Weight Loss Surgery: What would YOU do?

1

Help, I need some of your wise assistance deciding what to do about medical coverage and weight-loss surgery.

I recently took a job via a technical staffing agency that has a health policy available for which they make NO employer contribution.

I already have an individual policy via an HMO here in Washington state.

Their plan is $620 per month and mine is $420 per month. Theirs only covers Novolog and Lantus in vials, not pens. They don’t cover Synthroid at all (not a huge tragedy, I’ve taken levothyroid in the past.) They only cover 80% of a lot of things that my HMO covers in full, e.g. scoping procedures and other diagnostics, like mammograms.

It sounds like a no-brainer that my current plan is better until you go to about page 15 in their brochure and read that they DO cover weight-loss surgery (at 80%) whereas my HMO does NOT cover any bariatric surgery.

As a morbidly obese T2 who has been complaining for eight years that my insurance policies have never covered weight-loss surgery, I feel like the universe is calling my bluff:

“Oh, yeah. Well here. It’s covered. What are you going to do? Hmmmm???”

Yikes.

I’ve had four different doctors (sleep specialist, endo and two internists) tell me that I am the IDEAL candidate for weight-loss surgery. I’m what it was created for: someone who has struggled with a high BMI for decades and lost – and regained – large amounts of weight (between 70 and 130 lbs) FOUR times as an adult. Someone who has two serious conditions caused/exacerbated by weight: sleep apnea and T2, plus lots of joint problems exacerbated by weight.

I’m basically a complete and utter failure where weight loss via diet and exercise is concerned – despite spending basically forty of the past fifty-four years on every kind of diet under the sun (some of them four or five tries each.)

What would you do?!? Tic-tock, tic-tock, I have to make an enrollment decision in the next few days or miss my chance to enroll until next year – and I might not even have this same job next year.

I’d love your thoughts. If you could have surgery to turn your stomach into a little bag the size of an egg – but you’d be pretty much guaranteed to be “cured” of diabetes either for life or for a very, very long time – would you do it?

Thanks!

2

I am not a huge fan of the procedure. Two of my former coworkers had it and had decent results weight loss wise but a lot of complications and problems with it. With no diabetes involved. Still, if you feel that’s the best solution and you’ll save a bunch of money, it may be useful to get into the new plan if the 20%s on tests/ supplies/ etc. won’t put you out too much?

3

Thanks acidrock23 – what I need is a crystal ball. If it worked, I’d save tens of thousands ($30,000 or more) by having the surgery paid for by the new insurance and I’d have a personal miracle – tremendous improvement in my quality of life long-term.



If it didn’t work or I chickened out, I’d be as bad as I am or worse and out at least $6,000 until I could convert back to the HMO (at least twenty months until I could exhaust COBRA again and the HMO would be forced by Washington state law to take me back.)



If I had bad complications from the surgery or died from it…well…“no one ever expects the Spanish Inquisition”, eh?

4

From what I understand, the weight loss surgery only works if you’re totally committed to it. That is, you’re willing to do all the work that goes into making it successful (following a strict diet being one of them). If you’ve failed on previous diets in the past, you need to identify why those diets have failed. I have a good friend who is going through something similar right now in that she’s very overweight and while is interested in some sort of weight loss surgery, isn’t willing yet to make the commitment to it, because she knows her overeating is all emotional/self-medicating. As a result, while she might appear to be a good candidate on the surface, she is well aware that she’d probably ruin any chances of the procedure working.

I know someone else (a friend of a friend) who had the surgery a couple of years ago. She has lost over 100 lbs, but the surgery has had some serious side effects. She has a hard time following her diet and the results when she strays are less-than-pleasant to say the least.

If you think you’re ready for this and truly committed to what it means at the end…I’d say go for it. Do the surgery, get rid of the diabetes, and get on with your life! D sux and I would do anything to get rid of mine (I have T1). While I’ve never been overweight, I’ve known enough people who have struggled with their weight to understand that it’s a complicated challenge, one that science doesn’t completely understand yet.

5

I’d go for the surgery. It’s like sewing up the wound once and for all instead of covering it with a bunch of bandaids. I know someone who recently had lapband done and I endorse what everyone else said about a person needing to be totally committed to the new way of life, but it seems like a great chance to make a permanent change.

6

I did some reading into this after a tall, thin, cocky jerk of a doctor recommended bariatric surgery as a good option for me.

My BMI was 23.9 at dx, and 28 at the time that this recommendation was made. To meet funding criteria, I’d have had to gain at least 50 pounds.

Yes, my jaw dropped when this suggestion was made. I later mentioned it to the thin jerk’s boss, who is short, really fat, and a leading international authority on obesity. His jaw dropped too.

Anyway, bitter anecdotes aside, the reading I did made me really scared. I think the main issue is that when rates of ‘success’ are mentioned, the follow-through time is actually quite short. Not long enough to properly evaluate the true cost and side-effects of the surgery. And those can be considerable. And I am not so sure about it being a cure. Yes I know you are morbidly obese now, but who’s to say that you didn’t have the genes to be a T2 anyway, and that under it all, you might really be a thin Type 2?

I have heard that there is a hypnosis procedure you can go through, where you are hypnotized into thinking that you have had bariatric surgery. Maybe this is something you could investigate?

7

Thanks, Lila. I LOL’d at the hypnosis idea – I actually tried to do this on myself at one point. I thought, “Let’s give this a whirl before I commit to surgery”. I measured my food out in tiny portions (quarter cups of things) and tried to walk around everywhere with a water bottle in my hand.

My biggest fear is the water issue. I can’t even imagine not being able to just grab a big glass of water when I’ve been working out or if I wake up parched on a summer morning and just GLUG down a cup or two. The whole sip…sip…sip…sip thing people have to do post-surgery scares the heck out of me.

8

Yeah, I know that the side effects can be…challenging. “Dumping syndrome” doesn’t sound all that fun, does it? Eeeek.

However, it would be an excellent deterrent to pushing the envelope post-surgery. A kind of Enforcer lurking in your tummy.

I struggle with whether or not I think bariatric surgery is a kind of abuse of obese people – the risks are so high and the benefits are truly modest in many folks. A ten-year “good” result is maintaining a loss of about 40% of the excess weight (in people like me with a BMI over 50) – so I’m not exactly going into this starry-eyed with naive expectations.

It’s taking a big risk in the hopes of rewards that are worth the struggle.

Some people get all the excess body-fat off and keep it all off. Others struggle with complications for the rest of their lives…or fail miserably.

9

I watched this for a bit …am more confused than ever about the surgery …have no inkling , what one should /should not attempt http://www.youtube.com/watch?v=tuw50UZqkQ0&feature=related I. also looked for a Tu chap from Ontario , Canada who had the surgery and could not locate …he was thrilled with the outcome .

10

Thanks for your thoughts, Lynne. I am on contract – supposedly just for three months. I have no idea what happens next, but there is a gal in my same job title (an FTE) in my same small work-group (one of eight of us) who is due to deliver her first child within a week of the end of my 90-day contract…so the possibility of extending is there, at least until her baby-leave is over. I’m also watching for FTE positions, too.

I am no longer on COBRA. I got my own individual plan after my last round of COBRA expired, but GHC doesn’t cover bariatric surgery. If I switched to this company plan I’d be eligible for COBRA again at the end of this contract (for eighteen months) and then I could always switch back to my current plan if nothing else came up during that time (no FTE with benefits, that is.)

I have been thinking about the time when I couldn’t work – at least a few weeks, I’ve heard, and complications are the wild card, of course.

I’ve also been thinking about the 20% co-pays, which would probably run $6,000 to $8,000 – it could be astronomically more if I had serious complications.

There are a lot of “what if’s” to this whole thing.

Let’s talk soon – I see a bolus in your future. ;0)

11

Tough decision! I know one person who had this procedure. She’s not a PWD. Though she lost weight, she regretted it. As a result of the surgery, her life was far from normal.

12

Thanks, Gerri. On some level it just seems…wrong…you know?

I didn’t get so fat by drinking “too much” water, eating large salads, or snacking on celery, steamed broccoli or chopped bok choi and Nappa cabbage…things that will be difficult to impossible to consume post-surgery (big glasses of water, crudite and cruciferous veggies.)

13

Oh honey, I agree.

14

The other thing that has stuck with me re the surgery option is the Oprah show, where they explained that post-surgery, some people replace addiction to food w/ addiction to booze/ sex. Of course, this seemed intriguing but the person was on was like “I drink a lot” and Oprah was like “how much is a lot?” and I was thinking “8, 10? hmmm” and she said 20-30 beers/ night as there’s a apparently some “short circuit” in how alcohol gets processed? At my most debauched, I don’t think I’d have drank 20-30 beers/ day, much less an evening. I recall an F. Scott Fitzgerald bio that mentioned that he’d put away 43 while being interviewed in an Asheville hotel room, as the interviewer counted the cans after he nodded off. That was 2.3% beer though and he had the hypoglycemic excuse? The 20-30 beers was quite stunning!

15

Surgery is very aggressive but if you feel there is NO way you can do it by yourself then I would recommend that you switch and take advantage. For eight years that has been your reason why you can not lose the weight, well now its your chance…You can always get back on that Washington insurance and who knows you may get to the point where you dont need all those meds anyway. Weight loss and exercising helps heal the body!

More importantly I think you need to maybe seek some sort of mental support. Being that I have also struggled with weight I know first and foremost its mental struggle as well. When your feeling bad you eat, not just regular food, you eat all the bad stuff. You are not motivated to get up and exercise at all. Of course there are other reasons for weight gain but for years you have been a creature of habit and that has to change. I think you need to get to the mental source also in order to maintain your weight loss…

Good luck!!!

And if you do not decide to get the surgery I have faith in you that you can lose the weight anyway!

16

I located the Canadian member’s name , who had the Bypass Surgery : Grant Buchan-Terrell’s …his last post was March 17 ;as I mentioned before , he seems very positive about his results …
There is also a group, started by debb called " Gastric Bypass : The last Resort " …hope this info is helpful .

17

This just came out in the Houston news. Here is the link for the article. Hope this helps…

http://www.click2houston.com/health/28051230/detail.html

18

I want to echo what Rye said. I’m not saying this applies to you, Jean, but I have found through my own personal experience and that of others I’ve worked with that some of us have a strong emotional component to our overeating/weight gain. If this is the case, we spend years losing and gaining weight and never finding a solution until we deal with the underlying emotional aspect to our overeating. One resource for this is OA and/or therapy for food and weight issues. Again, I wouldn’t presume to say this is or isn’t the case for you, Jean, but if it resonates I’d be glad to talk further.

19

Wow! I can’t even imagine drinking that much. I am not a fan of beer – I can say with complete certainty that I have not had 30 beers in my entire life, much less in one night. Just thinking about it makes me feel a bit whoozy.

I don’t really like the way alcohol makes me feel. I have about three or four glasses of wine in a year and maybe one mixed drink, tops.

I was a (heavily addicted) smoker between the ages of twelve and twenty-two (three packs a day in high school and college…eeeek) with a couple of brief relapses (lasting a month or two) since then – I’m not saying that I can’t abuse things I shouldn’t, just not alcohol or mood-altering drugs. I’m blessed with not liking the feeling of being high. Given the alcoholism in my family, it’s sheer dumb luck that I’m wired that way.

I know that a few famous gastric bypass patients started drinking and smoking a lot of dope post-bypass. I just don’t see that as a risk for me. I’m more worried about physical complications such as constant nausea, things getting “stuck” if you don’t chew or prepare it correctly, being tempted to cheat with soft things like milkshakes, pernicious anemia, calcium deficiencies, not being able to take supplements or medications without having to “taste” them by grinding them up and drinking them down in milk or something (nasty!), not being able to take oral chemo agents if my melanoma were to come back or I were to develop some other cancer down the road (e.g. tamoxifin for breast cancer), having a heart attack, stroke or blood clot in my lungs during/just after the surgery, etc.

You know, cheerful stuff like that. ;0\

20

Yeah, I’m the queen of emotional eating…but years of therapy and groups haven’t really helped. There’s something inside me driving the cravings that feels biochemical or genetic. If you look at pictures of my paternal grandmother or my maternal great-grandmother, I could be twinsies with either of these ladies, just photograph me in sepia and photoshop my head onto one of their bodies. There’s something going on there that’s beyond and in addition to my seeking emotional comfort with food. Something primal and biological.