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Tinatana

Pre Op
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    Tinatana reacted to RickM in Surgery for illness instead of weight loss - Gastroparesis   
    I went through much the same thing of researching all of this a few years ago for a prospective cancer treatment (though didn't have to go through with it, as it turns out.) Your surgery should be coded as a gastrectomy, partial or total, for the sake of your GP, rather than an RNY gastric bypass for weight loss. Same basic procedure, (called a Billroth II, which has been around for about 140 years for just this kind of problem) but different codes and rules for the insurance. So, you shouldn't have to jump through the same insurance hoops of psych eval and possible 3-6 month diets, etc., though neither is a bad idea given the lifestyle changes you will probably encounter post op.
    There are a number of Facebook groups for partial and total gastrectomy patients, which would be good to look into. One of the things that I found there is that bile reflux is a relatively common problem post op, which doesn't seem to be that common within the RNY population. Discussing this with my prospective surgeon, he told me that he has never had a problem with that if he kept the limb length over 60cm, which would be fairly typical in the RNY. He also wasn't restricted on choice of limb length as he would be under RNY rules; he could go shorter or longer as needed for the circumstance. Implicitly, this means that many surgeons who perform this procedure for non-weightloss purposes try to keep that limb length, and the associated malabsorption, short to minimize weight loss, but that brings the pouch and anastomosis closer to the bile ducts. Since you are in the BMI range that would normally qualify for WLS, this should not be an issue as you can benefit from the weightloss, but it is something to discuss with the surgeon.
    It is good for you to work through a bariatric surgeon (most major hospital GI surgery departments are also their bariatric department,as well, given the overlap in skills and experience, though the surgeons may drift to their own specialties within) as you should get all of the necessary education on dietary, medication and supplement restrictions that you need; my wife knew a guy in her office that was having all kinds of health issues and it turned out that he had this same type of procedure for non-weightloss reasons (don't know if it was GP or something else) but he was never told about the ramifications of the procedure, so duh - yeah, he was having issues. Between your bariatric office (most are pretty good these days) and these forums, you should pick up what you need to know to live healthy in your post op years.
    Good luck.....

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