Anyone at first stage of DS?

I am wondering if any of you were set up with bascially a Duodenal Switch and had the sleeve part done first?  If so, what did they call the procedure?   Was it a "two-step" something? And how has it been working for you?

TIA!

Gwen

The two part is the VSG (Vertical Sleeve Gastrectomy) as part 1 and the intestine by-pass/switch as part 2.  I don't think it has a separate name.  For people who have very high BMI's they may suggest the DS surgery be done in 2 parts because the surgery itself can cause complications.  Once a pateint loses a large amount of weight from the VSG alone they can go back in and do the second part and the patient does better in surgery because they weigh less. All of us VSG'ers are basically the first part of a DS as we have the same stomach. Most of us just don't need to go back in for the second part because we are able to lose the weight without touching the intestines.

Yeah - thanks!  I know what you are saying.... I am a potential VSGer, I think.  I am looking for the term that my surgeon is using for the procedure since it isn't VSG or DS.  I was told it was a 'two-stage' something.  Anyway, I am not having any luck with getting a response from his office and was hoping someone would know what it was here so I could look into it more just to make sure it was really the DS in two steps.  I posted this on the DS board too, but it came off sounding like I was bashing my surgeon and that he was trying to commit insurance fraud.  Not my intentions at all! I just figured some one else may have another name for the two parts if they were thru the sleeve part and are on this board.  Thanks again!

Hi Gwen, My doc is primarily a DS doctor.  He said that he leaves the DS stomachs bigger than he did mine because they need to eat more calories for absorption.  He told me that when he does the DS part one their stomachs are bigger, but they loose weight.  After they get to a safer weight for surgery, he des the second part.  However, he told me that with my smaller stomach, I would not be a candidate for the second part.  But then again with my Crohn's disease, I would never be able to have that second surgery anyway. Hope this helps Bernice

Thanks Bernice.  That makes sense.  I am just going to have to call again to see if I can get the term he used.  I've called twice and haven't got an answer.  I am still waiting for my approval thru insurance.  It has only been about a week and 1/2 (provided they were able to fax it, if not only a couple of days via snail mail).   I want to make sure that we are on the same page and hopefully ward off any more delays. How are you feeling?  I hope everything is going well for you! 

Gwen

There are a few here, and others on the DS board.

Can I ask why, at a 52 BMI, they want to do two parts? Most of the time, they do two parts when it would be dangerous to do the switch part of the surgery. The VSG can be done easily on many patients, but a good DS surgeon should be able to do a full DS with a 52 BMI.

Hi -  Well that is part of the reason I am trying to find out if anyone else has been giving this other 'two-stage' something as a procedure name.  He has been around a while and is familiar with having to get things worded and submitted right to the insurance companies.   It may also be that since I have been overweight for so long, he may be familiar with those whose bodies are more resistant to lose.  I really hope that it doesn't get to that stage, but with my luck....  I think we all have the fears of being one who just won't lose weight.  I know he is a very skilled surgeon.  There is no funny business of him trying to perform insurance fraud either (I don't want it to come across that way).  I am just trying to make sure that I understand FULLY the procedure they have submitted for approval from my insurance co.    I'd also feel better that someone else has heard of it being called a 'two-stage' something.  I really thought this would be easily answered.  It is now getting too late for me to look it up and I might as well wait and call the office in the morning. Thanks! Gwen

No, its usually called the DS in two parts. You can try posting on the DS board. Warning, they will rag on you for not having an experienced DS surgeon.

Its also a different VSG. The DS stomach is about twice the size of the VSG, which makes a difference in weight loss and weight maintenance. If I went for a full DS I would be able to eat a lot more, as it is, I would struggle to get enough food if I had the DS. (At least now, but im not considering the DS.)

The DS is easier to get covered by insurance than the VSG, because the DS has long term follow ups (15 years). Though, because two surgeries cost more than one longer surgery, most insurance companies would prefer to approve the DS as one surgery, unless there are reasons why they shouldnt (aka, a very high BMI, like 70+). But, there are a few people here who had their VSGs approved as a two part DS, and they just didnt get the switch part done.

Gwen, Not sure if you are referring to the BPD/DS? Spelled out it's "BilioPancreatic Diversion with Duodenal Switch. It's usually concatenated to just DS or Duodenal Switch. HTH, Fred

I have Blue Cross PPO thru the state of michigan.  With my insurance the VSG is only covered as the first step of the DS.  That is exactly how my doctor phased it.  Since I cant have the DS or RNY he had to get an exception for coverage cause I also didn't have the weight requirement that BC wants for the approval of the DS.  They got the approval we just had to wait six weeks.  I was told that for some reason BC is taking six weeks now.