All who pray, please pray for me.

Hello All,

I just found this website today.  I've been encouraged thus far from reading through the various posts.  Thanks for taking the time to share your experiences.  I am currently 28 years old, I've been battling obesity since I was about 7 years old.  I am looking to have the duodenal switch surgery.  However, my insurance wants me to pay a sizable deductible, 20% of the surgery, and any other costs associated with the surgery outside of the procedure itself.  On top of that, I am required to enter a 12 month supervised weight loss management program before I can even be considered for approval.  I am sooooo frustrated.  I am sick and tired of diets that don't work.  I am tired of losing 20 pounds only to gain 30 back.  I'm not sure that I have another 12 months of dieting with no results left in me.  I'm hoping to get the funds from my bank and just pay for the surgery myself to get it done.  I've done my research and know someone personally who has had DS.  I know its NO EASY WAY out, but it is the tool that I know will help me finally defeat my weight problem and live a normal life.  

There is so much I could write, but I will cut this short.  Please pray for me that something works out financially that I can get this surgery done and have the strength and discipline to follow diet/exercise protocol post-op for the best results.  Hopefully this time next year, I can share my success story and help someone else.

God Bless,

Abe

Abe, I can't help you with the deductible, but I can say that the 12 month (ridiculous!) supervised weight loss program is something that could be appealed. Whether or not the appeal would be successful I don't know - your insurer would probably not cave in, because the less people have surgery, the less money they spend, and that's what it's really all about. But there should be some kind of external appeals mechanism in your state that hopefully would back you up, because there is NO evidence that this type of requirement makes wls any more successful. 
     And while appeals don't get won overnight, it would certainly take less than 12 months to get an answer one way or the other, and you could always start the program in the meantime so as not to delay matters further.
     The DS truly is life changing surgery, and you will find following the proper post-op diet so very much easier than trying to lose weight and keep it off is for you now. If you would like a link to a recent position statement from the ASMBS regarding the futility of this pre-op weight loss program that you can use for your appeal, and also a link to a website where a lot of DS'ers can be found, just send me a pm.

Larra

Welcome! Praying for you. Know that God will provide this to you in His time. I started my journey last June and am scheduled for Thursday. I hope this goes quickly for you.

Who is your surgeon? I agree, 12 months is crazy.

Before you spend all that money, try to appeal. I know you're excited and just want to get it done, but if someone told you they would give you $20,000 to diet for a year, wouldn't you at least give it a shot? Play along, appeal, and if you get nowhere then go to plan B.

PM Larra and get that link. Lots of people who can help you there, both with insurance and with the surgery info itself.

God bless...

Don't give up!!!  I had explored surgery for years and was turned down because of previous stomach surgery.  In July 2007 I heard about the DS and within a few days had an appointment with one of the only two surgeons in Atlanta who did the surgery and he was a preferred provider for my insurance.  I was scheduled for Dec. 28 but got bronchitis and was rescheduled for early Feb.  Two days before surgery I received a call canceling because the hospital where my surgeon was on staff no longer allowed it to be done as an open procedure and that was the way he did it.

After three months of waiting for him to get on staff somewhere else, I sucked it up and went to the only other DS surgeon in Atlanta.  He was not in network and I had to pay 20%.  It was worth every penny!  I had my surgery Oct. 23, 2008 and have not regretted one thing about it.  DS is the only way in my opinion.  I know too many from other surgeries who have gained the weight back.  I was hardcore!  If there were a way to mess it up I would.  I started at 340 lbs. and was 157 today.

Don't give up!!  Go for it!!

 Bless your heart hun! I'm sure that's a terrible burden on you! Especially since you are 28, I KNOW you've probably tried every weight loss diet known, every fad, every magic shake imaginable. I've been there myself! I'm 30, just getting started in this process finally. I hope things happen in your favor! I will be thinking positive thoughts for you! Best of luck!!!!  

 Thank you, and yes I've tried shakes, pills, injections, powders, green tea, weight lifting, walking, fasts, etc!  It's been a rough fight 

Abe,

I will pray you can win over your insurance.  There is also another Texas Surgery Dr Stewart, you might check his prices against your surgeons to see which is cheaper.  Though I prefer Dr Stewart.

Betty

 Thank you all so much.  This is helping me not feel so alone.  

Good Luck Abe,
You sound like you have the right attitude to be successful with the D.S. It's the most powerful tool in WLS out there!!!   Do you have any comorbidities to help your surgeon fight the insurance co for you? My D.S. was the biggest  life changing decision I have ever made. Never any regrets, I love my D.S. !!!  Exercise has become easier with lots of weight gone. I have more muscle, and energy than ever before in my life. Prayer and support from all who have gone before us on this journey gives us all strength to succeed with our greatest wishes!!!!

sandra  ;-)

 Yes I do.  High blood pressure, sleep apnea, Acid reflux