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> Now are you

> saying that BCBS PPO may not cover the DS??

Joy,

Blue Cross of California is currently denying the DS to everyone as

of June of this year. However, each state is different, and you will

have to find out in your particular state if Blue Cross is choosing

to cover it.

When discussing this situation with a potential insurer, don't

discuss the procedure name, but rather the CPT code. Here are the

two key codes:

43847:

Gastric restrictive procedure; with small bowel reconstruction

to limit absorption

43633:

Gastrectomy, partial, distal; with gastroduodenostomy;

with Roux-en-Y reconstruction

Check if BCBS in your state will cover these two CPT codes. If they

do then you are in good shape.

Hull

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Hi Joy,

I had the DS done by Dr. Lutrzykowski on July31st and I think he is a

wonderful doctor!! Also, I have BCBS PPO and they did pay for the

surgery, as long as it was deemed necessary (the usual requirements:

100 pounds overweight, tried dieting, etc). Dr. L even requests that

his patients get private rooms for their recovery( I had requested

one because I didn't know that at the time and was worried that I

would have to pay an arm and a leg for it, but havent' gotten any

bills for that and I think since he requests them, I won't).

Anyways, I just thought I would give you my 2 cents since I know Dr.

L and have the same type insurance (although I'm not sure how it

works if you are out of state). Please feel free to email me if

you'd like any more info on Dr. L, etc. I'd be glad to help any way I

can.

Darlene

> > > >

> > > > > What I don't understand about it is this, why does weight

> loss

> > > > stop

> > > > > after this 18 months have passed, what happens to our

bodies

> at

> > > > about 18

> > > > > months? Because our stomach stretches over time what keeps

us

> > in

> > > > say 5 years

> > > > > or so later from gaining more weight back?

> > > >

> > > > A number of factors influence the time frame. First, when

you

> > > loose

> > > > weight your body naturally burns fewer calories. Lean body

> mass

> > > > burns more calories than fat body mass. If you do weight

> > training

> > > > you will increase your lean body mass and therefore your

> > metabolic

> > > > rate will stay high (i.e. # of calories your burn) and you

will

> > > keep

> > > > loosing weight. If you stay sedentary, you will loose more

> lean

> > > body

> > > > mass and your metabolic rate will drop as you loose weight.

> When

> > > > your body burns the same number of calories as you absorb,

you

> > > reach

> > > > equalibrium and your weight loss stops.

> > > >

> > > > Two other factors influence the weight stabilization, but I

> > believe

> > > > they are secondary. First, the stomach does stretch for the

> > first

> > > > year or so and then stabilizes. Second, the instestines tend

> to

> > > > adapt to the new situation and expand logitundinally. This

> effect

> > > is

> > > > minor though.

> > > >

> > > > Now the big difference between the VBG and the DS is that the

> VBG

> > > is

> > > > a purely restrictive procedure. Therefore, calories absorbed

> is

> > > > equal to calories consumed. There is no malabsorption. The

> > result

> > > > is that after your weight stabilizes, any increase in eating

> will

> > > > result in an immediate gain of fat. Unfortunately, fat does

> not

> > > > change your metabolic rate by much, so you will continue to

> gain

> > > > weight for a long time (several years) without increasing

your

> > > > consumption rate. Further, the VBG tends to allow

consumption

> of

> > > > high density caloric beverages and discourage consumption of

> meat

> > > and

> > > > other protien rich sources (in essene you eat junk food).

> > Finally,

> > > > the VBG is prone to mechanical failure in about 1/3 of the

> > cases.

> > > > The staples fail and the procedure is defeated.

> > > >

> > > > With the DS there is a constant malabsorption factor in your

> > favor

> > > > (as long as you don't eat sugars in large volumes). The

ability

> > to

> > > > consume a reasonable amount of food allows you to focus on

> > protien

> > > > rich foods that tend to satisfy you more quickly and keep you

> > from

> > > > snacking. Also, research indicates that as you increase the

> > volume

> > > > of food you eat, your absorb a smaller percentage of the

> calories

> > > > that you eat. This self-regulating mechanism further

explains

> > the

> > > > stable weight loss accomplished by the malabsorptive

procedures.

> > > >

> > > > So as long as you stay away from the cola and chips and eat

> > mostly

> > > > protien rich food you will not regain weight (even if you

> overeat

> > > > tremendously).

> > > >

> > > > Hull

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