Dr Inman did a Barium Swallow to look at my band

[Yvonne]

Someone please tell me this is going to help? I went today, and she had intended on doing a fill under fluoroscope and then a barium swallow so she could look at my band etc. She said "Oh" as soon as she looked and said, "I think your port is upside down". She tried to push it up so she could put fluid in it but had to give up. She came out with a bent needle. None of that hurt, btw.

She said I not only have an upside down port, but she can see where I have severe reflux AND my pouch is super small, like it moved up. Isn't that a slip? I know the pouch was not stretched out or anything (from overeating), cause it looked tiny when I swallowed and watched it. It also delayed before emptying and I shouldn't have anything in my band at all in regards to fluid.

My DS has been approved, but they denied my crap band removal stating that I showed no diet compliance, which is bullsh*t, because they require that for DS approval as well, and that was approved. I guess that YEAR LONG, MONTHLY visits to a bariatric doctor (not surgeon), didn't count in 2014. Duh. They also said since there is nothing structurally wrong with it they are denying it. Does this sound like enough wrong with it or what they may be looking for? @Larra and @DianaCox

She did an electronic note to Coleen and said they would be sending it right back out to insurance.

Yvonne

 

[DianaCox]

Since we have no idea what she wrote, or really what she found, based on what you said, I don't see how we can answer that question. Needing to fix an upside down port doesn't sound like a reason, by itself, to justify a medical necessity to remove the band - the port can easily be flipped in an outpatient procedure, from what I've seen.

 

[Yvonne]

So the severe reflux and the fact that it had moved to make a very small pouch doesn't count? Like a slip maybe? Those were the 3 things she was going to put down as reasons - flipped port, severe reflux from band, band moved up.

 

[Larra]

Well, as @DianaCox said we don't know exactly what was found of what she has documented in your chart, but I would think that she would take this and run with it and use it if at all possible to justify removal of that band, and to also demonstrate that you could not be any more compliant that you were given that you have a port that can't be accessed for fills or unfills. The band only works (if at all) if it is filled such that it's neither too tight nor too loose. If it can't be adjusted, it's useless, and you are in no way responsible for a flipped port.
Will this approach work? I don't know, but it's worth a shot, and better than if she found everything looking perfect. I don't know what to make of the band location based on your description, but a flipped port is a flipped port.

 

[Yvonne]

She said it looked to have moved upwards. So that my pouch is really small now. A slipped band. Although it's not severe, it doesn't mean it won't be. Also, I NEVER had reflux before the band, so any I have is being caused from the band. I know we talked about her putting that in the appeal. I talked to someone today and said it was only $600 cash pay to have the band removed if the rest was being paid for by the insurance company. I'm going to call them tomorrow and ask them directly how much it would be.

 

[Larra]

$600 up front would be a steal to get that thing out and get your DS done, and you would still have the right to appeal the denial. Let us know what you find out.

 

[VDLT]

So obviously I am not a doctor... And I am not sure if you have had a recent official upper GI or endoscopy. I can tell you that I had my band for 14 years. While I never had a slip I did develop a hiatal hernia and my esophagus got dilated due to the band. I also developed gastritis and esophagitis. Insurance paid for removal as medically necessary. I would be happy to share the letter I wrote in which I quoted the findings of my most recent studies if that would help. Was this a bariatric surgeon? I find it peculiar they spoke in such vague terms and not say it was a slip or a hernia. I agree that $600 to get it out is a great deal.

 

[VDLT]

P.S. I had a flipped port that required a crazy amount of painful digging and could only be accessed under fluro. I feel you on that one.

 

[Yvonne]

Yes, it was my surgeon. But she was more talking to herself than me. Lol she used technical terms once and just thought mmm hmmm. I'd love to see a copy of that letter. I had an endoscope in March and my ex-surgeon said he couldn't see anything from the inside that was wrong. I think we are really reaching to find things at this point to get them to pay.

 

[DSRIGGS]

I know you are very stressed over this situation but just keep telling yourself that everything is going to work out. A year from now this will be a distant memory and you will be on with life. You have things in the hands of a very well respected surgeon and she will make it happen.