Paying it forward.....or not?

Julie,

This is where I don't think the DS is for everyone... it's ultimately her choice, but I hear about someone like that and think they would be putting their health at risk by a lack of follow up.

Let me know when you'll be downstate! I'll get something set up!

Lisa

Unfortunately, I had to delete this post due to privacy concerns.

Julie,

A couple of things.

First, most Medicaid programs have very limited over the counter (OTC) formularies because they do not receive matching funds from the federal government (most states receive at least 50 cents on the dollar from the feds). The most coverage I have ever seen for vitamins and supplements is vitamin D (in oil I might add) only for renal patients and liquid iron for kids. Protein shakes would be considered a food supplement and I don't know of any state that covers these for adults. However most states vary widely so there is a possibility. But right now states are in a severe budget crunch and Medicaid is usually being cut. I don't know if she can get protein shakes covered with food stamps though.

Second, it is not a HIPAA violation for you to give your doc a heads up. He cannot discuss her with you but that does not preclude you from communicating with him.

Last, I think you need to help her by 'not helping her'. By this I mean, mention the surgeon, tell her to do her own research on OH (might want to get this thread deleted), possibly mention she might want to pursue a major medical center for her GYN problems, and suggest counseling for all the upcoming changes associated with WLS (I imagine they can dress her other problems).  Then I would be supportive at 'arms length'. This may be the impetus to get her to start advocating for herself. She needs to make the decision regarding any WLS (or she can follow her surgeon).  If she doesn't have internet refer her to the public library.

I would be cautious in this instance. My concern would be that if you steer her into one surgery (or she perceives that) then if she has complications or unsatisfactory weight loss she would blame you.  

That being said, you are a super sweet person and kudos to you for trying to help her.

Just my two cents and it ain't worth that!

 Thanks, Ann, for the info about OTC supplements and Medicaid!

Tough spot.  I don't envy you.  You are a dear to try to help her.

I would just briefly discuss each type of surgery with the pros and cons of each.  I would warn her against the lap-band and make sure she understands the vites/protein/labs in respect to the DS (and Rny).  And definitely explain the need for self care.

I would give her all the resources you can.  (But does she even have a computer?)

I hope you will let us know what happens.

~Becky

 I already warned her away from the lap band, LOL

Tough call!

So here are my observations about being really fat:   I was depressed but didn't actually know it. I was exhausted all of the time and utterly vitamin deficient.  I hardly went to work and had every illness going. I cut myself off from others and then when I had to interact with them struggled with social norms and misread situations like any idiot with cabin fever.  I chose to not see the impact my ennui was having on all around me.  I knew that not walking my dogs and keeping them in the house with me 24-7 and not cleaning up the thousands of turds in the back yard was neglect but thought that lavishing them with love would make up for it (this was back over 15 years ago BTW).  I ended up living in a total flea pit of my own making.  I ate all of my wages and couldn't pay my bills so instead I got stoned. I let everything slip until I ended up living in a car with my two dogs pregnant and drug ****** wondering how I got there and how I would get out. I let my grief at my hideous upbringing keep me where I was.  I failed everyone in my life including those I loved most in the world (my dogs who were adopted by a friend, a source of perpetual grief and shame to me).  If I had of gone through with the pregnancy I doubt my child's life would have been any better and I would have spiraled deeper into depression and poverty.

I am white trash and likely the very girl that you would have thought EXACTLY the same thing about had I waddled up to you asking for help.  I was needy and desperate.  The things that changed was that I lost weight, started full time education expanded my friend base to include non-drug ****** idiots and found how to be happy.   I was the lost cause.

So here I am still **** with money but one of the best paid staff in my Hospital in  a senior position.  I live exactly where I always dreamed of, I have two beautiful dogs that I walk every day up hills and around Lochs.  I live with and love the greatest man in the world and it is reciprocated, I have a Degree and a Masters and am getting another Masters next year.  I have lost over half my body weight and remain exquisitely healthy and mentor other DS patients for my Surgeon.  I have arrived and it was my chubby legs that got me here.  I wonder if you should write this girl off.  Maybe she is calling up to you from the bottom of the well.  Are you going to send her down a rope???

 You have provided me with some honestly compelling feedback, Kirmy, and have given me much to think about.   I do feel though, that even in the depths of your ennui, I still would have seen that incredible spark of intelligence and wit that I see in this Kirmy of now.   I saw it in the pre-op Kirmy too.     I think this gal is far simpler a mind than you, but that's okay.   Not every successful DS'er is a genius (like you, LOL) - they simply need to be able to not be steered off course and to speak for themselves.    She may turn out to be a good DS'er after all, and I'd be her best cheerleader.     I simply want to see how capable she is of making her own DS journey a safe and successful one.  I plan to have her over for tea and talk.    I'll show her my vites, these sites, and tell her my tale.    WIsh me luck!

Julie, other have given you great advice and cautionary words. I don't know about Medicaid in your state, but in mine, it covers darn near anything for kids, but not a whole lot for adults. I'm a therapist and my agency works mainly with Medicaid recipients.

It speaks volumes for you that she found you approachable. Sounds like the best approach in dealing with that is 'Here's the info, here's my experience, here's what to expect post-op, if you don't have a therapist, here's where to get one.'

 I believe honesty is the best policy.  Sugar coat things and you haven't really helped this person.  I would flat tell her that it appears to you that her life is way out of control and to have the DS, she has to be able to take charge of her life...and her kids...and her finances.  She needs to replace all the excuses with action.

Yes, it's sad and regrettable that X, Y, and Z happened and derailed her life.  But that is all in the past and she needs to work on now instead of yesterday.  Stop relying on excuses.  This woman probably needs counseling.  Quite a bit of it in addition to WLS.

Can you tell if she has a lack of brainpower or is just an eternal victim?