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Revision to RNY
lisa0617 replied to Sam.is.sassy's topic in Revision Weight Loss Surgery Forums (NEW!)
My revision is a week from Monday. Do you expect to lose more weight Sent from my LGLS991 using BariatricPal mobile app -
Actually, with the DS (at least the "traditional" bileopancreatic diversion (BPD) DS. bile reflux is near impossibility, as the duodenum is split between the bile ducts and stomach, forcing the bile and pancreatic enzymes to flow downstream some ten feet or so (depending on individual variations) until it hits the common channel where it meets the food flow and actual digestion can occur; for it to reflux into the stomach, it would then have to flow back upstream some 4-5 feet or more (again, depending upon individual variations) before it could get to the pyloric valve and reflux into the stomach. The newer "simplified" SIPS/SADI/Loop DS is more of a classic Billroth II configuration (cousin to the RNY) where bile reflux may be possible, depending upon how the surgeon sets up the limb lengths. With the RNY, like any Billroth II based procedures, bile flows downstream from the bile ducts and can reflux into the stomach pouch. The main counters to this is neutralizing the bile with stomach acid from the remnant stomach, and limb length between the bile ducts and pouch. Bile reflux is not uncommon amongst cancer patients who have had a gastrectomy, where the basic layout is an RNY without the remnant stomach, The surgeon that I worked with when I was considering this told me that he has never had any bile reflux problems if he keeps that limb length at 60cm or above; presumably, some of these cancer patients received a shorter limb in an effort to minimize malabsorption and weight loss. As with many things in life (and medicine in particular here,) there is a balance between the therapeutic and objectionable side effects - and people will vary as to where that balance may be in their particular case. Perhaps the OP experienced classic RNY marginal ulcers from the acid incompatibility with the intestine and anastomosis, and in the process of these serial revisions, wound up with an overly short jejunum? Hopefully she can get this sorted out, but the DS does provide something of a last ditch option of other avenues don't resolve the problem; unfortunately, such revisions are very complex, and there are only a half dozen or so surgeons in the country with the skills and experience to perform it. Perhaps a distal RNY, where they move the pouch waaaayyy down the intestines toward the colon may be a middle ground that might do the job.
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I am having the sleeve done as this was what my surgeon recommended. I have gone back and forth with both the sleeve and the Bypass with uncountable research but will go with what my doc recommended. About doing the removal and the revision simultaneously or separately appears to be surgeon dependent. So, your surgeon could do do it simultaneously. My lapband never slipped and I didn't have any damage after the removal or during the surgery. Life just went a bit better afterwards. I did gain 6lbs in 3 weeks so I couldn't be more sure about the revision. Good luck and keep is updated as I would as well. Cheers. Sent from my SM-N960U using BariatricPal mobile app
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The gas pain I felt when I had lapband wasn’t me needing to pass it was the gas they pumped in to make room and it works it’s way up into your shoulders- it was bad. The gas pain I had after 2 sections was me needing to pass it and more from anesthesia - it was nothing compared to the gastric surgery. I go back Friday to remove the lapband and revise to sleeve with ds
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Thank you both! I broke down and have an appointment next week to discuss a revision. I have had mine for 8 yrs and it hasn’t been a tool for the last 3 and started out with regaining 20 lb but the last year I packed on 30 more and don’t even know how. I didn’t think about two separate surgeries, glad you brought up the healing as I was hoping to knock it out in 1 only because I don’t like going under Anastasia. Can I ask why you both are going to the sleeve over the Bypass?
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Hello Dee Tee, I guess it depends on the insurance and the surgeon. After 7 years of the lapband of which the final 6 months were hell and bondage! I'd had enough. I self paid for the lapband was why I tolerated it for that long. I found out my current insurance covered bariatric surgery so I bit the bullet and met with the surgeon April 24th, got approval for lapband removal as my surgeon does 2 separate surgeries so that stomach can heal (I was initially gutted that I couldn't have the sleeve done simultaneously but now I am glad for all the research and preparation it afforded me). My surgeon was convinced that for Aetna, I had to do the process of 4 months supervised nutritional visits, psych evaluation, etc was needed again to qualify for the approval especially as my BMI is 35 (I am prediabetic and have been prescribed metformin which was my final straw by the way!!). I asked the surgeon's office review to please submit the one surgeon note that was in my file for the lapband removal. I wanted to know my fate early on and not go through all the hoops and be denied honestly! She submitted May 1st initially but they had the wrong CPT code, found that out May 8th, she then resubmitted May 15th and I was approved May 29th!! Even unbeknownst to my surgeon whom I saw May 30th for the first Dr. Supervised nutritional visit. I told her and she was flabbergasted as she didn't even know the office woman had submitted for approval. After that visit, I was given my surgery date as she said I didn't even need to do the 4 consecutive months visits any longer. She just needed 6 weeks after the lap band removal. My point is that it's okay to push the envelope and not even go with what the office says. Especially as this is for a revision. The reason I pushed was to know my fate early. They wanted to give me a June surgery date but I chose to wait till August, chose to continue to see the nutritionist and learn everything I need for this new tool but it's at my own leisure without all the angst of approval swirling around my head. Good luck!! I wanted to share my experience. Hope it helps. Sent from my SM-N960U using BariatricPal mobile app
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I’m having revision in a week from lapband to sleeve with ds. The process to get the revision approved may actually have been harder at least for me. I got my band 9 years ago and they accepted my weight watchers membership as 6 month diet. This time I had to do way more tests plus dr weight loss for 6 months (I lost nothing) and the psych evaluation too. My band has been nothing but trouble the last 2.5 years. I gained back 50 pounds from when it started acting up. Im ready to have the control again over food
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Know what you mean, my surgeon is 50 miles from my town. They are thinking of starting a modified Bariatric program at my local hospital, only lap band and VSG so far. Knew I couldn't wait until 2020 and I had to be a Bypass, it would correct all my problems, whereas the Sleeve would not, and I didn't want to try for Revision later. So I went to Ohio State, a Center of Excellence hospital from the word go, my surgeon is the Big 🐕, the chief of Bariatric Medicine and Metabolic Weight Loss, a Full Professor in COLLEGE of MEDICINE. And a wonderful skilled surgeon, if I have a crush on him, it is for his abilities, he is the kind of doctor I once aspired to be. Of course I doubt I would have wished to become a General Surgeon, let alone a Bariatric one, my chosen dream was Immunology. And I believe I would have been a Good One! But life, love and finances got in my way and all the Woulda- Coulda-Shoulda in the World can't repair that! But I still cry when I see the United Negro College Fund commercial comes on, the one that says "A mind is a terrible thing to waste" and I am white but it still applies to ME so I cry💦for the lost opportunities. And now you know something about me that few dom
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Sleeve revision to bypass
curvy gets fit replied to Colorchic's topic in Revision Weight Loss Surgery Forums (NEW!)
Hello everyone. I am going to see if my insurance will approve me for a revision to bypass . I currently have the sleeve. I have gerd, gastritis, and a small hiatal hernia. Did anyone who has meritain health insurance get approved for a revision? -
MINI GASTRIC BYPASS AND ACID REFLUX
FloraBama Girl replied to NYCGAL000's topic in Mini Gastric Bypass Surgery Forum
I was a sleeve revision to MGB. I had horrible reflux with the sleeve and unsatisfactory weight loss. I don’t have reflux with the MGB but for unknown reasons I have ulcers. I am at 136 lbs from high weight of 269. This is better than my goal of 150. I am 5’ 6” I eat pretty much anything. Chicken, ground beef, steak, turkey. Any kind of vegetable and a little protein pasta sometimes. If I take my medicine I am fine. No issues. I had IBS with Constipation and WLS did not improve this. I will be glad to answers any other questions. My revision two years ago this month. -
Will FEP bcbs cover revision to bypass due to Gerd and hiatal hernia
SlimChickadee replied to clrobinson2014's topic in Revision Weight Loss Surgery Forums (NEW!)
I had my barium swallow test today and the doctor that was present stated he saw a small hiatal hernia and asked if I was on medication, I told him I was for the Gastric Reflux and he said, "Well, they will probably just change your medication!" I am so hoping this do not deter me from getting approved for my lap-band (banded since 2009) removal as well as my revision to Roux en y procedure later. I was told my insurance covers 90% but hope I am approved to have it done. Haven't heard from my Bariatric surgeon's office yet but again only had the swallow test today. #keepingfingerscrossed. Can anyone tell me how long it took for the approval. Also had my first nutrition visit today as well and I was told I have to contact a psychologist for an eval. So, why would I have to go through all of this if I am not going to be able to have the surgeries? -
The latest, after 4 or 5 test totaling over $50,000? I have severe GERD. Medical treatment is revision. It cost more money to keep testing me then the procedure to fix the issue. In the states, insurance has gone crazy. Now, I am waiting on a new date. Meanwhile, I am the one in constant pain. I have the best docs ever. My insurance well TBD. Fighting for my health. Make sure you fight for yours. Sent from my SAMSUNG-SM-G935A using BariatricPal mobile app
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Never considered anythi g but RNY bypass, needed to lose quckly, take the pressure of my body before both hips joined my 2 knees, 1 thumb and an upper arm. Had Gerd from Hades and a 1st cousin that died from Esophageal Cancer. Didn't have time at 72 to go through a VSG and then a revision later. Besides I have Medicare/Medicaid, those Dudes got no sense of Humor and I knew, for me, this was the once- in- a--lifetime surgery!
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The surgeon actually told me I'd be a good candidate for Gastric Bypass. I was leaning that way myself. The idea of taking supplements forever didn't bother me as I was already taking most of them because I was a fussy eater. After researching more, like others have said I certainly didn't want gerd or to have to revise to RNY so I this was the best choice for me. I am about 3 and ½ months out now and I haven't ever really felt hungry, I hope it stays that way. I measure out what I eat, I have never really felt full. I have felt pressure and discomfort when eating to fast.
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Revision to RNY
traeleo replied to Sam.is.sassy's topic in Revision Weight Loss Surgery Forums (NEW!)
I’m 7 days post op. My revision from sleeve to bypass was March 23rd. I had really bad GERD even with liquids. I’m on clear liquids right now and I’ve had tea which usually causes an issue, but so far so good. I don’t feel that burning in my throat are feel like gagging anymore. So I’m glad I did it. RNY all the way!😉 -
That is amazing. I am 3 weeks out and am on track for a similar loss (but since my pre-op diet). My experience from the sleeve (I had a revision) is that it is a slow and steady loss. It doesn’t drop off rapidly. Just keep up the good work!
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Revision to RNY
SeattleLady replied to Sam.is.sassy's topic in Revision Weight Loss Surgery Forums (NEW!)
Okay, what happened to the 95% who have relief from GERD? Did anyone else feel better after revision? Sent from my SAMSUNG-SM-G935A using BariatricPal mobile app -
Highmark BCBS TN insurance approval
SlimChickadee replied to SlimChickadee's topic in Insurance & Financing
So, got a call today confirming my barium swallow test tomorrow and asked the receptionist if I was jumping the gun of asking if my insurance will cover both surgeries (removal of lap-band and revision to RNY). She called me back and stated that my surgeries will be covered under my insurance. Removal of lap-band as well as revision to RNY 3 months after the fact. Fortunately, my insurance covers 90%! All I can say is Wooooo Hooooo! -
August 5th here! I'm having a revision sleeve to bypass.
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Bypass v’s Sleeve..... help!
Mint2bskinny replied to MinnieSD's topic in Gastric Bypass Surgery Forums
RNY was something I was scared of but after research most sleeves get revision. My sister had sleeve and 4 years later she wants RNY. I love it sure its malabsorption so you take lot of supplements but one of BEST decisions ever if you are foodie! Everything has changed. Grille onions are my sweets now its CRAZY! And cakes dont even smell good. good luck on your path cant wait to follow your progress. -
I'd be wary of the sleeve if you've had preexisting reflux. it is generally not recommended. one study i've seen has stats as high as 84% with reflux post sleeve if there was preexisting reflux. Bypass usually cures it. I can provide you the study link if you want. but my doc warned me i'd likely eventually be back for a revision if I went sleeve. Is there a reason they have not offered the traditional bypass, it is the gold standard. Are you doing this through OHIP? i didn't think they offered the mini.
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I Sonia Rosario had a gastric bypass surgery n recently had a corrective revision surgery for the gastric bypass n I'm reaching my correct BMI but I would like the excess skin from under my arms n my inner thigh area n a breast augmentation n tummy tuck done but i need to know how much will my 1199seiu benefits cover cause this is a very costly procedure n money is very tight these days but i need this excessive skin removed can you please give me some kind of reply.. Soniarosario4343@gmail.com Or 3477499600 or Soniarosario4343@yahoo.com Thank you....
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May Day #28 Confide in someone: Told Mr. that I want to get a tummy tuck (on top of the already agreed upon arm lift). Well, he didn't balk, so thats a good start... 22 pushups: Done. The last 5 or so where done badly, I recall (was getting tired). May Day #29 Help someone in need: Going to help a cousin move this weekend, will count that for today 23 pushups: Haven't done these yet, was late getting up this morning. I'll do them later tonight. B-side: Realistic vs. Fantasy Goal Weight: My initial goal weight when I was pre-op was 130lbs. Soon after the weight started shedding, I revised that to 120lbs. Now, I've revised it again to be the weight I am currently (127). I don't think I had a "fantasy" goal weight.
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Approved UHC Medicare Advantage
Deedee12 replied to LearningToLoveMeAgain's topic in Insurance & Financing
Hello LLane RN, how are you? And how is preop diet going? I bet you are at the edge of your seat! I just wanted to give you my update. I too got my approoval today and I could not be happier!! I met surgeon first time 4/24 to have my lap band removed after 7 years od bondage (not all bad, but felt like it). I was disappointed to find that my surgeon would not do the revision simultaneously...but now I am glad she did not as I have had the chance to not go off how I was feeling with the labpband and do some very necessary research both on the site and generally. I did tell the office to go ahead an submit as I did not want a long wait and wanted to know my faith early on in the process. Request was submitted initially on 4/30 but they had the wrong CPT code and it was resubmitted immediately and we waited 1 week to come find out the new CPT code request was also cancelled same day. So they resubmitted again on 5/13 and they made me wait exactly 2 weeks to hear back today as yesterday was a public holiday that the request was approved. I met surgeon once, lap band removed on 5/3 and approval today. I am yet to meet the Nutritionist, Psych etc. I plan to still do all that but it feels good to know the approval is in and I can do all other appointments at my leisure. Thanks to your encouragement and this site for all the GOLDEN nuggets, it was invaluable. Good luck to you LLaneRN, I'll be praying that your surgery goes very well and your recovery is speedy! -
Had my sleeve on May 23 and had to go to ER twice over the weekend for pain and dehydration. Now pain almost gone but still get something like esophageal spasms. Driving me crazy and very worried that it won’t go away and that I will have to revise to bypass down the road. Psychologically I am really hurting and questioning this decision. Very anxious.
