First, thank you for putting up with me!

So, here is where we are with hubby and I'm going to put and paste the email conversation with the surgeon and then ask my question.

just spoke with Teresa in your office and she explained about our insurance not covering the sleeve for Chris and she told me that you had said we could just submit as RNY if we wanted to do it that way. I have one question. I know that the two stage operation, per our consult with you, was a third case scenario. We had discussed that you would prefer to just do the lap RNY and if you had any problems then it would move to the open RNY. At that point if there were still problems it would be the sleeve and then 100 pounds later, you would do a second surgery to do the bypass. So, if we just submit it as RNY, which would be approved, does that put Chris at any higher risk? I guess I don't quite understand what would change as far as doing the RNY -vs- the sleeve. Are you still concerned that you may not be able to do a lap RNY if that is what he is approved for?

Am I making any sense? I just am not quite following why if we can do an RNY in one surgery, why we submitted for two surgeries instead. I'm not upset that it was done that way (though we don't have the benefit as the insurance considers the sleeve "experimental") but I guess I just don't understand the benefit or need of one over the other. As long as Chris is not placed at any greater risk, we have no problem with just doing it in one shot, but I need your thoughts on this.

And his response to me, which you all might have already known the answer, was:

Hi
because his bmi=66 he is at high risk for complication and also conversion to open. He is also at high risk for an open operation that includes a very high risk of wound infection, large open wound and hernia.

we will go ahead as stated below and file for laparoscopic possible open RNY Gastric bypass

So, with that being the case, were any of you anywhere near a 66 BMI, what kind of surgery did you have and what were your complications, if any?

I had a BMI of 56 and had open RNY as they had to remove my gall bladder. Over half of the patients that had surgery the same week that I did, had to have their staples re-inserted as the incisions were not closing.

I was 58.3, which is just above where my surgeon's cutoff is between lap & open RNY. We decided he would attempt lap, but would open me up if he ran into complications. He did. My intestine didn't want to stay attached to my pouch. So, I woke up w/ a huge incision down my belly. I wouldn't have had it any other way. Dr. M is very good & has done RNY for almost 30 yrs. By opening me up he was able to hand stitch everything, including my incision. I didn't have as much worry that my incision would open up. I had a llittle seepage from my incision due to a small pocket of fluid accumulating behind it, but no other complications. By the way, he had a barium swallow done the next morning to make sure that there was no leakage anywhere.
Every patient and every surgeon is different. If yours has a lot of experience and you trust him, go with what he thinks is best.

Hi there...my bmi @ surgery was 79.4

My surgeon and I went into the surgery with the plan to attempt a lap, but to switch to either open or a sleeve if neccessary. I was lucky...the lap took, and I had few complications. They did keep me in the hospital for 7 days after, because I was at greater risk of complications and infections. I was reasonably healthy aside from my weight itself before the surgery. My biggest issue was my knees. I was told I would have to have 2 total knee replacements, and in researching them, came across my solution of wls instead.

I dont know about the insurance issues...I never really researched it. They fought with me originally, so I paid out of pocket, and fought them for a refund afterwards. They only paid a small portion of it that way...but for me it was more the point at the time...I wish now I had fought harder...lol!

I really wish you the best of luck with this. I have been reading all your posts about it...and am praying that your husbands approval comes through soon. I know the waiting stinks!

My BMI was somewhere in the neighborhood of 80ish(OK SO 84.6; WHEW THAT WAS HIGH!)...it's at the end of my post in my TickerFactor...can't remember exactly...but I had lap RnY (going in I knew there was a possibility that it could become open, thank God it did not) with absolutely NO COMPLICATIONS...it was a real miracle, surgeon even told my family that it was a very easy surgery, it did not even take 1 1/2 hours to do it....I did very well...

Keep us posted!

Blessings!