Short & Round

[Ignoti]

Hello,

I am looking for resources, etc, on possibly petitioning Cigna to cover weight loss surgery (they do not cover it at my level). I recently hit 300 lbs and my ankles and feet have never hurt so horribly bad (lower back, too). I'm pretty sure I've met "maximum capacity" of my body.

My husband is adamantly against the surgery due to monetary reasoning; but I feel that if I don't loose weight soon bad things might happen to me. I've already lost a gallbladder.

I have a friend that got DS and she absolutely swears by it.

My doctor states that she doesn't believe in weight loss pills or surgeries, she always gives me this bad diets to try. I would probably have to find another doctor or convince my nueralogist to prescribe it...

I guess I just don't know where to start or what to expect.

 

[Caitlunn]

@Ignoti I don't know much about petitioning for coverage, but others do. I just wanted to let you know that you are not alone. Hitting 300 lbs was a wake up call for me. And I'm tall!

 

[galaxygrrl]

I;m 5'3' and my body was giving out at 264. I was 49 years old. Everything hurt and i had diabetes. I did no have these issues when i was younger, but just as heavy.

The DS is the best thing I ever did for myself. I'm healthy and happy.

@DianaCox and @Larra can help you with coverage.

As for your husband's argument, I would say what are 10 years or more life worth and a healthy life worth to you. I went to Mexico and it's about $11,000. We have lots of people here who went to Mexico and saved money and were happy with the work they got done there.

 

[Ignoti]

I just called my insurance, and as of 2017 they DO cover it! I'm calling around Denver for DS doctors, now

I think my husband might actually approve, now

 

[Ignoti]

I;m 5'3' and my body was giving out at 264. I was 49 years old. Everything hurt and i had diabetes. I did no have these issues when i was younger, but just as heavy.

The DS is the best thing I ever did for myself. I'm healthy and happy.

@DianaCox and @Larra can help you with coverage.

As for your husband's argument, I would say what are 10 years or more life worth and a healthy life worth to you. I went to Mexico and it's about $11,000. We have lots of people here who went to Mexico and saved money and were happy with the work they got done there.

Hi!

That's the results I'm hoping for! I can't remember when my ankles started giving out, but it's just been getting worse and now when it walks I feel like a tendon is tearing >.< I have gastro issues, the weight makes my migraines and headaches worse. I'm falling apart and I'm 36

 

[Larra]

I'm glad you have insurance coverage, though I would still recommend that you get a copy of your EOC (evidence of coverage) and check your policy for yourself. Many, many people are given misinformation over the phone. No one cares about this more than you.
There are, to the best of my knowledge, no DS surgeons in Colorado. You will need to travel, which many people do for the DS. The temporary inconvenience is well worth the lifetime of improved health and quality of life, and at your age hopefully you have many years ahead to enjoy those benefits. I would suggest either Dr. simper in Utah or Dr. Keshishian in the Los Angeles area (Glendale) or Dr. Rabkin of Pacific Laparoscopy in San Francisco. All are well regarded, do the real, standard of care DS, and are accustomed to working with patients from out of town.

 

[Duckman]

The way my surgeon put it was "the difference between seeing your grandkids born and seeing them graduate college"

 

[DianaCox]

You are going to have to travel, as Larra noted. There is a surgeon in Colorado, Dr. Metz, whose website is highly misleading - he says he does the DS but it's really a loop DS, which is an EXPERIMENTAL procedure that doesn't have the same metabolic efficacy, in particular because it doesn't have a preferential effect on fat malabsorption. Don't be fooled.

 

[KathrynK]

First, get a different primary care physician who can talk with you and your husband about the effects of obesity on health and lifespan. I am a former Colorado native and I want to warn you about the difference between two surgeries that sound like the same thing, a classic Hess duodenal switch (with decades of long-term proven success) and an investigational procedure, a loop duodenal switch, aka SADI-DS. The University of Colorado surgical weight loss group does not do a Hess DS or even a SADI-DS, but Bariatric and Metabolic Center of Colorado does SADI-DS. Beware of surgeons who do not do the classic Hess DS (even outside of CO) who try to steer you away to one of the procedures that they do. My niece was talked into a gastrectomy in Denver and never reached goal or even a BMI that was not obese. She's back nearly to where she started. Surgeons make money with the procedures they can do. Good luck on this search! You will have to be persistent with the hunt for right surgeon to get the classic DS.

 

[southernlady]

Welcome @Ignoti

 

[k9ophile]

You've gotten some very good advice and I cannot contribute any more regarding insurance coverage, CO surgeons, and the importance of a real DS. As you progress in this, you will undoubtedly get discouraged. Those around you will pressure to do what they want. Fire that doctor who keeps trying to sell you diets. (Sheesh, even my surgeon tried to sell me a diet for weight gain that follows an RNY.)

Keep reading here. We'll give you the support needed so you can stick to your goals.

 

[galaxygrrl]

Yes, get a different doctor!!! My PCP pushed into researching surgery and then my current PCP got the surgery. Your doctor seems very old school, get a new one. You are the customer!

 

[aaa]

Hello @Ignoti

 

[Ignoti]

Hello everyone!

I love that everyone is responding!

So yes, no DS in Colorado. I am hearing that DS and sleeve are bad for people with acid reflux. I get terrible reflux! But I've been told it's because of my weight. Can anyone tell me about experiences with other surgeries?

 

[Larra]

Sleeve is bad for reflux because, without the "switch" part of the DS, some surgeons are making very narrow, tight sleeves to try to prevent weight regain when the sleeve stretches out. That can cause bad problems with reflux (and may just postpone the regain). With the full DS, your surgeon can make a more generous sleeve because you will have the malabsorption and metabolic changes of the switch to help with both weight loss and with maintenance. And of course losing weight also helps with reflux, and people lose more weight with the DS than with any other bariatric surgery, on average. So while you may need some kind of reflux meds with the DS, as many of us do, it usually isn't a severe problem.