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Sleeve to DS/RNY revision
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I have not been here in quite some time so Iittle update -background. I was sleeved 12/27/17. Starting weight was 256, I managed to lose 61 pounds and got to a low of 195, ( this was May of 2019)then I started to regain. I refocused, got back on the right eating plan/exercise but continued to gain weight. Went to see the nutritionist last fall for help. We went over my food logs and by the numbers I was a little low in calories for the amount of exercise I was doing so we adjusted my plan but still no weight loss. I was 242 in Jan/Feb. I was prescribed the generic form of Contrave in March for a 3 month trial, managed to lose all of 5 pounds down to 237. Labs have been decent- except now I developed high cholesterol and my primary prescribed Atorvastin(Lipitor) and I have been on that since May. I consistently tell the dietician that I feel no restriction and can eat way more than I think I should. However in all this time, not once have I had a scope to check to see if my pouch has been stretched out. My primary thinks I am eating to much, the nutritionist thinks I'm not eating enough so I'm just trying to eat enough protein and stay low on the carbs. I have gone as low as 900 calories and as high as 1500. carbs as low as 20 and high as 75. All of that to say I found out my original surgeon does not believe in performing revisions so I have a consultation in 2 weeks with a surgeon that does perform revisions just so I can get answers. I still have sleep apnea, that has improved some but not enough for me to come off my CPAP. Recently I have had mild cases of heartburn late at night so I have altered my diet again, cutting out dairy, coffee, spicy foods to see what could be triggering it. I did intermittent fasting in July of just watermelon and water and managed to get down to 224. I know this was not healthy but hey I was willing to try anything. So all of that to say, with my weight as it is now, my BMI is 36. I meet insurance requirements for BMI with my sleep apnea as comorbidity but the surgeon must find it medically necessary for revision- but if surgeon requires weight loss and lose weight that puts my BMI under requirements, would insurance deny the revision?