2011 - Seeking Revision to DS

May 26, 2011

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 questions are:

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!

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