Surgery for illness instead of weight loss - Gastroparesis

[Chellesy 3]

Hello, everyone. I'm new here and just starting the WLS journey.

I am curious if anyone here has had the gastric bypass surgery for anything other than weight loss? I have a chronic condition called Gastroparesis (paralysis of the stomach) and it has turned my life upside down. I won't go into the details or symptoms (cause there's a lot), but suffice it to say it is pretty awful, greatly affected motility and slowly killing me. I am also overweight, just shy of the 40 BMI mark. Weight loss would be an added bonus, but not my sole reason for looking into this. My PCP wanted me to speak to a bariatric surgeon to see if a bypass would help since it bypasses the paralyzed, useless part of my stomach. I have a consultation tomorrow.

I'm also wondering if this (medical, not weight management) might make the process go any quicker? I know you basically have several tests, speak to a psychologist, and diet, etc. Just wondering if anyone has gone through this for a different medical reason. Hope that makes some sense.

Edited June 12, 2019 by Chellesy
added more info

[toodlerue 433]

I had a RNY because of a previous failed surgery (10 years ago) to correct my L shaped esophagus. 1/2 of my stomach was above my diaphragm. food was getting stuck just about every day. My BMI was about 34.

I didn't have to do any of the pre-op things that people with high BMI’s have to do. My doctor wasn’t a WLS surgeon. He was a thoracic surgeon & told me to find all of my info on the internet.

After I decided I wanted to do the surgery it was only 2 months til I had it.

I spoke with a nurse and a nutritionist through my insurance (Cigna) several times before & after my surgery.

I am 13 months out from my surgery. I have lost 65 lbs. I would like to loose 5 more to get me to the top end of a healthy BMI for my height.

The weight has dropped pretty easily & I know it’s gotta be exercise that takes off the last 5. I also know I would not have lost 65 lbs on my own. Now I just got to keep it off & that scares me

Good luck in whatever you decide to do.

[GreenTealael 24,906]

1 hour ago, Chellesy said:

I'm also wondering if this (medical, not weight management) might make the process go any quicker? I know you basically have several tests, speak to a psychologist, and diet, etc. Just wondering if anyone has gone through this for a different medical reason. Hope that makes some sense.

That depends entirely on your sugeon and insurance.

1 hour ago, Chellesy said:

I am also overweight, just shy of the 40 BMI mark. Weight loss would be an added bonus, but not my sole reason for looking into this

At a BMI of almost 40 you are considered obese not overweight. Whether you have it for one reason or another, weight and BMI will be used in your file and hard to ignore by a Bariatric surgeon.

But this may be to your advantage when trying to get approval from insurance. You'll want as many co morbidites (contributing factors) as possible so you can't be denied.

Self pay is a different set of rules and time lines.

Hopefully both health concerns can be resolved.

Good luck 💙

[Chellesy 3]

1 hour ago, GreenTealael said:

That depends entirely on your sugeon and insurance.

At a BMI of almost 40 you are considered obese not overweight. Whether you have it for one reason or another, weight and BMI will be used in your file and hard to ignore by a Bariatric surgeon.

But this may be to your advantage when trying to get approval from insurance. You'll want as many co morbidites (contributing factors) as possible so you can't be denied.

Self pay is a different set of rules and time lines.

Hopefully both health concerns can be resolved.

Good luck 💙

Thank you, GreenTealael. This gives me hope!

[Chellesy 3]

1 hour ago, toodlerue said:

I had a RNY because of a previous failed surgery (10 years ago) to correct my L shaped esophagus. 1/2 of my stomach was above my diaphragm. food was getting stuck just about every day. My BMI was about 34.

I didn't have to do any of the pre-op things that people with high BMI’s have to do. My doctor wasn’t a WLS surgeon. He was a thoracic surgeon & told me to find all of my info on the internet.

After I decided I wanted to do the surgery it was only 2 months til I had it.

Oh wow, that sucks, toodlerue! I'm so glad you were able to have the surgery. As GreenTealael said, I have more than one problem.. hadn't really gave that much thought but she is so right... so I'm hopeful he'll get to me quickly and fix me. I realize there's going to be a lot of discipline, etc... but I'm up for it. I already have to have a lot of it just for the Gastroparesis.

[RickM 1,747]

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.....

[vovo2013 35]

I had a RNY because of a previous failed surgery (10 years ago) to correct my L shaped esophagus. 1/2 of my stomach was above my diaphragm. food was getting stuck just about every day. My BMI was about 34.
I didn't have to do any of the pre-op things that people with high BMI’s have to do. My doctor wasn’t a WLS surgeon. He was a thoracic surgeon & told me to find all of my info on the internet.
After I decided I wanted to do the surgery it was only 2 months til I had it.
I spoke with a nurse and a nutritionist through my insurance (Cigna) several times before & after my surgery.
I am 13 months out from my surgery. I have lost 65 lbs. I would like to loose 5 more to get me to the top end of a healthy BMI for my height.
The weight has dropped pretty easily & I know it’s gotta be exercise that takes off the last 5. I also know I would not have lost 65 lbs on my own. Now I just got to keep it off & that scares me
Good luck in whatever you decide to do.

I have Cigna 2 and not doing it for weight loss but for gastroparesis and GERD. I though I was the only one on here not doing it for weight loss. Gastro Family...

Sent from my SM-G973U using BariatricPal mobile app

[Chellesy 3]

2 hours ago, RickM said:

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.

RickM, thank you so much for such a in depth response. I really appreciate it. I had no idea there was even a choice of length for the limb. I will certainly discuss all of this with my surgeon tomorrow. And really, I already have issues with bile reflux thanks to the GP, so I'm used to it.