I am 41 yrs old, married for five years and have a 4 yr old son. I have been overweight since I was 6 yrs old. I have tried every diet and weight loss program known to man, and while I have had some success it has not been premanent.  (Obviously!)  I had SRVG (basically the VBG) in 1997 and lost 105 lbs but gained it back, plus some. I didn't have the typical co-morbidities that most people have.  I didn't have diabetes, high blood pressure, etc., but had sleep apnea and my joints, hips, knees and feet ached constantly.  I was too young to feel like that!!  I finally realized a revision was needed when I was walking down the stairs while holding my then 1 yr old son and my ankle and knee gave out.  I almost fell, but luckily caught myself before going all the way down.  That was scary and I knew something had to give, and it wasn't going to be my joints.

Why the DS?
I was a revision from the SRVG and my surgery was Oct. 3rd, 2007.  Back 10 years ago when I had surgery my choice was either the SRVG or the RNY.  The RNY scared me, I didn't like the thought of dumping and having my stomach Frankensteined like that.  I was truly wary of the RNY, so I went for the SRVG.  Well, here I was, 10 years later with a failed ring and looking for WLS once again.  

When I first decided on WLS a second time I really thought my only other option was the RNY until I went to my surgeon's consultation and she explained the DS, and all I can say is, the light bulb went on over my head!  I was amazed at the DS and knew immediately it was for me.  I came home and read as much research as I could find, and the more I read, the more I liked.  I like having a natural stomach (even if part of it is cut away) and I like that I can take NSAIDs (gotta love Advil!), I can eat like a normal, healthy person but still have a piece of my son's birthday cake or some other treat, I can eat whatever meat I want without the fear of it getting "stuck," and I don't have to worry about strictures, ulcers and stoma enlargement or closing.  Yes, I will have to be Nazi-ist regarding my vitamins and getting the amount of protein in I need every day, but to me that is a small price to pay to lead a fairly normal life.  I've already been punished enough in  my life -  I've yo-yo'd, I'd already been through one WLS and I was tired of abusing my body and my self-esteem.  I'm ready to "get thee behind me" obesity satan.    I believe I deserve to have a "normal" life (as much as anyone can, anyway) and I don't deserve to be punished by my surgery choice because I want to be thin and healthy.

So that, in a not so small nutshell, is why I chose the DS.

Insurance
I have CIGNA-POS through my husband's job at FedEx.  My surgeon's office first submitted my paperwork in August 2006 and then the fight began.  They approved me for revision surgery but they denied my choice of DS stating it is "experimental / investigational," which it isn't.  I had to go through 3 internal appeals, then 2 external appeals with IMEDECS before the external reviewer approved the DS in March 2007.  It was a fight, but it has been well worth it.

Complications
My revision surgery went ok considering I had a lot of stomach scar tissue from the previous WLS.  I was in the hospital for 5 days before I came home.  I was doing fairly well even though I really didn't want anything to eat or drink and had to force myself.  On Monday Oct. 15th I woke up to excruciating stomach pains and went to the ER where they determined I had a stomach leak and I had to go back under the knife.  Turns out I had two leaks and a kink in my bowel, which Dr. Inman fixed.  I came through ok, but a few days later they found yet another leak which eventually lead to an abcess.  Dr. Inman didn't want to operate yet again, so I spent six weeks in the hospital with nothing to eat or drink so it could heal on its own.  Unfortunately it didn't heal very quickly so I was sent home with a PICC line inserted so I could take TPN, which was in place from Oct. until January 08.  Once the PICC line was removed (it got infected once which sent me back to the hospital for another 3 days) I then had to take nightly feedings of Nutren through my feeding tube until March 08, at which time it was determined (after the upteenth CT scan) that the abcess was sufficiently scarred over and the leak small enough that I could start eating and drinking again.  It's been a long, hard road but I am on my way to recovery.  Revisions are NOT easy, and even though complications can happen to anyone, do yourself a favor and do all of your research so you only have to go through this once!

Appeal Information
If you have CIGNA then be prepared for the fight of your life.  CIGNA still considers the DS "experimental / investigational" and they will NOT approve you.  You will have to go through the entire appeals process before you will be approved on external appeal.  You can find a lot of the studies I used for my appeals at www.duodenalswitch.com.  I also have a lot of other information that I used like the Medicare decision, coding information, etc.  If you would a like a copy of anything I have, please let me know.

Once your surgeon's office has submitted the paperwork, CIGNA will come back within 2-3 weeks with a denial.  If you are smart, you will have already put together your first appeal packet containing a letter as to why the DS is the only surgery that will benefit you and all the studies and research you can find, plus letters from your PCP and any other professional that has treated you and supports your choice of WLS.  (My packet was over 200 pages!)  Send it off as soon as you get your denial letter, and always send everything signature required!  CIGNA will then have 30 days to render a decision.  If you call to see if they have received your packet, they will almost always say no.  Keep a notebook handy and write down the date you send anything to CIGNA, the date, time and who you talked to when you call, etc.  It will come in handy, trust me!  After the 30 days (longer if they insist they didn't receive it even tho' you have a signature to prove that they did) you will receive another denial letter.  Have your next appeal packet ready to send as soon as you receive the denial letter.  It doesn't really matter what you put in the next packet as it won't matter anyway because they will deny it yet again.  They may even go through a peer to peer phone call that you can participate in, but it still won't make a difference.  You will still be denied.  You will then receive information about the external appeals process and a choice of two companies to use for the external appeal.  IMEDECS is one of the companies, and I recommend you choose them as they are very DS friendly.  As long as you qualify for WLS you should be approved through the external appeal.

Good luck, and I'll be glad to help if I can.

I have fought the evil empire that is CIGNA, and I WON!!