|
Post by kyal on Aug 16, 2013 10:23:56 GMT -5
I know he has done many DS's in Australia though. Bullshit. No one wants to touch the DS in AU apart from two surgeons. Fielding is a band buddy. Plain and simple.
|
|
|
Post by newyorkbitch on Aug 16, 2013 10:34:58 GMT -5
Dr. Herron participates in United Healthcare HMO - but of course you need to call to make sure your particular HMO works there. Go see him. He's terrific.
If he's on your insurance and he's willing to work with you - you'd be nuts to choose Fielding over Herron.
And I echo what other people are saying - put the WLS aside for now. Deal with the GERD, the hernia.....get those issues taken care of and THEN you will see if WLS is indicated, which type, etc. If Herron thinks that RNY needs to happen in order to deal with the GERD, that's a discussion to have.
|
|
|
Post by newyorkbitch on Aug 16, 2013 10:37:21 GMT -5
Dakin and Pomp only participated in United Healthcare Medicare -not the regular HMO
|
|
|
Post by Girlrocker on Aug 16, 2013 10:48:49 GMT -5
Why are you looking at your BMI dropping as a BAD thing? If I had a BMI <40 and never needed WLS, I would have been ecstatic! No one WANTS to be at the point of needing surgery. You have to question your own motivations. If I remember correctly, because his insurance has a stipulation about what BMI he has to be at to qualify for bariatric surgery? nyuboi, I really hope you will step back and analyze your situation, relieved to see you acknowledge you're a bit lost right now, Paula really nailed it. And maybe think about some booster counseling to see you through this time.
|
|
|
Post by debathajane on Aug 16, 2013 11:49:10 GMT -5
You don't need to justify your reasons for which surgery you want or which surgeon. I think you have made an exhaustive case, had tons of feedback from the vets, had this information repeated and repeated. Just make your decision and be done, just like the rest of us had to do.
|
|
|
Post by nyuboi on Aug 17, 2013 1:37:25 GMT -5
Dakin and Pomp only participated in United Healthcare Medicare -not the regular HMO Thank you for helping with the insurance stuff. I will make calls on Monday.
|
|
|
Post by Paula on Aug 18, 2013 16:22:56 GMT -5
You're right about this. I know I am not seeing the big picture. I am just so sick of waiting on the WLS. :/ I'll think about this. Again though, what if my BMI drops? I am positive on wanting WLS, positive. What I am not positive about is an RNY over a DS, which brings me to agreeing with you: ** The major advantage to doing what you say is that I might be a better candidate for a DS if my acid reflux goes away with the hernia repair, instead of rushing into the RNY just because I know its the safest with my current situation. ** Paul, you spend so much time focused on a BMI number. Is that what is driving your decision? I know you said something about insurance and BMI. But your insurance and your BMI should not be the deciding factor for a surgery. You yourself have said you aren't sure about the RNY. Sweetie, THAT right there is the ultimate deciding factor. I hope you take your own rational thinking to mind. The advantage might be to see how the hernia repair changes things and then reexamine your WLS options. That way, you'd know better what your body post-hernia would be like. And you could see if you could have the surgery you want instead of the only choice being offered to you in New York. Im not trying in the least to talk you out of surgery. Id just like to see you have all of your options available to make the decision. This is totally your life and 100% your decision. I want for you to see if you can get what you really want. Not the only choice you are being offered given a condition that MIGHT change if you got the hernia repaired. The only reason I say what I say is because your words over time on the board remind me of myself in many ways. And I know, based on 12 years of living with it, that the RNY was not the right surgery for me. I've got no skin in your game and no dog in your fight, so my words should always be taken with that in mind.
|
|
|
Post by nyuboi on Aug 19, 2013 0:35:29 GMT -5
You're right about this. I know I am not seeing the big picture. I am just so sick of waiting on the WLS. :/ I'll think about this. Again though, what if my BMI drops? I am positive on wanting WLS, positive. What I am not positive about is an RNY over a DS, which brings me to agreeing with you: ** The major advantage to doing what you say is that I might be a better candidate for a DS if my acid reflux goes away with the hernia repair, instead of rushing into the RNY just because I know its the safest with my current situation. ** Paul, you spend so much time focused on a BMI number. Is that what is driving your decision? I know you said something about insurance and BMI. But your insurance and your BMI should not be the deciding factor for a surgery. You yourself have said you aren't sure about the RNY. Sweetie, THAT right there is the ultimate deciding factor. I hope you take your own rational thinking to mind. The advantage might be to see how the hernia repair changes things and then reexamine your WLS options. That way, you'd know better what your body post-hernia would be like. And you could see if you could have the surgery you want instead of the only choice being offered to you in New York. Im not trying in the least to talk you out of surgery. Id just like to see you have all of your options available to make the decision. This is totally your life and 100% your decision. I want for you to see if you can get what you really want. Not the only choice you are being offered given a condition that MIGHT change if you got the hernia repaired. The only reason I say what I say is because your words over time on the board remind me of myself in many ways. And I know, based on 12 years of living with it, that the RNY was not the right surgery for me. I've got no skin in your game and no dog in your fight, so my words should always be taken with that in mind. Hey Paula, thank you for the feedback and nice words. It's not just the BMI -- its being 100 pounds overweight with health problems. I wanted the DS a year ago and waited. I don't want to put this off too long. I am positive I will be having WLS one way or another. Positive. 100%. My sleep apnea has become severe, asthma is bad, and I cant put my shoes on without losing my breath. The CPAP machine doesn't even have my level of oxygen, so they switched my machine to a BPAP. The DS is being offered to me in New York, in response. Just so Im clear, I do have the option of getting it here and now. The major advantage in waiting, as you said, is I can see if my GERD is better post-hernia repair -- and then I would be a better candidate for the DS, instead of rushing into the RNY.
|
|
|
Post by nyuboi on Aug 19, 2013 0:47:24 GMT -5
Why are you looking at your BMI dropping as a BAD thing? If I had a BMI <40 and never needed WLS, I would have been ecstatic! No one WANTS to be at the point of needing surgery. You have to question your own motivations. The BMI dropping to 35 alone is a bad thing because I will plateau there and then have no ins. coverage. My weight jumps up and down between 33 BMI and 40 (and now counting). I will never be at a healthy weight even if I am able to lose 30 pounds. The only way I will cure the sleep apnea and co-morbidities is if I take off an excessive amount of weight. Say I got to a 35 BMI and dropped my weight from 280 to 240. I still would want the surgery. Without surgery, I wont come close to a normal healthy weight. I am positive I want WLS. 100% positive. The band gave me a complication, but was working until that -- I was 90 pounds lighter than I am now. A revisional procedure was always the intention with my surgeons, they expected the weight to come back on after the band removal. RNY and DS were the two things I was told to choose between when the band came out. They couldn't do it at the time of band removal because they had to see how my esophagus went so they wanted 4-6 months after band removal, which is when I put on massive weight, and counting. I just want to be clear that, even if I delayed WLS and did the hernia repair first, I will still want WLS. It is not something I would debate about. It would just potentially open my options up more in terms of choosing the procedure, a good thing. But wouldn't have me re-thinking about wanting WLS or not.
|
|
Deleted
Deleted Member
Posts: 0
|
Post by Deleted on Aug 19, 2013 12:17:20 GMT -5
Nyuboi, I understand where your coming from. I don't feel that getting the hernia repaired first will lower your BMI. In fact, It may cause more gain, because you may be comfortable again, and go back to eating as you did after the band came out.
If you can get the hernia fixed, stop the reflux, they will not have any reason to deny you a DS.
Just my opinion. If i'm way off track here, just ignore me........
|
|
|
Post by goodkel on Aug 19, 2013 12:31:29 GMT -5
Nyuboi, I understand where your coming from. I don't feel that getting the hernia repaired first will lower your BMI. In fact, It may cause more gain, because you may be comfortable again, and go back to eating as you did after the band came out. If you can get the hernia fixed, stop the reflux, they will not have any reason to deny you a DS. Just my opinion. If i'm way off track here, just ignore me........ Exactly. It won't take long to heal from your hernia repair, either. A few months at most, not even a year.
|
|
Deleted
Deleted Member
Posts: 0
|
Post by Deleted on Aug 19, 2013 20:38:59 GMT -5
NYUBOI, you do understand that losing weight is not a guarantee of sleep apnea rsolution? Most people have obstructive sleep apnea and yes excess fat can be a huge contributing factor. That being said I have a friend who is 6'2 and 220 pounds who had a UVPP and he is still on CPAP. Chances are if you have severe GERD that you may having scarring of your airway. Scarring alone can cause sleep apnea. Hopefully if you lose weight your apnea will go away, but you need to prepare yourself for the possibility that it might not go away.
|
|
|
Post by nyuboi on Aug 20, 2013 0:31:45 GMT -5
Nyuboi, I understand where your coming from. I don't feel that getting the hernia repaired first will lower your BMI. In fact, It may cause more gain, because you may be comfortable again, and go back to eating as you did after the band came out. If you can get the hernia fixed, stop the reflux, they will not have any reason to deny you a DS. Just my opinion. If i'm way off track here, just ignore me........ You lost 155 pounds in a year? Amazing. Good for you!!
|
|
|
Post by nyuboi on Aug 20, 2013 0:34:00 GMT -5
NYUBOI, you do understand that losing weight is not a guarantee of sleep apnea rsolution? Most people have obstructive sleep apnea and yes excess fat can be a huge contributing factor. That being said I have a friend who is 6'2 and 220 pounds who had a UVPP and he is still on CPAP. Chances are if you have severe GERD that you may having scarring of your airway. Scarring alone can cause sleep apnea. Hopefully if you lose weight your apnea will go away, but you need to prepare yourself for the possibility that it might not go away. My sleep apnea went away after the lap-band. It did not come back till my lapband was removed. I realize there's always a chance of the weight not being enough, but gambling wise I would think it is for me.
|
|
|
Post by nyuboi on Aug 20, 2013 0:35:09 GMT -5
Nyuboi, I understand where your coming from. I don't feel that getting the hernia repaired first will lower your BMI. In fact, It may cause more gain, because you may be comfortable again, and go back to eating as you did after the band came out. If you can get the hernia fixed, stop the reflux, they will not have any reason to deny you a DS. Just my opinion. If i'm way off track here, just ignore me........ Oh, someone on here was saying I would lose weight, possibly 50 pounds, from the hernia repair. They might have meant if I had a Nissen wrap with it.
|
|
|
Post by goodkel on Aug 20, 2013 1:19:59 GMT -5
Nyuboi, I understand where your coming from. I don't feel that getting the hernia repaired first will lower your BMI. In fact, It may cause more gain, because you may be comfortable again, and go back to eating as you did after the band came out. If you can get the hernia fixed, stop the reflux, they will not have any reason to deny you a DS. Just my opinion. If i'm way off track here, just ignore me........ Oh, someone on here was saying I would lose weight, possibly 50 pounds, from the hernia repair. They might have meant if I had a Nissen wrap with it. Please call in the morning to schedule your hernia repair. In the time you are taking to try to get everything done at once, you could be all fixed up and have a date for your DS already. Sheesh. You are morbidly obese. Should you happen to accidentally lose enough to put you below an allowable BMI, there is a 95% chance that you will regain the lost weight and then some. If you are making no attempt to diet, that will come sooner rather than later. Stop fretting about it and fix the hernia already.
|
|
Deleted
Deleted Member
Posts: 0
|
Post by Deleted on Aug 20, 2013 12:57:39 GMT -5
Nyuboi, I understand where your coming from. I don't feel that getting the hernia repaired first will lower your BMI. In fact, It may cause more gain, because you may be comfortable again, and go back to eating as you did after the band came out. If you can get the hernia fixed, stop the reflux, they will not have any reason to deny you a DS. Just my opinion. If i'm way off track here, just ignore me........ You lost 155 pounds in a year? Amazing. Good for you!! Less, Sept 5 is my surgiversary... I've been at 155 for a month or more now..
|
|
|
Post by nyuboi on Aug 20, 2013 23:38:52 GMT -5
Oh, someone on here was saying I would lose weight, possibly 50 pounds, from the hernia repair. They might have meant if I had a Nissen wrap with it. Please call in the morning to schedule your hernia repair. In the time you are taking to try to get everything done at once, you could be all fixed up and have a date for your DS already. Sheesh. You are morbidly obese. Should you happen to accidentally lose enough to put you below an allowable BMI, there is a 95% chance that you will regain the lost weight and then some. If you are making no attempt to diet, that will come sooner rather than later. Stop fretting about it and fix the hernia already. Hmmmm. I could get the hernia repaired and then see for 30 days if my GERD went away. If it did, schedule a DS and if not consider RNY. Maybe it doesn't have to be a long delay. I just didn't like the idea of delaying a whole year and having to worry about insurance. I agree 100% about the weight regain if I drop below the BMI. Like you said, I am morbidly obese.
|
|
|
Post by pandykorn on Aug 21, 2013 9:04:27 GMT -5
I am a female, shorter than you and weight 220. I have to work really hard with my DS to keep my weight there. My BMI is 34.5 FFS.
Given the vast amount of other complex issues that you have, why do you feel you need to get a WLS before you need to fix those other issues? Why is your BMI more important?
You have a lot of weight going up and down, what do you do now to maintain your weight? the DS is not going to give you some magic fix , it is a lot of work for some people to stay at a desired weight.
I do not understand why you would suffer through ANY WLS when in reality you do not need.
|
|
|
Post by goodkel on Aug 21, 2013 12:19:20 GMT -5
Please call in the morning to schedule your hernia repair. In the time you are taking to try to get everything done at once, you could be all fixed up and have a date for your DS already. Sheesh. You are morbidly obese. Should you happen to accidentally lose enough to put you below an allowable BMI, there is a 95% chance that you will regain the lost weight and then some. If you are making no attempt to diet, that will come sooner rather than later. Stop fretting about it and fix the hernia already. Hmmmm. I could get the hernia repaired and then see for 30 days if my GERD went away. If it did, schedule a DS and if not consider RNY. Maybe it doesn't have to be a long delay. I just didn't like the idea of delaying a whole year and having to worry about insurance. I agree 100% about the weight regain if I drop below the BMI. Like you said, I am morbidly obese. The hernia repair won't set you back a whole year. A few months at most. And while I can't step foot into a hospital without losing weight (probably from the stress and gawdawful food), that weight always comes back. I don't know what the Nissen would do, but there is no way you would lose 50 pounds just from a hernia repair. Just go get it fixed and remove that complication out of the equation.
|
|
Deleted
Deleted Member
Posts: 0
|
Post by Deleted on Aug 21, 2013 12:55:15 GMT -5
Hmmmm. I could get the hernia repaired and then see for 30 days if my GERD went away. If it did, schedule a DS and if not consider RNY. Maybe it doesn't have to be a long delay. I just didn't like the idea of delaying a whole year and having to worry about insurance. I agree 100% about the weight regain if I drop below the BMI. Like you said, I am morbidly obese. The hernia repair won't set you back a whole year. A few months at most. And while I can't step foot into a hospital without losing weight (probably from the stress and gawdawful food), that weight always comes back. I don't know what the Nissen would do, but there is no way you would lose 50 pounds just from a hernia repair. Just go get it fixed and remove that complication out of the equation. My son lost 40 pounds from his Nissan....he filled up Mich quicker. That lasted for about six months then it slipped and he developed a bad hernia so he gained it back.....so who knows if he would have gained back or not. BTW he would have been ready for an additional surgery in a month after the nissen.
|
|
|
Post by goodkel on Aug 21, 2013 13:02:52 GMT -5
Ok. Take care of one issue at a time. So here's your to-do list:
1. Simple hernia repair 2. Nissen if that proves insufficient 3. DS
I see no reason why you shouldn't get started on this asap.
|
|
|
Post by newyorkbitch on Aug 21, 2013 16:14:37 GMT -5
Go see Dan Herron about this plan.
|
|
|
Post by nyuboi on Aug 27, 2013 19:13:25 GMT -5
Go see Dan Herron about this plan. Contacted him last week and got a response today. He can meet with me in the Fall but based on what he has read and seen so far on me, he said he would recommend against the sleeve or BPD-DS and would suggest RNY as best option. Additionally, he said my BMI is not high enough to warrant the side effects that accompany a DS.
|
|
|
Post by goodkel on Aug 27, 2013 19:18:18 GMT -5
Ok. Take care of one issue at a time. So here's your to-do list: 1. Simple hernia repair 2. Nissen if that proves insufficient 3. DS I see no reason why you shouldn't get started on this asap. Stop beating your head against the wall and do this. And I'm not talking about having the same surgeon do it all. Fix the hernia, heal from that, and then go scouting for a DS surgeon when they won't have that issue to contend with during your DS.
|
|
|
Post by nyuboi on Aug 27, 2013 19:37:49 GMT -5
Per your suggestions, I contacted the surgeons and hospitals last week to see if I have any other options with insurance.
Columbia-Presbyterian owns two hospitals, Cornell Medical Center and Columbia:
Columbia (Marc Bessler, etc.) doesn't take my insurance.
As for Cornell, no one on the team takes the insurance. I did contact an associate surgeon, per suggestions on here, about my case (Gregory Dakin) and he forwarded my information to the head bariatric surgeon, Alfons Pomp. I had met with Dr. Pomp a year ago. His reply this week said he imagines DS would be a poor choice and RNY a better option. But I could meet with him in the fall to go into details and bring xrays and all if I want. Last year, when I was a 33 BMI, he wanted to do RNY and NO DS. But now that I've hit 40 BMI, I don't know if he would reconsider. He said based on the information though the RNY would be a better option. He doesn't take my insurance.
Mt. Sinai (the hospital as a whole) does not take the insurance, so even if I like a surgeon they cant actually operate on me. Dr. Inabnet doesn't take it, and neither does Daniel Herron. Having said that, I do have the option to switch insurance companies 10/1/13 to HIP, who Dr. Herron accepts, as well as the hospital. He can meet in the Fall, but based on what he knows so far from my letter he said he would recommend against sleeve or DS, and suggest RNY as best. He also feels my BMI isn't high enough for the side effects of the DS. I am likely going to self-pay to meet with him in September but my guess is that he's going to say RNY.
So I know some of you suggested to go to Cornell or Columbia, but these aren't covered options. The bariatric teams that take my insurance are Lenox Hill and NYU. (Lenox Hill is obviously out because of Dr. Roslin). So that leaves NYU. If I switch to HIP in October, I would also have coverage at Mt. Sinai.
So I can use NYU currently, or switch to HIP to have Mt. Sinai. The only risk there is if there approval process is going to be as easy, as United Healthcare had already approved me with Dr. Roslin so I know they wont give a hard time with the prior authorization.
If if I get RNY, it sounds like people on here will say I'm getter off with Mt. Sinai than NYU/Fielding and to change insurance companies?
BTW, I could also have any associate at NYU (with my current plan) and NOT use Fielding but someone in his practice. I never told everyone that's an option too.
|
|
|
Post by newyorkbitch on Aug 27, 2013 19:49:00 GMT -5
Why didn't you speak to Herron about DOING NO WLS AT THIS TIME and just fixing the hernia/GERD FIRST, and thinking about WLS later???
|
|
|
Post by PrettyGirlBounce on Aug 27, 2013 20:07:35 GMT -5
Why didn't you speak to Herron about DOING NO WLS AT THIS TIME and just fixing the hernia FIRST, and thinking about WLS later??? My thoughts exactly. It seems we are once again back to your concerns regarding a potential subsequent WLS rather than solutions for your immediate debilitating problem, you know, the one that keeps you up at night vomiting pints of acid-y liquids? If this was happening to *me*, dealing with the pressing issue as you have painstakingly described it in great lengthy detail would leave no room or time for consideration of potential WLS's in the future. I would be taking necessary steps to rid myself of this current condition IMMEDIATELY. Like Paula said...tunnel vision...around and around we go. Good luck with everything.
|
|
|
Post by goodkel on Aug 27, 2013 20:50:19 GMT -5
You do NOT require a bariatric surgeon to fix your hernia. ANY gastric surgeon will do.
Back off from the weight loss surgery surgeons until AFTER your hernia has been repaired and healed.
|
|
|
Post by newyorkbitch on Aug 27, 2013 21:48:12 GMT -5
Herron is a good choice, in general. I think doing the hernia surgery with someone who is also a bariatric surgeon is a good idea, given your desire to keep WLS in the picture for the future. If you can use the same surgeon for both, that only works to your advantage.
If Herron for some reason doesn't do hernias of this type, he can coordinate with another surgeon at Sinai, be involved, consult with that surgeon when/if the time comes for WLS, etc.
Also it would be great if you could get the hernia done lap, if that's an option. Sinai can certainly manage that.
|
|