New Here :D

[4handstohold]

Hi,
I'm new here
I am getting the requirements done for Surgery with Dr Cottam in SLC Utah. Since my BMI is 52, he thinks it would be best that I get the DS but my new insurance will only cover the RNY or Sleeve.
I am 37 years old, married for 13 years and 4 children ranging from 11 to 1 year old.

I have been looking into WLS for the past 10 years. It's never worked out for me the other times I tried to get it done. In the mean time, my BMI has gotten higher every time I've had a baby and now it's the highest it's ever been.
Any advice for me?
If my BMI was lower, I'd love to get the less invasive Sleeve and not have my intestines cut but, I also want to be successful at weightloss.
Thanks for reading

 

[BebeZed]

Hi and welcome @4handstohold! Whatever you do, do NOT get the RNY... the failure rate is quite high. Insurance can be fought (and won!) so please take advantage of the advice of some of our vets who are very good with that sort of thing. Seriously, the DS is the best surgery for long term results and to not consider it due to insurance would be doing yourself a disservice.

 

[4handstohold]

How is the failure rate high? Or where do I find out more information on that?

 

[4handstohold]

My husband was laid off work and we are on State insurance, where would I find someone who has fought insurance with them?

 

[BebeZed]

How is the failure rate high? Or where do I find out more information on that?

About half those undergoing RNY will gain weight back after a couple of years. In another post, @southernlady and others talk about fighting insurance and why the RNY is not a good option... the thread is at http://bariatricfacts.org/threads/im-so-excited.3848/#post-57256.

EDIT: I found an even better link with scientific evidence of weight regain after RNY, which was also posted by @southernlady https://scholar.google.com/scholar?...a=X&ei=5nCYVYicKIj7tQWfr4XQCg&ved=0CBwQgQMwAA

 

[DianaCox]

There are people here (me for one) who help people fight their insurance for the DS, for free.

 

[Larra]

Hi and welcome!

You need to get a copy of your EOC (evidence of coverage) and see what is and isn't covered, or perhaps there are circumstances in which the DS would be covered, or you may have appeals rights. Without knowing all the details of your policy, there is no way to know. Your EOC is a lengthy document, maybe 60 - 100 pages, NOT a little summary of benefits. Do not take the word of some low paid agent who answers questions when you phone in. They don't care about your welfare, they are just putting in their hours.

If you can get the DS, you also need a different surgeon. Dr. Cottam used to do the DS but has not gone to only doing the loop DS, aka SADI and aka SIPS (as he likes to call it). This operation is not the same as the DS, long term results are unknown, and there is no insurance code for it. Most people in the field consider it to be experimental. Some surgeons are using the DS code for insurance purposes, which may or may not be accepted. we know of at least one person who had pre-approval and after her surgery the insurance company withdrew coverage because she didn't really have a DS, and she was sent a large bill. There are other surgeons using creative coding. Again, this may or may not fly when the insurer figures it out.

Lastly, you asked about failure rate with gastric bypass. The statistics are well known as this is a well established operation. The failure rate is about 30%, with "failure" being defined, usually, as losing less than 50% of your excess weight. In other words, if you lose 51% or more, you are counted as a success. Personally, I would not have been happy with, let's say, losing just 50 - 60 % of my excess weight, which is a frequent results. Weight regain is a major problem. You will also never be able to take NSAIDs again as they are contraindicated with gastric bypass for life.

I think you need to be a bit more research. Find out what you are and are not able to get with your insurance, and don't make any hasty decisions now that you've decided to take the plunge.

 

[4handstohold]

Ok, thank you, I'll look at that

 

[DianaCox]

Larra - I "think" he told her she needed a DS - I suspect some of his early SIPS results are coming in and they're not that good for the heavier people (sooprize sooprize sooprize!) and just like that arrogant bastard Cirangle did with the sleeve, as his vaunted new procedure started failing the heavier people, he started limiting it to "lightweights" to make his stats look better.

 

[Larra]

@DianaCox you're right, it does sound like he recommended DS, the question I would still have is does he mean what you and I consider to be the DS or is he calling what he's doing the DS. If he is seeing not so hot results with SIPS and adjusting his practice accordingly, that's great, and perhaps you have inside info that I don't have. In the meantime, if I were his patient, I would ask very directly exactly what he means by "DS".

@4handstohold there are some great threads on this website about the loop DS aka SADI aka SIPS. Check them out. If someone understands the differences, understands that insurance may not cover it (or may cover it unknowingly and withdraw their coverage later), understands that long term results are unknown, and for his or her own reasons chooses this new operation, fine. What disturbs me is when patients are told it's just like the DS, or an "upgrade", or lower risk, or some such thing, and doesn't understand that it does NOT have the proven long term results of the DS.

 

[DianaCox]

And Larra, you're right about that - his "Informed Consent" form is grossly misleading. It talks about the DS and only in one place does he note that he means the LOOP DS. http://bariatricfacts.org/threads/hello.3190/page-2#post-47280

I think he's a snake in the grass and an arrogant prick (in my opinion, of course). If you can get him to SWEAR he means a conventional, two-anastomosis DS, and under no circumstances will you accept his experimental (yes, he's doing a clinical trial on it: https://clinicaltrials.gov/ct2/show/NCT02275208?term=SIPS+bariatric&rank=1) SIPS/SADI/LoopDS, or you will sue him.

 

[southernlady]

Welcome @4handstohold
Regarding Dr. Cottam: http://bariatricfacts.org/threads/dr-daniel-cottam-bmi-of-utah.2661/

 

[aaa]

Hello.

 

[JuliaDS]

Hi,
I'm new here
I am getting the requirements done for Surgery with Dr Cottam in SLC Utah. Since my BMI is 52, he thinks it would be best that I get the DS but my new insurance will only cover the RNY or Sleeve.
I am 37 years old, married for 13 years and 4 children ranging from 11 to 1 year old.

I have been looking into WLS for the past 10 years. It's never worked out for me the other times I tried to get it done. In the mean time, my BMI has gotten higher every time I've had a baby and now it's the highest it's ever been.
Any advice for me?
If my BMI was lower, I'd love to get the less invasive Sleeve and not have my intestines cut but, I also want to be successful at weightloss.
Thanks for reading

Welcome @4handstohold! You've come to the right place. Lot's of quality information and support here.
I'll add to those urging you to accept help from the wonderful folks here and continue to investigate all options to get yourself a DS. I too have seen many 'fail' with RNY and sleeve - they loose initially, sometimes a substantial amount, but always seem to gain it all back and then some... Good luck!
Gorgeous children, by the way!

 

[DSRIGGS]

Hi and welcome.