Weight loss surgery advice please

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Forum -> Health & Wellness -> Healthy Lifestyle/ Weight Loss/ Exercise

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Purple Hug Bunny

Fri, Jul 21 2006, 6:15 pm

Ok.
I got a date for my lapband surgery..
I'm scheduled for August 18... however, I don't know if the date is worth anything bec. the dr told me that my insurance has never paid for banding (they do pay for other methods, gastric bypass, duodenal switch and sleeve gastrectome...)
The only reason I got a date is bec. insurance needs to know.. so they sent in all the documents to insurance, although they said, they don't know if there's any point in sending the stuff, bec. they KNOW that they wont pay for it, but I told them to send it anyways, I've got nothing to lose (besides for weight of course)..

The dr had discussed with me the other surgeries and said that I'd be a good candidate for the gastric bypass too, but e/one talked me out ot if..

The recovery time is basically the same, and with the bypass I can expect to lose more of the weight AND in a shorter amount of time..

e/one talked me out of it, but now if insurance wont pay, ppl have told me that maybe it's not such a bad idea for me to do the bypass..

I don't need advice or admonishings on why I shouldnt do the surgery..

What I want to know is as follows:

If insurance denies coverage (which they prob. will, unless some miracle happens and I'll be the first person to ever get covered for this, by this insurance) should I fight the denial and try to get covered.. which I'm not sure is possible and if yes, It would take time and the date would have to be moved further away....
Or if they deny it, should I do the bypass and keep the date..
I'd love it if I get covered for the band, then there's no problem, but if they don't,... I don't want to wait either, but I"d much rather do the band..

So... lets hear from you.

southernbubby

Fri, Jul 21 2006, 6:18 pm

A friend of mine had weight loss surgery a year ago and she really shrunk!

DefyGravity

Fri, Jul 21 2006, 7:14 pm

I don't know anything about insurance, but a friend of mine had it done over a year ago and has lost 80 pounds! She is SO happy she had the surgery.

Chani

Fri, Jul 21 2006, 7:23 pm

First of all, I'd suggest reading your insurance policy and seeing what it says...

Purple Hug Bunny

Sun, Jul 23 2006, 12:14 am

ok ppl... I know all about the surgery, my boss and her husband did it, her sister and husband did it with the same dr Im using and my BIL also did it with the same dr I'm using..
I dont need info on the surgery, I just want to know whether it pays to fight it and wait, or keep the date and do the bypass (which I really only want to do if I have no other choice).

Chani, I don't have a manual, and I know why they wont pay, I don't know if it wouldve said in the manual bec. lapband wasnt around then.

Tefila

Sun, Jul 23 2006, 5:53 am

Quote:

I just want to know whether it pays to fight it and wait, or keep the date and do the bypass

I would bite the bullet and do it Confused

What is the diff though with that and the lap band?

Oh one other thing I too know of four cases of people doing it and three years later 3 of them are back to square one what a waste of surgery and money Exclamation

Purple Hug Bunny

Sun, Jul 23 2006, 12:36 pm

Tefila, maybe that depends on what kind of surgery they did.. the ppl I know all did the lapband, my boss lost 95 lbs, her husband lost 105.
My BIL lost about 60-70, and the other ppl I know who did it, did it recently so I don't know.

The recovery time is basically the same
with the bypass I can expect to lose more weight and quicker then with the lapband.
The lapband however is the least invasive, and most sophisticated one. and the safest if I'm not mistaken.. I really only want to do the lapband, the bypass I only want to do if I really have no choice..
I just dont know how long it might take if I decide to fight for the lapband..

Click on this link to see the different kinds of weight loss surgery and how they are done.
http://wo-pub2.med.cornell.edu.....tloss

brooklyn

Sun, Jul 23 2006, 1:47 pm

I think that fighting the insurance company is a waste of time, you will not win, Try switching companies to one that will cover it. I personally would rather the lap band as it is reversible and like you said the least invasive and less of a risk. Just my 2 cents. Good luck.

chocolate moose

Sun, Jul 23 2006, 8:11 pm

With the surgery, you can only eat small amounts. Why not just do that now?

Purple Hug Bunny

Mon, Jul 24 2006, 12:41 am

brooklyn, I don't have an option of changing insurance right now and the dr said that even if I did it would take at least a year till they will approve me for any surgery...
I'm not eligible for medicaid, bec. I'm single and also because according to the state I make too much, although I don't see any of that money.

elisecohen

Mon, Jul 24 2006, 6:39 am

How much is your health being affected by the weight? If you have serious problems with diabetes, heart disease, breathing troubles, etc, then I would go ahead as soon as possible to improve your life and health, in fact it might be halachically preferable I imagine. OTOH if not, maybe you could take more time to fight them. Get an advocate, a lawyer, someone from your human resources dept, etc, to help.

And call your local bikkur cholim--they may have a fund for people to help pay medical expenses, even somewhat elective ones, or know of a gemach which will help advance the money.

Ambassador-to-KJ

Mon, Jul 24 2006, 8:58 am

Quote:

With the surgery, you can only eat small amounts. Why not just do that now?

I dont even know how to respond to that! shock

mother48

Mon, Jul 24 2006, 9:26 am

I know s/o who recently did the bypass. twice he had to go back in to have the opening stretched(with balloons etc) b/c it got blocked by food.

I would wait and do the lapband. as you said, much less invasive and safer(I think). and long term, you eat less, if you're careful, loose the wait, but you can eat! with the bypass you can really never eat a normal meal for the rest of your life.

I vote lapband. if you need to wait, might be worth it.

ps: you might want to find out about doing it close to yom kippur, in terms of fasting.

chocolate moose

Mon, Jul 24 2006, 10:53 am

At the end of 2004, I had to lose 30 lbs for medical reasons. And keep it off. It wasn't easy. And it continues to be not easy as I age.

This surgery is not a quick fix and it's not foolproof..and it's not nec. the answer.

The answer is diet and exercise. Plain & simple.

Ambassador-to-KJ

Mon, Jul 24 2006, 10:56 am

Seven I found in your post for another topic that you have GHI insurance. I know at least two people who have had GHI pay for their lap bands, they give you a hassle but you can fight them....

brooklyn

Mon, Jul 24 2006, 10:57 am

There are people who have other issues where diet and excercise is not enough. It is not always so cut and dry. I know someone with severe pcos, she barely eats and works out four days a week and in a years time she has lost maybe five pounds. If someone is healthy and can lose weight on their own they should thank hashem for that. For others they unfortunately have to look at other methods and we should thank hashem that other methods are now available to us.

yoyosma

Mon, Jul 24 2006, 10:59 am

brooklyn, has your friend considered taking Metformin? It can really help her!

brooklyn

Mon, Jul 24 2006, 11:05 am

I remember her saying that she took Glucophage and that it mande her really sick (stomach). Since then I don't think that she tried anything else.

shopaholic

Mon, Jul 24 2006, 12:18 pm

Diet & exercise aren't easy for everyone. 30 lbs is nothing comapred to what some people have to lose. My mother tried every diet under the sun for years until she did the lap band 4 years ago. She looks amazing, feels amazing.

chocolate moose

Mon, Jul 24 2006, 12:21 pm

D and E are def. not easy for everyone! They're not easy for ANYONE!

But won't most dr's ask you to lose the weight you can, and THEN do surgery?

Who said everyone is meant to be thin?

Seven is young, she's hasn't had several pregnancies or an older not a bubbie with a slower metabolism.

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