Removal of LapBand and doing RounY Gastric Bypass

Question
I recently had to have my lap band removed due to 2 surgeries to have it put back in place after it slipped. During this time I also had to have my Gallbladder taken out.  I have been told that I need to wait for 6 mo's for my stomach to heal before I even consider the RounY Gastric Bypass.  Had I known that I would be doing all these surgeries, having so much nausea and vomiting, not able to eat solids toward the end due to the pain, I would never have even considered doing it.  I so want to have the Bypass done, but I may be up against a small wall at the present time.  I currently weigh 277 lbs and am 5ft 11in. No diabetes yet, but I just had a blood draw before the lap band removal and the blood sugar test came back and my family Dr. said that it is at a reading of pre Diabetes.  Arthritis is rampant in my family.  I am the youngest of 6 siblings. 5 Older brothers, I am the only girl, currently 54yrs old.  They all have Diabetes, 3 have had knee replacement surgeries, 1 has had the knee replacement, sleep apnea, diabetes, back problems,the list could go on.  I already experience the arthritis. Depression issues, sleep issues, bladder leakage issues, The Ins. Co. covered all the previous issues, but are holding back on the gastric bypass because of no co-morbidities. Any ideas on what I can do to make the Ins go my way?  I know that the surgeon won't do any bypass for 6 months and I'm ok with that. Is there anything I can do for now though.  I know of all the risks, I've memorized them all. The surgeon explained them all.  And I'm still willing and wanting to do this bypass surgery.  Can you offer any help?

Answer
Cathy,

This is really an insurance question and we just don't have anyone on our category who answers insurance questions (although we need someone!)

I am going to make a couple of suggestions and a comment.

First, if you have not gone back and spoken to your surgeon's office to see how they can help you, you should.  Revisions/reoperations should be seen differently than the initial operation.  Assuming you qualified for surgery the first time around, there is likely to be greater chance of you getting the revision done with coverage, but you will need your surgeon to help with providing the justification.  Most doctors have a billing specialist who can at least give you some guidance.

If you have already gone down this path, the best person I know to contact is a lawyer named Walter Lindstrom.  Walt is a patient and runs a group called The Obesity Law and Advocacy Center (www.obesitylaw.com, 619-656-5251).  His specialty is helping people get access to care, especially dealing with difficult insurance cases.  Plus, he's really nice.

On a different note - since my expertise is in nutrition - I am concerned about any patient who reports repeated difficulty with nausea and vomiting.  Despite your stomach trauma, this is not normal.  Persistent nausea and vomiting is a common symptom of thiamine deficiency - this deficiency is known to occur with all bariatric procedures as well as in pre-operative patients, and can cause serious complications.  You should talk to your doctor about having some testing done - especially before you consider any more surgery.  

Please let me know if you need any further information.  I hope some of this is helpful.

In Health,

Dr. Jacques

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