XPost - Having Revisional Surgery Aug 15th!

You may or may not 'know me' but here's my story shortened to the Reader's Digest version.  --

Had RNY in June 2003 with Dr Heather McMullen at Staten Island University Hospital, at a starting weight of 340, (buried my husband in May 2004), lost 180 pounds within 18 months to 160 pounds.  Insurance covered 100% of RNY.  Coincidentally, Dr McMullen was doing DS at the time, and although I made myself familiar with it, my insurance wouldn't cover it, and I dismissed it -- Hindsight now!  STUPID.....

Had all of my plastics in 2005.  Insurance covered most of LBL and I self-paid (financed) for other procedures.  Maintained my weight through 2006 (remarried in June 2006).

Started regaining in early 2007, never feeling any restriction, got full eating, but shortly after was hungry again and could re-eat the amount I just ate!  Had endoscopy done which showed excessively enlarged stoma, and slightly enlarged pouch.  At 195 pounds, I saw Dr Shawn Garber in LI and had Stomophyx in October 2007 -- Self-paid -- What a RIP-OFF!  I was grasping at straws -- Did absolutely nothing for me -- I basically threw away $9K!!!!!!

Fast forward to 2011 -- I am currently at 225-230 pounds - gaining about 15 pounds per year, and desperate not to let all that I've already done go to waste -- started researching revisions.  Checked out BOB - dismissed rather quickly.  Checked out DS -- realized that was my last shot!

Met with Dr Greenbaum in NJ early this year -- he said I hadn't gained enough weight back, and that he was cutting back on revisions.  Met with Dr Roslin couple of months ago, provided him with all copies of past surgical reports, endoscopy and blood work, and he agreed to take me on. 

JOY -- (not for long) -- Come to find out that my medical insurance with small firm employer that I have been with for last two years has a Bariatric Exclusion against any surgery, as well as complications from past bariatric surgeries!  Tried several things to get around it, including getting on my husband's plan, which although they cover bariatric surgery -- is an HMO and does not have ANY out-of-network benefits.  Dr Roslin's office tried to see if they could get an exemption --  NO GO -- which means I am SELF-PAY!  OUCH>>>>>>

Decided I'm worth it -- and will take out money from retirement IRA that matures in December -- in the meantime, it's going on credit cards......Definately scared that any complications, however minor, could financially devastate me -- Total cost will be approximately $39K.  Hospital charge just went up another $1,500, plus a new NYS tax of $3,500 within last three week.  Oh well, guess I'm a gambler, but asking for prayers and good thoughts anyway!

Met with Dr Roslin yesterday for my final consult -- surgery scheduled for August 15th -- Here's how I understand the procedure, but many of you will probably be able to enlighten me further.  He will reconstruct my stomache into sleeve from unused part left behind from RNY (piecing portion of pou***** - and reinstate my pyloric valve.  He will then do traditional DS -- he mentioned lenghs of 125m for one, and 150m for other (although I'm not clear on which is which).  He said that there will be three connections/reconnections involved.

He briefly mentioned a type of DS being done in Spain with the intestined looped, that is a bit easier to do, with less connections, that he had done only once, but was very optimistic about, but gave me the choice.  I had read about this on this site, but when he mentioned it, he said my body language spoke volumns and he would do the traditional DS instead.

So, I have ordered my vitamins and some protein drinks -- let my job know that I will be out for three weeks (that's all I can take off reasonably), and will make the surgeon and hospital pre-payments next week.  The balance will be billed to me after the surgery.

I'll be getting myself to the hospital day of surgery by bus from the Jersey Shore -- day of dismissal, I'm hoping my sister or a friend can pick me up to drive me home.

I'll take any well wishes, hints, tips, etc -- I've read the DS Facts and other info you guys routinely give to pre-ops and newbies -- Thanks guys.

Hugs,
Nannette

Nannette,

You are one of many who inspire me. Thank you for sharing your story. Know we're here for you, and love ya!!

Let me know how it works out.

Tom

Welcome to the Dark Side   (a DS joke, of course!).   I've liked my DS, and have had relatively few problems.....  If you need info, or a DS buddy, a co-hort in Vitalady vitamin ordering, etc....   hang on to my name   MaryC543.       The supplements you take will be different, and it's a hoot to be out of the Low Fat frame of mind....   Fat is now malabsorped, so you eat full fat everything, in order to get your body to hang onto the fat soluable vitamins  (and NOT get constipated!).   This took me a while to get used to!!!!!   Cream, not skim milk ,    full fat yogurt, sour cream, etc....  and even an occasional Ben and Jerry's!!   Of course, you'll be tracking your calcium levels, and PTH's.... and supplementing them endlessly,  same with the D's.....   most DS'ers wind up taking mega amounts of DRY vitamin D,  (the oil based ones get malabsorped!),....   
     I'm from North Jersey, but spend most weekends in South  (deep, deep South Jersey, about 30 mins past Pennsville)     I try to make a lot of the IGT dinners, when I'm not in night school!      Good luck and hugs,  Mary

 Wishing you the best and sending you great BIG hugs from Long Island!

Curious, have you tried to fight your insurance company?  There are some lawyers who have helped denials and was wondering if you tried that route.  

Wishing you the best of luck!

No MaryEllen -- it is a TOTAL Bariatric Exclusion clearly set out in both Summary Plan Description as well as the full one -- it even goes on to exclude any complications from previous bariatric surgeries -- I would not have had any chance of winning.

Thanks for the good wishes.
Keep me in your prayers.
Nannette

Sending prayers