Jumping in

[ClareLynn 153]

I have been lurking for a while and using everyone's experience on this forum to build up the courage to do the surgery. I am nearly done with the pre-op appointments, and then I'm having a duodenal switch (the newer single kind).

I quickly ran into a big snag when I saw the pulmonologist to be cleared for surgery. He insisted that I stop my endometriosis medication (progesterone only) for 3 weeks before and a month afterwards. I have stage iv endometriosis and am disabled without the medication, can barely walk due to pain and usually end up in the ER every month. He just absolutely refused to engage with my questions about how to be smart about blood clots, and also not undo years of work to get to a level of "able to live with endo". I understand the risks of blood clots but he just wouldn't even listen to the risks if I stop either.

I spoke with my gynecologist and she thought that it was fine to be on it. She really blew me away with her support, she called that pulmonologist and got him to agree that the risks of me being off meds outweighed the blood clot risk. I nearly cried to have doctor advocate for me, especially to another doctor on my behalf.

So now I can look forward to the surgery! I am dreaming of doing it before the end of the year (since I've already hit my deductible and out of pocket max) but it's beyond a long shot probably.

Thanks everyone for sharing here on the forum, it's been a great help.

[Maroux 7]

Hi ClareLynn,

I'm so glad you got the help and the information you deserved to continue onto your journey.

Some doctors can be obnoxious and hear their voice 1st before their patients'.

Do you know anyone else with endometriosis who did the duodenal switch? This forum is so huge, you are bound to find at least one person who can share their own journey with you, with tips and all, specifically around endometriosis in this context.

Take care,

Maroux

[ClareLynn 153]

I didn't think to search for that! Hopefully it's not a big complication, my surgeon didn't even comment on it when I listed it in my medical history. I'll look around and see.

[ShoppGirl 5,024]

Happy to hear you have a good doctor who took the time to advocate for you. Fingers crossed you will get a surgery date this year.

[vikingbeast 987]

Your gyno gets a gold star. That's outstanding.

[learn2cook 592]

Finding out someone stuck up for you is so heartening! I’m so happy for you. Endo is no joke.

[ClareLynn 153]

It's been a roller coaster the past two days! 😀 They scheduled my surgery for Nov 24th, and then called back the next day saying that it will be denied by insurance if I can't provide better proof of my 3 month medically supervised diet.

I have been on a diet, medication and seeing my endocrinologist regularly for 3 years. I've lost 35 lbs total, 10 in the last couple months. The coordinator said that a letter from my doctor would be sufficient and I wouldn't need to do another diet. But now seems like whatever my doctor wrote isn't good enough. She hadn't given me calorie goals and instead we focused on the plate diet, limiting starchy carbs, filling it up with vegetables, lean meats and really really really reducing portion sizes. Also a lot of the focus was on blood sugar control since I'm on an insulin pump.

My doctor just sent more notes from my office visits, and now I'm waiting to hear back on if I can still have the surgery as scheduled. So we'll see if I have to do some 1200 calorie diet again and have the surgery pushed out until next year or not. Fingers crossed!

[ShoppGirl 5,024]

58 minutes ago, ClareLynn said:

It's been a roller coaster the past two days! 😀 They scheduled my surgery for Nov 24th, and then called back the next day saying that it will be denied by insurance if I can't provide better proof of my 3 month medically supervised diet.

I have been on a diet, medication and seeing my endocrinologist regularly for 3 years. I've lost 35 lbs total, 10 in the last couple months. The coordinator said that a letter from my doctor would be sufficient and I wouldn't need to do another diet. But now seems like whatever my doctor wrote isn't good enough. She hadn't given me calorie goals and instead we focused on the plate diet, limiting starchy carbs, filling it up with vegetables, lean meats and really really really reducing portion sizes. Also a lot of the focus was on blood sugar control since I'm on an insulin pump.

My doctor just sent more notes from my office visits, and now I'm waiting to hear back on if I can still have the surgery as scheduled. So we'll see if I have to do some 1200 calorie diet again and have the surgery pushed out until next year or not. Fingers crossed!

My fingers are crossed as well tbat it goes your way. If it does jim get pushed out though try to think of it as a chance to practice some of your post op behaviors beforehand. Many people on here have had to wait longer than they hoped and took the opportunity to lose a little weight and better prepare for post surgery. It’s a marathon not a sprint. Still crossing them that it’s sooner than later though.

[ClareLynn 153]

I'm prepared to do another diet (and this time have it documented the way insurance requires) as it seems like my doctor didn't document everything the way insurance wants it. It's a huge disappointment because now instead of the surgery being literally free (I've hit my out of pocket this year), I'll have to pay $5,000 since this pushes it out to next year.

My diet from this doctor has been working well. I've lost another 5 lbs, and am down a total of 40lbs. It's really too bad that we didn't realize what needed to be written down in the office notes so that the diet would count.😫

I wonder if insurance will get upset if I am successful with this second diet? I hope they go off my starting weight and not whatever I weigh immediately before surgery.

[vikingbeast 987]

15 minutes ago, ClareLynn said:

I'm prepared to do another diet (and this time have it documented the way insurance requires) as it seems like my doctor didn't document everything the way insurance wants it. It's a huge disappointment because now instead of the surgery being literally free (I've hit my out of pocket this year), I'll have to pay $5,000 since this pushes it out to next year.

My diet from this doctor has been working well. I've lost another 5 lbs, and am down a total of 40lbs. It's really too bad that we didn't realize what needed to be written down in the office notes so that the diet would count.😫

I wonder if insurance will get upset if I am successful with this second diet? I hope they go off my starting weight and not whatever I weigh immediately before surgery.

As long as you qualify for surgery by your insurance's rules (usually BMI>40 or BMI>35+comorbidities) at the time your bariatric center applies for authorization, you should be good to go.

[ClareLynn 153]

Thanks, that's a relief! Hah, not like I don't want to lose weight or anything but I wasn't sure about the timing of it all.

[ClareLynn 153]

I am still waiting to know if insurance will pay for the surgery, but I have started the pre-op diet, done all the last minute pre-op tests. The office said that they are confident it will be approved but it takes time. 🤷‍♀️ Or maybe it’s been approved and no one told me.

My short term disability / fmla leave was approved though!

After 2 days on the 700 calorie low carb (30g) liquid diet, I am completely off my insulin. Makes me wonder why I haven’t just been living off of Protein Shakes since I seem to do so well with them! 😅

[ClareLynn 153]

I am 12 days post-op! Insurance ended up approving the surgery, they just took their sweet time about it. I’m so glad that my doctors wrote extra letters and went above and beyond so that I could have the surgery safely.

I have lost 13lbs since the surgery for a total of 64lbs down from my highest weight. 100-ish more to go!

I’m also glad that I took short term disability and did the full 5 weeks my surgeon recommended. I didn’t honestly understand just how impacted I’d be by the surgery and it’s comforting to know that I don’t need to magically get better in time to go back to work.