Which way to go??

Hi All Please give me definitions of all of the ways I can be “fixed”. I have lost 150 but  gained 35lbs of it back since RNY in Nov 2004.  I would like to do something about it now, before that number increases, but don’t know which way to go.

My doctor told me on the next visit, he will discuss with me a procedure that is done  hat will make my pouch smaller.  What is that called?     What is a revision (distal or promixal), a RESTORE??  EROS??  STOMOPHYX??  REALIZE??

 Please help so that I can make a wise decision.

 

 

Thanks so much  PS  Congrats to all who have and will have surgeries.  I pray for all of you speedy recoveries.

The RESTORE, EROS, & REALIZE are clinical trials that is suppose to tighten the stoma or pouch.  The stomaphx is a FDA approved procedure that is new and there has been mixed results on this board on the effectiveness of the procedure.  I do know that most insurance is not paying for the stomaphx because it is so new.  As for the distal or proximal revision that is based on how much you are bypassed.  Most people are bypassed proximal.  The distal bypass is when you are bypassed a lot and can really lead to other health problems such as malnutrition and and iron deficeincy.  I'm not an expert on this but I hope I helped a little.

Thanks so much for your help. I am doing some research on my own, but was hopeful that I can attain some "layman" terms.  I also want to be more knowledgeable when I discuss my options with my doctor.  Thanks again for giving me more information.

You best bet to get all the info you need to prepare yourself is to read all the forums, but do not limit yourself to RnY distal. Read about the DS at the DS forum and also read Duodenalswitch.com. There is not really malnutrition, but malabsorption, but this is what keeps the weight off. Just have to take vitamins for life (just like RnY), have to be proactive in getting your blood work done regularly. It works!

Hi Karen Thanks for your advice.  I have been doing just that.  Sadly, a lot of what I am finding is self pay types of fixes unless I have problems.  I dont have any, but I do know that my pouch has stretched, according to my xrays, but getting the insurance company to pay for another wls is going to be a battle.   Thanks again,  Shawn

Are you sure they won't pay for a revision? What insurance do you have?. My original surgeon said that if the diabetes has returned, and mine has, and I still have other co-morbidities and a hugh weight gain (I gained 40 lbs), then insurance should cover. I do have medicare. Did you talk to someone at your insurance.? I have a fast follow-through (meaning food flows right through very fast). You may have that and that is considered a problem. You will need an upper GI to see what is going on inside you.

According to my new surgeon (not the one that performed my gastic bypass), he tells me that I really dont need a revision.  He says I should consider Stomaphyx but again I do not want to pay out of pocket.  I havent spoken to him about any other procedure beside the Stomaphyx and the revision. I want to be able to converse with him about all of my options before deciding to fight the insurance company. He has, however, confirmed that revision and stomaphyx are both self pay. I dont beleive I have a fast follow through.  I have had a procdure where I dranked a chalky milky substance and then my pouch was x rayed. I was told that this could measure my pouch size to see if it had indeed stretched. Was that an upper GI?  The results from the procedure showed that my pouch has stretched, but we dont know why (outside of bad eating habits).  I am desparately trying to find a fix.  I tried Time Out-to no avail, because I couldnt stick to it.  I know that I need to catch this re-gain before I get back to the weight I was prior to wls.   I really appreciate all that information that you are giving me, so that I can broaden my discussion with my surgeon on my next visit. 

Go to a different surgeon, not one who tells you that "you really don't need a revision."   Yes, you had an upper G.I., but it not only shows the pouch size, but how fast food is coming out of the stoma. That's why the Stomaphyx alone won't work if the problem is the stoma, not the pouch.

Pat told you the same thing I was going to say. Go to a different surgeon. It sounds like this surgeon maybe doesn't do revisions so he is trying to talk you into something else. And revisions are not self-pay usually. I don't know where he got his info. And yeah drinking that chalky stuff was the upper GI. If I were you, I would call my insurance company first before you even see another doc and ask them right out what is the criteria to have a revision and do they pay for it. Only if your insurance doesn't pay for bariatric surgery at all, then they wouldn't pay for it. Who paid for your original surgery?

As far as insurance goes.  Find out the CPT or ICD9 codes from the surgeons office and then call your insurance and give them the codes and they will tell you if they will cover it.  That is what my Blue Cross Blue Sheild - Federal Plan has told me to do.  When or if I ever get to a point of a revision. Barbara Brewer