hoping for a revision had rny feb 15, 2005 weight regain after psych drugs changed

Hi my name is Brandi and I had open rny in 2005 and it was a HUGE HUGE HUGE success till they changed my psych meds 2 yrs ago and I started gaining weight and it has not stopped till I sought a new psych dr who agreed to change the meds but now I can't seem to lose the weight so that is why I am considering a revision. I was 278lbs when I had my first surgery and I got down to and maintain weight of 110-115 for years ( I'm 5'1). I just wanna be small again I have chronic pain from injury to my spine and have had surgery on both my knees so the pain is awful and I also have fibromyalgia. I suspect that sleep apnea is back and previous to the rny I had diabetes. My insurance is Medicare/Medicaid anyone have anything to share that might help me with my journey???

There used to be DS surgeons who took Medicare but seems like some had high out of pocket program fees.   Someone will come along and answer that for you.  Just wanted to give you a pat on the back for being proactive and seeking a revision to a DS.  A revision worked for me and should work for you too.

thank you I don't know maybe they can resize my pouch and stoma or something I just wanna be healthy again :(

You didn't say what your current weight is back up to, so I think that will be a factor, and, if your BMI is under 40, you may need one or more _obesity-related_ diagnoses currently.

I won't lie -- it will be hard for you to get a surgeon who both does the RNY-to-DS AND takes the poorly-reimbursing combo. of Medicare and Medicaid for this *extrememly* complex revision.  Dr. Buchwald in Minnesota and Dr. Simper in Salt Lake City, Utah may be possibilities for you.  If I recall correctly, I think they take Medicare and Medicaid.

Have you been good about taking your supplements and getting labs done after your RNY?  If you think you have a return of sleep apnea, it would concern me if you haven't gotten that checked again and returned to using a bi-pap or c-pap if needed. 

My start weight date of surgery was 278 then I dropped VERY QUICKLY down to 94lbs and was put on a feeding tube cuz I never stopped losing weight. I leveled out between 110 and 115 until about year and a half ago when they put me on Zyprexa and Remeron. Zyprexa is the worst med out of all psych drugs for weight gain and Remeron was responsible for my original weight gain previous to the bypass but my then dr wouldn't change my meds so now I have a new dr and he has changed my meds. I go see the dr on Thursday so I will ask for an upper GI test to see what shape my pouch and stoma are in. The surgeon I contacted today said I would have to have a sleeve and that medicare would pay but they wouldn't cover 20% and they don't take medicaid. That means no surgery as I have no way of coming up with the 20k they quoted me. As far as the sleep apnea no I haven't had it mentioned to her as yet. Btw I am approx 5'1 1/2 tall. My BMI is like 37. I'm in chronic pain due to previous accidents that injured my neck, back, hips, and knees plus I have fibromyalgia. I was diabetic but the surgery seemed to help that. Not sure what else to add but any questions I will get back to you....thank you

There are very, very few surgeons who do the RNY-to-DS revision at all, in the whole world.  So, of course, if you go to an average bariatric place, such as the one near you you mention, they are unlikely to be in the handful that do it.  Out of those that do do the RNY-to-DS, very, very few of those few will accept the insurance combination of Medicare plus Medicaid.  That is why you will have the best success finding one by learning online who does the surgery, calling their office to confirm they accept your insurances, and then travelling to them.  I know the travel is a financial hardship if you have Medicaid, but there is no other way for you to get a DS.

If your current BMI is between 35-40, you will probably need to have current diabetes, high blood pressure, sleep apnea, or perhaps one or more of a few other things like high cholesterol for the revision to DS to be covered.  However, if you have not been compliant with supplements and labs for your RNY, or using bi-pap or c-pap if you have current apnea, then you might not be a good candidate for the DS (I don't know if you fit those or not, I was just saying _if_ you do....).