Newbie :)

[Meep]

Hello, everyone! I posted in the "hello" thread a bit ago. I'm slowly amassing research for my revision. I would like the DS, however the surgeon suggested the SADI as well, which I have strong reservations about. That aside, a far bigger issue is that I have GERD and the surgeon is concerned that even the DS will not improve it. Like, impossible heart attack level GERD pain. I have an EGD the 25th to determine the cause. It's either: the sleeve, my severe Celiac, candida, an infection, unknown cause of yet. I do have a small hiatal hernia, however it is very teeny and multiple doctors said it is not large enough to cause the GERD I am having. Gallbladder checks out 100% dandy, and my heart is perfect. I honestly forget my sleeve size, but we were expecting to switch to the DS down the road. My health at the time of the surgery was too poor for the DS. I had some bad comorbidities, and a high BMI (78) at the time of surgery. My highest weight was around 750 pounds. Given that I'm under 300 at all and have kept it off I'm grateful for, but, well, I always assumed I'd need malabsorption. Don't get me wrong, the sleeve worked well for me - I did lose 130 pounds in 9 months, then stalled horribly when the GERD started. I have only regained the past week after adding gluten for the endoscopy, and we were expecting a 10 pound weight gain from it.

I realllly don't want to get the gastric bypass. I am hoping I can present a logical, and evidence-based medical argument, that the DS weight loss plus the hernia repair will help resolve the GERD.

A third larger issue is that I now have HMO insurance, and my medical group will not approve my surgery out of network to get a second opinion at the University of Chicago if I need to get one. At any rate, I may push and will fight that battle if the cause of the GERD winds up being the sleeve. Thankfully I am familiar with bariatrics from being a newbie counselor who worked with other patients like myself. Still, it's all rather overwhelming.

 

[DianaCox]

You request the DS; if they refuse, request a second opinion with the UoC; get the denial (important for getting reimbursement later); self-pay (probably less than $500) for the consult with the surgeons at UoC; and then appeal your denials. You MUST request and be denied to vest your rights to appeal/reimbursement.

 

[Meep]

Thank you, Diana, for your response. I will definitely take your advice. The more I work in healthcare the more I dislike insurance, though I am fortunate and while it's an HMO have excellent coverage. I am better off than many others.

My surgeon was actually once the executive chief resident at U of C, so he knows the physicians there. He is actually a great guy and a tremendous surgeon, and he even suggested a second opinion would be good depending on the EGD and how complex it is. I'm more worried about my regular doctor's office. I suppose I should just wait until the endoscopy is done.

I am just worried that they will do the "you have GERD so you need the RNY" thing. I don't think it will do me an iota of good. I also don't want the SADI, since there's literally no data on it. I am putting my clinical training to good use and amassing studies.

 

[DSRIGGS]

Welcome. I assume you are on the max dose of a PPI twice a day. A SADI would do nothing to help your GERD and could make it worse as bile reflux is a major risk with the loop. Obviously having bile in your stomach that could then reflux to the esophagus is not something you want.

I don't know if you have enough fundus left to do a partial fundoplication when they do the switch but consulting with a very good DS surgeon is worth your time. Prachande is a goid DS doc and I can't remember if he is at UC or UIC. There is a GI doc at NW who is one of the best GERD guys in the country. My son who has a Nissen because of horrible gerd saw him and he diagnosed Camerons severe gastroparesis that was later surgically fixed by Dr Keshishian. The guy at NW isn't a surgeon and I dint know what he knows about the DS and or VSG but he is GERD recognized expert so it might be worth talking with him. I forgot his name so I will have to try and remember to dig it up tomorrow.

Best wishes. GERD sucks and I hope you can get relief.

 

[DSRIGGS]

http://www.medicine.northwestern.edu/divisions/gastroenterology-and-hepatology/

Pandolfino

 

[southernlady]

@Meep listen to Diana.

I ill say that my GERD is as bad post op as it was pre op. I was also given the song and dance that the RNY was better for me with GERD and being a lightweight. My absolute unshakable requirement for NSAIDS made me pursue the DS.

Oh and them mentioning the SADI won't change the GERD.

 

[Meep]

I can honestly live with some degree of GERD. It beats being obese, bad as that may sound.

My insurance also refuses to cover the SADI due to its experimental nature, and I also refuse to allow them to bill one procedure as another, since it might prevent them covering care at a later date. He told me to investigate it for the sake of "checking all the options," but I am unimpressed. I have barely been able to find any research for it in my school's databases, but I have probably 800+ pages of studies on the VSG & DS.

I need a complete knee replacement. I can no longer even bend my right knee except for slightly. The 750 pound fat girl tax, of course. However, I may also have rheumatoid arthritis... I put THAT one off until the revision is done. I already have two of the trifecta (Celiac, Hashimoto's) and I think it's plain stupid to get a surgery where you can't take NSAIDs when you have arthritis. I have a ridiculous pain tolerance, but I am also turning 40 next year, and well, I don't expect to continue this madness.

Also, I completely adore Heinlein @southernlady, though Friday is probably my favorite of his books.

 

[southernlady]

Also, I completely adore Heinlein @southernlady, though Friday is probably my favorite of his books.

My favorite has been the Lazarus Long series esp, The Cat Who Walks Through Walls and Time Enough For Love. In fact, two of my cats are named for Heinlein characters: Pixel (the cat who walks through walls) and Pollux, one of the twins. Although in his books, Pollux is a male. My Pollux is a female.