Looking at Out of Country Surgery....OHIP Question

Hi, I am just starting my journey and I am now looking at having my surgery in Michigan. I have a BMI of about 58 but I wonder if that is not enough to get approved. I don't have any diagnosed comorbidities but I beleive I do have sleep apnea and could get it confirmed if required. DO I need to do this before applying to OHIP? Looking for advice! Lori

Hi Lori! Welcome to the Ontario Forum! If you have a BMI of 58, you will defiantly qualify for surgery in Ontario or Out of Country. If you have co morbidities, you may find it easier getting approval. Here are some other common co morbidities: Diabetes Hypertension (high blood pressure) Hypoglycaemia (High Cholesterol) Back Pain Knee Pain Hip Pain Ankle Pain Foot Pain Sciatica Etc... Most weight loss surgeons will need you to do a sleep study to confirm whether you have sleep apnea before you have your surgery so you should get your GP to refer you to a respirologist for a sleep study right away. I would get your OCC application into OHIP immediately and draft a letter for your GP to sign that describes your obesity condition (i.e. height, weight, BMI, waist circumference, diagnosed and suspected co morbidities) and most importantly; that in his/her opinion that a delay in obtaining the procedure will result in increased risk of death and/or medically significant long term tissue damage (e.g. heart, discs, knees, hips. etc.). Finally, if you want an RNY, you can get one within a window of about one to one and one half years with an Ontario Surgeon (Dr. Reed in Guelph or Drs. Hagen and Starr in Toronto among others). Finally, I must ask if you have considered a Duodenal Switch (DS) procedure. I had mine done in Michigan in June 2005 and I have lost 152 lbs so far. The Duodenal Switch is also covered by OHIP has been statistically proven to be the most successful of al the 20 types of weight loss surgery for long-term excess weight loss. The statistics are even more superior for patients with BMI;s over 50 (I had a pre-op BMI of 60). Additional information on the Duodenal Switch is available on the obesityhelp.com site in the duodenal switch forum section and on another amazing site, www.duodenalswitch.com Good luck with your journey and be sure to continue your research before, during and after your OCC application process. You should also join the Toronto OSSG Yahoo Group (Obesity Surgery Support Group) and the London OSSG Yahoo Group. The London OSSG Yahoo Group has monthly support group meetings in London and Ingersol and the Toronto OSSG Yahoo Group has monthly meetings in Barrie, Milton, Toronto and Niagara Region. David

Hi Lori, Welcome to the group. My BMI was 59 and I had my surgery in Michegan at the Barix Clinic. I was denied by OHIP first, but most people are. I then sent a letter of appeal along with some photos of me and a list of all the diets I had tried. I also printed off this list of co morbidities that I am posting here and went through and highlighted all the ones that applied to me as I though I only had knee and back pain and sleep apnea. You may be surprised at how many you have. Check it out. Don't get discouraged, lots of people here have gone to the States for surgery Take care Joyce 1. Diabetes; 2. Neuropathy in feet, ankles, hands and lower arms; 3. Hypertension; 4. Family history of heart disease; 5. Family history of stroke; 6. Family history of Diabetes: 7. Family history of heart attacks; 8. Thickened heart walls due to weight/hypertension; 9. Intracranial hypertension (psudeotumor cerebra); 10. Migraines/Headaches directly related to obesity/cranial hypertension 11. Bells Palsy; 12. Cardiac Arrhythmias; 13. Ocular Hypertension; 14. High Cholesterol (hypercholesteralemia); 15. Elevated Triglycerides; 16. Hypothyroidism; 17. Excess Testosterone; 18. Excess Facial & Body Hair (Hirsutism); 19. Acne; 20. Rashes, 21. Chronic Skin Infections, 22. Excess Sweating, 23. frequent yeast infections; 24. Hormonal Abnormalities; 25. Infertility; 26. Polycystic Ovaries; 27. Dysfunctional uterine bleeding; 28. Amenorrhea related to obesity; 29. Incontinence related to obesity; 30. Lower Back Pain; and muscle spasams (can't stand/work in house for more than five minutes without pain in lower back) 31. Ankle/knees swelling; 32. Shortness of breath upon exertion; 33. Decreased Exercise Tolerance; 34. Hip pain; 35. Heavy Snoring 36. Acid Reflux; 37. Lack of Self Esteem; 38. Social Rejection; 39. Loss of Job Potential; 40. Inappropriate Coping Strategies; 41. Anxiety; 42. Severe Depression due to weight, inability to exercise, foot unable to heal properly because of weight, and health-related issues. 43. Fatigue; 44. Fluid retention; 45. Gall Bladder 46. Activity Intolerance; shortness of breath and severe fatigue even with minimal activity 47. Decreased endurance limiting daily activities, including, but not limited to; walking, housework, working, dressing, standing, getting up, bathing, sitting, travel 48. Depression related to difficulty coping with frequent failures at diet attempts 49. Frequent constipation alternating with frequent diarrhea 50. Stress incontinence 51. Fibrocystic breast disease 52. Abdominal gas and frequent nausea 53. Hemorrhoids 54. Personal history of colon polyps 55. Family history of (Fill in the blank) 56. Symptomatic ventral hernia; 57. Congestive Heart failure 58. cardiomyopathy; 59. Heart Attack 60. CPAP 61. Stroke 62. Heel spur surgeries 63. Knee surgeries 64. Osteoarthritis 65. Gout 66. Sleep Apnea 67. Venous stasis disease 68. Chronic leg pain 69. Degenerative Joint disease 70. Recommended joint replacement from specialist 71. Accelerated degenerative joint disease 72. GERD 73. Gall Stones 74. Repeated pneumonia 75. Repeated pleurisy 76. Repeated bronchitis 77. Lung restriction 78. Renal failure 79. End stage renal disease with difficulty dialyzing 80. Hernias 81. Hiatial Hernia 82. Kidney stones 83 Increased risk of certain cancers 84. Fibromyalgia (chronic fatigue syndrome) 85. Hyperlipidemia 86. Extremity edema with ulceration 87. Dyslipidemia 88. Dyspnea 89. Eating Disorder 90. Fatty Liver 91. D.J.D. 92. Coronary artery disease 93. Irregular or Absent periods 94. Skin Tags 95. Traumatic Injuries to Teeth 96. insulin resistance 97. dyslipidema 98. cardiovascular disease 99. stroke 100. Priorsurgical Complications 101. hyperuricemia 102. Sever Acute Biliary and Alcoholic Pancreatitis 103. osteoarthritis 104. Certain cancers are also associated with obesity, including colorectal and prostate cancer in men and endometrial, breast, and gallbladder cancer in women [1-6]. 105. binge-eating disorder 106. social stigmatization 107. discrimination 108. impaired psychosocial and physical functioning, causing a negative impact on their quality of life 109. Rheumatoid arthritis 110. Birth Defects Cancers 111. Breast Cancer in Women 112. Breast Cancer in Men 113. Cancers of the Esophagus and Gastric Cardia 114. Colorectal Cancer 115. Endometrial Cancer 116. Renal Cell Cancer 117. Carpal Tunnel Syndrome 118. Chronic Venous Insufficiency 119. Daytime Sleepiness 110. Deep Vein Thrombosis 111. End Stage Renal Disease 112. Heat Disorders 113. Hypertension 114. Impaired Immune Response 115. Impaired Respiratory Function 116. Infections Following Wounds 117. Obstetric and Gynecological Complications 118. Liver Disease 119. Pain

Welcome Lori. I'm just starting my journey as well! Start talking to your doctor and get the process in motion. I think a BMI over 50 will be substantial in getting approval. Even if you don't have alot of comorbidities, go through the process. I am doing this myself right now. It might take an appeal or two, but we'll get there Stefani

Hi Lori I am just starting this journey as well! I am hoping to have the surgery in Michigan also...I dont want to wait to start a new life!!! Anyway I have a consult on Wed. with them, I haven't applied for OHIP yet, I am waiting for my forms back from my GP. He somehow thinks that I have patience, lol. Hopefully I can get them mailed tomorrow morning!! I have written a letter as well as my GP to send with the forms. Will be praying lots for all of us waiting for approval!!!!! Dawnya

Hey Dawn, Who is your surgeon? Where in Michegan are you going? Just curious Joyce

I have been looking at the Barix Clinic in Michigan, my GP is really supportive and I hope to speak to him some more tomorrow. Lori

Hi Joyce I believe that it will be Jon Shram (sp?) in Yipisanti(sp?)Michigan. I have learned a lot in here by being curious!! Dawnya