What made you pick RNY over DS?

[Remingtonh]

Looks like United Healthcare indicates Biliopancreatic diversion with duodenal switch is one of the treatments "proven and/or medically necessary in adults for treating extreme obesity." Extreme obesity is defined as "BMI > 40 kg/m2".

 

[southernlady]

Looks like United Healthcare indicates Biliopancreatic diversion with duodenal switch is one of the treatments "proven and/or medically necessary in adults for treating extreme obesity." Extreme obesity is defined as "BMI > 40 kg/m2".

There is usually another part to that which indicates if a major comorbid (diabetes, sleep apnea) is present, then extreme obesity then becomes over 35.

 

[Remingtonh]

There is usually another part to that which indicates if a major comorbid (diabetes, sleep apnea) is present, then extreme obesity then becomes over 35.

There is, it's in the PDF I posted earlier in this thread. I just posted the stuff that is relevant to my situation.

The >/= 50 BMI seems to be nonsense. It's amazing that bariatric surgery practices seem to have trouble when it comes to DS. I guess this is one reason RNY is so much more popular.

 

[DianaCox]

Most insurance staff prefer easy paperwork.

 

[Remingtonh]

Well the saga continues. Dr. Ganta's office was really busy today, running an hour behind. When I was finally seen it was by a nurse practitioner, not Dr. Ganta. After talking with me, they made me wait for Dr. Ganta, but he was too busy apparently. He was supposed to call me this afternoon to discuss, but guess what? - no call yet!

I do feel kind of bad though. The Nurse asked me why I didn't want the RNY - so I basically spent a minute or two trashing the RNY. She then told me she got the RNY 14 months ago, and lost over 100 pounds (she did look great). She did tell me she would have gotten the switch if her insurance covered it. I missed the opportunity to point out: "what difference would it make if insurance covered it? Dr. Ganta wouldn't accept it anyway..."

 

[DianaCox]

Strike two.

 

[Larra]

Keep in mind that she just had her surgery 14 months ago. It's great that she's doing well so far, but she's still in her honeymoon phase. At some point, she will probably hit a wall where she can't lose any more weight no matter how hard she tries, and in fact struggles to avoid regain.

I would like to see everyone succeed with every operation, but we all know that isn't reality. I wish only the best for her. But the hard part is still in front of her. And, while you may feel you put part of you foot in your mouth, at least you didn't point out that she might have been able to appeal for insurance coverage for the DS.

 

[DianaCox]

14 months ago??
Bwahahahahahahahaha. Look at Fig. 1 in this article: https://slideheaven.com/weight-regain-10years-after-roux-en-y-gastric-bypass.html

 

[Remingtonh]

lol. I still haven't heard from Dr. Ganta's office. Well they know where I stand in no uncertain terms. If they don't feel the need to contact me I guess I'll just assume we're on for the DS.

 

[Susan in Tennessee]

Oh, please don’t assume anything. You know the old saying, Assume: makes an “ass” out of “u” and “me”! This makes my husband so mad when I remind him of this! Lol. I really hope you can get things worked out, maybe with a different Dr. , did I hear Ayoola mentioned?

 

[GrammyLuLu]

The majority of gastric bypass patients only restrict water/beverage consumption to during and after meals, not 30 minutes before eating. That’s what I do and were the rules my surgeon and many others advise.

As a former RnYer I was told and did stop liquids 30 mins prior and after meals and no liquids during meals. That was extremely hard but it kept the food in the pouch longer. I also used to "water load" my system by drinking a good amount of water before eating (30 mins) to keep me feeling full.

 

[Remingtonh]

Yes I have been in contact with Dr. Ayoola's office. They've been helpful when I've gotten ahold of them, but all calls to that office go directly to voicemail. I'm waiting for a return call to get information on how to transfer records from Dr. Ganta's office to them, should the need arise. One way or the other I'm sure this will all work out. I'm going to try not to stress about it anymore.

Supposedly, Dr Ganta is going to send the paperwork to insurance on the 20th, and they told me to expect surgery July 30th, but that surgery date seems highly optimistic. So I have more time to deal with this, I think.

 

[Spiky Bugger]

I don't know if you've already had surgery...or not. But, here's a clue...

While visiting various bariatric surgery boards, how many people have YOU found who want a revision:
a) from any other bariatric surgery to the DS; and
b) from the DS to any other bariatric surgery?

That should tell you something.

 

[Remingtonh]

I don't know if you've already had surgery...or not. But, here's a clue...

While visiting various bariatric surgery boards, how many people have YOU found who want a revision:
a) from any other bariatric surgery to the DS; and
b) from the DS to any other bariatric surgery?

That should tell you something.

Hi! No, I haven't yet had the the surgery, but the insurance company just approved my DS last Friday! I'm scheduled for the DS on August 13th.

The folks on this forum persuaded me to put my foot down and not accept the RNY (and for that I'm grateful). I never liked the mechanics of that procedure anyway.

 

[Spiky Bugger]

Hi! No, I haven't yet had the the surgery, but the insurance company just approved my DS last Friday! I'm scheduled for the DS on August 13th.

The folks on this forum persuaded me to put my foot down and not accept the RNY (and for that I'm grateful). I never liked the mechanics of that procedure anyway.

Good luck.