Newbie Needs Some Advice

Hello Everyone,

I am bit intimidated to post, but I have read through the various forums on ObesityHelp for years. I finally decided to register and see if I can get some guidance and maybe some support. As I am typing this I am already tearing up. When I was 20 years old I thought I needed to lose weight if I was ever going to find a husband. I was 296 lbs and so unhappy with myself. I have always suffered silently hoping people would overlook my fat for my pretty face. I have been told my whole life I would be so much prettier if I lost weight. I begged my mom to help me get a lap-band in Mexico. She was reluctant, but being her only child and seeing how much pain I was in, she caved. I flew to Monterrey by myself and under went surgery. I lost about 50 lbs over the first year. Which was great, but not at all what I expected. I did not really commit to the diet change and found myself constantly throwing up. In addition, I never really accounted for all of the adjustments. Needless to say I was young and dumb. 

Fast forward 10 years...

I did find an amazing man that loves me and all 360ish pounds of me. I got married and now I am about to turn 30 years old. I have always convinced myself that I am too fat to ever get pregnant. I have been off of birth control for over 2 years. I have also had the most stressful and horrible 2 years of my life. I realize that can mess with ovulation, but it has also messed with my head. This month I thought I was pregnant due to a late period, but 2 home pregnancy tests confirmed that is not the case. I have realized that I need to have my band removed for quite some time, but the last 2 years my complications have amplified. I have a crazy amount of heartburn (even from water) and occasionally I still can not get down my food and have to vomit it up. Even though I have no fill and supposedly should have no restriction. However, feeling like I cannot have a baby has crushed me. I tried to convince my husband that we are better off not having children so that I don't hurt him when I can't get pregnant. I have tricked myself into believing I am too selfish / career-driven to be  mom. The truth is I want it more than anything. These negative pregnancy tests opened the flood gates of fat sorrow and I have hit rock bottom. I did the only thing I knew how to do and sat in front of the TV eating frosting. My husband was asleep and I was drowning my pain. 

What I am asking for?

I am a graduate student and do not have healthcare. My husband's job is going to pay the fine instead of provide him healthcare. I would like to get health insurance through Covered CA, but I have no clue who would cover my lap-band removal or a revision to DS? Do I call different insurance  companies and ask them if the cover it? Also I am a bit concerned about the bowel / gas issues with the DS? How bad can that get and for how long? Finally, I am ready to change my diet and my husband would support me 100%, but I feel odd about taking 30 vitamin pills per day. Can I do a powder version in a protein shake? Thank you in advance for reading my tale of woe. I just really needed to tell someone who would understand.

Hi and welcome!

I'm sorry you have gone through so much and suffered so. You are NOT dumb. You are simply one of the many, many people who bought the false promises of the lap band. The failure rate, and reoperation rate for that gadget is very high. There are people having their bands removed and revising to other, better bariatric operations all the time. Given your long history of morbid obesity and present eight, the DS is your best choice by far. The Ds has the highest percentage excess weight loss, best maintenance of that weight loss (so important but often overlooked) and best rate of resolution of almost all comorbidities of any bariatric surgery. As far as the vitamins go, many people take less than 30/day, but frankly, it's not that difficult. You get into a routine and it becomes almost automatic. This is not to minimize how important those vitamins are. they are crucial for maintaining good nutritional health. But not hard to do once you make the commitment to do it.

Your question about insurance coverage is difficult. I don't have the answers for you. I would recommend that you call the surgeons in CA known for doing the Ds on a regular basis and speaking with their insurance people to see what they know. I don't know exactly where you are, so will recommend Dr. John Rabkin of Pacific Laparoscopy in San Francisco and Dr. Ara Keshishian in Glendale. See if their staffs can answer your insurance question.

It is quite possible that covered CA won't cover the surgery you need. In that case, there are 2 surgeons in Mexico with excellent reputations who do the DS: Dr. Ungson and Dr. Aceves. I would not recommend anyone else in Mexico.

Larra

Larra,

Thank you so much for your response. I appreciate the information you have given me. I have called Dr. Keshishian's office and they suggested I call the various insurance companies and ask what plan covers WLS. I guess I am somewhat distrustful of that seeing as I am telling them up front I am going to need an expensive procedure. I am in SoCal and I have considered going back to Mexico to at least have the lap-band removed. Which of the two doctors you mentioned would you want to operate on you? 

Don't be afraid to make those phone calls. Remember that as of 1/1/14 insurers can't deny you coverage based on any pre-existing conditions. But when you call, ask about the DS specifically and not just coverage for bariatric surgery. Most insurers do cover bariatric surgery, but not all cover the DS. Some will cover it only for a bmi over 50. So try to get specifics if you possibly can, keeping in mind also that the people you get when you call A) may not appreciate that there are differences between bariatric operations and that these differences matter and B) no one cares about your health and future as much as you do. If you can get anything in writing that you can review yourself, either on paper or on line, that would be great.

As far as Mexico goes, I have no personal experience with either of these physicians. I guess I would go with Dr. Ungson just because he's been doing the DS longer than Dr. Aceves. Dr. Aceves learned the DS from Dr. Ungson. He had already been doing the sleeve and I'm sure has done many sleeves. He did the Ds with Dr. Ungson as his assistant surgeon for awhile, which was a great way to learn, and now does them without Dr. Ungson. Last I knew, he had some kind of deal going where dr. Ungson would join him for an additional fee. I don't know how much the fee was or if that option is still available or not.

Larra

I can only help with the DS questions. I was a self pay in Ohio.

For me I had the most problems with Gas / bowel movements the first month after surgery. I came out of
surgery lactose intolerant and it took me a while to figure that out. Once I stopped using milk and switched to
Lactaid most of my early gas and bloating issues were gone.

I'm going on 10 months and usually have two bowel movements a day. Luckily I have not found many other foods
that hit me like milk does (dark chocolate - I just think in that case it was worth it). As long as I stick to a high protein,
medium fat, low carb diet I don't have any problems. Life happens and sometimes I will have something that doesn't agree
with me and that will cause a couple more trips to the bathroom. For me that is an easy tradeoff.

I thought there were a lot of vitamins when I started at around 6 weeks but at 9 months I hardly think about them. I currently
take 26 pills/capsules a day (6 of these are calcium). I sort them out once a month - just no big deal.

Good luck with your journey and your decision. Getting rid of the lap band is a good idea no matter what you do after that.

PeteA,

Thank you for your response. Can I ask how much your surgery was? I have been thinking about looking into a financing option. I am already pretty lactose intolerant from the lap-band so that won't be so hard. Also how much is your monthly vitamin bill? I am guessing you buy them in bulk? I am really trying to think about every angle of the DS because I did not do that with the lap-band. 

No problem. It was 32k. That covered Most of the pre-op, the operation, and visits through the first 3 months. They enroll you in an additional insurance program as part of the fee that would cover any additional complications resulting from the surgery.

I average about $60 a month on vitamins.

Pete

welcome, and we have all sat there eating frosting.....we know how that feels,

what I think is critical is to have your band looked at, probably removed, you could have a slip.  heartburn even with water....you are asking for it,  I had the band for 8 years, I have permanent irreversible damage don;t let that happen to you.    you are not going to know who will cover your lap band removal, how can you?  you dont even know what is wrong, how can you expect an insurance co to pay unless it is medically necessary to be removed (with the lap band and all those complications I am sure it is, BUT you have to prove it to them)

forget about your bowel issue ever being normal after the DS, but it is a BM, we worry about the strangest things sometimes, you adjust trust me, gas not an issue unless I eat simple carbs, then run for the hills and run very very fast.  feel odd about taking 30 vitamins pills per day, but it is ok to stay MO?  yep we all think the same, you are normal, taking pills gets real easy...seriously it does....I take 37 pills/day...horray....well 13 are RX and before the DS i took zero, none yep not even one RX...0 to 37 and I take Vit d injections or it would be more like 40/day...just resolve that you have to take pills, that is part of the ds, forget about powder this and that, take your pills, you have to or don't get a ds....get that band out....before it is too late.

airbender,

Thank you so much for your response and for understanding my love/hate relationship with frosting. Can you tell me more about your permanent irreversible damage? I have had it for 10 years and I am constantly nervous about it. Did your insurance cover band removal? Thanks for the vitamin perspective. I would rather take 37 pills a day and be a healthy weight. 

you are very welcome. I was very very sick with the band,and removal was medically necessary so pretty much any insurance would pay for the removal, you have to prove you have medical necessity not the other way around,  I had so many things wrong one of the issues constituted medical necessity since they were so severe.  now getting a revision paid for that is a different story.  my esophagus is trashed....

I have severe late complications caused by the lap band, anterior and posterior hiatal hernia,  anterior band slip, severe esophageal dysmotilty, poor primary peristaltic wave, severe esophageal dilation, gastroesophogeal erosion, gastric antral erosion, dysphasia, gastroesophageal reflux disease etc

geesh the pills thing scared the crap out of me, like I said I went from taking not one pill to a trainload...oh my gosh...now, who cares, it is easy....anything is better than that pain I was in.....I wish you luck while you decide what to do...