RNY to DS revision, how much $$
My new insurance does not cover ANYTHING for obesity.
My prior insurance policy had a cap of only covering $25,000.00
So, I was just curious if anyone had a revision from RNY to DS, and paid for it out-of-pocket, and if so, did you "get a break" beacuse you paid cash?
Just gathering information & exploring my options.
Any input would be welcomed!!
Thanks!!!
-Jamie
My prior insurance policy had a cap of only covering $25,000.00
So, I was just curious if anyone had a revision from RNY to DS, and paid for it out-of-pocket, and if so, did you "get a break" beacuse you paid cash?
Just gathering information & exploring my options.
Any input would be welcomed!!
Thanks!!!
-Jamie
RNY 2/26/2002 DS 12/29/2011
HW 317 SW 263 BMI 45.1
SW 298 CW 192 BMI 32.9~60% EWL
LW 151 in 2003
TT 4/9/2003
Normal BMI 24.8 is my GOAL!!!
GBP (RNY) 2/26/02 298 lbs, TT 4/9/03 151 lbs, DS 12/29/11
HW 317 SW 263 BMI 45.1/CW 192 BMI 32.9/GW 145 ~ Normal BMI 24.8
**Revision Journey started 3/2009 Approved 12/12/11**
Most hospitals in country will entertain discounts for cash payouts. I'm not a revision, just a delightfully happy post-op DS'r.
Here is some information you might find useful in your quest taken form a composite of posts that hopefully adequately acknowledge the authors therein.
From Vicki in OR
Post Date: 1/8/09 11:58 am
Here is a list of DS surgeons performing/not performing revisions to DS in your region:
- Dr. Inman in Indiana performs only GLB-to-DS and VSG-to-DS revisions and is no longer performing RNY-to-DS or VBG-to-DS revisions, according to Lori Black. Instead, she revises all RNY to distal RNY (or "long limb" RNY). She requires all out-of-town patients to stay in town for at least 3 weeks after being released from the hospital, according to an e-mail from her office which was copied onto a posting in 4/2008.
- Dr. Husted in Kentucky (formerly California) performs RNY-to-DS revisions, as well as a number of other revisions, including GLB/VBG/other stomach stapling operations/MGB/VSG revisions, according to his website. He mentioned to a member on the DS board that if the pouch has too much scar tissue, then the VSG portion would be too risky to be completed. Instead, he would revise to the switch portion only and leave the pouch intact (looks like a revision to a distal RNY). He has already moved to the Lake Cumberland Hospital in Somerset, Kentucky as of 9/2008. Visit his website at www.johnhustedmd.com
- Dr. Hares in Michigan performs RNY-to-DS and GLB-to-DS revisions, according to several members on the DS board. It appears that he also performs other revisions as well.
- Dr. Lutrzykowski in Michigan wants RNY surgical reports before he decides if he will do RNY-to-DS revisions. However, one member reported on the DS board that he is more than willing to perform VBG-to-DS revisions, since those are much more straightforward operations than RNY-to-DS revisions.
- Dr. Anderson ("Dr. Rita") in Ohio does not specialize in revisions at all. Instead, she refers patients to Dr. Schumacher in Ohio, who performs RNY-to-DS revisions as well as other revisions, according to a member on the DS board.
- Dr. Hess in Ohio is retired now.
- Dr. Lane in Ohio usually performs RNY-to-DS revisions for those with higher BMIs but determines on case-to-case basis. He also performs VBG-to-DS revisions. He has moved his practice to the Dept of Surgery at the University of Toledo MC (UTMC) as of 7/2008. His address is: The University of Toledo Medical Center; Department of Surgery-Bariatric Surgery; 3000 Arlington Ave., Floor 2C; Toledo, OH 43614. His new phone number is 419-383-6932. URL: http://utmc.utoledo.edu/clinics/bariatricsurgery/
- Dr. Maguire in Ohio does not do RNY-to-DS revisions but does a distal RNY. He told a member on the Revision board that he used to do the RNY-to-DS revisions for patients who insisted on them. However, he mentioned that in his experience, his patients who had distal RNY revisions achieved the same weight loss results with lesser risks and fewer complications than with the RNY-to-DS revisions. Therefore, he no longer performs the complete DS revisions.
- Dr. Teel in Ohio does not perform any revisions.
- Dr. Thomford in Ohio has retired as of 2005.
- Dr. Bonanni in Pennsylvania has no info pertaining to any revision to DS.
- Dr. Peters in Pennsylvania does not perform RNY-to-DS revisions and does not intend to get involved in them. However, he does perform GLB-to-DS revisions and revisions from old stomach stapling operations on a case-by-case basis. He appears to be very anti-GLB from what was reported on the DS board and is more than willing to remove GLBs and VBGs.
- Dr. Spaw in Tennessee does not perform any revisions of any kind, according to a member on the Revision board.
Further info about each DS surgeon can be found in the following link:
http://www.duodenalswitch.com/surgeons/surgeons.html
(Note: A few DS surgeons are not vetted into the ds.com website.)
http://www.dsfacts.com/North-American-Duodenal-Switch-Surgeo ns.html
--------
List of DS Surgeons Doing Revisions:
- Dr. Warden in Louisiana has revised a lot of people who have failed RNY by making what is usually a large pouch into a small pouch and sometimes extending the limb length to increase malabsorption.
- Dr. Anthone in Nebraska stopped doing RNY-to-DS revisions in 2006. However, one member reported that he probably still performs LB-to-DS revisions.
- Dr. Prachand in Chicago does RNY-to-DS revisions only if the BMI is over 50.
- Dr. Gagner in Florida (formerly NY) performs RNY-to-DS revisions. Members have reported that he is one of the best!
- Dr. Alverdy in Illinois evaluates case-by-case but he is very selective.
- Dr. Inman in Indiana has done only 20 RNY-to-DS revisions (as of 9/2007).
- Dr. Lutrzykowski in Michigan wants RNY op reports before he decides if he will do revisions.
- Dr. Lane in Ohio usually does RNY-to-DS for those with higher BMI but determines on case-to-case basis.
- Dr. Anderson in Ohio does not do revisions.
- Dr. Peters in Pennsylvania does not do revisions.
- Dr. Shah in NYC does revisions on a case-to-case basis.
- Dr. Deveney in Oregon performs RNY-to-DS revisions.
- Dr. Husted in California performs RNY-to-DS revisions.
- Dr. Antelmo Sasso Fin in Brazil does RNY-to-DS revisions.
- Dr. Maguire in Ohio does not do RNY-to-DS revisions but does a distal RNY. He told a member on the Revision board that he used to do the RNY-to-DS revisions for patients who insisted on them. However, he mentioned that in his experience, his patients who had distal RNY revisions achieved the same weight loss results with less risks and fewer complications than with the RNY-to-DS revisions. Therefore, he no longer performs the complete DS revisions.
- Dr. Greenbaum in New Jersey has done 50 DS surgeries and 8 DS revisions (as of 9/2007). Several members have mentioned that he is an excellent surgeon, especially for RNY-to-DS revisions.
- Dr. Roslin in New York does DS but when doing a revision from RNY, makes it a distal RNY. But he does not do RNY-to-DS.
- Dr. Feng in California does not do RNY-to-DS revisions.
- Dr. Jossart in California has done 150 DS surgeries and has done many revisions (as of 9/2007).
- Dr. Schlosser in Minnesota is no longer working in Minnesota. She is overseas at the moment (9/2007) and will be for several months. She is not returning to the state...no longer doing DS.
- Dr. Maynard in Georgia performs DS but in his response did not mention revisions. Did encourage a member to attend seminar for more questions. However, another member reported in 12/2007 that he does not do RNY-to-DS revisions.
- Dr. Smith in Georgia performs DS as well but it is unclear if he also does RNY-to-DS revisions. One member thinks he does while another doesn't think so.
- Dr. Cirangle in California has performed hundreds of DS procedures, including revisions from RNY.
- Dr. Keshishian in California performs RNY-to-DS revisions. However, he charges a $4K fee upfront for revisions that are not covered by insurance. Plus, he requires his out-of-town patients to stay in a hotel for 10 days after being released from the hospital.
- Dr. Rabkin in California performs RNY-to-DS revisions, according to several members on the DS board.
- Dr. Buchwald in Minnesota performs RNY-to-DS revisions, according to several members on the DS board.
- Dr. Hess in Ohio is retired now.
- Dr. Ungson in Mexico performs RNY-to-DS revisions. He also takes on cases considered too "complicated" or "high risk" by other surgeons. Members have said that he is considered one of the greatest DS surgeons.
- Dr. Inabnet in NYC performs RNY-to-DS revisions and has performed hundreds of DS, according to a member on the DS board.
- Dr. Crookes in California performs RNY-to-DS revisions, according to several members on the DS board.
- Dr. Elariney in Virginia performs RNY-to-DS revisions, according to a member on the DS board.
- Dr. Baltasar in Spain performs RNY-to-DS revisions and has trained Dr. Ungson. One member on the DS board reported that he is one of the most experienced virgin DS and RNY-to-DS revision surgeons. Plus, the same member reportedly paid $16K for the surgery plus $2K in traveling expenses in 2005 (the cost may have gone up since then).
A number of members reported on the DS board that DS surgeons in California may charge upfront fees of $4K-$8K to cover services that are not reimbursed by insurance.
The following DS surgeons have no info on performing RNY-to-DS revisions
(source: http://www.duodenalswitch.com/surgeons/surgeons.html):
- Dr. Oakley in Idaho.
- Dr. Edinger in Idaho.
- Dr. Schweitzer in Maryland.
- Dr. Vanguri in Maryland.
- Dr. Hares in Michigan.
- Dr. Sudan in Nebraska.
- Dr. Herron in NYC.
- Dr. Kurian in NYC.
- Dr. Nicastro in NY.
- Dr. McMullen in NY.
- Dr. Sparks in NY.
- Dr. Voellinger in NC.
- Dr. Thomford in Ohio.
- Dr. Teel in Ohio.
- Dr. Hoddinott in Pennsylvania.
- Dr. Fichter in West Virginia.
- Dr. Marchesini in Brazil.
- Dr. Alcides Jose Branco Filho in Brazil.
- Dr. Marco in Spain.
Initial research done by Karla H.
Source: http://www.obesityhelp.com/member/karlahook/
Click on "September 2007" blog
Last updated 1/14/2008
=====
Dr. Keshishian charges $4000 which is not covered by insurance
- Dr. Warden hasn't done many DS much less DS revisions.
- Dr. Anthone has stopped doing RNY to DS surgeries
- Dr. Prachand only does RNY to DS revisions if the BMI is over 50
- Dr. Gagner is switching institutions and will start at the new place in January 2008. He recommends I wait until January to set up appt.
- Dr. Alverdy evaluates case by case but they are very selective
- Dr. Inman has only done 20 RNY to DS revisions
- Dr. Lutrzykowski wants RNY op report before he decides if he will do revision
- Dr. Lane usually does RNY to DS in higher BMI but determines on case to case basis
- Dr. Anderson does not do revisions
- Dr. Peters does not do revisions
---------
Please be advised I cannot attest to the accuracy above.
Let me just applaud you in your seeking out the very best WLS by all the conventional known standards today. That said, this a revision and by far the most COMPLEX revision that exist. There are indeed real risks and your choice of revision surgeon is CRUCIAL to your outcome. Many surgeons claiming to do same DO NOT do the FULL RNY take down and are capable of following through with a full DS, and sometimes, perioperatively a patient's presentation may not allow for this. Damn few DS surgeons have the skill level to do so, so pick wisely. YOUR VERY LIFE AND OUTCOME DEPENDS ON IT!
It's entirely understandable you want to make this affordable, but the reality is, you need to weigh the consequences of endeavoring in such rarefied air as this type of revision entails. Pinching pennies "could" put you at needless additional risk.
Having said that, with the caveat of complications that might or might be covered should they arise out of country, your least expensive route with experienced revisionist would likely be with Dr. Ungson in Mexico, Dr. Baltasar in Spain or possibly Dr. Antelmo Sasso Fin in Brazil. I have little knowledge of the Brazilan practitioner so please vet him carefully.
Rockne
Here is some information you might find useful in your quest taken form a composite of posts that hopefully adequately acknowledge the authors therein.
From Vicki in OR
Post Date: 1/8/09 11:58 am
Here is a list of DS surgeons performing/not performing revisions to DS in your region:
- Dr. Inman in Indiana performs only GLB-to-DS and VSG-to-DS revisions and is no longer performing RNY-to-DS or VBG-to-DS revisions, according to Lori Black. Instead, she revises all RNY to distal RNY (or "long limb" RNY). She requires all out-of-town patients to stay in town for at least 3 weeks after being released from the hospital, according to an e-mail from her office which was copied onto a posting in 4/2008.
- Dr. Husted in Kentucky (formerly California) performs RNY-to-DS revisions, as well as a number of other revisions, including GLB/VBG/other stomach stapling operations/MGB/VSG revisions, according to his website. He mentioned to a member on the DS board that if the pouch has too much scar tissue, then the VSG portion would be too risky to be completed. Instead, he would revise to the switch portion only and leave the pouch intact (looks like a revision to a distal RNY). He has already moved to the Lake Cumberland Hospital in Somerset, Kentucky as of 9/2008. Visit his website at www.johnhustedmd.com
- Dr. Hares in Michigan performs RNY-to-DS and GLB-to-DS revisions, according to several members on the DS board. It appears that he also performs other revisions as well.
- Dr. Lutrzykowski in Michigan wants RNY surgical reports before he decides if he will do RNY-to-DS revisions. However, one member reported on the DS board that he is more than willing to perform VBG-to-DS revisions, since those are much more straightforward operations than RNY-to-DS revisions.
- Dr. Anderson ("Dr. Rita") in Ohio does not specialize in revisions at all. Instead, she refers patients to Dr. Schumacher in Ohio, who performs RNY-to-DS revisions as well as other revisions, according to a member on the DS board.
- Dr. Hess in Ohio is retired now.
- Dr. Lane in Ohio usually performs RNY-to-DS revisions for those with higher BMIs but determines on case-to-case basis. He also performs VBG-to-DS revisions. He has moved his practice to the Dept of Surgery at the University of Toledo MC (UTMC) as of 7/2008. His address is: The University of Toledo Medical Center; Department of Surgery-Bariatric Surgery; 3000 Arlington Ave., Floor 2C; Toledo, OH 43614. His new phone number is 419-383-6932. URL: http://utmc.utoledo.edu/clinics/bariatricsurgery/
- Dr. Maguire in Ohio does not do RNY-to-DS revisions but does a distal RNY. He told a member on the Revision board that he used to do the RNY-to-DS revisions for patients who insisted on them. However, he mentioned that in his experience, his patients who had distal RNY revisions achieved the same weight loss results with lesser risks and fewer complications than with the RNY-to-DS revisions. Therefore, he no longer performs the complete DS revisions.
- Dr. Teel in Ohio does not perform any revisions.
- Dr. Thomford in Ohio has retired as of 2005.
- Dr. Bonanni in Pennsylvania has no info pertaining to any revision to DS.
- Dr. Peters in Pennsylvania does not perform RNY-to-DS revisions and does not intend to get involved in them. However, he does perform GLB-to-DS revisions and revisions from old stomach stapling operations on a case-by-case basis. He appears to be very anti-GLB from what was reported on the DS board and is more than willing to remove GLBs and VBGs.
- Dr. Spaw in Tennessee does not perform any revisions of any kind, according to a member on the Revision board.
Further info about each DS surgeon can be found in the following link:
http://www.duodenalswitch.com/surgeons/surgeons.html
(Note: A few DS surgeons are not vetted into the ds.com website.)
http://www.dsfacts.com/North-American-Duodenal-Switch-Surgeo ns.html
--------
List of DS Surgeons Doing Revisions:
- Dr. Warden in Louisiana has revised a lot of people who have failed RNY by making what is usually a large pouch into a small pouch and sometimes extending the limb length to increase malabsorption.
- Dr. Anthone in Nebraska stopped doing RNY-to-DS revisions in 2006. However, one member reported that he probably still performs LB-to-DS revisions.
- Dr. Prachand in Chicago does RNY-to-DS revisions only if the BMI is over 50.
- Dr. Gagner in Florida (formerly NY) performs RNY-to-DS revisions. Members have reported that he is one of the best!
- Dr. Alverdy in Illinois evaluates case-by-case but he is very selective.
- Dr. Inman in Indiana has done only 20 RNY-to-DS revisions (as of 9/2007).
- Dr. Lutrzykowski in Michigan wants RNY op reports before he decides if he will do revisions.
- Dr. Lane in Ohio usually does RNY-to-DS for those with higher BMI but determines on case-to-case basis.
- Dr. Anderson in Ohio does not do revisions.
- Dr. Peters in Pennsylvania does not do revisions.
- Dr. Shah in NYC does revisions on a case-to-case basis.
- Dr. Deveney in Oregon performs RNY-to-DS revisions.
- Dr. Husted in California performs RNY-to-DS revisions.
- Dr. Antelmo Sasso Fin in Brazil does RNY-to-DS revisions.
- Dr. Maguire in Ohio does not do RNY-to-DS revisions but does a distal RNY. He told a member on the Revision board that he used to do the RNY-to-DS revisions for patients who insisted on them. However, he mentioned that in his experience, his patients who had distal RNY revisions achieved the same weight loss results with less risks and fewer complications than with the RNY-to-DS revisions. Therefore, he no longer performs the complete DS revisions.
- Dr. Greenbaum in New Jersey has done 50 DS surgeries and 8 DS revisions (as of 9/2007). Several members have mentioned that he is an excellent surgeon, especially for RNY-to-DS revisions.
- Dr. Roslin in New York does DS but when doing a revision from RNY, makes it a distal RNY. But he does not do RNY-to-DS.
- Dr. Feng in California does not do RNY-to-DS revisions.
- Dr. Jossart in California has done 150 DS surgeries and has done many revisions (as of 9/2007).
- Dr. Schlosser in Minnesota is no longer working in Minnesota. She is overseas at the moment (9/2007) and will be for several months. She is not returning to the state...no longer doing DS.
- Dr. Maynard in Georgia performs DS but in his response did not mention revisions. Did encourage a member to attend seminar for more questions. However, another member reported in 12/2007 that he does not do RNY-to-DS revisions.
- Dr. Smith in Georgia performs DS as well but it is unclear if he also does RNY-to-DS revisions. One member thinks he does while another doesn't think so.
- Dr. Cirangle in California has performed hundreds of DS procedures, including revisions from RNY.
- Dr. Keshishian in California performs RNY-to-DS revisions. However, he charges a $4K fee upfront for revisions that are not covered by insurance. Plus, he requires his out-of-town patients to stay in a hotel for 10 days after being released from the hospital.
- Dr. Rabkin in California performs RNY-to-DS revisions, according to several members on the DS board.
- Dr. Buchwald in Minnesota performs RNY-to-DS revisions, according to several members on the DS board.
- Dr. Hess in Ohio is retired now.
- Dr. Ungson in Mexico performs RNY-to-DS revisions. He also takes on cases considered too "complicated" or "high risk" by other surgeons. Members have said that he is considered one of the greatest DS surgeons.
- Dr. Inabnet in NYC performs RNY-to-DS revisions and has performed hundreds of DS, according to a member on the DS board.
- Dr. Crookes in California performs RNY-to-DS revisions, according to several members on the DS board.
- Dr. Elariney in Virginia performs RNY-to-DS revisions, according to a member on the DS board.
- Dr. Baltasar in Spain performs RNY-to-DS revisions and has trained Dr. Ungson. One member on the DS board reported that he is one of the most experienced virgin DS and RNY-to-DS revision surgeons. Plus, the same member reportedly paid $16K for the surgery plus $2K in traveling expenses in 2005 (the cost may have gone up since then).
A number of members reported on the DS board that DS surgeons in California may charge upfront fees of $4K-$8K to cover services that are not reimbursed by insurance.
The following DS surgeons have no info on performing RNY-to-DS revisions
(source: http://www.duodenalswitch.com/surgeons/surgeons.html):
- Dr. Oakley in Idaho.
- Dr. Edinger in Idaho.
- Dr. Schweitzer in Maryland.
- Dr. Vanguri in Maryland.
- Dr. Hares in Michigan.
- Dr. Sudan in Nebraska.
- Dr. Herron in NYC.
- Dr. Kurian in NYC.
- Dr. Nicastro in NY.
- Dr. McMullen in NY.
- Dr. Sparks in NY.
- Dr. Voellinger in NC.
- Dr. Thomford in Ohio.
- Dr. Teel in Ohio.
- Dr. Hoddinott in Pennsylvania.
- Dr. Fichter in West Virginia.
- Dr. Marchesini in Brazil.
- Dr. Alcides Jose Branco Filho in Brazil.
- Dr. Marco in Spain.
Initial research done by Karla H.
Source: http://www.obesityhelp.com/member/karlahook/
Click on "September 2007" blog
Last updated 1/14/2008
=====
Dr. Keshishian charges $4000 which is not covered by insurance
- Dr. Warden hasn't done many DS much less DS revisions.
- Dr. Anthone has stopped doing RNY to DS surgeries
- Dr. Prachand only does RNY to DS revisions if the BMI is over 50
- Dr. Gagner is switching institutions and will start at the new place in January 2008. He recommends I wait until January to set up appt.
- Dr. Alverdy evaluates case by case but they are very selective
- Dr. Inman has only done 20 RNY to DS revisions
- Dr. Lutrzykowski wants RNY op report before he decides if he will do revision
- Dr. Lane usually does RNY to DS in higher BMI but determines on case to case basis
- Dr. Anderson does not do revisions
- Dr. Peters does not do revisions
---------
Please be advised I cannot attest to the accuracy above.
Let me just applaud you in your seeking out the very best WLS by all the conventional known standards today. That said, this a revision and by far the most COMPLEX revision that exist. There are indeed real risks and your choice of revision surgeon is CRUCIAL to your outcome. Many surgeons claiming to do same DO NOT do the FULL RNY take down and are capable of following through with a full DS, and sometimes, perioperatively a patient's presentation may not allow for this. Damn few DS surgeons have the skill level to do so, so pick wisely. YOUR VERY LIFE AND OUTCOME DEPENDS ON IT!
It's entirely understandable you want to make this affordable, but the reality is, you need to weigh the consequences of endeavoring in such rarefied air as this type of revision entails. Pinching pennies "could" put you at needless additional risk.
Having said that, with the caveat of complications that might or might be covered should they arise out of country, your least expensive route with experienced revisionist would likely be with Dr. Ungson in Mexico, Dr. Baltasar in Spain or possibly Dr. Antelmo Sasso Fin in Brazil. I have little knowledge of the Brazilan practitioner so please vet him carefully.
Rockne
Thank YOU so MUCH for the information!!!!! I DO appreciate it, very much!!
I too, agree about the "pinching pennies" part. My health is worth alot, and so is my life.
-Jamie
I too, agree about the "pinching pennies" part. My health is worth alot, and so is my life.
-Jamie
RNY 2/26/2002 DS 12/29/2011
HW 317 SW 263 BMI 45.1
SW 298 CW 192 BMI 32.9~60% EWL
LW 151 in 2003
TT 4/9/2003
Normal BMI 24.8 is my GOAL!!!
GBP (RNY) 2/26/02 298 lbs, TT 4/9/03 151 lbs, DS 12/29/11
HW 317 SW 263 BMI 45.1/CW 192 BMI 32.9/GW 145 ~ Normal BMI 24.8
**Revision Journey started 3/2009 Approved 12/12/11**
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