Gastric bypass after sleeve

When you post here, you get what you get. 

Suck it up buttercup.

When I was new here, I was grateful for any advice I got.  Many of the responses made me stop and think, and reevaluate my course of action.

You've been given some good info to mull over.  You can always call your insurance company or have a consultation with your doc, but you should really read the responses - they're from a lot of experienced peeps.

As Sharyn said, dumping and reactive hypoglycemia aren't fun.

No UHC will not pay again for you to have your original surgery taken down only a little more than a year out and re-do another one. I have UHC and they have a 1 surgery per lifetime limit.  is that the answer you are looking for??? You may need to go back to the hospital with Dr. Scott and see what he thinks...and your first few responses are correct. Taking a sleeve to an RNY is not a good idea. IF you HAVE to convert so soon after your initial operation then the DS is your only choice to get to goal. And also, the closest DS surgeon to us is in Chicago I think. and UHC does cover the DS....if that would have been your original choice...

 UHC has many plans. Only your claims adminstrator can answer your original questions. Please forgive the people who gave you unwanted advice.  It is just an instinct, like if you see a child running into the path of a speeding car, you might yell "Stop", even though the mother might tell you that it is none of your business.

OK - now that I see my question stirred up so many feathers and has really bummed me out, I thank the last poster for her guidance and tactful way of responding. I have researched all procedures and it was MY DECISION to have the sleeve last year and after a considerable amount of weight loss (which I have) to have the RNY. This is my decision. No doctor could sway me in a particular direction, just to do a surgery, as I have a family to think about and their future and mine. I appreciate all the advice and opinions, but really none of you know me or my cir****tances or the reason for MY DECISION. I just wanted to get some quick responses to my original question as this morning I have a telephone consult with my nurse who is assigned to me from UHC to discuss the next phase and requirements. And, I have learned my lesson as to not to respond back to posts as it was stated that if you post to a public board, you will get all kinds. Thanks again.

The second step to the sleeve if you want malabsorbtion is the duodenal switch.  Starting at 400lbs  that should have been the natural option presented to you "if needed"  or better yet as a first surgery.  No matter, you will do fantastic.

I wish you the very best Melissa.

Leila

Ok Melissa.  Help us understand.

You say that we don't know you, your cir****tances, what you need to do with your family etc etc etc.  YOU are making this decision and no doctor has led  you here.

You'll have to forgive us for wondering what led you to this decision?  And really?  I want to know.    Tell me why an RNY after getting a sleeve is the BETTER decision than getting a full DS.  How is an RNY better for your family, exactly?  What do you think the differences are that make this a better choice?
 
Now - you can ignore this message, but since you were so quick to call out some well intentioned people, I figure you would want to clarify why you are so over the top about this.

Based on MY experience, the ONLY doctor that would give an RNY to someone who just had a sleeve ONE year ago would be one that doesn't perform the DS.  And really, your insurance will likely give you a hard time if you are only one year out of ANY procedure looking for a revision.

Very interested to see if you respond.

Sharon

I am curious as to the answer also, I won't weigh in on what I think you should do but I am interested to hear why go from a sleeve to rny and what the rationale is.  It would seem the DS would be the natural option so can you explain why that isn't so?  No one is trying to bash you here but what you are suggesting is something I can honestly say I have never heard of requested before and we are trying to understand.

Good Luck

It was my decision to have the sleeve. The only problems I had at 400 lbs was sleep apnea. No diabetes, hypertension, heart, etc. I took motrin for a torn miniscus when needed. That was it. Originaly I had chosen the band and then decided on the sleeve. Reason quite honestly was being afraid or I would of picked the RNY originally. I had a friend who chose the RNY who did fantastic. I also had a family member who chose the DS after a horrible experience with the band who also did fantastic. But, like I have said - MY CHOICE was the sleeve and then RNY.

Also, I have talked with my surgeon at the beginning of my journey, at all the follow up visits and at my one year anniversary. We talked last week and I will be seeing him in 3 months to see if this is the route I wish to take. He was not quick to do the RNY at one year, since I have done so well with the sleeve. Also, UHC will pay for the RNY (per my conversation with my UHC nurse this morning) as long as the RNY is completed within 2 years of the 6 month supervised diet, 40 or above BMI, and another psych exam. And again, I have not made my decision yet. Who knows, in 3 months I may be below 40 on my BMI and all this prep could of been for nothing.

I normally do not respond to people who make me feel intimidated or call me names (I believe one said I was an ingrate - which I have blocked). As far as giving advice, that is absolutely fine, but I did not ask for advice just wanted to know if anyone had UHC and what their guidelines were before my telephone conversation today. I had already been approved for the RNY at 6 months with the original approval for the sleeve, but had decided not to at that time. I hope this answers all the inquiring minds, but for some reason, I bet not.

You win that bet---it doesn't. (*grin*)

So---you planned on having two surgeries, from the get-go? Did your surgeon just not feel he could do the RNY on you at 399, and suggested the Sleeve as the first of a two-part surgery? I've seen that before, but generally it's a two-part surgery that finishes up with the Switch.

If that's what you want, go for it. I hope it works out well for you, and that you don't develop reactive hypoglycemia, etc. as a result of losing your pylorus. Just be completely certain, because there'll be no going back.

And you are correct.  While you have given more story, you've given no information that helps me understand WHY you think this is a good idea.

Let's face it, giving up your pyloric valve seems ridiculous to many of us.  Yet you claim to have done your research - but seriously - what gives? 

You can't or won't articulate it, which makes me think you really have no idea what you are getting into.  Have fun with that.