UPPER GI BARIUM SWALLOW RESULTS. HELP??

[Melanie1218]

There is small sliding- type hiatal hernia measuring approximately 3.5 x 3 cm.. There are post surgical changes of gastric bypass. The remnant gastric pouch measures approximately 4 x 7 cm. There is passage of contradt from the remnant gastric pouch through the gastrojejunostomy and into the jejunum. The gastrojejunostomy appears widely patent. No evidence of to suggest a gastro-gastric fistula.

 

[DSRIGGS]

and?

 

[Melanie1218]

I'm trying to find out if this has any info that would give me more added reason to get insurance approval for revision to DS

 

[Clematis]

I'm not a medical professional, but everything is noted as ok other than you have a hiatal hernia -- which would neither preclude a DS nor show a need to have a revision to DS.

 

[Melanie1218]

Does anyone know if my pouch size is considered stretched? I know most of your are DSers but anyone knowledgeable with the normal gastric bypass pouch size?

 

[Melanie1218]

I'm not a medical professional, but everything is noted as ok other than you have a hiatal hernia -- which would neither preclude a DS nor show a need to have a revision to DS.

Thank you!

 

[DSRIGGS]

I'm trying to find out if this has any info that would give me more added reason to get insurance approval for revision to DS

I am not 100% sure. The Hiatal hernia is not a justification because those are fixed in normies all the time and doesn't require getting a DS to fix it.

 

[DianaCox]

The stoma is "widely patent?" How big? If it is wide open, you are getting no restriction, and food is just falling through the pouch.

 

[Melanie1218]

I am not 100% sure. The Hiatal hernia is not a justification because those are fixed in normies all the time and doesn't require getting a DS to fix it.

I have major dumping too and major weight gain

 

[Melanie1218]

The stoma is "widely patent?" How big? If it is wide open, you are getting no restriction, and food is just falling through the pouch.

Diana good question. I asked him to measure that and he didnt comprehend what i was saying.

 

[DSRIGGS]

I have major dumping too and major weight gain

I understand. Just saying that the hiatal hernia would not cause those things and would not justify the revision. The large Stoma I would think might give ammunition for the medical necessity argument. Dr k and office will be able to advise you as to whether or not he can justify the revision based on medical necessity.

 

[Melanie1218]

I understand. Just saying that the hiatal hernia would not cause those things and would not justify the revision. The large Stoma I would think might give ammunition for the medical necessity argument. Dr k and office will be able to advise you as to whether or not he can justify the revision based on medical necessity.

Thank you so very much for your input!

 

[Larra]

Late to the party here, but "widely patent" is not what a stoma is supposed to be. It's unfortunate that the radiologist (I hope you spoke directly with the radiologist, the technicians would no nothing about this) didn't understand how important this is, but not surprising. Everyone seems to focus on the size of the pouch and ignore the stoma unless it's strictured, which is clearly not your problem.
Dr. K will know how large a stoma is acceptable. Hopefully he can make an accurate assessment from the photos you will provide for him and use this as a justification for a revision.

 

[Melanie1218]

Late to the party here, but "widely patent" is not what a stoma is supposed to be. It's unfortunate that the radiologist (I hope you spoke directly with the radiologist, the technicians would no nothing about this) didn't understand how important this is, but not surprising. Everyone seems to focus on the size of the pouch and ignore the stoma unless it's strictured, which is clearly not your problem.
Dr. K will know how large a stoma is acceptable. Hopefully he can make an accurate assessment from the photos you will provide for him and use this as a justification for a revision.

Larra thank you. I posted yesterday that he (the radiologist) thought i was crazy when i asked him to measure the stoma. He said he has never heard the word stoma before and that i need to talk to my Dr cause its not a term they use. I am sending the report and disk today to Dr K just wish this radiologist would have known his terms. He claims he is very involved with all the gastric bypass patients at his hospital. Cleary not since he never heard of a "stoma"

 

[Melanie1218]

Would anyone mind supplying me with Dr Ks email or Kristina's i have documents I'd like to email as well as send him my disk.Thank you!