Lightweight DS

[katie]

Hey guys! I'm new to the board (and to WLS in general). I just completed my 6 month diet and am almost done with all of my pre surgery clearances (endocrinology, pulmonary, psychology, cardiology) and then I will get a referral to see a surgeon. I have Health Net HMO and the surgeon my medical group uses is Dr. Suh in Murrieta.

I was just wondering if anyone had any information on lightweights getting approved for a DS with Health Net. My BMI is 37 and I have pre-diabetes, PCOS (insulin resistance) and urinary stress incontinence.

The more research I do on the DS, the more I want it. I just keep reading that it's for people with a BMI over 50. I'd really appreciate any help.

Thanks,
Katie

[Deleted]

Katie, as long as your insurance company does the DS as the list of surgeries and you are approved for surgery, you can get the DS...now remember, you have to be diligent the rest of your life...this surgery is not for those who want the surgeon to "fix" their innards and then not get fluids, protein, vitamins...those are a critical part of the rest of your life.

I was a BMI of 35.2 when I signed in to my surgeon, and have done very well with the DS.

Liz

[trxxyy]

I am a lightweight and was a bmi of 37/38 but with chronic hypertension and insulin resistance as my co-morbs. I was approved by Anthem BC and I had my surgery last April with Dr. Keshishian.

Check out dsfacts.com for a lot of great information on the DS procedure and the DS lifestyle. I have not heard of Dr. Suh being a vetted DS surgeon, as of now there are 2 vetted DS surgeons in Southern California, Dr. Keshishian and Dr. Crookes. There is also Dr. Belzberg with So. Cal. Kaiser but he is not considered a vetted surgeon by the typical DS standards.

Just make sure and do a lot of research about the DS and the surgeon you choose, especially their experience performing the DS.

[sherbearmama]

I had a bmi of 39 and then lost weight before surgery and had a bmi of 38 and still got it. I'm 5ft5 and weighed 228 on my surgery date.

[baileymouse]

The Ds is the best choice for those with insulin resistance/pcos, hands down. I was a lightweight when I had my revision, and had no trouble getting approved for the DS with Horizon BCBS NJ.

[sherbearmama]

I too have PCOS-insulin resistance and am/was diabetic.

[Sandra C.]

Hi Katie,
I was a light weight, BMI in the high 30's with hip arthritis and knee pain comorbidity and a few others like swelling painful legs with blood clot risk while flying, and hypothyroid. No problem being approved by BCBS of Mi. I did a lot of the investigation of the list needed for approval by calling my insurance with the code numbers from the Dr's billing office. My Doc said the insurance co's are planning on lowering the BMI for these surgeries soon. My D.S. choice was approved for me by my surgeon, after I demonstrated to him why it was the best one for me. I really talked him into it with my positive attitude about being a well organized, able to research resources on line to be fully educated, positive person. He liked my ability to take charge of the changes in my body, and lifestyle modifications the surgery would be throwing my way instantly post surgery. A lot had to do with attitude. I sold him on the idea it was the best surgery for me. His nurses told me they knew I would succeed with all my preparations and organizational skills. I compiled a notebook with sections for insurance, pre and post surgery diet/food plans, exercise importance, diagrams and explanations of the surgery, why the other surgeries were not good for my lifestyle, vitamins and supplements necessary from now on and many more. I brought the notebook to all my pre surgery meetings and check-ups. No one took the time to look in the book, but remarked about it, as being a sign I could do this with my preparation skills. Each insurance has different restrictions and long lists of things to qualify with. Your doc can help with ideas for qualifying knowing your current state of health. Start with an appointment with him/her. A call from you is the best way to have the insurance requirement list for reference, and to speed up your doctors office with approval information. Don't wait for them to do all this for you if you are as impatient as I was to get started. I gave the office my insurance qualifications. Make your calls, and get the ball rolling!! Any other questions, just ask. ;-) Sandra

[Deleted]

I am a lightweight who had a DS. You need to see if the surgeon you want to use will perform a DS on a lightweight person. I had to travel to New York to have my surgery.

Best of luck to you. You are in for one heck of a ride.

[katie]

Thank you so much everyone for all of your replies. I definetly have more research to do, but I really feel like this could be a good option for me.

I'm so thankful for all the amazing people on here who are willing to give their advice! I'll keep ya posted on my DS journey... I'm glad to hear lightweights can get it, I was worried about that!!!

Thanks!
Katie

[actiongirl]

I am also in this lightweight range with a 38 BMI, with insulin resistance, asthma, and GERD. I am considering between the DS and VSG. I'm concerned the DS is "overkill" for my situation, but I also don't want to face a possible revision in a couple years wondering what went wrong.

[Paula]

*sigh* I wish I was a lightweight DS patient.

Ive heard its a particularly good surgery for people with a BMI over 50, but havent seen anything that sets a limit at it. Its not like there is a "you must be this fat to ride this ride" kinda thing

I do know it has great results as far as Type 2 diabetes resolution goes, so I can imagine it would probably do wonders to take you out of your pre-diabetic state. If its a surgery you feel is going to be the best one for you and you have researched all it entails, then by all means you should consult with the surgeon of your choice (or one who your insurance chooses for you) and see what comes from that.

I wish you the best of luck in your journey. Best piece of advice I can give to both you and actiongirl is to "think twice, cut once." Make the decision you feel is the best one FOR YOU

[sherbearmama]

Dec 26, 2011 22:05:19 GMT -5 actiongirl said:

I am also in this lightweight range with a 38 BMI, with insulin resistance, asthma, and GERD. I am considering between the DS and VSG. I'm concerned the DS is "overkill" for my situation, but I also don't want to face a possible revision in a couple years wondering what went wrong.

With the insulin resistance, I'd just be worried about Diabetes down the road. The VSG doesn't have all that much affect on insulin resistance or Diabetes because there is no malabsorption. Also, the DS forces you to live a high protein low carb lifestyle (or you'll get sick AND you'll gain weight) whereas you're able to eat the carbs with the VSG and could definitely end up with Diabetes (and gaining back the weight).

It's a really tough decision and it sounds like you're doing your research. The DS isn't for everyone but I wouldn't consider it "overkill". It's just a far greater commitment than the other surgeries.

Good luck to you!!!!
Cheers,
Sheri ;D

[wanttolose]

I am hesitating too between VSG and DS. I can tell you what my surgeon said to me. He said the DS works best with an obsessive-compulsive personality type. He said it would make me too thin. He said the difference in diabetes and PCOS resolution between the VSG and the DS is 10% in favour of the DS. This was also something that another member has said to me in another post on another board. My surgeon does the DS so it is not a case of a surgeon not recommending a surgery he cannot perform. It is Dr Gagner, pretty much one of the best from all accounts. I have a BMI of about 38 now and have 80 lbs to lose.
This having been said, I am still not 100% sure. I cannot ignore the experiences of those who have had the DS and the VSG and yes, it is not an easy decision. I would also not like to be a revision candidate. OTOH my work and lifestyle may not be optimal for the DS.
Good luck to you in your decision making.

[Seeking Healthy]

I was an "underweight" when I had my DS. But mine was due to medical reason, obviously. I am not suffering any ill effects do to my low weight and the DS surgery. If anything, I weight more then I want to now.

I have read some posts where some surgeons will not perform a DS unless your BMI is 50 or over. Some surgeons seem to be changing their criteria on this requirement. Unfortunately there are so few DS surgeons so you may have to look a bit. Like others have noted, if your insurance allows the DS procedure then there is a good chance you can fight it and win if this is a reason they state for non approval.

You are fortunate to have legal know how here on this site who has helped others win insurance battles. Diana Cox is a wealth of knowledge in these matters.
SH