Can't get the surgery if over 50+ BMI

Tricare covers Gastric Bypass, Sleeve and lapband .  I want RNY .  You have to be under 400 lbs and a bmi of 50 or less.  This is what I read on their site that was updated 7/11

I think someone on the DS forum did recently have a DS through tricare but I think there is just one surgeon at one hospital. If you are interested it wouldn't hurt to ask over there

Hello and welcome.  With a BMI as high as yours, you should look into the DS.  That is statistically shown to have much better long term results.  Please check out the DS forum and dsfacts.com.  You can also come over to the other board as well.  There are more places to get support...the more the better I say, lol.

If your insurance will pay for the other WLS, they can more than likely be made to pay for the DS.  DO NOT let that stop you.  Do your research and choose your surgery first, then choose your surgeon based on the surgery that you want.  

Research, research, research...that is the key.  Once you have all the correct information about all the surgery options, then and only then can you really choose what is best for you.  Think twice, cut once!  I am a RNY to DS revision and I sure wish I would have researched ALL of my options at the time I had RNY.  It was my own fault for not learning everything I could and because of that I ended up having to get a revision because of complications from the RNY.  If I would have known about the DS before having the RNY I would have never had the RNY. 

I guess all I am saying is make sure that you know ALL your options.  You don't want to look back on anything with regrets, or have to get a revision down the road.  Best wishes to you!

Good solid evidence of DS effectiveness.... I wonder, how did the risks figure in to your decision making? What was your original BMI, if I might ask. Just mere months ago I'm chatting with highly active (400 surgeries per year) surgeons from Australia, and they're very proud of their lap band achievements with BMI 80+ patients. Meanwhile, if the sleeve kills the RNY, one would expect DS acceptance (as a gold standard) to increase.

Was your own insurance ultimately useful?
Were your RNY complications, in your opinion, a result of a surgery prone to complications (compared to the RNY).

I had lunch with Scorpinaro last Sept. Probably 80 years old by now. (He invented, kind of, the DS). A nice, intelligent, crumpled Italian. His big theme was how DS was different from BPD/DS. Just curious... did your surgeon ever talk about "BPD" at all as assocaited with DS?

Experienced surgeons (ex: Gagner (NY)) describe very low mortality rates for the very highest EWL% improvements.

It's interesting how lap band proponents emphasize reversibility, and sleeve advocates emphasize RNY-value,l but ith lap band risks. Meanwhile, a good dozen or so world DS/BPD leaders have held their own with the DS as a gold standard in, hand down, achieving the very best EWL% results (with additional mortality rates varying).  Something very traditionally respectful, I believe, in deciding on desired results and going with the best proven method to get those results, even with some additional risk.

Did your RNY doc even mention the DS as an option?

 Just an FYI, Gagner is in Montreal Canada now :D

The BPD/DS is the same thing as the DS, the BPD (without the DS) is something different and what people will want to avoid. 

You say you "want " the RNY ?  Are you aware the DS has a higher success rate ?

 Have your  heard it ? Read about it ?

 Go to www.dsfacts.com and check it out... do not miss an opportunity. There are a lot of people with tricare who have gotten the DS approved, although I think have had to appeal to get it covered.. But it's worth it ! If you are going to have surgery do it right the first time.. There are also yahoo groups that talk about the DS as well.. you can go to http://health.groups.yahoo.com/group/duodenalswitch/?yguid=4 73555398  for another forum... want to see a BUNCH of pre/post op pics  Go here   http://health.groups.yahoo.com/group/duodenalswitch_extra/?y guid=204075911

My first WLS was botched.. I had to have a revision a few years later. Please research thoroughly and do not jump at the first chance you get.

Also get the wording directly from Tricare on what is covered and not covered.. Check the insurance codes etc and their exact wording.

 The surgeon in our area doesn't do DS.

 Well then you travel to get it. My first one I traveled 4 hours and he was a bad doc... Second time I traveled 13 hours for my revision. Do what is best for your health. Others have gone as far as Brazil if their insurance will not pay. There is a doc, I wish I could think of who it was that accepts Tricare and does the DS.. I will try to think of it. Go post on the DS board and ask, someone will answer you. 

Why settle for less than the best ?    Vetted DS surgeons are few and far between, but they are worth the travel to get to one.  Of course, the final decision is yours, but at least take the time to check it out.  

Second time I traveled 13 hours for my revision.

I had mine done in Kuwait but I lived there at the time. My mother however lives in Michigan and traveled over to have her DS with the same surgeon that I had mine with. Travel is more and more the norm for a lot of procedures.

There is an EXCELLENT DS surgeon in the Raleigh/Durham area which is not far from you. Check him out: Ranjan Sudan, MD, another is David Voellinger., he's located in Charlotte, and  ask on the DS board about Paul Enochs

Most of us pick our surgery and then our surgeon and if we have to travel, so be it...Think TWICE, CUT ONCE.

Also make sure you check the revisions and the regrets boards.

The DS (even at MY BMI pre-op of 35.2) was the single best decision I made.

Liz