Question:
My Lap RNY In Nov I started out at 384. I got to 248. I am now for 6 months at 263.

I want to have a second surgery to loose another 100lbs. Is this possible? Has anyone gone back and had it done again?Are surgeons, insurance co'm receptive to this? It seems that those who only have a little over a little more than 100 pounds to loose are able to reach goal,l but those of us who start out with so much weight to loose always seem to fall short of our weight loss goals. Please share your experience. My insurance has changed. I had Med Mutual with the RNY (Proximal),now Anthem BLue cross and want more distal. Is this possible ? Please help    — Jay C. (posted on July 25, 2004)

July 25, 2004
It is my understanding that the only way and insurance will pay for a revision or for another surgery is if you have a mechanical failure with the first.
   — Shayna T.

July 25, 2004
I you are saying you had it in Nov 03 then no doctor will touch you as you are not even 1 yr out. Even Nov 02 might be questionable. Do you know what size pouch you had and how much was bypassed? Do you know if you were transected? All of these could be factoring into your situation. Your profile doesn't provide any information, so it's difficult to figure much out. I know of many people who were SMO that have reached goal or come darn close, so it is possible. I reached goal at 12-3/4 months, 242 lbs lost, and have since lost another 10 lbs, but do float up and down 5 lbs depending on how I choose to eat. <p>Assuming you do not have anything mechanically wrong, have you taken a hard look at what you are eating and doing for exercise? It is never too late to go heavy protein and push yourself back into ketosis to get the weight moving again. It's not easy but nothing worth having is! I went 75% or higher protein for at least 9 months. It's only since I had my first PS that I have been eating too many carbs and struggling to figure out this thing called maintenance. So it's not that I am perfect, far from it! But I did do what I had to, to ge the weight off initially. <p>Assuming you are further out, you need to get to your surgeon and get your anatomy checked out. If that's okay then ask to work with a nutritionist to help you figure out what changes you need to make. This truly is a wonderful tool, but it truly is only a tool. If abused it won't work and won't protect us from gaining a lot of weight. I hope the surgoen is able to figure out what is going on and get you back on the weight loss train. Good Luck!
   — zoedogcbr

July 25, 2004
I do not think a second surgery will be possible. I used to work in reviews at Blue Cross and we would only approve if there was a mechanical failure which is rare. I know many many people have made their goal weight and these were people over 500 lbs. It takes some real hard work..you have to remember the surgery is a tool and not a cure. There is no reason to fall short of your goal. It just takes sometimes re-evaluation at what you are eating and your exercise and lifestyle. You can get there!
   — [Deactivated Member]

July 26, 2004
Hi there. First let me say that many, many, many people who have far more than 100 pounds make it to goal. I see it in our program every single day. We've done around 1700 cases. I agree that you must first rule out a mechanical failure. In the event of a mechanical failure you might be able to get coverage for a 2nd surgery. However, if there is no mechanical failure then all I can say is (and I'm not being cynical or nasty - it's hard to tell with the written word instead of the spoken word)......welcome to the real world! Almost everyone has to work at either losing the last several pounds or at maintaining a total loss or both. Unfortunately this surgery is not a "get out of obesity free" card. It requires dedication, motivation and hard work on the part of the patient. If you don't have a mechanical failure I would encourage you to get involved with a good support group in your area, up your high quality protein, up your fluid intake and get moving. It's not the easiest thing in the world but I know you can do it. Lastly, there are patients who were super morbidly obese who are having the Lap Band done a few years following RNY to lose the last pounds or to lose regain. They discussed this at ASBS this year. However, it's done on a "cash only" basis and is several thousand dollars. Best wishes to you.
   — ronascott

July 26, 2004
Jay, I started at 316 and have been about 187 for the last several months. This puts me in the lower end of the obese category although I've lost about 130 pounds and I am 21 months post RNY. I have lost 70% of my excess which means I've been successful. However, while I do agree that surgery is a tool and not a get out of obesity free card, I disagree that everyone can get to goal meaning within the normal BMI weight range. I go to the gym 5 hours per week - consisting of 50 minutes of hard cardio and 15 more minutes of weight training; 100+ oz water daily; 40 or fewer carbs per day; and daily calories in the 1000-1200 range. I probably would lose 15 pounds with plastics, but that would still put me at the high overweight range. I think genetics play a huge part in this. I don't have an answer for you on the revision question, but I just wanted to share my experience and provide some support.
   — Yolanda J.