Question:
This is my 2nd time posting this question...the 1st did not generate any response
Can anyone give me any tips on how to appeal. My daughter's surgery was turned down because managemed claimed she is too young. She is only 13 yrs of age and over 100lbs overweight with health issues. Dr. Capella is experienced in operaing on children as young as 14. — MARY R. (posted on October 9, 2000)
October 8, 2000
surgery is a decision that needs to be made by a Legal adult, it is not a
decision that you should make for your 13 yr. old. Most insurance
companies have such guidelines, as do most doctors.......Can a 13 year old
child really make a decision for a lifelong commitment like WLS......maybe
a step should be taken back to look at the big picture
— Jack N.
October 9, 2000
I think, personally, that 13 is way too young for this type of surgery. The
pain, the lifelong commitment, she won't be able to fully understand the
seriousness of it all. Her body is still growing, changing. I don't think
anyone under the age of 18 should have this surgery. Of course there are
surgeons who'll do the surgery--that's their job, their income. Do they
have your daughter's best interests at heart? Do you think they spend
sleepless nights about it? Of course not. YOU need to be your daughters
advocate--if, at 18, she is still heavy and decides it is what she wants to
do, then fine. Until then, I'd be a good role model and try to help her
change her eating habits, begin walking (even short distances), trade bad
sweets for good sweets like raisins, fruits, etc. At 13 she can still
relearn good habits. Surgery is not the way to go, not yet.
— [Anonymous]
October 9, 2000
It is my opinion that 13 is not too young. My surgeon operated on an 11
year old. I do not know the circumstances that led to him deciding to
operate on someone that age but knowing him the way I do, I am certain the
decision was NOT motivated by profit. If your child has health issues that
are related to obesity I'm sure you and your surgeon want to do everything
possible to help your child live a normal healthy life. Also...it is
amazing the responsibility a child will assume by necessity. Young
children that have diabetes assume the responsibility for food choices,
injections, monitoring, etc. As a parent you'll be there to advise and
support your child. Assuming they will fail just because of age negates
the child's intelligence and your parenting abilities.
— Roseann M.
October 9, 2000
Mary... I wrote to you privately concerning this when you posted this
originally. I offered to share my experiences concerning my own daughter
who was 16 at the time of her surgery. She is doing very well. The offer
still stands if you wish to email me privately. My daughter, my mother and
I had the BPD/DS.
— Kris S.
October 9, 2000
Dear Mary, When I was 13 years old, I got on a scale for the first time in
many years. It read 235 and I almost died. I couldn't believe that I was
that big, (I was also 5'3"). Anyway that summer, I decided to diet
and I lost about 45 pounds. I kept that weight off for about 6 years. I
may have lost more but I rarely ever weighed myself. I was very happy at
about 180-190. Bottom line is this: your daughter (like any other obese
person), needs to try various methods of weight reduction before opting for
this surgery. I know that you probably don't want her to experience the
ridicule that you may have been subjected to as an adolescent. However,
you can't just "save" her. She must try on her own and make this
life altering decision on her own. (Unfortunatley she is way too young to
do that now.) Best of luck to your daughter!
— [Anonymous]
October 9, 2000
I am seeing a lot of negativity here concerning your daughters age and her
ability to make this decision and the strict post op rules.
I can tell you Mary, that yes, if she has certain types of surgery, she
will have to comply. However, that level of compliance depends on the
surgery.
With the BPD/DS, a person has the most normal eating habits and the
long-term success is inspiring. This surgery requires that one take
vitamins everyday for the rest of one's life. In reality, whether we are
pre-op, post-op, or non-op, we should take daily vitamins.
The BPD/DS offers the most natural way for the stomach to empty and not
have to worry about eating the wrong way (i.e. not chewing food to mush,
blockage of the stoma and dumping), since the pyloric valve is left
intact.
People who say that good habits can be traded for bad, obviously have
selective memories. If this were the truth, not many of us would need this
surgery. People cant know what it is like and the amount of desperation
one experiences when you see your own child suffering from this horrible
disease.
I had my daughter on a diet from age 4 and no matter how much she
excercised and how right she ate, the very best she could do was maintain
her weight while I made her suffer by making her eat nothing but salads and
extremely low-fat food. The truth is, the moment she deviated from her
diet... the pounds came back with a vengeance and they brought friends to
pile up on my daughters body.
Mary, I applaud your decision to help your baby.
— Kris S.
October 9, 2000
Mary, I am with Kris on this one. I applaud you for trying to help your
daughter. I know it must be really hard on you to watch her suffer. I
know a few people here are saying to switch bad habits with good ones and
diet and try now to change. Well if these people had to write and appeal
letter, I know of one statistic that would be in that letter. And it would
say something to the effect of people who are morbidly obese only have a 2%
chance of keeping this weight off. That is true no matter what age you
are. I would contact Walter Lindstorm at www.obesitylaw.com and see what
he can do for you. I know I wouldn't want my 13 year old to suffer like
that. And Lord only knows you have probably already put her on diets and
took away junk food. I would also do what Kris said and to investigate the
different types of surgeries. I too think the BPD/DS would be a better
choice for such a young person. Hell I think it is the surgery I should
have had. But that is another post. :) Good luck to you and please keep
us informed. I would love to hear how she does. Hugs and Love
— Alison B.
October 9, 2000
Mary, I too think this is worthy of consideration. I was always obese, and
I remember all too clearly what my childhood was like because of it. You
have an advantage in that you've already had the surgery, so your daughter
will have a role model with her, showing her how to eat and how to be
successful. You also have an opportunity to give her what so many of us
missed out as obese children: A normal life with free from bullying and a
chance at a happy social life. I wish I had this done at 13...who knows
what choices I might have made in high school and as an adult? Good Luck
to you and you'll be in my prayers.
— Allie B.
October 9, 2000
Mary, good luck in your quest to help your daughter. I had a VBG at age
16. It was hard for my mother to accept, but everything went off without a
hitch, until 2 1/2 years later when I began gaining weight again. My
surgeon had since retired and my Mother refused to go through it all again.
I was very young and had no idea the resources available to me at the
time. I had the VBG revised to RNY this past April. I wish I could have
spent the last 16 years weighing 139, which was my lowest weight following
my first surgery. I've still got a very long way to go, but I will always
remember my Mother's refusal to help me because of her own selfishness. 13
may be too young, but keep looking for the right surgeon and the right
procedure. She may be unable to have surgery until she's 16, but I would
keep supporting her to the fullest. Best wishes to you and your daughter.
— [Deactivated Member]
October 9, 2000
It is interesting to me that the neigh sayers post anonymously. Either
they are not obese or were not as children. I wish I could help you on how
to appeal. Begin by reading your insurance policy. If the Dr. says it is
medically necessary I do not see how they can deny it based on age.
Whatever you do, do appeal. Give your daughter the chance for a life with
all possibilities open to her.
— Marty R.
October 9, 2000
i don't agree with a 13 yr. old having WLS, but i am not one to condemn
someone for considering it.....personally i think that @13yrs old the body
hasn't finished developing, WLS surgery should be a LAST resort....if your
daughter has tried everything, which @13 I sincerely doubt....then one
might consider WLS, but think about it......13 years old...you are trying
to make a life altering decision FOR someone.....whether you want to
believe it or not.....a 13 child isn't going to have the courage to stand
up to their parents and say "I don't want to do this" no matter
how much they don't want to ....children don't want to let their parents
down, they are sometimes even afraid to say something because they know how
much it means to YOU.....Please just evaluate the situation from an
objective view....and if you still feel that weight loss surgery is the
ONLY option......may everything go very safely and very successfully....
— Jack N.
October 9, 2000
Hi..I feel that everyone has given good feedback to you on this issue...I
too grew up heavy and all the hell that came with it...But I also have a
son who at 1 year old had all his large intestine and some of his small
removed and as a child his body has gone to a great extent to make up for
the removal....so since your child is still growing I'd be curious if her
body would be as effective as our adult bodies are at this major change...I
guess my point is to really investigate this before you go ahead with it.
— Debora H.
October 9, 2000
Hi I responded to your other post, I must say alot the post that I am
reading here are disturbing. They sound just like the "uneducated
about surgery" people that I ran into during my quest. If we know what
we know about obesity and the family gene why prolong this young womans
current physical condition. She does not need to experience the frustration
of yo-yo diets that we did. They are unhealthy, we all know this. Its hard
to hear that a 13 year old is considering this surgery. But how many of us
said and look back and know that we should have (if we could have) done it
sooner. Check with her doctor, if she is physically ready then do it. My
intent is not to offend previous posters, I was thrown for a loop when I
read the comments. Blessings to all...
— Courtrina Amur W.
October 9, 2000
Wow, what a decision! I am praying for you! The only thing
that comes to my mind (as I also have a 13 year old daughter)
is the changes her body is going through right now due to
puberty. Could this sugery, done at this time, mess up her
growth and development (physical as well as emotional)?
I don't know, but that is a question I would ask more than
one Dr.- PCP, endocrinologist, Gyn, surgeon. Good Luck for
both you and her daughter!
wait a year or two
— M B.
October 9, 2000
Please erase the "wait a year or two" I was editing and
that is out of context- I don't know if you should wait or
not!!
— M B.
October 9, 2000
Mary, the surrent issue of the newsletter *Beyond Change* deals with
obesity in children. Go to www.beyondchange-obesity.com. They have a few
things to say about the minimum age for surgery thst might be helpful to
you.
This is an online newsletter which you can also subscribe to and have it
delivered to your home. I reslly like it and have found it helpful. They
deal with a variety of pre-and-post-op issues, new obesity reserach, etc.
Good luck. blessings,
Ann
— [Deactivated Member]
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