3 BARIATRIC CONSULTS - 3 RECOMMENDATIONS

I don't usually post all that often but here goes!  I had Roux-En Y lap surgery in 2001 and went from 330 to 225 by 2003 (I am 5;10").  I always seemed to be able to eat more than my bariatric peers and began regaining weight in 2004.  Poor eating habits and lack of exercise definitely did not help the process.  I was now up to the late 290's.  After at leat 5 failed diet attempts in 2008, I decided to get a consultation with a new bariatric surgeon ( the surgeon who performed my original surgery was not part of my insurance's bariatric network).  Bariatric surgeon #1 performed an endoscopy and upper GI, and the conclusion was that my stoma was enlarged and my pouch had widened, as well as the fact I have a hiatal hernia.  Bariatric surgeon #1 recommended lap band over my RNY. 

Bariatric Surgeon #2 was forwarded all of my labs and diagnostics and recommended the ERNY (Distal Roux En Y).  This doctor was not covered under my insurance so I had to scrap that one. 

Today I had my 3rd consultation with a very experienced bariatric surgeon who performs all kinds of bariatric surgery.  He recommended a revision of my original Roux-En Y surgery (this has been my preference all along but I wanted to keep an open mind).  He, of course, wants to perform another endoscopy to see the stomach for itself.  One of the possible issues is I am unsure if my Blue Shield PPO insurance will cover a revision as I have no comorbidities other than extreme fatigue, back pain, and a little acid reflux.  Of course, the doctor said I am 10 times more likely to have a leak, and he may not be able to perform the surgery laparoscopically (but he will not know until he is in there).  

I guess my going on about the above is a way to try and become part of the group.  Positive and informative input is greatly appreciated.  No negative posts please as I have experienced more than my share of negativity in my  lifetime.  

 

Lala, I commend you on doing you homework and research.  I am like you except that my original RNY was in 2002 and I am only 5'8" (well I was until I was disgnosed with degenerative disk disease and I am down to near 5'7"). 

Okay down to the nitty-gritty, in my quest to find out what was going on with me I went to 1 doctor in FW TX, who without even a test suggested I get stomaphyx and sent me to a shrink who couldn't keep me straight from all of her other patients I suppose because she contradicts herself several times in my report.  I saw another doctor in Dallas who I wouldn't give an award to for bedside manner and on the 65 mile trip back to my house from his office; I cried all the way. In between the two doctors I tried to qualify for one of the clinical studies but got turned down.  Then I went north of my home to investigate another physician who blatantly told me that he would convert my RNY to a DS but that he had never done it before and it wouldn't be covered by insurance to the tune of 35K.....um, I don't think so.

About that time I did a phone consult with a physcian in AZ who for the first time in all my research didn't make me feel like crap.  He spoke to me and listened to me and I was in love with him and his ERNY surgery.  The problem is that he was out of state and there would be massive logistical problems in getting there and back.  So I drove to Shreveport to see another doctor who purported to do ERNY.  I was amazed that his was completely different from the doctor in AZ but had the same name...his bill for $250 beat me back to my home. 

Fast forward, I went to my primary doctor and she noticed that all my levels were dropping in spite of my gaining weight so I am consumming more food, right?  Anyway, I decided that no matter how much weight ERNY promised I couldn't do it given my body's proclivity to malabsorb anything beneficial.  I was about to give up and had already started buying clothes in a size I never thought I would see again when I went to one more doctor.  I had no expectations in going to see him, I just wanted to hear his spiel...he suggested a revision to my RNY and that I probably had a hole or distention in my juejenum.  It seemed to agree with my psyche but what did I know...within a month of seeing him I was approved by insurance and on the table.  I didn't have time to protest although I tried.  I am now recouperating.  I guess when the Lord wants something for you or it settles a piece of your mind; it will happen.

Good luck, what is for you is for you.

Shay,

Thanks for sharing your amazing journey with me.  Its nice to know I'm not alone.  Keep me posted on your recuperation.  Was the surgery performed a revision of your original RNY ?  If so, how long has it been and are you happy with the results thus far ? 

Shay!  You are a persistent lil girlfriend and I LOVE your happily ever after story!  So, how did he revise?  Rebuild the entire Rny?  Extend?  Lengthen?  New Pouch?  Open or Lap?  Christmas surgery?....

Me thinks you must have been living right!!!  Weigh 2 go!  Keep us posted!

I'm sooooo excited for you!

I go in next Tuesday for my revision. He is making my pouch smaller and doubling the amount of intestine bypassed. As far as insurance goes I have Blue Shield Netvalue which is an HMO through the State and my surgery is covered. I don't have to pay anything out of pocket except for follow up office visits after I'm 90 days out from surgery. I do still have sleep apnea, but I'll probably never get rid of that. I also have back pain, but that is the extent of my co-morbitities. I would contact your insurance and just ask them is it covered. Mine said if it is medically necessary then it is. When my medical group said that it wasn't covered the customer service rep on the phone (from Blue Shield) did an appeal for me which I thought was strange. Anyway it only took a little while before I got a call from my case manager saying that it was covered and she was faxing the approval over to my surgeon that day.

As Shay was saying, what God has for us is for us. So go for it!!