Where do I start?

bradshaw0506
on 7/10/07 12:31 am - Chicago, IL

I"m not sure where to begin with looking into a revision. Do I call the doc I want to go to? Do I need to research what surgery I want? Which is best a DS or a Lap Band? I had an Open RNY 4/1999. I know right off the bat that I have an enlarged stoma, I've know since 2001. My diabetes is back, hypertension is back, severe heartburn is back...and I'm 12 lbs from where I had WLS to begin with. I'm really depressed and my only hope, yet again, is surgery. I've yo-yo dieted since having my daughter a year ago and have actually gained an additional 25 pounds. Big fat surprise there! Oh, and the biggest question of all...INSURANCE?! I can't do anything unless they say yes. Any advice would be great. Lori~

Nunyo B.
on 7/10/07 5:35 am, edited 7/10/07 5:36 am

Hi Lori,

First off, good for you for coming to the OH site looking for answers. There are so many wonderful, helpful people here!

Secondly, since you have an enlarged stoma, plus your co-morbids are back, you sound like a candidate for revision surgery. I had SRVG (basically the same procedure as the VBG) back in 1997, and I have gained all of my weight, plus some, back. After all of my research I came to the conclusion the DS is the right procedure for me because I know I need something more than just a restrictive procedure. The Lapband is purely restrictive. Also, while there are people on OH who have lost a lot of weight with the Lapband, and there are RNYers that have had revision to the Lapband and have done ok, research shows that as far as permanent weight loss goes, the Lapband just doesn’t stand up over time. I also know this is the last time I want to go under the knife so I decided not only am I going to go with a procedure that has the highest percentage of weight loss, but also the highest percentage of maintaining weight loss – the DS. So, just like with your original surgery, your first task is to research, research and research some more to see which procedure will fit for you. You questioned which would be better… DS or Lapband. INHO, the DS wins hands-down.

If you would like some more info on RNYers who have had revisions to the DS, please visit the DS forum here on OH. We really are a bunch of super-nice people and there are those who were in your position that can answer more specific questions you may have.

Once you have decided which procedure is best for you, then check out your insurance to see if it is covered, and if so, then check out doctors in your area to see who not only performs revisions and are very experienced in revisions, but also whether or not they perform the surgery you want. Just remember, tho, if a local surgeon doesn’t fit all the criteria, that doesn’t mean you have to stay local.

I hope I was some help to you. Good luck on your revision journey!

bradshaw0506
on 7/10/07 12:11 pm, edited 7/10/07 12:14 pm - Chicago, IL

Revision on 02/25/08

Thanks for the info. Lyndia! After much research today and speaking with a woman at the doctor's office at the Univ. of Chicago, she said I was a candidate for revision surgery and told me what I needed to get together before I came to my appt. on the 25th. 1. My Operative Report from 4/28/99 - Open RNY 2. Copies of the 2 upper GI reports I had done years ago (2001 & 2002) 3. A new upper GI 4. Letter from my PCP about my weight loss attempts over the years plus a list of current co-morbidities and medications I'm taking for them. 5. Letter from my OB/GYN since she saw me the most from 2005 to 2007. I'm going to get everything together and hope for the best. I did call Horizon's BCBS of NJ to find out exactly what was covered and their requirements. I was terrified to do it, but there's not much you can do but take their word for it, but she pretty much gave me info. I kinda already knew....5 years of attempted dieting OR a BMI >40 or a BMI of >35 w/ co-morbidities. Which if you think about it doesn't make sense...so if my BMI was not more than 35 but I had 5 years of dieting then I'm covered? Weird. Oh I and I have to show 6 months of monitored dieting by my pcp or WW or whatever. Done! I kinda feel like this is going to be a hard battle to get it all together, especially compared to the first time I had WLS. I didn't do anything other than go to a couple of appts. UHC-EPO covered it instantly, they got approval over the phone! That was 1999! Back then I started researching and exactly 1 month later (no lie) I had surgery. It was that fast....now all of this? I'm just hoping the upper GI shows a serious malfunction, I know I have one...this heartburn is killing me!

(deactivated member)
on 7/11/07 12:18 pm - TX

DS on 08/25/06

Read my profile. I also had stoma enlargement and a large staple line disruption.

KRWaters
on 7/15/07 7:51 am - Manteca, CA

DS on 05/19/09

Dawn, I don't know if I told you, but the upper GI I had last week only showed some regurgitation and a RNY there. I have not had an endoscopy yet. the PA is on my side and had told me even if there were no malfunction, the fact that I have diabetes back is a good reason to get approved for the revision. My question, is it enough? I plan to call the PA tomorrow and get the info again. In other words, is it worth my while to continue pursuing the revision to a DS? I would hate to do all the work and told in no uncertain terms that I am not qualified to have it.

KAREN W.

I LOVE MY DS!!!!!

STRIVE TO BE THE BEST YOU CAN BE AND DO THE BEST THAT YOU CAN.

Check out www.dsfacts.com and www.duodenalswitch.com for all the accurate information on the great DS, and find surgeons in your area or around the country or out of the country.

I couldn't have done without all the great peeps on this board.

SW: 234.5 CW: 157 GW: 140 - ish

bradshaw0506
on 7/16/07 1:41 am, edited 7/16/07 1:43 am - Chicago, IL

Revision on 02/25/08

Great questions! I'm having my Endo. today at 1pm. I was checking things out online over the weekend and noticed a few things that are kind of scaring me actually. It was Sat. afternoon and I asked my DH if having severe heartburn would leave a bad taste in your mouth, and he said he didn't know so I got online. 1st though, during my PCP visit from last Fri. she was checking my glands underneath my neck and I aked her if she felt anything because often I get this lump in my throat, and she just said maybe I was sick/had a virus and wrote it off. With that said, I saw some symptoms of a hiatal hernia....DING DING DING! Lump in throat, bad taste in mouth and then all the others that go w/ having a stomach ulcer. I never figured these thing would all go together. I guess we'll see. Question is...can a lap DS be done with a hiatal hernia? Do they fix it at the same time? What happens if my endo shows absolutely nothing other than a stretched stoma? Can I still get my revision? I'm full of questions too, seems like we both want some answers/advice. Lori~

KRWaters
on 7/16/07 7:57 am - Manteca, CA

DS on 05/19/09

Well I certainly would ask your PCP or surgeon about the hiatal hernia Lori. Maybe take out the hernia first before DS done?

KAREN W.

I LOVE MY DS!!!!!

STRIVE TO BE THE BEST YOU CAN BE AND DO THE BEST THAT YOU CAN.

Check out www.dsfacts.com and www.duodenalswitch.com for all the accurate information on the great DS, and find surgeons in your area or around the country or out of the country.

I couldn't have done without all the great peeps on this board.

SW: 234.5 CW: 157 GW: 140 - ish

bradshaw0506
on 7/16/07 12:37 pm - Chicago, IL

Revision on 02/25/08

Endo. done. No hernia...matter of fact, he saw a few polyps on the connection site and took biopsies. From what I understand it's no big deal. I won't know anything further about my endo. for about a week. What my doc and I had thought was there is definitely not. So tell me why in Feb. 2002 I had an upper GI done and the doc said I had a stretched stoma and a serious case of GERD. With the intense heartburn I've been having my pcp was certain I had something else going on too, like ulcers and then I was putting 2 & 2 together and was thinking haital hernia. So anyway, this doc says there's nothing there, and that my RNY is fine. Really? How come I can eat a ton? How come I'm freakin' hungry ALL THE TIME?! I really feel like I want a second opinion here. So with all that said, how does one get a revision if their RNY is intact, no hernias, ALL co-morbidies are back, and so is the weight? I feel like I need to "qualify" all over again, and I do as soon as I finish my 6 month supervised diet plan.

I'm determined to get my DS, I'm tired of the dumping, the heartburn and the weight gain that's apparently out of control.

KRWaters
on 7/16/07 2:59 pm - Manteca, CA

DS on 05/19/09

If you have been reading my posts Lori, you would see that I, too, have been gaining weight, diabetes is back and my severe sleep apnea never went away. The upper GI I had last week just showed some regurgitation and nothing else according to my PCP. My PA at my local surgeon's office said previously that even if the upper GI did not show any malfunction of the RNY, that I have a case just because the diabetes has returned. I plan to call her soon and ask again that question to see if I should still pursue the DS.

KAREN W.

I LOVE MY DS!!!!!

STRIVE TO BE THE BEST YOU CAN BE AND DO THE BEST THAT YOU CAN.

Check out www.dsfacts.com and www.duodenalswitch.com for all the accurate information on the great DS, and find surgeons in your area or around the country or out of the country.

I couldn't have done without all the great peeps on this board.

SW: 234.5 CW: 157 GW: 140 - ish

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