Hope, hesitant but very hopfull now
Well I met with Dr Chae today. And ironically with the same nutritionist / dietitian that I had 12 years ago! She is great and I have looked for her all over for years. I had no idea she worked for Dr. Chae now! It was more than awesome to see her. And Dr Chae is wow! He is so nice, took a ton of time to go over my history to learn about me and what surgery was best for me. He feels the long distal revision is definitely the best of all choices. He has done 4000 of them already! Wow.. he is sure he can do the revision via a lap surgery not open. He told me the distal he does is very similar to the DS but without the extreme risk of the DS. I didn't know it, but there is a 4% chance of death from the DS surgery vs. the Distal. In his opinion, which I feel is very educated and experienced (which when I look at his qualifications he most certainly is extensive) the distal is the best surgery for revisions out there for those with a metabolic disorder and is extremely successful without the negative aspects of the DS. He said there is a slight risk I may lose too much weight (haa haa I cannot even imagine such a possibility for me) but in the 4000 revisions he has done he has never had it happen..
His office has three staff people who are just there to get the insurance approvals, and he said they have a very high success rate. So whooopie.. maybe I will get the second chance I so desperately need.
In a twist of irony, 12 years ago when I had my first surgery, less than 24 hours before I was to go in for the RNY, I learned my surgeon was out of network and they would not cover my surgery. At the time, Dr. Chae was the only one in network but I had not been informed of this until then. The wait to even get into see him for a consult was over 6 months, then at least that long to get the surgery if approved. I just could not do it.. it was too long a wait for something I had already gone through a year of waiting for already so we did it self pay. So here I am full circle. My old nutritionist / dietitian and the surgeon who should have done the first surgery! Dr. Chae told me that the biggest wait was for the insurance to bless it. He does surgery Monday, Tuesday and Wednesday each week so he should be able to get me in fast once I am (hopefully) approved for surgery.
One other piece of information he shared, as did the nutritionist Kelly, the lap band is not a successful surgery in most cases for any length. Neither is the vertical sleeve or BOB. He feels in most cases the metabolic aspect of the surgery is one of the most important part of success in long term weight loss. So for those wondering what is a good option for revision it sounds like this is a good option. I hope and pray that I will be able to confirm that within the next six months after my own distal!
I humbly ask for prayers to help me on the way!
I sincerely hope you will continue to research the similarities and differences between the distal RNY and the DS. Revising you from your current proximal RNY to a distal RNY is definitely the easier procedure for the surgeon---but will it really give you what's easiest and best for YOU?
The DS is the form of WLs that makes the greatest, most permanent change in how your body metabolizes food, so if metabolic change is what you need, then you need a DS.
Dr. Chae is willing to do a DS if it is really what I want. He is extremely experienced in both and actually had a iPad with comparisons of the different surgeries. He has done over a thousand of both so he uses the specific data from his own experiences based on patient success and compilations so I really feel comfortable with what h wants to do. He actually had graphics of where intestines and (in the case of the Distal) what he does with the stomach pouch. In his surgeries, he decreases back down the stomach to the original post op 3 oz. size, something from everything I have read, does not normally happen. And the location of his resection is about the same distance as a DS. So the main difference is does the stomach get eliminated or just decreased in ability to hold food. I asked him specifically if metabolically will I just go back to the situation I am in now, and he said no because of the distance he rescets to is so far down. He is a few cm's shy of a DS but that is where he feels, based on experience, were the best results happen without resulting in an overage of absorption, which can cause serious if not deadly consequences with a full DS. If for some reason I did get to where I do suffer from serious absorption issues ( LOL, not likely with me) with the Distal I can always be modified to a healthier state because I still have the stomach pouch. A reversal of a true DS cannot be reversed. So I am confident in what he feels is best for me.
The next step will be a peer to peer eval by the surgeons. My surgeon has clinic on Thursday, and he will find out about my insurance refusal. Your post doesn't really make a lot of sense to me.
"Very similar to the DS without the extreme risk of the DS"
That makes absolutely no sense. What extreme risk is he referring to that would not be present in what he's going to do?
"...extremely successful without the negative aspects of the DS"
Again, what negative aspects? You said the amount of intestines bypassed will be very similar...so the potential negative aspects (bathroom issues? smelly gas? malnutrition? vitamin deficiencies? - all completely controllable btw) would be identical.
The negative to me in that procedure is that you're still left with a RNY pouch that will likely stretch out again and stoma which will likely stretch out and NO pyloric valve. I don't see any benefit at all to that. Way more negatives with a RNY pouch than there are with a fully functioning sleeve stomach with a pyloric valve.
