How do you qualify for a revision?
Hello all:
I guess I am feeling a bit down about my 2 months+ stall that I am looking on this board..its almost a year and I am stuck at 150 lbs...trying my hardest to get down to the 130's. I'm thankful that I was able to get RNY but i feel like this is not giving me the results I wanted. Am I just overreacting?
Question is, how do you qualify for a revision from RNY to DS..does one have to be morbidly obese again or just obese or overweight? at my height i am still concidered overweight! taking in less than 1,200 cals a day.. i work out 3-4 times a week..elliptical, walking etc etc.
I guess I am feeling a bit down about my 2 months+ stall that I am looking on this board..its almost a year and I am stuck at 150 lbs...trying my hardest to get down to the 130's. I'm thankful that I was able to get RNY but i feel like this is not giving me the results I wanted. Am I just overreacting?
Question is, how do you qualify for a revision from RNY to DS..does one have to be morbidly obese again or just obese or overweight? at my height i am still concidered overweight! taking in less than 1,200 cals a day.. i work out 3-4 times a week..elliptical, walking etc etc.
"Live like its your last day on earth, laugh till your tummy hurts and Dance like no one is watching!!!"
The general rule is that you have to have a BMI of 40, or 35 with comorbidities, unless there's a mechanical problem. People who have mechanical problems (like staple line disruptions) will be given necessary revisions.
Many insurance companies have strict guidelines for revisions, much like they do with all weight loss surgeries. I had to show compliance with my prior RNY, I had to document diet and exercise with my PCP, and I had to submit a series of test results. I had a mechanical problem - a too-tight ring around the stoma was causing esophageal erosion - but I still had to wait from July until December for surgery. I documented everything along the way.
I think that if you're at 150, you wouldn't qualify. I never made it down that far.
Many insurance companies have strict guidelines for revisions, much like they do with all weight loss surgeries. I had to show compliance with my prior RNY, I had to document diet and exercise with my PCP, and I had to submit a series of test results. I had a mechanical problem - a too-tight ring around the stoma was causing esophageal erosion - but I still had to wait from July until December for surgery. I documented everything along the way.
I think that if you're at 150, you wouldn't qualify. I never made it down that far.
baileymouse:
I am consulting with Dr. Greenbaum, I went to my Pulmonary Dr. today, I have to have a chest ex-ray, a breathing study and a sleep apnea test done, Friday I go to the cardiologist and that is it for me. Please tell me it wil be over soon. Can you tell me what vitamins you take and when do you buy from vitalady, please advise. Thanks!
I am consulting with Dr. Greenbaum, I went to my Pulmonary Dr. today, I have to have a chest ex-ray, a breathing study and a sleep apnea test done, Friday I go to the cardiologist and that is it for me. Please tell me it wil be over soon. Can you tell me what vitamins you take and when do you buy from vitalady, please advise. Thanks!
You're on the right track. I started in August, I think, and had all the tests completed by the end of September. I weighed in monthly with my primary and she faxed over everything in November. I had surgery in December.
I take multivitamins, iron + C, D, E, K, A, biotin, acidophilus, and I just added in potassium. I get some locally and some from Vitalady. I get her tender iron + c, the 50K of dry D, etc. I get the calcium locally, I buy CVS calcium citrate with D + magnesium.
Hang in there, I'm sure all will go well.
I take multivitamins, iron + C, D, E, K, A, biotin, acidophilus, and I just added in potassium. I get some locally and some from Vitalady. I get her tender iron + c, the 50K of dry D, etc. I get the calcium locally, I buy CVS calcium citrate with D + magnesium.
Hang in there, I'm sure all will go well.
Are you insured? If so, I suggest you first check out your insurance policy bulletin on revision bariatric surgery if any. That was my starting point. My insurance allows for a revision 2 years following the surgery if I have been compliant with the nutrition and excersise protocol, and if I have not lost 50% of the excess weight. I am 5'0, so I should be at about 125 according to the. I only lost 20 lbs.
DS SW - 201 4/21/11; GW 130
Ms. Cal Culator
on 4/6/10 11:23 am - Tuvalu
on 4/6/10 11:23 am - Tuvalu
Yea...you are overreacting. (Sorry...but you asked.)
There is no guarantee that any wls will get of us to what some chart says is an ideal weight. That said...I *THINK* I'm reading that you are 20 pounds over your ideal weight. A lot of people would kill to be in that situation. Some of the weight MAY be--but may not because you weren't THAT heavy--excess skin and bones that are a big larger because you were carrying excess weight.
There is no guarantee that any wls will get of us to what some chart says is an ideal weight. That said...I *THINK* I'm reading that you are 20 pounds over your ideal weight. A lot of people would kill to be in that situation. Some of the weight MAY be--but may not because you weren't THAT heavy--excess skin and bones that are a big larger because you were carrying excess weight.
Hello
I cannot seem to get into the Forum--so I am hoping that someone can help me too.. I am not sure what i need.
I have to make an appt with a surgeon. I had my RNY 3 yrs ago and have lost a little over 200 lbs and thought i was doing well.
I was experiencing the symptoms of an ulcer--so i had an endoscopy done a few weeks ago.. Well there is no ulcer--But the gastro doc found 3 small polyps which he took out and biosied and were fine.. I also have a loose staple and a Fistula.. I read on here about what the reasons are for a Revision--My pouch has also enlarged some.. I feel like i did something wrong--I have been staying at around 240-250 and thought well I guess this weight is where it ends..I did not expect for them to find this and the GI NUtrition Doctor says that its because i am overeating--Well I know that i am no angel--But i swore this would never happen to me and I still get so full fast.. I am worried about gaining weight back and even more worried that if that staple falls out--what are the consequences..Now i have a different insur now then i did 3 yrs ago--so I am not usre if they will pay for a Revision and I truly do not want any more surgery--as I just had my shoulder operated on in Nov..I have diabetes still and i am on insulin still-very little tho and i have many diabetic complications.
So I was just wondering what others experiences are.. Does having this fistula and loose staple mean I need a Revision?
Also the pouch has gotten a little bigger..
well hope someone reads this and could answer my questions--Does this mean that my Surgery has failed?
Susie Smith
I cannot seem to get into the Forum--so I am hoping that someone can help me too.. I am not sure what i need.
I have to make an appt with a surgeon. I had my RNY 3 yrs ago and have lost a little over 200 lbs and thought i was doing well.
I was experiencing the symptoms of an ulcer--so i had an endoscopy done a few weeks ago.. Well there is no ulcer--But the gastro doc found 3 small polyps which he took out and biosied and were fine.. I also have a loose staple and a Fistula.. I read on here about what the reasons are for a Revision--My pouch has also enlarged some.. I feel like i did something wrong--I have been staying at around 240-250 and thought well I guess this weight is where it ends..I did not expect for them to find this and the GI NUtrition Doctor says that its because i am overeating--Well I know that i am no angel--But i swore this would never happen to me and I still get so full fast.. I am worried about gaining weight back and even more worried that if that staple falls out--what are the consequences..Now i have a different insur now then i did 3 yrs ago--so I am not usre if they will pay for a Revision and I truly do not want any more surgery--as I just had my shoulder operated on in Nov..I have diabetes still and i am on insulin still-very little tho and i have many diabetic complications.
So I was just wondering what others experiences are.. Does having this fistula and loose staple mean I need a Revision?
Also the pouch has gotten a little bigger..
well hope someone reads this and could answer my questions--Does this mean that my Surgery has failed?
Susie Smith
Hiya Susie,
You wondered if you need a revision?
1. Your BMI still sounds like it's 35+ (so check yes with that one)
2. You sitll have co-morbidities (diabetic)
3. You have a staple line issue, fistula, stretched pouch (some surgen's consider these medical necessities)
Did your surgery fail? WEll.....you lost OVER 200 pounds! It sounds like it did a darn good job for you! However....you still have some of the same goals that a newbie have: Get in a healthy weight range, ditch co-morbidites......get a better quality of life!
I'd say.....1. read your insurance details to see what coverage you have 2. research the various surgery options (check out www.dsfacts.com ) 3. research the surgeon's who specialize in revisions and make an appt for a consult (email, phone or office)
Go for it!
Good luck!
You wondered if you need a revision?
1. Your BMI still sounds like it's 35+ (so check yes with that one)
2. You sitll have co-morbidities (diabetic)
3. You have a staple line issue, fistula, stretched pouch (some surgen's consider these medical necessities)
Did your surgery fail? WEll.....you lost OVER 200 pounds! It sounds like it did a darn good job for you! However....you still have some of the same goals that a newbie have: Get in a healthy weight range, ditch co-morbidites......get a better quality of life!
I'd say.....1. read your insurance details to see what coverage you have 2. research the various surgery options (check out www.dsfacts.com ) 3. research the surgeon's who specialize in revisions and make an appt for a consult (email, phone or office)
Go for it!
Good luck!
Joyce Rny 2/11/03-> ERny 12/26/07-> Duodenal Switch 5/12/2010
www.dsfacts.com , www.dssurgery.com , & www.duodenalswitch.com
THAnk you Joyce.. How can they turn a RNY into a DS?
I did not think that was possible--I wanted to have a DS and thought since i had alot to lose that the DS would be best for me--But my insur only paid for the RNY or the Band.. I have to check out what my new insurance will pay for and hope that they will not turn me down cause it is not their insurance who paid for my original surgery.
You have a great day now and I will be praying for you.
Susie Smith
I did not think that was possible--I wanted to have a DS and thought since i had alot to lose that the DS would be best for me--But my insur only paid for the RNY or the Band.. I have to check out what my new insurance will pay for and hope that they will not turn me down cause it is not their insurance who paid for my original surgery.
You have a great day now and I will be praying for you.
Susie Smith
SUSIE SMITH FROM NE PA
Susie Smith from PA 
Hi Susie,
I'm a revision from a very old RNY type surgery; I had it done back in 1980. The main difference is that back then they didn't cut the stomach in two to make a pouch, they just stapled off the pouch. It worked the same way, but the staple line often came apart, which is why they started cutting the stomach in two; that way the edges would grow together around the staples, where as mine never did grow together.
To revise to DS, the surgeon has to put your pouch and blind stomach back together and then make it into a sleeve. Once that's done then they rearrange your small bowel to the DS version making a common channel of between 50 and 200 cm. It's a difficult revision and only a few surgeons have the skills to do it safely, but it can be done; I'm living proof.
Love my DS, it's far superior to the old RNY.
Kerry
I'm a revision from a very old RNY type surgery; I had it done back in 1980. The main difference is that back then they didn't cut the stomach in two to make a pouch, they just stapled off the pouch. It worked the same way, but the staple line often came apart, which is why they started cutting the stomach in two; that way the edges would grow together around the staples, where as mine never did grow together.
To revise to DS, the surgeon has to put your pouch and blind stomach back together and then make it into a sleeve. Once that's done then they rearrange your small bowel to the DS version making a common channel of between 50 and 200 cm. It's a difficult revision and only a few surgeons have the skills to do it safely, but it can be done; I'm living proof.
Love my DS, it's far superior to the old RNY.
Kerry
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