Path to revision

Well, it's gonna be a long and winding road for sure.  I saw my internist -- great guy, totally understands where I'm coming from with the RA and agrees that my situation results in very poor quality of life.  He gave me some steps to go through to try to get my insurance to realize how medically necessary this is.  1) try to get a revision appointment with a local doc - tried, and as both my internist and I suspected, it's a no go, both because they don't do revisions and because they won't touch another surgeon's work.  2) go back and talk about this with my wls surgeon again, confirming that he won't do it -- whole new monkey wrench here, my surgeon is moving to Michigan!  So, now I'll see another surgeon in the same practice and chat with him about all the meds I've tried for the reactive hypoglycemia, the very restricted diet, the ultra-sleepiness, and my need to stop dumping and passing out and to start living again!  3) we did another full blood panel and now I find out that I have elevated parathyroid hormone!  Another cause of sleepiness, pain, kidney stones, and misery.  I MUST get a recommendation for reversal and revision, preferably to DS with Dr. Keshishian.  I'm working on it, but it won't be easy.  My pre-retirement insurance covered WLS, my post-retirement insurance does not, so the medical necessity is going to be key here.  The RA is my main complication -- I've not had enough (isn't that crazy?) regain to consider me a failed WLS patient.

Well, one more step on the way to being completed.  While walking the dog in the park today, the cell phone rang and I have an appointment to see the other surgeon at my surgeon's office in Portland on May 2nd.  Not that far away.  Maybe the ball is rolling after all!

I didn't realize that your surgeon will be moving to Michigan.  Will you be seeing Dr. D? 

Best of luck at your appointment!

Yep!  Dr. D - may be a real blessing.

Elevated PTH is related to calcium and Vitamin D. You're not absorbing as much calcium as you need to function, so your PTH goes up and you're robbing calcium from your bones. How's your D level? If it's too low, you can't absorb the calcium you're taking.

I know - I looked it up.  Talked with the doc and he said he didn't seem that concerned because my calcium levels are fine and my vitamin D levels are fine.  I'm not so sure -- he said we'll re-test again in six months.  Anyway, when I go to see the surgeon on the 2nd, I'm gonna talk to him about it too.

Your calcium levels are going to be fine, until you're ready to drop dead. Calcium  is necessary for nerve transmission, so the body's going to rob what you need from your bones, until it's all gone. How much calcium are you taking, and what is your D level?

I take 600 mg Calcium Citrate +D in the morning and another in the afternoon.  My vitamin D level is fine.  I had a Dexascan in January and it was also fine.

Got an email from the NP at OHSU today saying that they believe they can revise me to a sleeve and the insurance should pay because it is medically necessary.  I'd rather have a revision to DS, but, considering I was so desperate that I called them back ready to accept just a reversal, this is a giant step forward.  We'll see how it goes from there.  I see the surgeon on Thursday.  If they want any more labs, I'll have them do the PTH again.

I would think that if they'll cover a Sleeve, they'll cover the full DS. I'd certainly act like I expected them to. (*grin*)

Oh Ya!  Let me tell you -- and I'm sure you'll understand -- I don't want to go back for a third time!