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I hate insurance companies. Yours seem to want you to become Sherlock Holmes, a Bariatric surgeon, a contract Lawyer and then draw venn diagrams to figure this out. It appears that this means that only Roux en Y gastric bypass with a roux limb longer than 100 cm is allowed under your benefits plans IF you fall into the category of morbid obesity. It outright excludes the antiquated vertical banded gastroplasty (stomach stapling) and short limb Roux en Y by name. You will have to look at the materials it says to refer to and find examples or call and ask for clarification on accepted procedures, but get it in writing. It seems that no gastric restrictive procedures are covered unless they are also malabsorptive. So your choice would have to be a Roux en Y gastric bypass with a roux limb longer than 100 cm and your BMI classifies you as morbidly obese in order for it to be covered. You will have to pay for every other procedure (Vertical sleeve gastrectomy, Lapband, ESG, *maybe* mini RNY, and *maybe* DS/SIPS but the language is not clear on the last 2) Below is a link to various types of Bariatric surgeries perfomed. Hope this helps ♥️ https://asmbs.org/patients/bariatric-surgery-procedures
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Finally starting to feel human again. It was such a struggle in the beginning. My colon does not like anesthesia. So much abdominal cramping and bloating! I was so upset thinking made the wrong decision. I watched a lot of YouTubes of other gastric bypass journeys and I never found one that mentioned the soreness and abdominal discomfort. So happy now that I'm feeling so much better now. I now know I did not make a mistake. Still struggling to reach my water and protein numbers on a daily basis. But I know I'm close. So glad I found this support group as it is difficult to go through this alone. Sent from my Moto Z (2) using BariatricPal mobile app
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This is just the Rider making a change about Gastric Bypass. Where is the original policy language that talks about bariatric surgery? There should be more information there to make this more clear. (I used to be an insurance adjuster).
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Wow, they probably could have put in a bit more effort to make that more clear. Though at first read, I get the impression RnY for morbid obesity is NOT covered. The first bullet seems to eliminate all procedures that aren't bypass or sleeve. The second bullet seems to eliminate bybass specifically (but not sleeve?). Can you post the list of what IS covered? As in "all other provisions as described in your Benefits Provision", and you can do a process of elimination.... P.S. btw I find it weird that the call centre can't just tell you if bypass is covered or not!!!
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Hi, I'm located in NYC. I'm 25 years old and considering lap band surgery at NYU. I am 5'4 and 260 pounds. While about 75% of me is for the surgery i still do have concerns that hopefully some of you can inform me on. I was wondering how many of you have had the surgery and had loose skin afterwards? I've read that the younger you are the less likely you are to have loose skin . I've also read that because the lap band doesn't make you loose weight as fast as the sleeve or bypass, another reason why i many not have loose skin. But i wanted to know how common it is with the lapband. Secondly, how many people have had this surgery within the last 2-3 years and have complications? I've been told that the newer lapbands are causing less complications in comparison to the older ones.
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Nov 2020 Bypass Peeps?
TrueNorth1 replied to Lanie Hardy's topic in PRE-Operation Weight Loss Surgery Q&A
There is the sleeve which I believe you are getting? Its slicing the stomach to make it smaller but no bypassing. Then there is the Gastric Bypass. This is surgery that makes your stomach smaller and also bypasses parts of your stomach and small intestine. Then there is a mini gastric bypass. This is the similar to the gastric bypass but involves less intestinal rerouting and the surgery is shorter. It is also reversible. I don't think Insurance companies cover this one yet. -
Nov 2020 Bypass Peeps?
TrueNorth1 replied to Lanie Hardy's topic in PRE-Operation Weight Loss Surgery Q&A
Hi Lynn and happy new year! You certainly have to be comfortable with the surgery. You need to weigh out the pros and cons. It is generally for people that are obese or morbidly obese and have been for a while. Those that cant get off the weight or yo-yo. Those that have health issues. As we know, there are major health issues of being severely overweight. With the surgery, you will lose weight, but if you push overeating and you continue to eat high fat and high sugar foods, you will eventually gain the weight back. It will take a while but you will. That is in your control. As for pain, the sleeve will be less painful than the full gastric bypass. I had the mini gastric bypass and I had no real pain. Some gas pain that was uncomfortable but no pain. I didn't have to take pain medication. I had it done on a Thursday and was working on Tuesday (desk job at home). I was doing laundry and walking around the house on the Saturday and Sunday - also trying to keep moving (it relieves the gas) and it was no problem. The only thing I would not do is lift anything heavy. Or bend with my stomach (I would bend with a squat) as not to put any pressure on the surgery site. I had the mini gastric bypass done in November 2020 and was also wondering if I should get it done. I did not qualify for insurance as my BMI was too low and I do not have any other health issues, so I had to pay for mine personally. I had a lap band that I needed removed so I had to make the call if I do a revision to mini gastric bypass or try weight loss on my own. At that time, I had already gained almost 30 pounds from my lowest with the band (I had the band in 2009 so it was 10 years). I tried and tried to loose weight on my own. I would loose 10 then gain it back. I never came close to losing 30. So, I did the surgery and I am happy. I am down 23 pounds in just a little over 6 weeks and I could never do that on my own. I want to lose a total of 60 pounds so I am 1/3 of the way there in 6 weeks. It may slow down but I am ok with it. Now, am I eating wings, nachos, pizza, burgers, fries, cake, cookies? Nope. Will I try these at some point? Yes. Just like any diet, as you see the results, its somewhat easy to be "good". I have had crackers, flavored rice cakes, bananas, salted almonds, carrots, turnip, butternut squash soup, etc and lost weight. When I hit a plateau ( recently) I went low cal and low carb and pushed through. So, you control your weight loss. The surgery just makes it easier to do that! -
What's a mini bypass?
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Hey ya'll, so i am almost 2 months post op, i had this surgery because my boyfriend and i want a baby! i plan on waiting the 12 months as directed by my surgeon, but i would LOVE to hear some success stories, and would love to know your starting weight and the weight you were when you found out you are pregnant, thank you in advance! and baby dust to all who are still trying!
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Hello. I’m new to the group. I had my gastric bypass on 12/15/20. I am currently experiencing some tightness only in the left middle quadrant. When I press on the area, it sort of feels hard. I’m not having any pain. I know that this is the area where work was performed but I’m just concerned. Has anyone else experienced this? Is this normal?
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College Student - Gastric Bypass during semester?
Suzi_the_Q replied to Overt28's topic in PRE-Operation Weight Loss Surgery Q&A
I just had my bypass last Tuesday and honestly I think you'll be ok. Yes, there is more fatigue, but you only sleep constantly for the first few days. You still sleep more (or at least I do) thereafter, but I'm up and able to focus etc. Your mileage will vary of course. Good luck! -
Weight regain...I don't know where to start.
jearl75 replied to Ann Parde's topic in WLS Veteran's Forum
I’m in a similar situation as the op. 8 years post op and almost back to starting weight. Looking at a revision possibly -
RNY because of GERD, not weight loss?
Rusnj1 replied to AmandaQB's topic in Gastric Bypass Surgery Forums
Hi, I am on the same road. Gerd with Barrett’s Esopighus condition. Belching and acid reflux are common. I also have Hypothyroid. Got my Gastric Sleeve done in 2017 along with fixing of Hiatal Hernia. I was well for a year and half and then everything returned. I gained all my weight back, belching and gastric attacks became an everyday occurance. Went in for 2nd Hernia repair in 2019. My surgeon said he stitched my Esophegus to small size as it had grown too big/wide. That did not help at all. Early this year I had COVID and the side effect is getting out of breath too soon. Shortness of breath along with a gastric/belching attack, this was making my life hell and my insurance suggested that I go for Gastric Bypass. After weighing the pro/cons and consulting 3 surgeons, I went ahead and had my Gastric Bypass done on 12/23/2020. I am 10 days out of surgery, and don’t have trouble keeping liquids down. I am at 45-48ozs of liquid a day only. Do get nausea without eating/drinking anything. Zofron really helps. I have lost only 6lbs of weight in 10 days. Is it normal. Would appreciate any and all support. Thank you all. -
College Student - Gastric Bypass during semester?
Overt28 posted a topic in PRE-Operation Weight Loss Surgery Q&A
Hi, I've been preparing to have laparoscopic gastric bypass surgery for a few months now. My plan has been to go to school part time (only taking two classes; Linear Algebra and Data Structures) this coming spring semester (starting in a couple weeks) , and have the surgery during the semester, probably in February. With Covid-19, being in school after the surgery won't require much physical activity on my part; just sitting in my apartment at a computer desk, writing math problems or doing work on a computer. But it occurred to me recently that I really have no idea how I'm going to feel after the surgery. If I'm always going to be tired and unable to focus, that could be a problem, because I can't just not study and do homework for two weeks straight. Would any of you be able to tell me how you felt after your surgeries? Do you think you could handle beginning to study at home again a few days after surgery? Thanks, Dan -
Sleeve to...? Revision seeker
cyndeelouwho replied to redhead_che's topic in Revision Weight Loss Surgery Forums (NEW!)
Could someone who has had the DS Loop tell me about this? I had a gastric bypass in 1980, due to regain I want to get a revision. I'm not sure what kind of surgery is possible after so long. I know I have a lot of scar tissue built up. I don't know if anything can be done. If anyone else has had this please let me know thank you in advance. Sent from my SM-G965U using BariatricPal mobile app -
Yea- I tend to do too much homework on everything. When it comes to a major decision like surgery - it makes sense but it is just my personality to research all of my decisions. When I started looking into surgery - I was thinking that I wanted the sleeve as well. The more I learned, and with my other conditions.. Well - feels like each day I switch from leaning to the gastric bypass to the duodenal. Side note- this forum, and YOU, have made my weekend! I found myself today looking forward to jumping online to come here.
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Terrible pulling and burning pain near incision
lynmcg posted a topic in Gastric Bypass Surgery Forums
Had gastric bypass on 12/14 due to acid reflux, was sleeved in 2013. This time around it’s been an incredibly tuff recovery and I was wondering if anyone has experienced the pulling and burning pain near your biggest incision area? Not sure what’s happening this time around because I never experienced this before. 😕 -
Sleeve after lap band complications
Heather RN Chambers replied to Heather RN Chambers's topic in Gastric Sleeve Surgery Forums
Thank you so much. I struggle with GERD as well. I’ve been flip flopping between the sleeve and mini bypass. I am from Nacogdoches, Tx. I appreciate hearing your story. -
Looks like you have done your research! That's great that you found a clinic you like close to home. Which way are you leaning for the type of surgery to have? No matter what the surgeon says, it is ultimately your decision. I actually went into my consultation leaning toward the sleeve, but my surgeon recommended gastric bypass and I ended up going with that. I never really considered duodenal switch because not many surgeons even do it, but I have since realized that it is more common than I thought.
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Absolutely surreal to be posting this as I have read so many of these threads! I didn’t think the day would ever come! Excited and petrified. My date is 2/22/21!! Any February 2021 bypassers out there? I would love to connect and share prep plans and how things go after surgery.
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Thank you! It’s was July 2018. Are you sleeve or bypass?
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RNY because of GERD, not weight loss?
Alexandra* replied to AmandaQB's topic in Gastric Bypass Surgery Forums
Hi my name is Alexandra, I had Gastric Bypass Surgery on 11/18/2018 due to GIRDS which caused Barrett's Esophagus. I started this road back in 2017 after many years of having food becoming stuck in my damaged swollen esophagus. It would just stop moving down and with each bite would back up further and further up my throat until I was in so much pain and had to stop eating and wait for 20 - 30 minutes until the food at the bottom would finally slide into my stomach. The pain as that food sat there stretching my already swollen damaged and inflamed esophagus was intense. The GIRDS that had gone on undetected for years had caused my esophagus lining to wallpaper itself with intestinal cells as to protect itself from the stomach acid, this is called Barrett's Esophagus. They told me that if it continued to do so I would end up with cancer. So I went ahead and had the surgery, and at that time I weighed 222 and at 5'7" which was right on the borderline of being able to qualify for surgery under my health insurance guidelines. Today I struggle to keep my weight at 127 and belch constantly after eating, for 15 to 20 minutes, and I mean constantly like every 4 to 5 seconds. Food still gets stuck in my esophagus on occasion but it is usually due to eating too fast and not chewing my bites enough. Sugar is another thing that causes me a great deal of pain with the dreaded "dumping syndrome" and I constantly have diarrhea everyday but I have had that for over 10 years. That started with a bad case of giardia that sent me to the ER and even though I have been tested for giardia many times since then the diarrhea is a constant in my life and makes it very difficult to go to work. But I'm happy to be able to tell you that my esophagus has returned to normal cells that make up the lining so no more threat of cancer at this point. Three weeks after my Roux-en-Y surgery my gallbladder was functioning at 10% so back to surgery I went and with one surgery after another so close together the road to recovery was long. But that is my long story to answer your question about GIRDS -
Pre-op question
Heather RN Chambers replied to Heather RN Chambers's topic in Gastric Bypass Surgery Forums
Thank you! I literally just asked another question on this forum to the bypass group if they could get the mini vs the RNY would they and why. I appreciate this. I hate to hear that this is limited in the states though. I really don’t want to travel outside fir my procedure due to my history of prior complications. -
I’m a previous lap-band patient gone haywire, thus causing it to be removed several years ago so I’m larger now than when I had it placed. I’m going to have surgery. Researching options and costs right now. How many of you would recommend the mini bypass? If so, why and is there a difference in percentage of weight lost and cost? I know that it has less chance of surgical complications. Thanks in advance.
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Thank you Sue! Luckily I found a clinic in WA. There is a team of surgeons and they offer the sleeve, SIPS, Duodenal Switch, RNY Gastric Bypass and a mini gastric bypass. I have been doing a lot of reading and research and since I am on blood pressure meds, and have pre-diabetes along with watching my cholesterol ... per the phone conversation with the clinics staff they said that the RNY and DDS (duodenal switch) are probably good options but that it will be looked at more closely when I have my in person consultation. I looked at the Mexico options, but I feel more comfortable having a clinic that I can get to in a matter of a couple of hours drive in case I need it. Happy 2021!
