Some questions from a newbie

I'm currently starting the 6 month diet required by my insurance, and am at the moment, decided on the sleeve.  Like a lot of people I'm sure I started this thinking I wanted the band, until I researched and decided there was no way in hell I would get one.  So, I was lurking around the different forums (ok, I mean I saw the Thanksgiving thread and came over here) and have a few questions.  I've read through the first 4-5 pages of posts, read the links for the pre-ops (Thank you for that awesome one stop-shop!!) and have went to dsfacts.com.

I still have a few questions though...

So, my insurance covers DS I think... here's a list of what they cover: (directly quoted from my policy)

* Gastric bypass (Roux-en-Y; gastrojejunal anastomosis)

* Adjustable gastric banding (laparoscopic adjustable silicone gastric banding) – See FDA
section/information 

*  Gastric sleeve procedure (also known as laparoscopic vertical gastrectomy or
laparoscopic sleeve gastrectomy) 
 
* Vertical banded gastroplasty (gastric banding; gastric stapling)

* Biliopancreatic bypass (Scopinaro procedure)

* Biliopancreatic diversion with duodenal switch 

It also goes on to say:  "Vertical banded gastroplasty (gastric banding; gastric stapling), biliopancreatic bypass (Scopinaro procedure), and biliopancreatic diversion with duodenal switch are not first-line procedures for the general bariatric surgery patient."

What the hell does THAT mean? lol

ANYWAY, What I'm conufesd about is the DS the same thing as the biliopancreatic diversion with DS?  I'm sorry if this is an obvious question, but I really can't seem to find the straightforward answer...or I'm too tired or blind to see it.

I only want to go through wls ONCE and I want to be sure I'm getting the surgery that is right for me, so I want to have all my options before I pick one.  Thanks in advance for any info!  You can even say "hey silly, this exact thing was answered here: insert awesome link here"...




 

Welcome!

The DS is the same thing as the biliopancreativ diversion with duodenal switch. But what the business about it not being a first-line procedure means, I have no idea.

Somebody more experienced than me will know.

Good luck with your research!

Lisa

Thanks Lisa and congrats on your approval!!

Well, the language of that policy is new to me, and I've been helping people with insurance stuff for almost 9 years - I would call them and ASK them to please put in writing what "not first-line procedures for the general bariatric surgery patient" means, and what is necessary to prove to them that the DS is the right one for you, since the ASMBS, Medicare and most mainline insurance companies acknowledge that the DS is a standard of care procedure (and in fact is the platinum standard)?  The first two procedures on their list are essentially outmoded surgeries than are never done anymore (except the BPD as a salvage procedure from a surgical or medical misadventure) - on what grounds (i.e., evidence-based principles) is the DS lumped in with those procedures?

 

"It also goes on to say:  "Vertical banded gastroplasty (gastric banding; gastric stapling), biliopancreatic bypass (Scopinaro procedure), and biliopancreatic diversion with duodenal switch are not first-line procedures for the general bariatric surgery patient"


Diana, do you suppose that's a fancy (or confusing) way to say she needs a BMI of over 40....i.e. without co-morbidities?

I would expect it means having a BMI > 50 at least.  But that stupid limitation is without foundation in evidence based medicine, and has and can be overcome.

 Getting you over here with questions is exactly what Diana was trying to accomplish.  
* Biliopancreatic diversion with duodenal switch is what you're looking for, and lucky for you, it's covered without question!

Jennifer I noticed that your in minnesota like I am and the only docs who do the DS here are at the U of M. Dr. Buchwald, Dr. Leslie and Dr. Ikramuddin. Dr.Buchwald has the most experiance of them all, but from what I have heard they are all good. I am going with Buchwald myself. The U is very knowledgeable about all the insurance stuff and I am sure you could call them and ask them as well. I had a ton of questions that I called and asked about before I was even there for the seminar and they took the time and answered them all.

Thank you everyone! :D  It's been a hella busy day today.  Had to work, had kids conferences and had my NUT appointment. 

SO, I spent 35 mins this morning getting bounced back and forth between "Benefits" and "Care Coordination" trying to get someone to explain the "not a first line procedure" thing.  I still don't have a clear answer.  The best they could do was to tell me that it's a case by case basis.  I have UHC.  SO, I called the UofM and set myeslf for a seminar with Dr. Ikramuddin, but am wondering if I should reschedule to see Buchwald?  I'm still keeping my appointments with Dr. Baker, but I want to make sure I have no regrets with the surgeon I pick, so I figure shopping around is ok

My nutritionist has me on a 1500 calorie diet, doing the exchange type of deal, like 2 protein, 1 starch, 1 fat etc.

Another newbie question about poo... like you haven't answered enough questions about poo...

But I briefly tried Alli pills, and they worked.  Is that the type of poo I can expect?

Thanks!!

Jen B

I have fairly new to the DS, only 4 months out. I sometimes have the same kind of poo as I did when I tried Alli. You know those little drops of oil floating on the water--I get that if I eat too much fat.