sleeve surgery on 4/7 been symptom free since! I know your pain! Keep us in the loop
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Prayers for you! I think you've got enough evidence now though. Best to you!
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Thank you Karlottap and Joysie! I will let yall know as soon as I know anything.0
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Thinking of you -0
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Good Luck! It sounds like you found the right person to help you! It is all coming together.0
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Best wishes. Hoping all goes smoothly and without stress for you.0
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I have no doubts this will be good for you. My husband is 1 year 3 months post sleeve and 2.5 weeks ago had his 4 abdominal and 1 groin hernia fixed and the excess skin removed. It is life changing for him.0
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