OHIP-Surgery options?

So I am about to go for my post op diet class on Nov.20th and then to meet a surgeon at guelph hospital.

here are my concerns, I have osteoarthritis in my left knee, obviosuly weight related as I am age 35. I have also been diagnosed with rheumatoid arthritis and we have a strong family history of this, my mom , my sister and I. My sister had gastric bypass about 10 years ago and she takes NSAIDS.

I have taken nsaids for years too. Without them I can hardly walk and my joints are extremely stiff making it impossible to get even the simpliest things done.

When i saw the nurse in guelph , she told me i would have to stop taking the anti-imflammatories for life. Granted i realize that my knee pain should get better but what if it doesnt get 100% better; she told me to only take narcotic pain relievers such as percocet and tylenols. Anyone who knows about arthritis knows that tylenol does really nothing for stiffness, pain etc.

The nurse told me that OHIP only covers the Sleeve in certain cir****tances and that mine wouldnt be one of them. Only 3% of all people get the sleeve paid for my the goverment and that basically having arthritis wouldnt be a good enough reason.

She also told me to decide to have surgery without the use of these meds or take the meds and forget about surgery!!!

Does anyone know how accurate this is? or what reasons did you have that were approved for the sleeve surgery? I am really hoping that i can convince the doctor that i need the sleeve vs. rny

I disagree with that nurse.  There are plenty of examples of people on these boards who have been able to get the sleeve because they need NSAIDS.  I would push for the surgery you want.  Bring your case to the surgeon at Guelph, and if he disagrees, you are within your rights to ask for a referral to another surgeon for a second opinion.  You may even want to ask for a surgeon at a different centre, as some are more amenable to the sleeve than others (I believe Hamilton is one).

Good luck to you!  Don't settle on this!

Hi there:

I am no expert by any means, I am still in the early stages...but, it seems to me that the person who would decide what kind of surgery you will have would be the surgeon...not the nurse.  She is giving her opinion, based on what she has seen, but it is the Doctor who makes the final decision.... Also, I question the accuracy of her statement that only 3% of people get the sleeve payed for by OHIP, look at the number of folks on this forum that have had the sleeve...more than 3% for sure!!!!  

In my humble opinion, until you speak with the surgeon I wouldn't worry about it...if you eventually have to pull out because of what the surgeon says, even the day before surgery, at least you are doing it with full and accurate knowledge.

Perhaps some folks who have had the sleeve will give you some feedback,

Blessings for the journey!

Kim

Jayme

I'm in a bit of a rush this morning so I'm going to be blunt. First of all, ignore the nurse. Don't even bother engaging her in this convo. Secondly, if the Dr refuses to give you a sleeve, tell him you want a second opinion.

Period. There are Dr's who WILL do sleeves. You can NOT live your life with out nsaids.

OHIP does have strict criteria about what they will and won't cover and I'm sure if you use the "search' function (top right corner) and put in "What does OHIP cover" it will spit out what you want to know. But OHIP is one of those archaic government beauracracies that needs a reboot.

And just as a FYI, it is your right to be able to live your life painfree.  Refusing  you surgery that allows this is a violation of your human rights... I kid you not

http://www.canadian-nurse.com/index.php?option=com_content&view=article&id=299%3Adeclaring-war-on-pain&catid=4%3Aperspectives&Itemid=39&lang=en

"OCTOBER 2010 • PERSPECTIVES

In September, at the inaugural International Pain Summit, in Montreal, health-care providers and researchers from 84 countries declared that access to pain management is a fundamental human right. The International Association for the Study of Pain hosted the summit to call attention to the woefully inadequate state of pain management worldwide."

I had the RnY and I DO require nsaids.. and now I'm paying for it big time.. in more ways than you can imagine. My future needs to have a revision in it..

I am one of the supposed 3% who got a sleeve. I got mine last December in Guelph with Dr. Pereira-Hong.  I started the process and had mentioned to the nurse, dietition and social worker that I was hoping for the sleeve rather than the RYN. Both the nurse and dietitian told me to forget about it. The only way I would get a sleeve was if it was medically impossible to have the RYN.  The social worker (Megan, I don't know if she's still there or not) told me not to bother to bring it up with anyone other than the surgeon because everyone would tell me I would not be able to get a sleeve.  The surgeon is the one who ultimately decides on what surgery you get (unless you refuse to have the one they suggest and ask for a referral to someone else).

I went into my surgeon appointment with two pages full of reasons as to why I felt the sleeve would be best for me long-term. Luckily and thankfully for me, Dr. Pereira-Hong suggested outright that the sleeve would be better for me than the RYN because of my medical history (I have Benign Intercranial Hypertension which requires NSAIDs for pain relief). 

I have only had my sleeve for about 11 months but I am so thankful for it.  My weight loss may be slower than those who have the RNY, but that doesn't bother me. I'm still losing weight and have lost nearly 110 lbs so far.

My mum is going through the Guelph clinic now and will be coming up to her surgeons appointment soon.  She has servere arthritic in both knees (she needs them replaced but won't do the surgery until she loses weight....but can't exercise cause she can barely walk. Such a horrible catch 22) and requires NSAIDs.  I'm going to be going with her to her surgeons appointment and have recommended to her to request Dr. Pereira-Hong (she is such a lovely woman and fantastic surgeon) and hopefully with my help she will be approved for the sleeve too.

Sorry, that was a really long post, but I hope some of it will be of some help.

It is NOT the nurses choice. It is the Surgeon.

Do you research. Have your reasons documented. Stand your ground. Show them you can make it work with the sleeve (some are against it because you can fail to lose if you have a high caloric liquid diet), etc.

I have 1 reason and 1 reason only that I pushed to get the VSG. I am allergic to Tylenol, codeine, Gravol, can't take the perks, etc. etc. I cannot and will not at 32 live my entire life without pain medication.

For you... Make sure you have documentation about your RA and Osteoarthritis with you in a folder or binder when you go see the surgeon. It is what I do. I make sure I have past medical info to back up my stance.

It is absolutely the Surgeon's decision and the key is to having a surgeon who is comfortable with performing them. If Dr Pereira-Hong in Guelph then Guelph's surgeons are clearly not as against it as the nurse.

My own surgeon is doing at least 2 VSG's in one day. Mine and another forum member. Only VSG that day. RNY is a week later... I've seen that person post as well.

Big hugs and good luck,

Shell

I have severe OA in my back and have been on NSAIDS for almost 20 yrs.  I did my research and when I had my surgeon appointment, I presented it all to convince the Dr that the RNY was NOT for me. (I also have mobility issues and not having NSAIDS would likely confine me to a bed!)

I was approved for VSG by Dr right on the spot and I'm loving it!!

Hope you are successful in getting one too!

Verity

Shell and Verity

Who are your surgeons if you don't mind me asking?.. and if I already asked just ignore and indulge a doped up old lady (it's FReAKiN raInING aGaIn!) because obviously I'm LOSING MY MIND

Please and thank you?

You have excellent reasons for wanting the VSG instead of RNY. Some surgeons will agree with you, and some will not. Some surgeons are ideologically opposed to the VSG for some reason - we see this in Guelph, HRRH and Ottawa a lot. Go through the assessment process and bring your reasons for wanting the sleeve to the surgeon. Document everything. IF the surgeon says no, don't take no for an answer. Tell them you want a second opinion and if necessary, ask to be referred to St. Joseph's Hamilton as the surgeons there are much more open-minded about the VSG. They cannot legally deny you a second opinion.