RNY to DS??

I am going to have a consultation/second opinion with a DS surgeon on March 15th.  Basically I have a dialated stoma and my tummy doesn't stay full.  I've gained back 25 pounds after not ever even getting out of the obesity bmi range.  I'm still a light weight though at 185.  Anyway, since I don't see him til the 15th, I'm wondering how do they convert the stomach to a ds after it is an rny?  Do they remove the old staples?  Do I get my pyloric valve back???  I really want my pyloric valve otherwise any surgery is pointless for me.  Also, I'm hearing it's near impossible to get a revision covered by insurance.  This is infuriating to me because DS was not ever mentioned to me at the time I was getting surgery.  I was told I had two options, lap band or RNY.  I knew I wouldn't be successful with the lap band so I took the big time surgery... went through a lot of pain, am always anemic, dump on carbs and sugar, and became SEVERELY lactose intolerant.  All that pain and I am gaining weight!!!  I was never told that this could happen to my stoma!  Hell I wasn't ever told what a stoma was and I had a supposedly extremely reputable bariatric group.  I cannot believe that they won't fix what they never succeeded in providing me!!  Now all he is offering me is the option of the band over bypass which is highly unlikely that my insurance will cover.  I do not want a band.  I don't want a port or foreign object inside of me.  I'm more about science... like lets see what, scientifically will change the way my body metabolizes food and make me a sucess!!  Anyway, so how hard did you have to fight for your revision?  And how bad was the recovery from surgery?  I had ALOT of pain with the RNY.
Thanks!

"I'm wondering how do they convert the stomach to a ds after it is an rny?  Do they remove the old staples?  Do I get my pyloric valve back???  I really want my pyloric valve otherwise any surgery is pointless for me.  Also, I'm hearing it's near impossible to get a revision covered by insurance." 

 I hope you asked these same questions over on the DS board.   That's where most of the DS'ers hang out, even if they were a revision/conversion from something else (usually the RNY).

"This is infuriating to me because DS was not ever mentioned to me at the time I was getting surgery.  I was told I had two options, lap band or RNY."

What happened to you is common.  Most surgeons run RNY/lapband "factories" and either don't tell prospective patients about all of the surgical options open to them OR they gloss over the other options (only mentioning the "dangers") because they are not surgeries that their practice offers.

Medicine is a business, like any other; so ask yourself, why would a business give out information regarding something that they don't offer?   It's common sense, but people put doctors on some kind of moral pedestal and forget that they are merely people trying to make a buck.

Hi Jenn,

I got a revision to DS from my 1980 gastric bypass / RNY and how it's done is that the surgeon has to take the RNY completely apart and put you back together, then do the DS. It's a difficult operation and there are only a few surgeons who have the skills and patients to do it safely and that I would recommend. Even though it's a difficult surgery and recovery, I would do it again in a heartbeat, no question about it. 

You do get your pyloric valve back, unless you go to one of the surgeons who claim to do RNY to  DS revision without taking down your pouch and rebuilding it into a sleeve.

I had all the same problems you're talking about, but I put up with them for 28 years; my only regret is that I didn't get the revision 10 years sooner.

I'll add you to my friends list so you can get on my profile if you want to, there's a lot more detail about my 28 years of RNY and my revision to DS.

You can also read and see my 1 year out post here:

www.obesityhelp.com/forums/DS/4024505/One-year-ago-today-who -could-have-known/action,replies/topic_id,4024505/page,1/

I can't tell you anything about insurance, I didn't have any WLS coverage so I self paid for the revision.

Kerry

Thanks Kerry.  I will definitely check out your story.

Kerry,

I would love to be added as a friend too.  I had the RNY in 2000 and gained it all back plus 10 more pounds. I am looking for a surgeon in CA that is covered under my BC PPO and COE Bariatric Clause, So that's a lot of work in itself.  I had all the problems that Jenn had and did start drinking diet and then reg Dr. Pepper too.  However, I was told by my surgery group to never drink carbonated drinks or it could enlarge the stoma and pouch.  I don't know how stretched out I am.  I stayed away from the sodas for 4 years then couldn't resist.  Also knew about DS, but in 2000, it sounded more dangerous. I'm hearing such a difference now.

Pam from CA

Hi Pam,

I believe Dr. Ara Keshishian would be covered under the clause you're insurance has; here's his contact information:

Ara Keshishian, MD, FASMBS, FACS *
Email: [email protected]
Karim Zahriya, MD, FACS *
Email: [email protected]

Central Valley Bariatrics
Phone: 818-812-7222
Fax: 661-725-8051

 

Primary Office:
1808 Verdugo Blvd., Suite 413
Glendale, CA 91208

Satellite Office:
Delano Regional Medical Arts Building
1205 Garces Highway, Suite 303
Delano, CA 93215

 

 

Dr. K is an excellent surgeon and does RNY to DS revisions all the time. You can also go here and see all the vetted DS surgeons in CA:

www.dsfacts.com/North-American-Duodenal-Switch-Surgeons.html #ca

I added you to my friends list, so you can get into my profile if you want to; it has a bunch of pictures and more detail about my years with the gastric bypass and revision.

Kerry

Well, I started looking into him first. Even though he is listed and my insurance has name as a BC provider, the hospital is not covered.  So now I researching Dr. Rabkin.  They want 10k upfront before the insurance reimburses. Any more suggestions?
Pam

How long ago did you look into this Pam? I'm not sure, but it's my understanding that this is one of the reasons he has two hospitals he operates from now. It seems like one of them is covered.

That being said, I don't know much about insurance; I self paid for my revision. But there are a number of very knowledgeable people over on the DS board who may be able to steer you in the right direction. I would post a thread there about what you're looking for there and see what turns up.

Kerry

You should also check out http://www.dsfacts.com/

There is A TON of great info in that site!!!!





GOOD LUCK!!!!
-Jamie

I am in the same boat as you, no one ever told me about DS when I went in 2002 and researched.  I asked would I ever regain the weight and was told it was impossible, well here I am, I have RNY on 1/29/2003 and now I have gained almost all of the 200 lbs I lost back and I am truly angry.  I am in the process of being qualitied for the revision from RNY to DS at this moment.  I have Aetna Select Insurance and they will pay for the revision, you need to check with your insurance company and see if they will pay and what you need to do to qualify.  I am going through Dr Greenbaum's practice in NJ, he is one of the very few that do the RNY to DS revision and he takes it all apart like someone else said below.  I have started the long process but I want to get this weight off once and for all and keep it off.  I have to get clearance from a Psychiatrist, Cardiologist, Pulmonary doctor, I have to have one appointment with a Nutritionist, plus I hae to have an Upper GI test done and a ultrasound of my gallbladder.  I also have to have an EKG and the pulmonary doctor might send me for a chest ex-ray etc.  After they get all the clearances, they put it all together along with the tests and send it to my insurance company, they said it usually takes anywhere from 2 to 4 weeks to get an answer, and then soon as it is approved, they will then schedule the surgery, my surgeon is 6 weeks out, so I am hoping to have everything done by 4/15, I have all the appointments set up, I just need to have the testing done.  I am hoping for the surgery in June, July at the latest.  Since my RNY was done laproscopically and I have never had any surgery before that, I am not sure about the pain with open surgery.  Dr Greenbaum said at the end of 2 weeks I should be fine to go back to work, I have an office in my home.  We will see.  I wish you luck, just do not let it go on too long and you keep gaining, that is what I did, I went to two other doctors and my original surgeon and they were all saying go back to the basics, well it did not work my stretched stoma made me hungry all the time................................Keep in touch.