Bleeding ulcers

I had a RNY in 2001 since then I have had 3 bleeding ulcers 3 times the most recent happening last month and I had to be hospitalized -endoscopy staples and bleeding has stopped, but still low on blood.  Doctor has submitted to insurance for approval to see a bariatric surgeon about repair.  Is this normal?  How likely is my insurance to deny?  I lost about 90 lbs, and have kept off 80lbs for about 14 years.  Is anyone else experiencing multiple ulcer bleeds this far post op?  Curious... Barb

I just responded on another post about insurance, that with Obamacare all pre-exsisting conditions are supposed to be covered. I would think that would apply to this situation, I'm not sure but you do have a medical necessity. I think it's odd though that your doctor had to submit to insurance for you to just consult with the Bariatric Surgeon. Congratulations of keeping the weight off. Good Luck!

I hadn't considered the Obamacare angle, that's a good point.  Maybe they will just drag their feet a bit then get me an approval. I don't like thinking I might start bleeding again with no symptoms.  I'm still dealing with anemia and the resultant fatigue from the blood loss. Thank you for giving me a different way to look at the approval situation!

Are you asking if it is normal to have to get insurance approval to even see a bariatric surgeon?  If so, that depends on your insurance. I personally have never had a plan that required even a referral (let alone pre-approval) to have a consultation with a surgeon, but some plans require referrals and others might require pre-approval to see a specialist.

Having bleeding ulcers isn't normal, of course.  I assume that you are not taking any aspirin or ibuprofen products (Aleve, Advil, Motrin, Celebrex, etc.) since those are known to cause ulcers. (If you ARE taking any of these, you need to stop immediately.)

Where are the ulcers located? In the pouch? Along the staple/suture line? At the stoma? Did the doctor give you any idea HOW they would fix the ulcers?

Lora

The gastric docs said it was in the area where they attached the intestine to the stomach, that the tissue was thin and had less blood flow than necessary.  They stapled the 3 ulcers as well as cauterizing them this time.  (2 previous bleeds were just cauterized.)  Been off any NSAID's since the first bleed.  I do take Tylenol occasionally.  

No idea how they would fix the ulcers-mentioned possibility of cutting off part & reattaching to the stomach.  No word from the insurance on approval and its been a month.  I wondered why I would need a bariatric surgeon to fix an ulcer?  Just because the configuration is different now?   

Thanks for taking time to reply...

Since it sounds like the ulcers are right at the anastamosis, it might require getting rid of the tissue that is ulcerated and the  making a NEW stoma (and that definitely requires a bariatric surgeon).

It sounds as if maybe they are getting approval for the entire procedure, bit just a consultation.  If it has been a month, I would call the insurance company yourself and ask what the status is.

i sure hope they can get it all fixed for you!

Been there, done that....insurance approval wasn't the problem, it was finding a GI doc with time to do it!  My bariatric surgeon went ahead and did it and checked on everything when he was in there. Insurance doesn't want to mess around with ulcers cause the longer they wait the more expensive it is to fix. I stay on carafate all the time now, and two does of PPI and stricter diet, and only had one recurrence since. Hope you feel better, stay hydrated!

Thanks for the encouragement.  I am a bit worried about getting approval to fix the ulcers... A friend had a band that slipped, and her insurance refused to pay for repair.  She had to foot the bill again herself.  I finished the PPI course and am back on Ranatidine.  Went to the store and got the OTC Omeprazole, as the pain and acid was pretty bad without it.  Doc said it was ok.  

An ulcer is a completely different thing. band slippage is a direct result of the actual band...ulcers can occur in anybody....Good luck....