Insurance Will Only Pay For Rny

[rtjhouse 0]

I have been on a two month journey to get a vertical sleeve surgery. Just two weeks to my scheduled surgery date; just to be told the insurance will only pay for RNY. I spent a lot of time researching the sleeve. Now I have to decide in a day or two if I want RNY. Can someone tell me all the drawbacks. (Sweets alcohol etc. ). I don't have a big sweet tooth but do like them once in a while. Also what are the pluses over the sleeve. THANKS.

[pointer 92]

U should do the rny anyways. Has been around longer worked out more kinks and better results. Also the rny is the only one I know of where people don't need to do revisions. There has been many revisions for the band and the sleeve is working its way there. Believe me insurance is only covering it bc it's the best end results for u and them.

[NikiG 113]

U should do the rny anyways. Has been around longer worked out more kinks and better results. Also the rny is the only one I know of where people don't need to do revisions. There has been many revisions for the band and the sleeve is working its way there. Believe me insurance is only covering it bc it's the best end results for u and them.

I agree

[TinyMamiOf3kids 1,280]

If you really need the surgery & rny is what's cover do it. No reversions & you have limitations & control. Not everyone gets dumping & vomiting.

[pointer 92]

If you really need the surgery & rny is what's cover do it. No reversions & you have limitations & control. Not everyone gets dumping & vomiting.

I agree

[peachee213 67]

My insurance did the same thing. It was afraid of RNY because I thought it was drastic but then the major thing for me was I only wanted to go through surgery once. That helped me decide and everything had been okay since my surgery on 11-14-12.

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[jls2012 41]

I was a sleeve patient originally. Once I had my egd I was told that I could not have the sleeve due to my results so I am having the rny. I was like you- had not researched rny very much and felt at a loss because I felt ready for the sleeve. I have researched rny and this forum is awesome!! These guys can answer pretty much any question you may have I am ready for my rny and have surgery on Monday :) I was disappointed about the sleeve at first but then had to remind myself why I started all if it in the first place- for a healthier me! Good luck to you!!

[rtjhouse 0]

Thanks everyone for your input. I have a lot to think about. I guess I just have to accept it. The insurance will only pay for RNY. It's just a big change for me and just two weeks from surgery.

[katmandu 30]

My insurance denied the VSG for me, and again on the appeal. My Docs submitted with RYN and was approved right away. If you want WLS, then you will have to go with the RYN. I still would prefer the sleeve, but RYN is the only way to have surgery paid by insurance. After lots of research, I am content with RYN.

[cnocon 36]

Honestly, the two things that make a RNY more difficult, in my opinion at least, are the risks for Vitamin deficiencies and then the dumping syndrome, if for example, you eat refined sugars or dairy products and certain fats or fried foods.

The Vitamin thing is really manageable though. And if you take lots of meds already, just think of it as trading some of the medications for your obesity related conditions for a couple Vitamins each day.

And I actually WANTED dumping syndrome because I know that to change my life, I have to change my relationship with those types of foods. I doubt any of us got so heavy on lean Proteins and nutrient rich fruits and veggies alone

My surgeon said it best when he said, "With the sleeve you can still sip milkshakes until you're another hundred pounds heavier."

And to echo what others have said, the fact that you will have a better idea of what you're getting in to LONG TERM with RNY is really valuable. There just isn't enough data on the sleeve at this time to put my mind at ease, at least.

And finally, you WILL be able to eat those sweets and junk foods again after a year or two post RNY. Your body adapts and can handle things like that again with time.

I hope that helps you feel better about the RNY. I debated between the sleeve and the RNY myself for quite some time, but it was for the above reasons that I picked RNY.

Good luck in two weeks!! Let us know how it goes!

[Eva Chavez 20]

I know it is scary but I would be thanking your insurance for being responsible. Below is a copy from another post I commented on.

I would also like to add that there are other medical reasons to choose the bypass vs the sleeve. One being if you are insulin dependent and on a high dose of insulin your best choice would be the bypass. The sleeve will lower your need for insulin and you may be able to stop using it at some point with the sleeve but the bypass is the gold standard for reversing insulin dependent diabetes. The second reason for choosing the bypass over the sleeve would be for instance if you are noticing even on your liquid pre op diet you are really not losing much or if over the years you can genuinely say with a good diet and excercise the weight just seems to hold on for dear life then chances are you might be what is called insulin resistant..without necessarily being diabetic of taking insulin. If you have PCOS the bypass is definitely the route to go and here is why. The bypass has shown to do what is described as a reset on our bodies. PCOS and insulin resistant people generally speaking have an underlying metabolic disorder that may or may not be weight related.

Studies have shown that the procedure due to the rerouting triggers your body to reverse the metabolic disorder in almost all cases. Now this won't be a one size fits all type of thing but generally speaking this is the case. I am a second year surgical resident and am going to be having the bypass on the 12th. My body just refuses to shed the weight. I also have developed abnormal menses and slightly abnormal hair growth which are all signs of a metabolic disorder. This further explains why we see people 5 or 6 days post op with 20lb weight losses. The body has been reset and is now function as it should and usually with greater efficiency.

[cnocon 36]

I know it is scary but I would be thanking your insurance for being responsible. Below is a copy from another post I commented on.

I would also like to add that there are other medical reasons to choose the bypass vs the sleeve. One being if you are insulin dependent and on a high dose of insulin your best choice would be the bypass. The sleeve will lower your need for insulin and you may be able to stop using it at some point with the sleeve but the bypass is the gold standard for reversing insulin dependent diabetes. The second reason for choosing the bypass over the sleeve would be for instance if you are noticing even on your liquid pre op diet you are really not losing much or if over the years you can genuinely say with a good diet and excercise the weight just seems to hold on for dear life then chances are you might be what is called insulin resistant..without necessarily being diabetic of taking insulin. If you have PCOS the bypass is definitely the route to go and here is why. The bypass has shown to do what is described as a reset on our bodies. PCOS and insulin resistant people generally speaking have an underlying metabolic disorder that may or may not be weight related.

Studies have shown that the procedure due to the rerouting triggers your body to reverse the metabolic disorder in almost all cases. Now this won't be a one size fits all type of thing but generally speaking this is the case. I am a second year surgical resident and am going to be having the bypass on the 12th. My body just refuses to shed the weight. I also have developed abnormal menses and slightly abnormal hair growth which are all signs of a metabolic disorder. This further explains why we see people 5 or 6 days post op with 20lb weight losses. The body has been reset and is now function as it should and usually with greater efficiency.

Good info. How likely is it that a metabolic disorder is contributing to an obese persons weight problems, overall (what is the incidence)? Is it a common thing, and how might one test for something like that? Thanks!

[NikiG 113]

I know it is scary but I would be thanking your insurance for being responsible. Below is a copy from another post I commented on.

I would also like to add that there are other medical reasons to choose the bypass vs the sleeve. One being if you are insulin dependent and on a high dose of insulin your best choice would be the bypass. The sleeve will lower your need for insulin and you may be able to stop using it at some point with the sleeve but the bypass is the gold standard for reversing insulin dependent diabetes. The second reason for choosing the bypass over the sleeve would be for instance if you are noticing even on your liquid pre op diet you are really not losing much or if over the years you can genuinely say with a good diet and excercise the weight just seems to hold on for dear life then chances are you might be what is called insulin resistant..without necessarily being diabetic of taking insulin. If you have PCOS the bypass is definitely the route to go and here is why. The bypass has shown to do what is described as a reset on our bodies. PCOS and insulin resistant people generally speaking have an underlying metabolic disorder that may or may not be weight related.

Studies have shown that the procedure due to the rerouting triggers your body to reverse the metabolic disorder in almost all cases. Now this won't be a one size fits all type of thing but generally speaking this is the case. I am a second year surgical resident and am going to be having the bypass on the 12th. My body just refuses to shed the weight. I also have developed abnormal menses and slightly abnormal hair growth which are all signs of a metabolic disorder. This further explains why we see people 5 or 6 days post op with 20lb weight losses. The body has been reset and is now function as it should and usually with greater efficiency.

Great info... Thanks for sharing. The bypass is the option for me. I never considered the sleeve or band.

[rtjhouse 0]

Thanks again for all the input. I was officially approved for RNY surgery yesterday. This Monday starts the liquid diet and surgery will be the following Monday on the 10th.