Re: VBG vs RNY

[Guest guest]

Dear " graydowney "

Your insurance problem is one that is shared by many people. We have

a separte list just for this issue. Please join us at:

http://groups.yahoo.com/group/DS-Insurance_Authorization_Problems

Regarding the VBG vs. RNY, the RNY is a more effective procedure.

However the RNY involves cutting the stomach in a manner that makes

furture conversion to the DS very difficult. The RNY suffers from a

syndrom known as " dumping " which causes post-ops to get ill if they

injest to much sugar. Both VBG and RNY procedures suffer from

vomitting and meat intolerance, but the VBG procedure is worse in

this regard. Weight regain is again common for both procedures,

though worse with the VBG. The VBG has the one virture that it is

realatively easy to convert to a DS, though the laprascopic

adjustable band would be easier still, and would probably be a better

short term solution.

If you only want to have 1 surgery then fighting your insurance

company is your best option. Which company are you with? Is it an

HMO or PPO? Blue Cross of California is infamous for denying the DS.

Aetna has also denied the DS sometimes, but it seems that one can

work around Aetna with the proper wording of the LOMN (letter of

medical necessity). HMO's present a problem because you usually have

to live within 35 miles of your surgeon and join the same medical

group that he is in to qualify.

Hull

> My insurance company will pay for either of these. I have had to

> appeal and now Im waiting for approval. I want the DS but they wont

> approve it as of yet.I was told that if I have the VBG it can be

> reversed in hopes of the insurance company approving the DS at a

> later date. Is the difference between the VBG and RNY that the VBG

> can be reversed? What are some of the diferrences between the VBG

and

> RNY? I hope some of you can give me some advice.I sent my appeal

> letter in with pics of me nude(I covered my face). My insurance

> company has approved others and they say I dont have enough

> supervised diet history. My next step is to get on disability, I am

> so front heavy that I have trouble standing for more than tn

> minutes.I had twins seven years ago and they were over fifteen

pounds

> between the two,my stomach and breasts weight me down.

[Guest guest]

The following is my opinion only, information represented is what I

have read and understood, however it could vary from other sources.

The VGB is a restrictive surgery only. Your stomach is sectioned off

to create a small funnel. The food will pass into the bigger section

of the stomach. The big problems with the VGB is that you can easily

" eat around the surgery " by eating soft food that can easily pass into

the bigger stomach cavity, ice cream, shakes, and regular soda are a

good example of this. You absorb every calorie you put into your body

with the VGB, so with that surgery you MUST commit to a low calorie,

low fat diet and exercise program in order for it to work. The VGB has

a 60% failure rate and of the 40% who have success with it the excess

weight loss is around 50%. For example; if you are 100 pounds over

weight you with the VGB you have a 40% chance of losing and maintaining

a 50 pound weight loss long term.

The RnY has a mal-absorption factor to it so the success rate is around

80% with excess weight loss of about 65% of excess weight maintained.

Again you must follow a low fat diet and exercise program in order to

be successful. The RnY is more difficult to revision to a DS.

You should not go into surgery thinking that it is anything but a

permanent solution. My insurance offered the RnY at 100%, my counter

was to call my lawyer and he told them that I want the DS and I would

not settle for anything else. Don't settle for less because it is

easier or because you want it now. Fight for what is right for you,

this is a serious decision and a permanent one. I kept fighting until

I won, now I cannot believe what a miracle the DS is.