Revisions from RNY to DS - Please Chime In!
OK - here goes -- and my story -- I am looking for opinions and experiences -- the good, the bad and the ugly --
I am currently 54 yrs old. I had RNY June 2003 with a starting weight of 340 -- lost 180-187 lbs in 18 months by December 2004 -- no complications, no dumping -- thought I had finally beat this weight thing that had haunted me for years! Spent 2005 going through various recontructive plastic surgeries -- LBL, eyes and neck, boobs, arms, thighs (twice). I was able to get insurance coverage for my LBL, but paid out of pocket for the balance (approximately $30K) thru loans, etc. My weight seemed to stabilize at 160, and though my own goal lwas 150, I was happy at that weight.
I remarried in June 2006 -- managed to keep weight off with minimum bounceback thru the end of that year, but it was definately getting harder, being able to eat more and no longer having ANY restriction. By October of 2007, I knew something was wrong and I went for an endoscopy that showed that I had an enlarged stoma as well as an enlarged pouch - that the food was just moving right thru me. At that time, the 'devious' STOMOPHYX revison surgeon was widely being discussed, and despite insurance denial, I decided to have it done with Dr Shawn Garber. It was like taking $9,000 and throwing it in the trash. At the time of the Stomophyx I was up to 197 lbs. Now I am at 230 lbs!!!!! BMI is borderline 38-40......
Being fair, I have to say that during this time of weight gain, my exercise regime severely dropped off due to foot surgery, knee replacement and just plain old "lack of"! All the old head demons came back -- the ones that say -- I know I shouldn't have that, but I'm hungry -- of course much of that head hunger is emotions coming from various issues that life throws at us all -- add to that no restriction, never feeling full due to pouch and stoma enlargement and you all get the picture.
Currently, I recently saw Dr Roslin about a revison to DS -- having realized that it is my last shot at conquering this weight issue. He reviewed all my past surgical reports -- RNY and Stomophyx as well as the endoscopy. He confirms that I am a candidate for a revision to DS and that he would take me on as a patient. Relief!!!!! Whooo not so fast.
I now find out that my current medical insurance (Cigna) (with different employer than in 2003)has a WLS exclusion against all bariatric surgury including revisions or complications from bariatric surgery. No way around it.
Dr Roslin quotes me self-pay fees of approximately $33,000 for surgery -- ($10K for him, $18K for hospital, and various other misc of $5K). Now I don't have that kind of money floating around, but I did clear up all my old loans and credit card bills in the last two years, and could put those fees on various credit cards and then early next year, take a withdrawal from a retirement account that will be due for a rollover. I believe that I could avoid the 10% penalty in taxes due to medical bills creating a hardship that will qualify under tax rules, etc.
My question to you guys is:
1. How much weight could I plan on losing with the DS over the next year, with my current weight of 230, as a revision?
2. Is the $33,000 cost worth it -- realizing this is strictly a personal opinion question?
3. Due to WLS exclusion in current medical insurance any possible 'complications' from revion would also not be covered -- is the risk worth it?
4. I have a four hour commute to work each day with no toilet access -- two hours each way -- would the change in bowel movements and gas be horrific?
5. Lastly, how long would I have to take off from work for recovery -- my job does not continue salary during times of disability, etc.....except for minimum state mandated payout....
I need to make a decision fairly quickly -- any and all opinions, comments and experiences welcomed!
Thank you.
Nannette
I am currently 54 yrs old. I had RNY June 2003 with a starting weight of 340 -- lost 180-187 lbs in 18 months by December 2004 -- no complications, no dumping -- thought I had finally beat this weight thing that had haunted me for years! Spent 2005 going through various recontructive plastic surgeries -- LBL, eyes and neck, boobs, arms, thighs (twice). I was able to get insurance coverage for my LBL, but paid out of pocket for the balance (approximately $30K) thru loans, etc. My weight seemed to stabilize at 160, and though my own goal lwas 150, I was happy at that weight.
I remarried in June 2006 -- managed to keep weight off with minimum bounceback thru the end of that year, but it was definately getting harder, being able to eat more and no longer having ANY restriction. By October of 2007, I knew something was wrong and I went for an endoscopy that showed that I had an enlarged stoma as well as an enlarged pouch - that the food was just moving right thru me. At that time, the 'devious' STOMOPHYX revison surgeon was widely being discussed, and despite insurance denial, I decided to have it done with Dr Shawn Garber. It was like taking $9,000 and throwing it in the trash. At the time of the Stomophyx I was up to 197 lbs. Now I am at 230 lbs!!!!! BMI is borderline 38-40......
Being fair, I have to say that during this time of weight gain, my exercise regime severely dropped off due to foot surgery, knee replacement and just plain old "lack of"! All the old head demons came back -- the ones that say -- I know I shouldn't have that, but I'm hungry -- of course much of that head hunger is emotions coming from various issues that life throws at us all -- add to that no restriction, never feeling full due to pouch and stoma enlargement and you all get the picture.
Currently, I recently saw Dr Roslin about a revison to DS -- having realized that it is my last shot at conquering this weight issue. He reviewed all my past surgical reports -- RNY and Stomophyx as well as the endoscopy. He confirms that I am a candidate for a revision to DS and that he would take me on as a patient. Relief!!!!! Whooo not so fast.
I now find out that my current medical insurance (Cigna) (with different employer than in 2003)has a WLS exclusion against all bariatric surgury including revisions or complications from bariatric surgery. No way around it.
Dr Roslin quotes me self-pay fees of approximately $33,000 for surgery -- ($10K for him, $18K for hospital, and various other misc of $5K). Now I don't have that kind of money floating around, but I did clear up all my old loans and credit card bills in the last two years, and could put those fees on various credit cards and then early next year, take a withdrawal from a retirement account that will be due for a rollover. I believe that I could avoid the 10% penalty in taxes due to medical bills creating a hardship that will qualify under tax rules, etc.
My question to you guys is:
1. How much weight could I plan on losing with the DS over the next year, with my current weight of 230, as a revision?
2. Is the $33,000 cost worth it -- realizing this is strictly a personal opinion question?
3. Due to WLS exclusion in current medical insurance any possible 'complications' from revion would also not be covered -- is the risk worth it?
4. I have a four hour commute to work each day with no toilet access -- two hours each way -- would the change in bowel movements and gas be horrific?
5. Lastly, how long would I have to take off from work for recovery -- my job does not continue salary during times of disability, etc.....except for minimum state mandated payout....
I need to make a decision fairly quickly -- any and all opinions, comments and experiences welcomed!
Thank you.
Nannette
Nannette
Lap RNY 6/16/03
Revise to DS 8/15/11
I am a RNY (fobi pouch) to DS revision patient.
1) I can't really answer this. I had a minimal regain before my revision, which was primarily to correct severe dumping syndrome. I know wl is slower after revision, but I have already dropped 30 pounds. I must say that being young (23) and being a dude makes for much faster wl. I also exercise a ton.
2) I do not believe you can put a price tag on your health. If my insurance didn't cover my revision, I was prepared to go to Dr. Marchesini, a vetted DS surgeon in Brazil. His open RNY to DS is 23,000 Real, which is about $14,200 USD.
3) I'm not sure how to answer.
4) Everyone seems to be different with this. I have had minimal issues. I had 2 days of constipation, and a couple gassy days after having some white flour goods. I've been avoiding all white flour, and I'm having no more BM or gas issues.
5) I think 6 weeks is typical recovery time.
Best of luck
1) I can't really answer this. I had a minimal regain before my revision, which was primarily to correct severe dumping syndrome. I know wl is slower after revision, but I have already dropped 30 pounds. I must say that being young (23) and being a dude makes for much faster wl. I also exercise a ton.
2) I do not believe you can put a price tag on your health. If my insurance didn't cover my revision, I was prepared to go to Dr. Marchesini, a vetted DS surgeon in Brazil. His open RNY to DS is 23,000 Real, which is about $14,200 USD.
3) I'm not sure how to answer.
4) Everyone seems to be different with this. I have had minimal issues. I had 2 days of constipation, and a couple gassy days after having some white flour goods. I've been avoiding all white flour, and I'm having no more BM or gas issues.
5) I think 6 weeks is typical recovery time.
Best of luck
I had a DS revision in 2008. I had the RNY in 2000 at 400+ pounds. I got down to 236. Then a RNY revision a year later, he made the pouch too big the first time.
I recently had a knee replacement and am due for another one in October. So my exercise regime is 'nil right now. I know if I could walk at least I could lose some more.
1. How much weight could I plan on losing with the DS over the next year, with my current weight of 230, as a revision?
*Everyone is different. Your body will lose fast and probably have a bit of a rebound gain after a year or two. But, lose you will.
2. Is the $33,000 cost worth it -- realizing this is strictly a personal opinion question?
* That is something I can't answer. But for me, it would be. You must also count the cost of vitamin and lab costs into the DS. You HAVE to keep these things in mind. Can u afford these things after shelling out 33K?
3. Due to WLS exclusion in current medical insurance any possible 'complications' from revion would also not be covered -- is the risk worth it?
* There are risks. My surgeon told me the risk was 10X normal surgery. You run the risk of leaks and strictures etc. Weither it's worth it or not is completely up to you.
4. I have a four hour commute to work each day with no toilet access -- two hours each way -- would the change in bowel movements and gas be horrific?
Basically YMMV - Your mileage may vary. Everyone is different. Some people have bathroom issues and adjust their eating etc. accordingly. Some of us don't. Many of us low-carb. Which helps with the gas and bathroom issues, along with taking probiotics. But, you really won't know until you have had the DS.
I recently had a knee replacement and am due for another one in October. So my exercise regime is 'nil right now. I know if I could walk at least I could lose some more.
1. How much weight could I plan on losing with the DS over the next year, with my current weight of 230, as a revision?
*Everyone is different. Your body will lose fast and probably have a bit of a rebound gain after a year or two. But, lose you will.
2. Is the $33,000 cost worth it -- realizing this is strictly a personal opinion question?
* That is something I can't answer. But for me, it would be. You must also count the cost of vitamin and lab costs into the DS. You HAVE to keep these things in mind. Can u afford these things after shelling out 33K?
3. Due to WLS exclusion in current medical insurance any possible 'complications' from revion would also not be covered -- is the risk worth it?
* There are risks. My surgeon told me the risk was 10X normal surgery. You run the risk of leaks and strictures etc. Weither it's worth it or not is completely up to you.
4. I have a four hour commute to work each day with no toilet access -- two hours each way -- would the change in bowel movements and gas be horrific?
Basically YMMV - Your mileage may vary. Everyone is different. Some people have bathroom issues and adjust their eating etc. accordingly. Some of us don't. Many of us low-carb. Which helps with the gas and bathroom issues, along with taking probiotics. But, you really won't know until you have had the DS.
I am 5 months put from a RNY revision to a DS and I was self pay. Not counting travel expenses etc, The cost was around $28,500.
The revision was done open and the first few weeks were tough, but I'm also older. I went back to work at 5 weeks and thought i'd die, but didn't. By 7-8 weeks I was feeling pretty decent.
I have lost 58# so far...very slow, but I was told to expect a slower weight loss than virgin DS'ers. Everyone is different though. I do have some bathroom issues, but pretty much confined to the 4-7 am time frame. I wish I'd have some of the constipation that so many others experience......but I can live with my issues.
Was it worth it? YES!
The revision was done open and the first few weeks were tough, but I'm also older. I went back to work at 5 weeks and thought i'd die, but didn't. By 7-8 weeks I was feeling pretty decent.
I have lost 58# so far...very slow, but I was told to expect a slower weight loss than virgin DS'ers. Everyone is different though. I do have some bathroom issues, but pretty much confined to the 4-7 am time frame. I wish I'd have some of the constipation that so many others experience......but I can live with my issues.
Was it worth it? YES!
-Gail-SW 257 CW 169 GW 165
1. Everyone is different and as more chime in you will see. I had my surgery 12/08/10 and I am down 73 pounds. I had RNY 2006 at 455 lost down to 282 and then started gaining my weight back. I found out that I had the same issues as you do. So my insurance did cover it but I did have to fight a little to get it done. When I went in for revision surgery I weight 351 and now down to 278 which is lower than I ever got with my RNY and I am so happy I did this. My goal is a little higher than most but because I was so heavy I feel like 200 for me with my height will be ok.
3. Yes the risk is worth it, well to me it was. I was going to die because of my weight and I have to many people around me that love me it was worth it for them and me. Mostly me!!!! LOL.
4. You will get use to it and for me my body adjusted to my schedule. I mostly go first thing in the morning and then about hour later I will need to go again. then once I am off work I will go and then maybe depending on what I have at will go once more before shower time.
5. I was off work for 5 weeks could have used a few extra weeks but I am cool with that.
Sophia
3. Yes the risk is worth it, well to me it was. I was going to die because of my weight and I have to many people around me that love me it was worth it for them and me. Mostly me!!!! LOL.
4. You will get use to it and for me my body adjusted to my schedule. I mostly go first thing in the morning and then about hour later I will need to go again. then once I am off work I will go and then maybe depending on what I have at will go once more before shower time.
5. I was off work for 5 weeks could have used a few extra weeks but I am cool with that.
Sophia
No, you don't need to make a decision like this quickley. This is a major, major decision.
The risks are higher for a RnY to DS revision and your choices of surgeons is limited. I don't know if you could save money by going with one of the (few) other revision surgeons but you should find out.
My only regret about my DS (20 months out so still a newbie) is not having done it 30 years ago.
~Becky
The risks are higher for a RnY to DS revision and your choices of surgeons is limited. I don't know if you could save money by going with one of the (few) other revision surgeons but you should find out.
My only regret about my DS (20 months out so still a newbie) is not having done it 30 years ago.
~Becky
RNY 1998 to DS 2008
1. How much weight could I plan on losing with the DS over the next year, with my current weight of 230, as a revision?
My SW was 286 and without revisiting my profile, I'm thinking I was about 160+/- at the one year mark and I've been 140-146 avg. My lowest was 130 something but I didn't feel "well" there (mental issue)
2. Is the $33,000 cost worth it -- realizing this is strictly a personal opinion question?
If you can do it, then yes.
3. Due to WLS exclusion in current medical insurance any possible 'complications' from revion would also not be covered -- is the risk worth it?
I didn't have any major complications - some have. You'd definitely wanna sit down w/your Dr to decide on this one...
4. I have a four hour commute to work each day with no toilet access -- two hours each way -- would the change in bowel movements and gas be horrific
For me, I'd make sure my bowels and bladder are empty before I hit the road...then again, I think most of us do that anyway. Also, what you eat and when you eat it of course will affect when you have the urge to go...unfortunately, you'll determine that only after you have surgery.
(edited to add: that probiotics and Devrom can/do help)
5. Lastly, how long would I have to take off from work for recovery -- my job does not continue salary during times of disability, etc.....except for minimum state mandated payout....
I took 6wks and was still tired but functional. You'll wanna factor that in economically as well.
Good Luck on your decision! Take the time you need - no rush ("easier said..." I know).
1. How much weight could I plan on losing with the DS over the next year, with my current weight of 230, as a revision?
My SW was 286 and without revisiting my profile, I'm thinking I was about 160+/- at the one year mark and I've been 140-146 avg. My lowest was 130 something but I didn't feel "well" there (mental issue)
2. Is the $33,000 cost worth it -- realizing this is strictly a personal opinion question?
If you can do it, then yes.
3. Due to WLS exclusion in current medical insurance any possible 'complications' from revion would also not be covered -- is the risk worth it?
I didn't have any major complications - some have. You'd definitely wanna sit down w/your Dr to decide on this one...
4. I have a four hour commute to work each day with no toilet access -- two hours each way -- would the change in bowel movements and gas be horrific
For me, I'd make sure my bowels and bladder are empty before I hit the road...then again, I think most of us do that anyway. Also, what you eat and when you eat it of course will affect when you have the urge to go...unfortunately, you'll determine that only after you have surgery.
(edited to add: that probiotics and Devrom can/do help)
5. Lastly, how long would I have to take off from work for recovery -- my job does not continue salary during times of disability, etc.....except for minimum state mandated payout....
I took 6wks and was still tired but functional. You'll wanna factor that in economically as well.
Good Luck on your decision! Take the time you need - no rush ("easier said..." I know).
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