Gastric Sleeve to SADI-S

[rlmontgomery1 0]

Hi folx,

My highest weight was 383 lbs in November 2020. I have sleep Apnea, Hypertension (Managed Well on Meds), Acid Reflux, Mild Hiatal Hernia, and Anomalous Right Coronary Artery.

When I had my sleeve surgery in November 2020, my BMI was 50.1. I was on a steady decline post op. I exercise, and somewhat maintain diet. I don’t overeat, but I am also not as religious as immediately following surgery.

I have a new insurance provider because of a new job and would like to consider revision to a SADI-S since the gastric sleeve part is already done. And, it’s been shown to have the best long term outcomes. I have bariatric benefits, but I would like to know what I need to do to get my insurance to cover a revision.

Also, after speaking to some medical professionals, I learned that with a BMI of 50.1, I probably should have had DS or Bypass to begin with. Why didn’t my doctor talk to me more about other options. I mean I had a great Doc. Best by far. But would have liked to had some more conversations.

I know that DS won’t fix the reflux, but I think it could help address the other things. Thoughts?

[NovaLuna 710]

Not sure what to say about how to get your insurance to cover a revision, but if you're having reflux problems then maybe have Bypass instead.

I had the Sadi-S myself, and have lucked out that my EOE didn't cause the acid issues to get worse (I have acid issues at night due to EOE a.k.a Eosinophilic Esophagitis). If you do get the Sadi-S here's some advice... 1. don't go too long without something in your stomach even if it's applesauce or fruit, etc. because if I wait to long inbetween eating my bowels decide to empty everything in them. (TMI, but you should know so you can avoid it happening to you) 2. Always take a probiotic every day because it helps with keeping you regular 3. I don't know if it's a common thing for Sadi-S or other surgeries or if it's just me... but I haven't been able to throw up since my surgery... 3 years ago (and yes, I've been sick and dry heaved for hours, but couldn't throw up). 4. having any WLS with a malabsorption factor gives you a 3% chance of developing a wheat allergy or Celiac's (I got the wheat allergy because my luck is ****). And, 5. I don't know if it's just a DS or Sadi-S thing, but there is a chance after surgery that you will vomit old blood (if this counts as vomiting then this is the only time I've thrown up since surgery. It happened three or four times while I was in the hospital after surgery. They didn't warn me and it scared the **** out of me). Anyway, yeah... I'm happy with my surgery choice, but if I'd had another chance I think I'd have gone for the original DS since it has slightly better weight loss results. I had the normal gain back you get going into your third year and straddle between 188-193 which I've been for 9 months. Also, any time you have surgery, ANY surgery, you risk the chance of health problems popping up that you would have got a little later in life. I developed Mast Cell Activation Syndrome after my WLS and it's been a b***h to deal with. I mean, technically the doctor told me she thinks I probably already had the beginnings of it before the surgery and the surgery itself just... made it progress to a more severe case (apparently they noticed a trend in people with EOE developing MCAS so it was pretty much going to happen anyway). But still. Health issues can pop up after surgery. So just be aware of it.

Hopefully everything goes well for you and sorry for the word vomit.

[Fred in Pa 236]

The first thing you need to do is call your insurance company and determine your bariatric benefits and ask for them to be sent to you in writing. At the same time, ask for their policy paper on bariatric surgery. Most insurance companies have the requirements written in detail. Ask for them to be sent to you in writing as well. This policy paper should detail the requirements to be met for a revision.

As far as the SADI-S, it is what my doctor recommended. Like you describe what “should” happen, my doctor listened to all of my issues, and explained all the procedures and recommended the SADI. Going in, I was thinking just a sleeve, but with my various metabolic issues the SADI made more sense.

If you stay with your current doctor, demand that he review the pros and cons of each revision as it relates to your specific issues. You will also find a lot of information here in this forum from others who have gone through each procedure. Read, read, read!

Good luck to you! Keep us posted on your progress.

[Native Girl 13]

Does anyone know how to rest from gastric bypass?