This afternoon I met with my new primary care physician. It started out well, then we started talking about my weight. She gave me the spiel about calories in versus calories out and diet and exercise are what what make you loose weight and maintain it. I totally understand that concept and the idea, but do you think that if I could control it, I would be in this position? She also told me that my insurance wouldn't cover it because my BMI is not at the magic number of 40. (BTW - she doesn't know my insurance nor did she check with them) Well I have a BMI of 38!!!! Plus high cholesterol and GERD. From her experience she said that insurance would only cover an under 40 BMI patient if I had diabetes. With that news, I started to well up. I told her how my weight has held me back, made me feel unhealthy, and overall in the dumps. She then said that patients with my "attitude" are not successful with weight loss surgery. WTF does that mean? Before you all had WLS were you fat, healthy and happy? She also -said that the Lap band really doesn't work and I should only expect a 5 - 10 pound loss. That's when I lost it and started balling my eyes out. She then changed her tone and said if that's what I really wanted she would refer me to a doctor, but she didn't think he would accept me as a candidate. I was so upset by this point, I told her that I didn't need her referral as I have a PPO. She offered me some kleenex and checked my heart and lungs. I walked away from the visit with a bunch of lab orders, a flu shot, and red swollen eyes and nose. UGH!!!
So with that be said, my appointment with the Bariatric surgeon is still on for October 26th. I am determined to have the surgery even if I have to pay out of pocket for it. I tried the whole "loving my body for what it is" idea for a while and I was still miserable. I am over being fat and unhealthy and JUST diet and exercise are not enough for me. I NEED HELP!!!!
BTW - About the whole magic 40 number. Why does someone who weighs 10 pounds more than me get help? You know what that makes me think? I could gain 10 more pounds in my sleep. I shouldn't have to do that to to get help (key word is "help") to lose 100 lbs.
There - I feel a bit better now. Thanks for listening.
Cheers!
Robin Wine Girl
Sorry that your new doctor was rather rude in my opinion...
ReplyDeleteMy doctor didnt really approve either. He is against the surgery but since my mom was so successful with it he gave me the go ahead.
Wow - she's definitely "anit" lap-band then isn't she. I had a similar convo with the dietitian I had to go see when going through the motions. Keep your head up. Go to the surgeon consult and see what he has to say. Put the negative vibes behind you and keep pushing forward!
ReplyDeleteFirst off, I highly recommend finding a new PCP. (Duh!) This sounds like an unfortunate case of a physicians personal biases steering her professional decisions. I can sympathize with you as I spent my childhood being put through the ringer by a pediatrician who held a very low personal opinion of overweight people. As an adult, I had a PCP that attempted to convince me that everything from a sprained wrist to a sinus infection could have been avoided if I would just lose some weight.
ReplyDeleteMy husband and I were very fortunate that the PCP that we began seeing to begin our Lap Band approval was a very supportive physician. He did emphasize to us that WLS isn't without risk (he related the story of his mother in law who ultimately passed away from ongoing complications with Gastric Bypass) but as we continued talking about the procedure he realized that we had done lots of research. Once he was confident that we fully understood what we were getting into, he was great.
Your PCP was obviously aware that the FDA recently adjusted the eligibility guidelines for LapBand to include patients with a BMI of 30 or more if one or more co-morbidities is present, including but not limited to diabetes. Diabetes is not the only co-morbidity that warrants Lapband treatment.
I am so sorry you had this terrible experience. And to answer your question, I was a miserable person when I decided to have LapBand. I had managed to give up on my life and I honestly cannot say where my life would be right now. I was at a complete breaking point. I think that you are gonna have a much better experience with your Bariatric surgeon. However, I hope you will give consideration to finding a new PCP. You will have enough challenges as you work to change your life you definitely don't need one of your physicians actively trying to derail your progress.
Hang in there!!
correction *PCP was not aware of the new eligibility guidelines*
ReplyDelete{{HUGS}}
ReplyDeleteI paid $16K for my band. Worth.Every.Penny
If you think that this is worth it, then I know that you'll find a way.
And yeah, get a new PCP. ASAP
There are other co-morbites for insurance to cover WLS under a 40 BMI other than diabetes - it would be a good idea to research all that your insurance will cover. I had a BMI of 36 and was finally approved due to sleep apnea.
ReplyDeleteIt might be a good idea to look into other physicians who are willing to stand behind you as well...
(((hugggssss))) to you
Good lord that new PCP should be kick for not being supportive at all! Go online and leave a review. Trust me.
ReplyDeleteThere was just a huge study out that reviewed lapband surgery and I am pretty sure they are allowing WLS for 35-36 BMI and up. So never fear!
Going to the WLS doctor will be a different experience all together so chin up! When I was 1st going I didn't have a PCP, I had a OBGYN. I was 39 BMI. And no real Co-morbitites or so I thought! I went in to the WLS clinic having done a lot of research and was really confident in what I wanted. They ordered blood work and lots of other tests and the blood work came back that my sugar was elevated. I was devistated. I mean in tears for a week that I let my health get this bad. He put me on the lowest dose of Metformin and then I had a comorbitiy. The same week as my surgery I was off metformin. My surgeon (different from the WLS Clinic Doc) feels that this was his way of loging that I was on my way to having more serious issues including diabetes. Same with sleep aptnea (sp). I went and did the very expensive sleep study and it was found that I had mild sleep apnea. No need to go on c-pap however #2 co morbidity.
So although I don't think he was lying in my paperwork I do think he was working to help me a bit.
Be confident. Tell your clinic why you want this surgery and what you have done in the past.
But the figures do jump all over the place with lapband. Not everyone why has this surgery is successful. That is why the WL averages are low. Some people just can't get that this is a tool that you have to work with every day. Although different from a diet it is a life altering change both good and bad! 70lbs down. 10 months out. So screw that PCP.
Wow, this PCP doesn't sound very pleasant. I'm sorry that happened to you because being treated like that was totally unnecessary. It'll work out for you, one way or another.
ReplyDelete*hugs*
That PCP is WRONG. She obviously knows nothing about the band or how it works. I have nothing to say that anyone else hasn't already, but just know we're behind you 100%!
ReplyDeleteI paid $13,000 for my LB and it was worth every penny!!!!
ReplyDeleteGood Luck!!
I'm just going to second what everyone else has said-- if she can't be supportive of your real efforts to get healthy because they don't match her idealized (and unsupported by research) way of losing weight and keeping it off, then she shouldn't be your doctor.
ReplyDeleteI don't know if insurance will cover you (they are all different, and they don't go by FDA guidelines- they set their own). But I do know that if you are determined and serious, it is worth the out-of-pocket expense. It's the cost of an economy car and in my mind, worth more than any car could ever be.
Get a new primary quick!
ReplyDelete