New to the forums

Hey Guys,
I've been lurking for a little while now and thought I'd introduce myself.

I'm just in the beginning stages of researching WLS and the options availalbe to me.  I had set my sights on a VSG, but my insurance has informed me that they only cover the band and RNY as the VSG is 'experimental.'  (Didn't ask about DS).  So I'm currently arguing with myself about band vs RNY.

My story is probably the same as most of yours -- I'm 36, been overweight for a long time (probably since I was 10-11 or so.  I'm 6'3" and as an adult my weight has swung from 290-420.  Am married with a step-son and we are trying to have another child.  Would kind of like to be around to see my step-son grow up and our potential other child as well.

I have had really good short term success on diets (I lose very fast when limiting my caloric intake to anything below 1700 calories a day).  However, like most people, I lose the momentum and desire to continue and I have nothing that prevents me from being on a diet one day, and then destroying a buffet the next day.

I've always been a volume eater.  Sweets really aren't my gig (although I do like them from time to time).  For me, the only thing better than a huge plate of food, is a second huge plate of food.

I am hoping that WLS will be a tool to help prevent me from living in that mindset long enough until I can adopt and embrace real change in the way I live my life. 

I'm in San Diego and my insurance has suggested I contact the offices of Zorn/Tanaka/Rumsey (which I have).  I am attended their lecture/seminar on the 1st of Sept.

I really enjoy reading through your successes and problem solving.  Just wanted to share a bit about me.

Thanks,
joshua

Welcome Joshua, you've come to a good place for answers to questions.  As to which surgery you have, it is a personal decision and in the state of California, even if your insurance turns you down for one type, you can appeal and it will generally be overturned.  Do check out all types of surgeries to be sure you are picking the right one for yourself and your lifestyle.  With any of the surgeries, however, there are lifestyle changes that must be made in order to be successful  Check out the various forums on here for the different types of surgeries and ask questions.  The DS forum and the RNY forum I'm sure can both be quite helpful to you.

Here on the CA board we have people with all types of surgeries, it just seems to be more RNYers than there are of others.

Anyway, good 1st step by reaching out.  This is the start of your new life.  Get ready for a fun ride.

Stephanie

Welcome, Josh. Sorry that you decided on a surgery of choice for you and then had it denied...

I'm quite happy w/my RNY.... others are quite happy w/their band...so.... research!

Glad you quit lurking and said hello...

hope to see more of you here....

Lori

Welcome to the boards!  Research, research, research . . . I know there are lots of Zorn fans on the board here . . . I myself have a band, and like the others who posted above, I'm very happy with it.  You have to do what YOU are comfortable with . . . but OMG . . . whatever you choose, it is going to change your life for the BEST!

Good luck, please keep posting . . . and welcome to the Cali Crew!

Chris

Joshua, Welcome to the CaLI board. Whatever you decide is better than what you are doing right now...and I am sure you would agree.
Good Luck.

HUGS
JOY

LMAO, Welcome, and I just have to tell you, when I started to read your story it never occurred to me that you might be male.  So my thoughts were, man you are really tall for a woman.  Then I was thinking once you lost some weight you would do well in getting pregnant without much problems.  I saw that you do good on  anything under 1700 calories, which on any woman, we would gain 5 pounds a week.  Then I saw you name, and I just started busting up.  I ASSUMED!!!!  But I had to share it with you.

I wish you luck and if you really are set on VGS there are attorneys that will fight your insurance companies to get what you want to have done.  I hope that it all works out well for you.  Come back and post often and ask away on the questions.

Again WELCOME< Diane

Hi! I am new here too.  I just have to tell you that everyone has been so nice to me.  They are so supportive!  I never expected it.  I would also advice you to do a lot of research and then discuss it with your physician.  I am scheduled for 9-9-9.  I hope all the paper work goes fast for you.  Good Luck with whatever procedure you choose.   (I love inserting these smiley faces!)

Joshua,

Welcome to the Cali board, so glad you're sharing your journey with us.  As I tell most, it really helped me when I was deciding on things, to read the blogs of those who have had the surgery as you get some very honest experiences.  Then sit down with your Dr and talk about the pros and cons of each and what will work best for you.  As everyone else has said, do your research as what works well on one person is not the best for all.

We're here to answer your questions, and I think you'll find that everyone on this board is supportive and honest and very helpful.

If you're in Nor Cal, we'll be having our luncheon next week and would love to meet you.  If you're in So Cal, there are many opportunities for get togethers down there with some fantastic folks too.

So glad you've joined us, we'll be saving you a spot on the losers bench!

Barb

Welcome aboard I am still relatively new as well but I can say the people here are wonderfully helpful and friendly.

BTW I love the name Joshua, it might be cause my hubby's name is Joshua I might be bias... I will ask around and find out.

You already know to find all the information on all kinds of WLS and the one that is right for you will be the one you keep going back to. Best of luck on you and see you posting.

Welcome, Joshua.


Didn’t ask about the DS. You well should as CA is one of the most friendly DS states in the country!  I, too, was super Morbidly obese as were you at your highest reported weight. Haven't much time here so let me just paste in a post from my friend Hayley  ]and one of my own previously.

They read as follows:
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cite reference!_____ Hayley_Hayley-

RNY - I got the surgery so I'd dump and the fear of that would keep me away from sugar.
DS - I got the surgery so that I wouldn't dump.

RNY - I needed the restriction to correct my relationship with food.
DS - I didn't want the restriction because I want to enjoy my relationship with food.

RNY - I wanted/needed to change my eating habits.
DS - I've dieted my whole life -- I want to quit dieting.

RNY - I'm sick of dieting and failing.
DS - I'm sick of dieting and failing.

RNY - I want a tool that I can work.
DS - I want a surgery that does the work.

RNY - I didn't want to be able to cheat the surgery.
DS - I want to be able to 'cheat' from time to time.

RNY - I want to be healthy.
DS - I want to be healthy.

RNY - I didn't want someone cutting off my stomach.
DS - I don't want a blind stomach.

RNY - I don't want to have to eat massive amounts of food.
DS - I want to be able to eat what I want.

RNY - I needed to change my habits.
DS - I've been trying to change my habits my whole life!

RNY - I never want to eat sugar or fat again!
DS - I don't want sugar and fat to be 'off-limits'.

RNY -- I want the convenience of a close by surgeon.
DS -- I want the convenience of a one-time surgery.

RNY - My insurance would only pay for the RNY.
DS - I fought my insurance long and hard for what I wanted.

RNY - I need to not eat fat because of my high cholesterol.
DS - I need to not absorb fat because of my high cholesterol.

RNY - I didn't want to risk that much malabsorption.
DS - Based on my own diet history, I knew that I needed the added malabsorption to keep off the weight.

RNY - I need help to lose weight.
DS - I'm great at losing weight, what I need is help to keep it off.

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Rockne here....

Well, lets see... I had a BMI just north of 51. Spent most of my life FAILING WITH DIETS, so, I'm going to risk my life having weight loss surgery to have to do what? ... MORE DIETING FOR THE REST OF MY LIFE with the demands the other WLS types required.

Homey says... "I don't think so!!!"

But it gets better...

http://tinyurl.com/24t7d3

BMI's 50 and over having had the RNY lose lots of weight initially, but longer term, 40 % of those will FAIL by regaining more than 50% of their excess weight loss back! Regain failures with the DS are virtually unheard of. Even for those RNYs having BMI's under 50 have failure rates approaching 33% longer term. RNY a Gold Standard?? And MUCH WORSE STATISTICS WITH THE LAP BAND, ESPECIALLY, OUT LONG TERM.

Homey says... "I don't think so!!!"

I get in my protein, supplements, fluids and the rest is gravy, often literally. I eat virtually everything I want when I want or feel the need. Not to be confused with pre-op gorging as now, a little goes a long way. Eating and drinking at the same time with meals is absolutely allowed, and even very much encouraged with the DS. This nonsense about chewing one's food to the point it can be tolerated by a pouch isn't even on the radar screen since we have a fully functioning stomach. Not having a fully functioning stomach and pylorus is one reason I feel strongly an RNY is actually a more radical treatment modality. Medications? Nothing, including NSAIDs with the exception of very early out is barred.

So the long and short of it is the fact that life for me is completely normal. I eat and enjoy food like normal size people do without sweating everything I put in my mouth. Truth is, I just don't think about it much, and I don't have to suffer the rest of my life being punished for having a wide variety choices including a treat here and there. Dieting is only part of my vocabulary now because most of the world, including other WLS types seem to be STUCK with them. Me?

Homey says... "I don't think so!!!"

The DS has been around for over 20 years, but the long-term longitudinal, peer reviewed studies have only been published in about the last 5 years or so. Here in CA, the Department Of Managed Health Care which is charged with, in part, determining the final appeals process for external Reviews/Appeals. Prior to these published studies, they assisted the insurance companies in upholding their denials. NOT SO ANY LONGER! They have seen the DS light and are often recommending the DS over that of almost all other procedures when a DS appeal comes in. AND EVEN IN SOME CASES WHEN A DS HAS NOT BEEN ASKED FOR.

Below are just 2 examples of the overturned denials being overturned.

------------
The patient is a 25-year-old female with a body mass index (BMI) of 37.3 and significant comorbid conditions. She indicates that she has researched all the surgical procedures and has selected the duodenal switch operation for treatment of her obesity. The patient has completed a psychological evaluation and was deemed an appropriate candidate for weight loss surgery. The Health Plan has denied coverage for the duodenal switch surgery asserting that this surgical procedure is not medically necessary for treatment of the patient’s condition. This patient clearly meets the criteria set forth by the National Institutes of Health for surgical treatment of obesity with a BMI of 37.3 and co-morbid conditions. The duodenal switch operation has been shown to be effective for patients with a BMI of less than 50. Additionally, there is no data indicating that nutritional deraignment after the duodenal switch operation is any more prevalent or more serious than what is encountered with the gastric bypass operation. In fact, the lifestyle of patients after duodenal switch is generally free of the ill effects of the gastric bypass, such as the dumping syndrome and intolerance of solid foods. As cited above, there is a large body of scientific evidence available that shows the duodenal switch operation is more durable with a better long-term success rate when compared to the gastric bypass or the Lap Band operation. Based upon the information set forth above, I have determined the requested duodenal switch bariatric surgical procedure is medically necessary for treatment of the patient’s medical condition. The Health Plan’s denial should be overturned.
------------

A 60-year-old female enrollee has requested for laparoscopic biliopancreatic diversion with duodenal switch (DS) for treatment of her morbid obesity. Findings: The physician reviewer found that with a BMI of 43.2 and multiple comorbid conditions, the patient met nationally accepted medical necessity criteria for consideration of weight loss surgery. Peer reviewed articles clearly demonstrate superior weight loss and maintenance of weight loss over the long term with the DS as compared to other surgical procedures. Published data also demonstrates that the Roux-en-Y procedure results in as much, if not more, protein calorie malnutrition as the DS. The patient’s assertion that the DS is the most effective surgical weight loss alternative is well supported in the literature and this option was a medically reasonable approach to surgical weight loss. Psychological, nutritional and cardiology evaluations indicated the patient was an appropriate candidate for the surgery.

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Rock
For whom failure was not an option.