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MsBatt
on 9/17/12 1:05 pm

On September 17, 2012 at 5:02 AM Pacific Time, Sherrie P. wrote:

Yes. I have. The docs here I have talked to do not recommend it unless your BMI is over 50 (and those are my insurance guidelines). I am honestly scared enough of the procedure here in the US and would hate to run into complications out of the country. I know they are possible with any surgery, but the list of vetted DS surgeons is significantly smaller than the other surgeries.

According to the ASMBS, anyone who qualifies for WLS qualifies for the DS, period. I know people who've had the DS with BMIs in the low 30s, due to their diabetes. Heck, surgeons in Europe have even been doing the intestinal part of the DS on NON-obese diabetics for years now, and clinical trials on this have started here in the US.

The list of vetted DS surgeons is small for several reasons. One is that it takes a lot longer to learn how to do the DS, and that takes time away from making money. Another is that the sewing the duodenum takes a LOT of skill---I've heard it compared to sewing wet tissue paper. And lastly, as long as the insurance companies make it realy hard for people to GET the DS, there isn't a really big market-share for a new surgeon who's just learned the DS.

The DS isn't any risker than the RNY, though perhaps risker than the Sleeve.

Sherrie P.
on 9/23/12 6:33 pm

RNY on 02/06/13

Sure, well - but my insurance won't pay for it unless my BMI is over 50.
If I go out of the country it is over double the RNY.
It really is not an option. I think it sounds good -- but it is not financially an option.

Revision Lapband to RNY 2-6-2013 HW: 286 Pre-Op Diet: 277 Surgery Day: 265 Goal: 155 CW: 155

Plastic surgery 8/28/2014: Brachioplasty, mastopexy, & abdominoplasty.

Plastic surgery 1/27/2015: Butt Lift

TamaraL
on 9/11/12 5:53 pm

Revision on 10/08/10

my insurance approved me for RNY but not for the removal of band. Luckily my dr. accepted payment for what insurance paid.

The billing person wanted to bill me for the lap band removal.

Tamara

pineview01
on 9/11/12 7:38 pm - Davison, MI

Lap Band on 02/25/09

That is wild that they would pay for a new WLS while you have a band.
How did they think you would get a rny with the band left in. Everyone
else is told they will pay for band removal but not the second surgery.

Glad to hear the surgeon was willing to remove the band for "free".
If they are like my center they get enough for one to cover two.

BAND REMOVED 9-4-12-fought insurance to get sleeve and won! Sleeved 1/22/13! Five years out and trying to get that last 15 pounds back off.

Sherrie P.
on 9/16/12 11:02 am

RNY on 02/06/13

I have yet to figure out why my insurance did not at least approve me for the RNY - that is going to be in my appeal letter.

Revision Lapband to RNY 2-6-2013 HW: 286 Pre-Op Diet: 277 Surgery Day: 265 Goal: 155 CW: 155

Plastic surgery 8/28/2014: Brachioplasty, mastopexy, & abdominoplasty.

Plastic surgery 1/27/2015: Butt Lift

TamaraL
on 9/16/12 11:28 am

Revision on 10/08/10

make sure you put in your appeal letter everything you have had problems with.

My band was either too loose or too tight and I had heart burn all the time. Sometimes when I ate i would throw up with just 1 bite.

I worked with a dietician, nurse, everyone tried to help me. It just wasnt meant to be.

Sherrie P.
on 9/16/12 11:43 am

RNY on 02/06/13

But it sounds like they never approved the removal for you? Correct.

:( I am not very hopeful.

Revision Lapband to RNY 2-6-2013 HW: 286 Pre-Op Diet: 277 Surgery Day: 265 Goal: 155 CW: 155

Plastic surgery 8/28/2014: Brachioplasty, mastopexy, & abdominoplasty.

Plastic surgery 1/27/2015: Butt Lift

TamaraL
on 9/16/12 2:00 pm

Revision on 10/08/10

My paperwork say RNY approved. WHAT!!??? I was freaking out. THe director of my program ended up going upstairs to the surgical center and personally talking to the surgeon because the finance person would only send him a email and he would not respond and she was too chickent **** to go ask him.

I had blue cross blue shield.

Tamara

(deactivated member)
on 9/22/12 9:55 pm - Wendell, NC

I am sorry what were you trying to revise to and from? Who is your insurance carrier if you dont mind me asking?

Sherrie P.
on 9/23/12 6:35 pm

RNY on 02/06/13

Lapband removal to an RNY.
Was denied because there was nothing wrong with the band and the fact I never lost more than 27 pounds with it was not enough cause. No evidence of pouch dilation and no indication that I had followed a post op diet.
BCBS of NC.

Revision Lapband to RNY 2-6-2013 HW: 286 Pre-Op Diet: 277 Surgery Day: 265 Goal: 155 CW: 155

Plastic surgery 8/28/2014: Brachioplasty, mastopexy, & abdominoplasty.

Plastic surgery 1/27/2015: Butt Lift

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