Alana Chock, MD

Be sure to tell your doctor that you take NSAIDS chronically which in my practice is contraindicated for a bypass.  NSAID use with the bypass is in the top 3 causes of marginal ulcers.  Your doctor is probably concerned with your GERD and hiatal hernia worsening with  the sleeve.  The sleeve is a high pressure system and the bypass is a low pressure system which is a good argument for the bypass.  You need to understand that a sleeve could potentially lead to worse GERD.  I have not found GERD to be as much of a problem as we had initially anticipated with the sleeve.  Losing weight and eating smaller portions can often alleviate GERD symptoms.


With that said, if you have Tricare, it only covers the lap band or bypass.  The sleeve is still considered experimental for Tricare insurance.  You might be able to get the sleeve approved if your insurance coordinator and surgeon are willing to make the argument with your insurance.  Additionally, if your BMI is <40 without a comorbidity, I question whether Tricare would cover the procedure. You do want an experienced sleeve surgeon to do your operation and if your surgeon is not doing these then perhaps you should consider paying for it with a non military surgeon or waiting.