One bariatric surgery in a lifetime!

I thought OH was chastising the OP. she was the one being mean,not Heidi,IMHO.

My insurance company (BCBS) has a similar policy of one surgery per lifetime. However, there is a exception. They will authorize a revision when the surgery has failed you. Sounds like this may be your situation. You might want to get and review the written version of the guidelines. The most common situation that we see now is with band problems. 

I agree that we all have to work at this. However, if you can get a boost of a 100 lb weight loss at the front end, it sure does level the playing field. Hope you find some answers. 

What is a "minimal RNY"?   It's not exactly true that most people don't know what their doctor is doing.  But I can only speak for myself.  I asked a bazillion questions.  Best of luck to whatever you decide, Tri - but take a deep breath and consider all your options.  Do make sure you at least request a revision through your insurance company - let them tell you no in writing.  Just make sure this time, that you are fully informed of your rights and options.  Again, good luck to you.

Sandie

It was a pleasure meeting you face to face, especially having read and appreciated your posts for two years.   Hope to be able to make it to LA for the next conference. 

Yeah, sometimes surgeons aren't really proficient in doing WLS and sometimes they don't do them correctly.  I felt that way after my first WLS.  I never had any restriction, either.  However, I take full responsibility for my regain.  I put the food in my mouth, not him.  I am not saying that is your situation, only that I understand not getting a tool that is helpful.  I too had no restriction and was always hungry.  I was also not educated in how to eat post op and what supplements to take or what labs to have done.  A recipe for disaster.  I did go back to him because I didn't know better and I completely blamed myself for my failure.  I was having such a miserable time of it and all I wanted was to be reversed since I was having bad side effects and absolutely no benefits form having WLS.

Thankfully my insurance did pay for revisions and my surgeon told me he couldn't reverse my surgery but he could revise it, including giving me a RNY pouch so I finally had restriction.  I am grateful for a second chance and also for having some help in not being hungry all the time and being satisfied with a much smaller amount of food.

I agree that going out of the country may be your best option in order to get a good surgery to help you.  I just wanted to add, though, that while it is much cheaper to go to Mexico as far as I know there are no surgeons there that will be able to revise a RNY to a DS.  It is a very complicated surgery and you need an experienced surgeon to do it.  The only surgeons I know of out of country that may be able to help are in Brazil and Spain and perhaps Dr. Gagner in Canada but I haven't heard good things about him.  In any case, a revision to a DS from a RNY is going to cost a lot more then a virgin DS no matter who does it.  If you can swing it your best bet would be Dr. K or Dr. Rabkin in California.  They cost more but they have the expertise to do it right and safely.  There are other surgeons in the US that do the revision, too, but again we are talking about more money.

Is there any chance of appealing the insurance on the basis of an incorrectly performed surgery?  If I knew then what I know now I would have found a way to go to an experienced revision surgeon and had it done right.

I noticed on your daily menus in your profile that you eat mostly carbs,soups cookies and the like. didn't notice much dense protein.is there a reason for that.

i can eat all the carbs and slider foods I want to and never feel much restriction. Dense protein on the other hand,fills me up and I know i am full.

Why aren't you eating on plan?

First thanks for caring enough to share your thoughts.  I wish that it were that easy.  I have been to 3 dietitians.  2 of them bariatric.  All 3 of them gave me diets with fruits, veggies, starches, meats, dairy etc.  Non of them gave me the diets that many people on this site follow.  I am not sure why?   Probably because my RNY was different.  My surgeon changed his surgery after doing mine and a few of the people before me.  After my surgery, the newer patients were eating like most post op RNY patients.  In the hospital I was given chicken, potatoes and carrots 2 days post op.  My discharge "protein shake" was nsa Carnation instant breakfast in milk between meals.  If you look at my profile the "cookies" are Metamucil cookies and are bought in the pharmacy.  They contain soluble fiber just in the form of a cookie.  Actually they are called crackers, but they are close to a cookie.  They reduce cholesterol.  I don't want to take cholesterol meds because they cause weight gain.  My carbs are almost always from veggies and fruits and whole fiber because it fills my lower gut up and keeps me from eating too many calories.  I eat a lot of dense protein...chicken, beef, turkey, ham, egg beaters and reduced fat or fat free cheese rather than milk for calcium because it is lower in carbs (no lactose which is a carb).  I try to limit my protein at 140 gms because I am a diabetic and it is hard on my kidneys.  I put in my soup recipe on my profile.  It is 8 quiarts of fat free chicken broth with an entire bunch of celery some carrots and 1 bag of mixed veggies.  It also contains 1 can of diced tomatoes and 2 cups hot salsa.  The celery is almost no calories, the carrots are for vitamins and the tomatoes are for leptin which helps in weight loss and the salsa is to pep up my metabolism.  Also when food travels down the intestine it reaches a spot that releases "feel full hormones".  I figure if the soup gets there quickly it will release those hormones faster and I will be less hungry.  It is packed with vitamins and is only a few calories per cup.  My problem is that I usually eat 2000 calories a day which maintains 200 lbs.  I have tried eating only protein and the calories are so dense that I eat more calories that way.  I have tried that many times over the years.  A 160 calorie 30 gm protein drink slides through.  Did you see the picture of my wide open stoma?   Dense protein does not fill me up because it goes into the intestine and the muscles pu**** through.  My GI doctor said the pyloric valve has a teeny tiny opening that food goes through slowly.  That is removed and the stoma is made.  My stoma was made with the larger stoma hole maker.  After my surgery he started using a smaller one.  thanks for caring,  Tri

Dear Tri

I want to tell you I am SO SO sorry. You do NOT deserve to live like this. I cannot imagine the hell it would be to NEVER feel satisfied from a meal. That must be sheer and utter freaking torture. It sounds like hell to be honest. That must be like feeling hungry all the time and shoveling food into a never ending trough. How awful. SOMETHING is wrong with your RNY if you have felt the exact same since surgery. I remember reading on another WLS forum and a member was stating that one month after her VSG surgery she was able to eat 3 pieces of pizza and 3 wings. She wanted to test her capacity because she KNEW something was wrong. That SHOULD be virtually impossible. Would you believe some of the members told her "remember it's a tool, you should not be eating that,". Yeah sure we all KNOW that she shouldn't have been. But was this person given a good sleeve surgery? Hell to the no. You should NOT be able to eat that much 4 weeks post op. Something was VERY wrong. At almost a year out, I CANNOT finish a full slice of pizza unless it's a very small piece. So this person was given a crappy sleeve. The people talking down to her obviously had a well done surgery and had a MUCh stronger tool. YOU should have been given the PROPER TOOL that everyone else has. You were NOT.

I agree with everyone about FIGHTING the insurance on this one. I've seen some people win revisions after band surgery even with a once per lifetime clause. You need to write a long letter about how you only lost 14 lbs post op in an entire year and how you have never experienced food restriction!! Write it to the insurance company, write a letter to a revision doctor or tell them in person. Something. FIGHT for it.

I know what it's like to not have insurance. I barely had enough to go to Mexico and self pay. I know the DS is expensive but maybe there is some way you can afford it. Maybe you can FIGHT for it. No way in hell do you deserve what you have gone through.

HUGSSSSS**** seriously....HUGS. I had so many dreams about my surgery being an effective tool and hoping beyond hope it would work. I was one of the lucky ones. It has worked beyond my dreams. YOU DESERVE THAT TOO!! It's definitely not fair that you didn't get what was paid for I would be sooooo pissed it would be unbelievable. I hope you can find a solution to this. It breaks my heart you've had to go through this and it is just not right.

I remember a bariatric dietitian telling me right after surgery...Just because you can eat it doesn't mean you should.  Although that is true, I felt that $ 30,000 should have given me some additional control.  Perhaps less appetite or feeling full or dumping if I cheated. If they would have told me they were going to give me a RNY that would make me more hungry, allow me to eat everything without consequence and never feel like I have eaten, I would have skipped the surgery.   I went through RNYs with several friends before and after me and all of them had some tool to work with.  I know 3 VSG patients as well now.  One would get so dehydrated from not being able to drink even water.  One lost 50 lbs and can't get the remaining 50 off.  The 3rd is just right.  It takes a while for surgeons to get the experience they need.  They learn on us.  I am trying to get calm enough to put together an appeal letter.  Thanks for understanding.  Tri