My IMR Decision

I just thought I'd type this out in case any of you were interested.

A 37-year-old female enrollee has requested bariatric revision surgery (duodenal switch) for treatment of her obesity.  Findings:  The physician reviewer found that the medical literature supports the opinion that the performance of a revisional procedure similar to the initial operation will fail in many instances, because the basic problem is metabolic and not mechanical. Rapid gastric emptying, as seen in this patient's case, leads to an enhanced insulin response resulting in either hypoglycemia or hyperglycemic episodes, and the most dramatic rises and falls have been associated with small pouches and wide anastomoses. Duodenal switch is a medically appropriate solution to the problem. If this procedure is not performed, the patient's comorbididites will likely worsen. Thus, bariatric revision surgery (duodenal switch) is medically indicated for this patient.
 

The part in bold is just something to keep in mind when trying to decide what revision to have. I see a lot of people having their rny revised to rny. I worry for them each time I see it. I do wish you must success, but I hope all those seeking a revision will keep this in mind and not have to go through what I did to try to get healthy.

Oh and as of this morning I'm down 25 pounds in 1 month  YAY ME!!!

Thank you for sharing, Monique!!!!  There is very GOOD information in that!!!

I decided over 21 months ago to have a revision, and here I am on my 2nd insurance submittal (Dr. K's office is just getting the 'finishing touches' ready to submit -- probably this week).

It is a LOOOONNNNGGGG journey, but I know had i given up, the insurance company would have won, and I would still be miserable.  I have to HOPE that I get an approval this time around!!!


-Jamie

Jamie you and Sophia are two people who I have been hoping and praying that you get your approvals. You've been at this so long and I can't wait to see your topic "I'm Approved" because I know I'll be seeing it shortly!

Jamie,

Your approval is on the way and you will be on the loser bench with everyone else soon. I will be praying for a speedy YES!!!!!!!!!!!!!!!!!

I have three weeks to go and getting a little excited I can't believe it at times. Keep me posted!!!

Sophia

Monique,

great info. I think rny distal is a procedure that should be banned.  I am glad you feel better with your revision and you are doing great!!!!   continued success.......


Mila

Thanks Mila and I do hope you have success as well.

I also feel bad for the individual that just accept what thier doctor want to do or has the ability to do. It is worth the fight and in many cases the patient wins. The funny thing to me is no one even mention this surgery to me originally when I was 455 pounds... Why??

Ok, look here Miss Skinny on the move you are just droping that weight!!!!! I know you are happy and will work that DS to the fullest.

Sophia

Miss Skinny, I kind of like that. It definitely has a nice ring to it. Do you know that even though I lost 25 pounds so far I'm still afraid something will happen with me and I won't lose the weight. I don't know what it is with my body that fights to keep on every pound, but I'm hoping and praying that my struggle is over. Oh wait there is power in the tongue. MY STRUGGLE IS OVER!