Crystal Ann Keister

Dub My surgeon has suggested I am a good candidate for either The Sleeve or the Duodenal Switch. Because my BMI is a 43.4 he and my PCP suggested I not try to lose any weight on my own during the 6 months insurance weight management wait period because if I lost to much weight I would not longer be a candidate. So they had me stick to a management program rather then a weight loss.

shelbys mom Duodenal Switch The duodenal switch is a weight loss operation that has been done for over 20 years but has increased in frequency significantly in the last several years. It has the greatest weight loss potential of all the operations available. It works by creating a sleeve gastrectomy for restriction and hunger control. Then after the sleeve the intestines are rerouted similar to a gastric bypass. The principle measured length with a duodenal switch is the common channel. This is the distance from where bile and food meet to the end of the intestines and determines the amount of malabsorption. This common channel distance is an important number and has changed significantly over time. Originally this number was 50-100 cm and while it provided excellent weight loss, it left patients with nutritional deficiencies and diarrhea. We currently do a common channel length of 300 cm for most procedures. Deviations from this number are dependent on thepatient’s needs and this appears to be the sweet spot where weight loss is still excellent with fewer downsides. Vitamin supplementation is important and patients may have some increase in the number of bowel movements. Surgery takes about an hour and a half and patients have a similar recovery to the other procedures. The dietary progression is the same. Food enters the sleeve and is held there with the pylorus just like a sleeve. Because of this the dumping syndrome does not occur unlike the gastric bypass. The ideal patient for a duodenal switch is a patient who has more weight to lose. We know that patients will lose more weight than the other surgical options. Particularly patients with a BMI over 50 will have better and more sustained weight loss than with other procedures. Additional benefits are a lower incidence of ulcers than a gastric bypass operation. This is particularly helpful for patients that need to take NSAIDs such as aspirin, ibuprofen etc. Patients can expect to lose 80-90% of excess weight in the first year after a duodenal switch operation.

I have United Healthcare Gold Compass HSA 1600. I took my Online Seminar at Bariatric Specialist of NC on 1/19/16 Initial Consultation 2/18/16 Started my 6 month supervised weight program 2/4/16 - 7/18/16 Worked with my case manager to get all required documentation 7/18/16 - 8/26/16 Documentation will be submitted to Insurance for approval on 7/28/16 The Dr. office is tell me its a 7 to 30 day approval process. But on average they get a response back in 15 Business days. We will see. I'm soooo nervous. Then I have to wait for the final results consultation appointment. Then they say it will probably take 3 weeks to get on the table. If your just starting now, and trying to get it for 2016 out of pocket with insurance. I don't think you will meet it. I'm sorry I know how stressfull this is. I am so ready for my surgery. I really pray I get approved and fast. These are the requirements my case manager says my insurance requires. A referral from your PCP BMI above 35 with obesity-related health problems (or BMI above 40 without health problems) Participation in consecutive 6 month "clinically supervised" weight management program Letter of Medical Necessity from your PCP Medical clearance (Psychological Clearance for surgery from a mental health physician, Nutritional evaluation from a Registered Dietitian, Gastroenterology, Blood Labs, Pulmonary, sleep Study) 5 Year weight history I hope this helps, CK

Does anyone else feel like their Case Manager could careless about them? I sent in my paper work after my 6 month weight management requirement from my insurance on Monday 7/18/16. Along with messaging in the portal that I faxed it over and here it is Wednesday and I still haven't heard back saying if they have received it. During my 6 months every time I asked question, I got the same response and no answers. I understand her hands are tied because of the insurance approval process. But I just thought they would be more hands on with communication leading up to the surgery. I'm just frustrated. I have been dreaming about this surgery for 8 months and I am beyond excited to start my new life. I'm afraid not enough information is going to be provided to the insurance company and cause a delay in the approval. Although I am not currently medicated for my medical issues. I have many issues that are causing life to become very uncomfortable and my doctor is holding off prescribing anything until after I have the surgery to see if they rectify themselves with weight loss. I have high blood pressure, and I'm beginning to have a lot of trouble with mobility, my back, my hips, my knees, my ankles, and most of all my feet hurt so bad that walking is very painful. And I don't feel that is being put into the documents to provided to the insurance to express why this surgery is so necessary. What did you provided to your insurance company for your approval, I have United Health Care? Any feed back would be great? Thank you for letting me Rant Crystal. Current Weight 261, 5'5 Goal Weight 145 Looking at having either the Sleeve or the SIPS procedure