Insurance approved my Stomaphyx

Hi Everyone,

I know this procedure is not a popular one, but right now it is the only option for me.  I have a 3yr little girl and my hubby works 12hrs a day and all of my family and friends live in another state.  I needed something that was not high risk and had very little recovery time.  My Ins. approved the procedure and I'll have it done on April 22.  I had a distal gastric bypass in 1999 went from 370 to 220 approx.(Low was 214 goal was 180).  I went through 5 yrs of Infertility with no live births(my daughter is adopted) and my metabolism is shot.  I started putting weight on about a 1.5 yrs ago after I quit smoking(current weight 250) and it seemed no matter what I tried the weight wouldn't come off.   I use to go to the gym 5 days a week but that was before my daughter..Lil now all I can get in is walking.  I had a scope and my stoma isn't to bad, but my pouch is stretched.  My doctor(Morris Washington, NJ) has done about 50 and he says that they've been successful.  He has had to do a couple of people twice(including his coordinator), but says they had very good weight loss after.  I'm hoping for the best and hope that all of you will send me your good thoughts and prayers that it works for me.   Anyone who had the procedure, your experience and advice is very much welcomed. 

Thanks for letting me vent, sorry so long.

 Please come back on several months from now and let everyone know if it worked for you.   I haven't read any success stories from this procedure - everyone had to go on to full surgical revisions.  Maybe you'll be the first!    I hope so.   But, if it doesn't work for you, will your insurance still pay for another type of revision?  That's the question I would be asking.    

Take a look at these two research studies:

www.obesityhelp.com/forums/revision/3886215/Everyone-should-read-this-Revision-Procedures-for-Failed/

and

www.obesityhelp.com/forums/revision/3886208/Great-article-on -RNY-revisions-from-Bariatric-Journal/

Yes please please come back every few months at least and let us know if you are still losing  and /or maintaining your weight loss.  No one has been saying anything but negative things about this procedure  but maybe we're just not hearing from the successful ones

I promise you I will keep you posted on my progress.

Congratulations on your approval. Good luck on your weight loss and I'll be praying for you.

Thank you so much.  I really appreciate you support and prayers!

Good luck and Congradulations!!  How did you get your insurance to pay.  I also have a busy little 3 year old daughter, who I want to be able to keep up with and my weigh is holding me back.  My surgeon is in the process of getting the equipment to do this procedure.  Please keep me updated on your success.  I feel this procedure will work if you use it correctly, at least give us a jump start to get going and feel good again! 

Kourtney

Thank you all for your encouragement.  I will definitely keep you updated on my progress.  I have read very little positive feed back about this surgery, but I'm willing to give it my best shot.  My doctor is in network (he's a general surgeon).  The approval letter says the description of service code is " Revise stomach-bowel fusion".  Maybe that's why they cover it ? I do have excellent insurance and because he's in network it's covered 100%.  I am meeting with the nutritionist next Monday and it's a 2hr consult.  I really am looking at this as a new start and I am determined for Mine and my daughters sake to do the best I can to make this work for me.  Thanks again for the good wishes and hopefully I can be successful.  One thing my doctor told me was that he puts quite a few folds I think he said approx. 40 of the little plastic things.  Maybe some doctors do as many so the result isn't successful.  He did say, as I stated above, that he did a couple of people twice putting more folds and they had significant weight loss.  Maybe the amount of folds is the key?   We'll soon find out..lol   Take care, I'll be in touch.

Hi garcot:

Congratulations on getting your approval from your insurance. I am still awaiting my approval for my Revision to Distal RNY, and I am getting very anxious. My surgery is actually scheduled for the first week in May.

I was wondering if your Doctor was more specific about significant weight loss, anotherwards did he say how much is significant? like 40, 50, 60 lbs?

I was originally enrolled in a clinical study a couple years ago, but when I found out that some of the patients would get a phony procedure and some a real...I didn't want to go through all that to find out that it was phony so I cancelled. Back then the Dr.'s were only doing a couple rows of pleats. Now I'm told, they're doing many to help the restriction.

I have read on this site where someone had the procedure and the little plastic sutures they use broke. I believe she didn't follow the after care diet very well and just began eating normal again. Go Figure....So I think it is critical that the liquid diet thing be followed to the letter.

Just by the way you write, I can tell you are a smart girl and will be successful. I can't wait to hear your success story!

Good Luck,

JRolfson

 

By all means, you need to try it to satisfy yourself.   My only concern for you is that, if it doesn't work, you won't be able to get your insurance to pay for a surgical revision because they have already paid for this.   What your surgeon is calling "Stomaphyx" may actually be the insurance "definition" for a surgical procedure (not an endoscopic one) and THAT'S how he's getting it covered.  

I hear you about your doctor putting in 40 fasteners.   I don't know how many the other doctors' used, but several of the docs whose patients have posted on here were the first docs in the U.S. to be certified in the Stomaphyx procedure and and several  of those patients said that their docs put in "several rows of pleats" (I don't know how many fasteners go in a "row"). 

If this works for you, there will be a lot of excitement over it, so you MUST keep everyone posted!

Good luck!!