My LINX journal

When I called to see if LINX was approved (after my pre-approval was sent in) UHC said that 43289 code and I had her look up Nissen just to double verify that it wasn't approved for Nissen and that was it's own code - so you're on that :)

My deductible is $2,500 and my insurance pays 90% of surgery. So that is where the $2k part comes from... then I had about 9 other tests done before surgery (my old GI thought it was my gallbladder, etc) and after all the random debts from that it's $1k. So this entire heartburn/GERD situation has cost me $3k out of pocket.

I'm not sure of a time frame? I've had issues for 8 years. I'm sure if you are a candidate then it doesn't matter, why go a few more years eroding your esophagus and doing more damage, you know? I know before you couldn't if you had Barrett's but I think that is slightly changing?

NoDoubtLove
Went back and looked at UHC papers. Code used was 43289. They paid then taken back. Yes, we were told we wouldn't have gotten to the surgeon if it hadn't been approved. Guess it pays to call ourselves rather then just taking the doctor staff word of approval. Thanks for listening to me. Hope, truly, that it stays paid for you. You have been inspiration and help for many. Keep writing. <hugs>

Hi NDL and PF,

Unfortunately, it is not like the old days where most business can be done with a handshake.

IMO, it is critical to have a original paper trail for any MD visit or procedure. I went to a known hospital referred Gastroenterologist way back who told me that my 24 Hour Ph/Impedence would cost me $775 out-of-pocket even though he was in-network. When I questioned him further as to why, he said that his "test" was more specialized.

I called the insurance company (with his statement of intended services) and they cancelled his contract.

Caveat emptor! Never assume.

Best,

Gastricman

P.S. If UHC approved the hospital/surgery and you have proof of this, IMO, you shouldn't have to pay anything.

Post Edited (Gastricman) : 2/11/2013 12:53:34 PM (GMT-7)

gastricman - So that doctor was doing something shady? At least that is what it sounds like!

I don't have paper proof - just the 2 phone conversations with UHC and I believe my doctors office said they had an email. I feel crazy calling and asking for that just yet - hopefully I'm just being paranoid. I wonder how long I have to wait around until I know for sure with UHC?

gigglesalc25 - I believe dr. Taiganides wants to do his own so he can "cover his a s s" sort of thing, you know? Like he has 100% idea of what really is going on in there and not just judging by someone else. My other endoscopy was very poor compared to the detail he gave with his.

You should speak with your doctor more clearly if you are confused with what he said. I know it's a lot to take in when they try to say what is going on. I learned that my regular GI doctors would minimize the heartburn issues and act like it wasn't that big of a deal. Dr. Taiganides was the first one who actually listened and agreed that heartburn is no way to live life. I'm very thankful I found him!

I'll keep my fingers crossed for you! I wish you the best. I know how stressful all of this but know there is a light at the end of the tunnel, even if it's not LINX you can see about Nissen and so many people praise that too! :D

And I thought if you have Barrett's you have it, it's not a maybe or not?

gastricman - He does do the endoscopy himself, him and another woman did the pH study but one of the heartburn specialist did the manometry. So he does do most of it himself :) I think he feels more comfortable knowing exactly what is going on with his own eyes before making surgery recommendations.

Knox is known for their Heartburn Treatment Center. Don't worry about the website... I am a web designer/programmer and I judge businesses on their websites so much lol but in this case - no worries, they handled everything so great and were all super nice :D

Worrying about it while waiting to get the consult/tests isn't going to change what is going on. Try not to obsess, I know that's really hard but you don't need to drive yourself insane on top of not feeling well.

The past GI doctors I had did the same confusing things. But I started to wonder if it's because they have no idea *** they are doing?! :( Sad but true!

Gastricman said...
Hi NDL,


Maybe time for a comprehensive status update on your condition?



Best,



Gastricman [img]/community/emoticons/smile.gif[/img]

4 WEEKS AFTER LINX
Today is my 4 week anniversary of having LINX implanted! Wow time is flying!

physical - I am not sore at all anymore, haven't been for about a week (most of the soreness went away after 2 weeks). My incisions are healing up nicely and are very small in length. After the steri-strips came off if I wore tight clothing it would rub on the incisions and make them irritated but that isn't an issue anymore.

food - Food wise I've ate everything under the sun that used to cause me heartburn and still have had NO HEARTBURN. I've ate more jalapenos than I ever have in my whole life! Before LINX anything spicy would cause heartburn. Garlic, tomato anything, food spices, greasy ... basically if it wasn't steamed veggies, milk or grilled chicken/fish I would get heartburn. So the fact that I can eat ANYTHING is amazing to me! I've been eating chocolate like it's going out of style... man I missed chocolate!

health - I sleep throughout the night now. Before LINX I would wake up at least 3 or 4 times, usually up to 10 times a night with heartburn or indigestion. I used to drink a full glass of water all night to help with the burning. But now, the water is still full and I wake up confused that it's daylight and I slept all night! My sinus' have felt much much better, less migraines and sinus pressure. I have noticed I don't have a sore throat every morning either! I barely cough anymore. I've noticed that I'm not as tired (probably from getting sleep) and I'm not as dizzy anymore. Another weird thing is that my tachycardia (high heart rate) hasn't been showing up anymore. I'm not sure if that was triggered by anxiety or what - but I know it's been much more steady. I'm slowly being able to burp too!

mood - My depression has really changed. I feel so much happier and like I finally reached the light at the end of the tunnel. I am stressed out though, worrying if United Healthcare will send me a letter saying LINX was investigational and they want money :/. But overall I feel like I have my life back!

"bad" - So those are ALL THE GOOD things of LINX. Here are the "bad". When I say "bad" it's not really "bad" though. The swallowing/stuck feeling is the only annoying part. This started about 2 weeks in and has eased up a bit. That could be because I'm chewing my food more thoroughly though. I haven't had to take any big pills like before, so I don't know if they would get stuck. 2 weeks ago I switched to gummy vitamins just in case. The stuck issue has been less painful and easing up. So I'm hoping in another 2 weeks it's eased up even more.

overall - Overall I'm SO HAPPY with LINX. I feel like I'm being annoying praising it so much but so far it's changed my life. I can eat now, I can relax, I can sleep. A few people have commented on how much nicer and happier I am LOL Nothing can be perfect but this is close enough to it so far. I feel like I have my life back!!!

I chew different after LINX than I did before. I had the habit of eating fast and not chewing well. After LINX I definitely have to make a conscious adjustment to chew thoroughly. I am getting better at this and it's becoming "normal" for me.

The pain of when food gets "stuck" is honestly getting better. It's not as painful in general, doesn't last as long and isn't happening as often. It is awkward though... I basically sit there trying to sip water quickly and feel it move past. It's the same sort of feeling as when I had the pH Bravo capsule in there on the 2nd day.

Overall - I'm the last one to finish my meals now... with my husband, coworkers and friends I'm the last one. So it's noticeable how slowly I eat.

Keep in mind, when it's stuck you are still able to breath normal and swallow water normal so there isn't any feeling of panic (well at least I don't panic).

Hopefully I answered well enough - if not just ask more questions! I'll answer anything :)

I didn't stay in the hospital overnight... they pretty much have you stay a few hours after the surgery and then you leave. Overall I didn't mind because sleeping in my own bed is much much better!!

If you take 2 weeks then you will good by the time you go back. That's how long I took. :)

NDL

Like you I am the last to eat now. Often go out to eat and find I do not finish my food as its cold as I cannot eat as fast as I used to. Just have to drink my wine faster than the rest

Pat Fill,

USC Keck used the EndoFlip to confirm that Linx is indeed working. They look at the LES distensibility against stomach Pressure curve. Details in my journal.

GH

Hey NDL!! Yay, I'm so happy for you :) Guess what?? I spoke with my doctor today and he confirmed that I still have acid coming up despite the PPIs, so I'm not crazy LOL! I guess the LES has pressure, but it relaxes a lot. He said I had both acid and nonacid. My esophagus is working well, but it seems that I have a tight spot in it so he wants to do another endoscopy. Anyway he said, let's talk about antireflux surgery. I was thinking, about time hahah! But he was talking mainly about the Nissen. Then he said, there is a new surgery, blah blah, I already knew lol. I said, yea I'm looking more into that one. So he is going to have me talk to a surgeon there at UCLA and then possibly the surgeon at USC who does the linx surgery. So it looks like the Linx is in my near future. So glad and tired of feeling reflux!

How have you been feeling?