Long post (sorry) - Need advice please

Kathy L.
on 6/15/07 4:21 am - Westland, MI

I need some advice, please.

 

Here is my situation:

 

I attended the Beaumont Weight Control Center in 2004-5 for a total of 14 months.  This meets my current insurance (M-Care) requirements of 12 monthly doctor visits within the last 2 years.  My documentation will expire in November 2007.

 

M-Care will pay for Lap-Band or RNY through U of M, Beaumont, or Hurley only.  I decided to go through the U of M program for Lap-Band as all my doctors are through U of M and I didn't need to gather all my medical records, just the Beaumont documentation.  U of M has not done any Lap-Bands yet and must meet FDA regulations by having 3 "perfect" patients lined up first.  I do not meet the "perfect" requirements.  It could be 6-8 months or more before I could have the Lap-Band at U of M. 

 

M-Care has been sold to Blue Cross Blue Shield and my workplace does not know what insurance will be replacing it in January 2008, but it may be Blue Care Network.  If it is Blue Care Network, they do not cover bariatric surgery through U of M.

 

I have had consultations with the nutritionist and physician assistant.    They have told me that I must:  lose 50 lbs. (It took me 14 months on a mostly liquid diet through Beaumont to lose 60 lbs.), have at least 2 sessions with an Eating Disorder therapist, attend at least 2 support group meetings (I've already attended one), have a psych consultation (scheduled for June 29), and have a stress test.  These are in addition to the sleep study, echocardiogram and pulmonary function test I've already had done.  Also, the physician assistant seemed to be trying to steer me towards RNY.  I'm not sure if this was just his preference or if it had to do with my high BMI.

 

Here are my questions:

 

Should I continue with the U of M program or should I try Beaumont or Hurley instead?

If I go elsewhere, should I keep my psych consultation appt?

Does anyone know of any people with high BMIs that have had the Lap-Band procedure or if there is a maximum BMI for the procedure?

Is there anyone who had a high BMI that can share there experiences through Beaumont or Hurley?

Are all these extra hoops really necessary?

Should I try to get a loan and go self-pay, and if I do will that eliminate any of these other hoops?

Any other advice you are willing to share?

 

I'm sorry this is so long-winded.  Thank you for reading this and thank you in advance for any responses.

 

Kathy

Ann M.
on 6/15/07 4:30 am - Peoria, AZ
I think I would go for one that will be covered by insurance.  I wouldn't want to wait until they had 3 "perfect" candidates, who knows how long that would take.  Since you've been doing the diet at Beaumont, I'd probably pick that one if I liked the doctors.  I don't know about the high BMI but I do know someone who was over 400 lbs that had the lap band at Barix and is doing well. This surgery is very expensive and the more you can get insurance to pay, the better unless you want to go into debt up to about $30,000.  I'd much rather save that debt for the plastic surgery afterwards but that's just me. Good luck with your decision.
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Kathy L.
on 6/15/07 4:32 am - Westland, MI
Ann, Thank you so much for your reply.  It's good to hear about your friend who is doing well. BTW, Congratulations on your surgiversary tomorrow! That is so cool! Kathy
ozlady1000
on 6/15/07 4:59 am - Davison, MI
Forgot to mention Hurley does both Lapband; and RNY! They have done a lot of them! They have a complete staff of nurses, phyicians assistance, nutritionist; and more. Hurley is the largest Bariatric center in this area; maybe in Michigan. Every year they have a marvelous ballroom dance to celebrate all the hard work we have all done. This year was in Frankenmuth; what a great blast. Well again best wishes. Feel free to contact me with any other ?'s.. Hugs, Judy R
ozlady1000
on 6/15/07 4:32 am - Davison, MI
HI Kathy,     I had my Lap RNY at Hurley; I am sure if you talked to them about your situtation they could help you. It sounds like any long delays could jeapordize all you have worked so hard to achieve this far. Hurley would not make you lose weight first; they do require a two week liquid diet prior to surgery! Hurley has a very good program; the first monday of the month they have meetings in the Hurley health and fitness center.. Don't just give up, get going stronger if this is what you truly want! I am so glad that I did not give up; and now I am on the losing side. I had my surgery in Feb 07; despite a few complications I would do it again in a heartbeat.. I think you may not find as many hoops at Hurley! If I can answer anymore ?'s I will try. I wish you all the best of luck. Sincerely, Judy R
Kathy L.
on 6/15/07 4:35 am - Westland, MI
Judy, Thank you so much for your response!  I was looking at Hurley's website this morning, but didn't have any "real" feedback about them and any "hoops" they might have.  I see they are having an info session in a couple of weeks.  Should I wait until then or call them?  Thanks! Kathy
ozlady1000
on 6/15/07 4:53 am - Davison, MI
Hey Kathy,     Don't wait CALL! I had my surgery there; and so did my daughter.. My daughter had Lapband! We are both satisfide; and happy with our results. Hurley is a state subsidized hospital and trama center; and they accept all types of insurance! There # is 877-648-7539 a toll free number. Let me know how things are going; and where and when it happens.. They will set you up a consulation apt as soon as they can. Tell them you need it a.s.a.p. Hurley has three doc's that do the surgery, Dr Wagner was mine; and Dr Farhan was my daughters. Good luck, Judy R
Kathy L.
on 6/15/07 4:59 am - Westland, MI
Thanks Judy! Kathy
Brenda M.
on 6/15/07 4:41 am - Westland, MI
Hi Kath, First off, I have to say that I don't have any knowledge of Lap Band, so I can't give any advice on what procedure to have. I do know that while I love love love U of M, it sure is great to have this expensive surgery and have it paid for.  Maybe you should look in to the other programs and see if you're comfortable with them. As for the extra "hoops"... I had to lose some weight and see an eating disorder specialist along with sleep study and psych. eval.  It is totally worth all the work.  I really felt prepared and ready for my surgery. I wish I could offer you more answers.  I would keep your psych appointment.  It may be hard to get another appointment somewhere else, and I would think that even if you go to another program it will transfer.
Kathy L.
on 6/15/07 4:58 am - Westland, MI

Brenda, Thanks for your reply.  I really value your opinion.  I too love U of M, which is another reason, I chose it.  I don't really have a problem with most of the requirements, but  I see the 50 lb loss and think OH MY GOD!  It took me 14 months drinking mostly liquids to lose 60 lbs.  How am I going to lose it and have surgery before my documentation expires?  I don't have anything against the RNY and if that is the only surgery that is possible for me I would have it (I told Patti and Bill this), but I feel that having the adjustability of the Lap-Band would be better for me.  Thanks for the advice about the psych eval.  I was sort of thinking the same thing, so it's good to get some validation there. Kathy

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