Looks like I might have to Self Pay for my DS - Switch only

My first surgery the Lap Band in 2008 (BCBS Fed covered) did not work for me. I also did not do my part following the prescribed nutrition and exercises.  I hated the band and I wanted it out, so I went for a revision from the LB to the Sleeve in 2009 (Self Pay)  I went with Dr. B in Edmound, OK. Dr. B asked me why the Lap Band did not work for me.  I told him food wood get stuck and I just did not want to go back in forth with fills and I also love to eat carbs.  So on my medical report Dr. B wrote patient did not follow prescribed nutrition and exercise.  Patient also stated " I love carbs".   

The Sleeve was not enough for me either I needed more than restriction.  So, I started looking for another revision.

At first I wanted a RNY then I decided to get the DS.  Only BCBS Fed would not cover the DS for me so I was trying one more time for the RNY.  

Back in 2011, I wanted to get revised to the RNY and to get my haital hernia fixed too.  The new doctor Dr. N in Moore, OK sent out the paper work to BCBS Fed but they denied it saying that it was not medically necessary.   I thought they denied it because I had the VSG in 2009 and it was too soon for a revision.  

Last week,  I called Dr. N. again she said that BCBS Fed had also stated it was denied because it was not medically necessary and the report that was on my record with the LB in 2008 stated  I was  not in compliance and admitted that I love carbs.  

 I understand there are not many surgeon's that will do a VSG to RNY revisions.  Dr. G in OKC said it was so very dangerous to revise from a VSG to RNY.   Dr. K. in Norman, OK office said he has never done a VSG to RNY revision.  It may not even be possible to do.  I don't know how but Dr. N in Moore, OK thought she could do it, don't really know if that was going to happen.

 I'm not going to get the revision to RNY since nobody does them here in OK.  Since I'm going to self pay it might as well be  the DS.

So, guess what I'm screwed.  I will have to self pay for the 2nd part of the DS.  I'm so going to do this, even if I have to reach in my 401K.  

Today I called Dr. Daryl Steward and asked if he would do the 2nd part of the  DS switch (Self Pay), they guy asked me questions and when I told him my BMI was 35 he said I would be the first patient the doctor has ever done with that low of a BMI.  I told him about my Type II Diabetes, High Blood Pressure, GERD.  He would get back with me and let me know if Steward would do it.  The quote price is  $22 - $25K.

That's what's going on with me!  

I love carbs too and that is why I was obese.  If you can't get a handle on your carb intake the DS is not going to work very well for you.  When my carbs take over I gain weight.  I gained about 20 lbs eating candy.  I went back on the low carb plan and lost that weight, but you really need to consider whether you are a good candidate for this very serious surgery if you are not going to be able to give up the carbs.

For instance could you buy two Bacon Egg and Cheese biscuits at McDonalds and throw away ALL the biscuit?  Could you eat burgers and sandwiches with no bread?  Can you give up cereal, sweet breads, milk?

The low carb lifestyle saved my life but I have to stay on it for life or I will gain weight.

~Becky

I know that my past behavior is to blame for my misery.  However, I have changed my eating habits already. 

Yes, I have been doing that during the week buying breakfast at McDonalds and throw away the biscuits.  I'm not much of a cereal lover or sweets.  I am not going to let CARBS ruin and send me to an early grave.  

Thanks for replying!  

I'm a bit confused.  It sounds like you'd like to go from a VSG to a RNY.  I'm guessing you mean DS or just going for the switch part, right? I agree, carbs are crazy addictive.  I'm four plus years out and only now seeing a bounce back of 10 pounds.  It's killing me to see my favorite clothes getting tighter and the scale moving up.  I had a nice long chat with myself and realized that I was letting carbs slip a noose around me.  Even with the Cadillac WLS, the DS, carbs are still a major negative factor. 

Sorry for the confusion.  I corrected my post just a few minutes ago,  at first I wanted a RNY.  Now I want to the DS.  I will have to do Self Pay, because BCBS Federal will not approve me because of my bad food choices.  

So are you a revision DS or a virgin DS.  That is so cute that you have DS baby girls, I bet they are precious!  I just want another chance.  I'm hoping and praying that Dr. Steward will be my surgeon for the DS.  I wish you the best on turning around the gained weight and getting back to your victory.  Sending positive thoughts to you.  

Thanks for chiming in.  Love your avatar picture!  

Virgie

Join the club of self pay and dipping or cashing the entire 401K retirement fund.  I had to deceide if I 1. cash in the $$ and live longer therefore work till I die. 2.  Die  younger and my nephews get the $$  I guess I will live longer , healthier and work FOREVER!  I am having my same surgeon do my revision from sleeve to DS.  He really just calls it my 2nd half of DS since I was too sick to have anything but the sleeve to start. My MD is J Stephen Scott in St Louis at My New Self program at Des Pere Hospital.  He has 20 year with WLS, lapro. new to the DS.  I trust him. God Bless us both on the revision journey.

Hi leanmama,  

I told DH that either I get the 2nd part of the DS or I just resign.  I am so depressed with my job and management.  I have tried to find another job but no luck.  I want to cash in the 401K pay off some bills and stay home.  But without the surgery I will probably gain more weight and feel even worse.  

I suppose I will pay for the surgery and continue to work.  I only have about 4 more years to go and I can retire.  The longer I stay my pension will be greater, but I don't care.  I will just find a part time job if we can't make it on my retirement in 4 years.  Who knows Uncle Sam may even give an incentive for early retirement,  Anyway!  

Hope you have researched the DS.  This is a very complex surgery.  If I were you I would get an experience surgeon to do the 2nd part.  Hopefully, your surgeon has been mentored by a skilled DS surgeon.  Don't mean to put fear in you or make you upset.  Just be sure you want him to do it.  

Best wishes to you leanmama.

WE all need to to what WE need to to for out lives.  So I cashed in the retirement fund, will get healthier and work FOREVER!

My Surgeon has 30+ lapro surgery, invented lapro tools other MD use, 25+ years WLS and one year doing DS alone,  Many years with Dr Royce (Knoxville TN) mentoring him.

My Dr Stephen Scott mentors others with running one of the lab at ASBMS meeting all over the world.  He specializes in weight loss revisional surgeries.

I have great trust in him.  His staff at the center and I are getting to know each other and I pray will be a great support for me  though as others have stated they try to put you into the roun en y GB surgery vits and meal plan.  Oh well I can teach them something maybe?   

That is wonderful that your surgeon has been mentored and has great brain to be able to invent lapro tools!  Impressive, I know you will be in good hands.  I'm glad for you!

 Keep us posted!

how new to the ds is dr. Scott?