Cross Post from DS Forum -- Input Appreciated

 I had RNY in 2003 at a starting weight of 340 lbs at 5.5"-- I had looked into DS at the time also, and although my surgeon (Heather McMullen) performed them, my insurance at the time (Aetna) did not recognize the DS as a valid surgery -- the only WLS surgery they would consider was RNY.  I had several comorbidities at the time - diabetes, sleep apnea, high cholesterol, stress inconentinence.

I lost 180 pounds (to 160) in 18th months, and proceeded to have various reconstructive plastic surgeries in 2005 - I was able to maintain my weight loss within 5-10 pounds through 2006.  In 2007, I started regaining some weight and by Fall of 2007 was up to 192 pounds.  An endoscopy revealed that although my pouch was 'within normal size' my stoma was extrememly enlarged and everything was passing thru.  Thru taking additional supplements I have been able to keep my bloodwork within reasonable ranges. 

Stupidly, I elected to have a Stomophyx in October 2007 - of course insurance would not cover given that it was "experimental" -- it proved to be a waste of time, emotion and money -- it did absolutely nothing for me at all.  I intiially lost 8 lbs during the first two weeks while on a liquid diet, but gained it all back.

I have now gained additional weight and am fluctuating between 215 and 220 pounds, and feeling really bad about myself.  I had gotten ****y in those first few years, and though I absolutely understand that although my stoma is enlarged, my grazing and decrease in exercise has added to the increased weight gain.  I cannot seem to get a hold of it.

My question for you guys is under the cir****tances, do you believe that I would be a candidate for a revision to a DS?  Would insurance even possibly cover it because of the enlarged stoma -- don't believe the RNY was a 'failure' - and if not, what is the out-of-pocket cost.  I am within a reasonable driving distance from Dr Greenbaum and if a candidate would purseue a revision surgery with him.

I'm just starting to think about this for me, and would welcome any comments or insights you may have.  Thank you.

Hugs,
Nannette
340-160-220

RNY 2006 I am having some of the same issues as you. I am currently in the process of getting test completed to prove that there is something wrong with my pouch. I have had a barium swallow test and that was difficult to read because of the speed of the barium that flowed through my body. I have an appointment with another doctor on the 13^th of January more than likely to be scoped. Part of the reason I am still in the testing mode is the hospitals inability to locate my original films to compare with the current ones. So be in for a ride with the insurance company they are not to ready to redo any type of revision surgery without extensive proof of a malfunction. My full feeling comes from the bottom half of my stomach a hardly feel anything in my pouch it just falls through.   Anyway from what I have learned for me personally the DS is the only way to go for revisions. I have seen may people lose their weight right on this website an get to goal. Do your research and then make a decision that is right for you.   Sophia

Hi Nannette,

I don't know much about insurance questions, but you should post this over on the DS Forum, there are a number of Insurnance experts over there and they may be able to help.

That being said; as far as qualifying for a revision to DS, it would depend on your BMI and co-morbitities.

I have no idea what Dr. Greenbaum's package self pay price is; it was $35,000.00 with Dr. rabkin in San Francisco.

Kerry

I qualified for revision surgery at a fairly low bmi,  not sure what it was but I think around 34ish.  I also had a normal size pouch, but an enlarged stoma and hx of marginal ulcers.

Please do go to a Dr that does all revisions, not just the bottom half or erny, They are not the same at all!

Just had rny to DS reivion with Dr. Greenbaum. I had mechanical failure in that the band that Dr. Kamelgard used on top of my rny caused vomiting.

I am 5'2.5" and weighed 220. If your bmi is 40 they.ll approve if you have the coverage and your bmi is 40.If you have comorbidities you can get it done between 35-40 bmi.

I had more than one person on staff comment on how thin I was compared to other patients and it made me feel weird but I decided that living without the puking was important.

Dr. Greenbaum was fantastic, btw. Very good, and my husband & I were both impressed.  I am being released today and can't wait but I think I made the very best choice this time.

 Hello Nannette,
The indication for weight loss surgery revision is divided to:

1-complication of the original surgery
2-inadequate weight loss or weight regain
Different surgeons may have a different way of outlining this. 
Here how I have done it on our website.

http://www.dssurgery.com/ourprogram/revision_surgery.php
Investigate all your options. As you have already noted, probably stay away from unproven "new" procedures. 
Dr.  Greenbaum is a very good surgeon.
Good luck.
Ara