Is My Potential Surgeon Right

[APRPro4U 2]

NEED YOUR INPUT MY FRIENDS!

Hello Friends

I had my consultation with a pretty well known and 5 star rated dr. today in Orange County, CA. Here's what occurred:

1. Although I am 238 lbs at 5'2, he thought I should just do Protein Shakes? Huh? He also talked about the fact that my insurance only pays him around $900 for the surgery. Is this something I need to know? I think not.

2. I had a RY lap gastric bypass 9 yrs ago. He said there is no way to redo a gastric bypass NOR have a gastric sleeve. Is this true?

3. He said I will only lose around 25 lbs with a lap band. Is this possible? If so, why?

He has no tests yet as he ordered them today after we met. He didn't ask about my gall bladder either.

I have Tri Care Prime so my choices are limited.

So what do you think of all this AND can you recommend an Orange County, CA bariatric surgeon who takes TriCare Prime? Thank you all!!

APR

[cheryl2586 3,053]

You can not redo a gastric by pass or undo it it is a permanent surgery. If you were unsuccesful with the bypass I would not consider the band as it is the same even harder. Surgeons only get paid about 1000 to 1500 per surgery its the hospitals that cost so much so he may be correct. He cant do a sleeve because most of your stomach was stapled and moved away no way to fix that. You can get the band but like I said its the same concept if you do not follow the diet you will not lose weight.

[APRPro4U 2]

You can not redo a gastric by pass or undo it it is a permanent surgery. If you were unsuccesful with the bypass I would not consider the band as it is the same even harder. Surgeons only get paid about 1000 to 1500 per surgery its the hospitals that cost so much so he may be correct. He cant do a sleeve because most of your stomach was stapled and moved away no way to fix that. You can get the band but like I said its the same concept if you do not follow the diet you will not lose weight.

[APRPro4U 2]

So what do you think my choices are? My understanding is there are revision specialists out there. I have heard of multiple people having more than one gastric bypass.

Also, don't you think it's inappropriate for a doctor to discuss his relationship with insurance companies?

BTW, I DID follow the program and was successful for 6 yrs. There is more to the story that I prefer not to discuss here.

Thank you!

APR

[MelindaH 3]

So what do you think my choices are? My understanding is there are revision specialists out there. I have heard of multiple people having more than one gastric bypass.

Also, don't you think it's inappropriate for a doctor to discuss his relationship with insurance companies?

BTW, I DID follow the program and was successful for 6 yrs. There is more to the story that I prefer not to discuss here.

Thank you!

APR

Hi APR,

Hon, I agree with the previous poster that your surgical options are few. And I reallly am sorry that good medicine dictates that. However, I would get a second or even third opinion until you are satisfied that you are being told the truth. I totally agree with you that the MD discussing his payment by your insurance company is totally over the top and inappropriate. That is what a insurance specialist is for. He, individually, and/ or his practice signed a contract with Tri-Care or whatever insurance you have to provide safe medical services for patients regardless of your stature in life. If your insurance is tricare call them and ask them where the revision specialists are. I do know and have been told that the weight loss with the band is considerably slower than with the other procedures. But it will not lose the weight for me. I have to follow the program and exercise. I have not done that this week well but tomorrow is a new day and I am still preop. You are right there is probably more to your story than we know at this time. I sense that there is a lot of pain and am only suggesting counseling as I have benefitted from it enormously over my life. I sincerely wish you all the best.

Melinda

[APRPro4U 2]

Hi APR,

Hon, I agree with the previous poster that your surgical options are few. And I reallly am sorry that good medicine dictates that. However, I would get a second or even third opinion until you are satisfied that you are being told the truth. I totally agree with you that the MD discussing his payment by your insurance company is totally over the top and inappropriate. That is what a insurance specialist is for. He, individually, and/ or his practice signed a contract with Tri-Care or whatever insurance you have to provide safe medical services for patients regardless of your stature in life. If your insurance is tricare call them and ask them where the revision specialists are. I do know and have been told that the weight loss with the band is considerably slower than with the other procedures. But it will not lose the weight for me. I have to follow the program and exercise. I have not done that this week well but tomorrow is a new day and I am still preop. You are right there is probably more to your story than we know at this time. I sense that there is a lot of pain and am only suggesting counseling as I have benefitted from it enormously over my life. I sincerely wish you all the best.

Melinda

[APRPro4U 2]

Hi Melinda!

To know me is to know I am incredibly positive, happy, driven, successful and RELENTLESS. I hold a law degree and have been an executive at 4 Fortune 500 companies. I have an awesome husband and live in paradise.

Since my first post on the site today, I found not one but TWO doctors who specialize in revisions of all kinds. It is covered by my insurance AND I have learned it is more complicated and I am VERY OK with that. I weigh risk and reward...and take it seriously. It could indeed be a life and death decision...

My weight was off for six years before i tore my PCL....and then endured multiple knee surgeries. And, so long as I am putting a lot out there, I can tell you I was in therapy and my therapist said I really didn't need to be there. I'm blessed. Also, I'm at that menopausal age....so I got that goin' for me too!

Anyway, I appreciate honest, positive, informed input. Thank you all so much.

APR

[MelindaH 3]

Hi Melinda!

To know me is to know I am incredibly positive, happy, driven, successful and RELENTLESS. I hold a law degree and have been an executive at 4 Fortune 500 companies. I have an awesome husband and live in paradise.

Since my first post on the site today, I found not one but TWO doctors who specialize in revisions of all kinds. It is covered by my insurance AND I have learned it is more complicated and I am VERY OK with that. I weigh risk and reward...and take it seriously. It could indeed be a life and death decision...

My weight was off for six years before i tore my PCL....and then endured multiple knee surgeries. And, so long as I am putting a lot out there, I can tell you I was in therapy and my therapist said I really didn't need to be there. I'm blessed. Also, I'm at that menopausal age....so I got that goin' for me too!

Anyway, I appreciate honest, positive, informed input. Thank you all so much.

APR

I hope that nothing I said to you offended you. I was only trying to help. If I did, please forgive me. I understand knee problems, having had both mine replaced. I understand the menopausal thing, too, lol. I wish you all the best and please keep us posted on your progress

Melinda

[elcee 3,343]

It is possible to get a band over bypass. Whether or not it/you will be successful is something else entirely and not something I am qualified to comment on.

[Jachut 487]

I dont really understand - if you were successful for six years until an injury occurred, and you have had a bypass, why do you need another surgery? If, like many, you've learned to outeat a bypass, then I have indeed heard about many people being banded AFTER they've had a bypass and not enjoyed long term success with it. That can definitely be done. But I've never heard about bypasses being redone.

[lizzy2150 3]

If you want a lap-band, your insurance will cover it, you can find a doctor who will work with you, and you believe that you can make it work, then I think you can and should do whatever you feel is right for you. And as you work toward figuring out what you finally want, perhaps you could take the first doctor's advice and try Protein shakes.

And I think that the Dr. telling you that he will only get paid $900 makes it sound like you're not worth his time--like he'd rather deal with someone who will net more cash for him. While that may be true, he shouldn't announce it. Sheesh.

[Jack 855]

re: "don't you think it's inappropriate for a doctor to discuss his relationship with insurance companies?"

This is my opinion only, and differs from other prior responses.

I believe it is appropriate for my provider to clearly state what the financial aspect of his care consists as relates to the overall cost.

The question of who pays what amount should be one of the basics a consultation needs to include. His medical recommendations shouldn't be based on that matter, but as a patient I want to know who pays what. With that data clearly stated, any confusion later in the front office can be avoided.

Personally, I would welcome such frank disclosure as part of the initial consult were it me there in the office seeking a medical opinion.

It is possible to shop around and find a provider to give any answer one wants. The opinions of the provider given in the practice of medicine, like the practice of law, is based on 'likely outcome' in similar circumstance in prior cases. Prediction of our individual results remains a matter of speculation based on a lot of factors identified and unidentified.

Prior WLS does add at least some degree of complexity to the usual questions regarding Banding.

[APRPro4U 2]

re: "don't you think it's inappropriate for a doctor to discuss his relationship with insurance companies?"

This is my opinion only, and differs from other prior responses.

I believe it is appropriate for my provider to clearly state what the financial aspect of his care consists as relates to the overall cost.

The question of who pays what amount should be one of the basics a consultation needs to include. His medical recommendations shouldn't be based on that matter, but as a patient I want to know who pays what. With that data clearly stated, any confusion later in the front office can be avoided.

Personally, I would welcome such frank disclosure as part of the initial consult were it me there in the office seeking a medical opinion.

It is possible to shop around and find a provider to give any answer one wants. The opinions of the provider given in the practice of medicine, like the practice of law, is based on 'likely outcome' in similar circumstance in prior cases. Prediction of our individual results remains a matter of speculation based on a lot of factors identified and unidentified.

Prior WLS does add at least some degree of complexity to the usual questions regarding Banding.

[APRPro4U 2]

Jack,

Thx for your input. I am learning a lot and being reminded of issues I have not thought about in years.

Because I have an MBA and a JD, I am used to discussing money, financial models, etc. with colleagues. That said, I don't think a heart surgeon would talk to a patient about how little he is getting paid for a bypass, stint, etc. Why are bariatric patients different? IMHO, I think the obese are still discriminated against by doctors and insurers....many of whom are also obese.

I know from complexity. I just know something is not right with the gastric bypass I had too. I haven't mentioned this before but a couple years ago, I was gulping (I know, it was stupid) Water and I felt a pop....In my head I wondered if the staple or surgical glue came undone. I didn't go to the doctor.

Further, before my knee injury and multiple knee surgeries, I was able to run 5 mile a day.....my current amt of activity because of all that has been greatly reduced. And I LOVE to work out!

I have no doubt that I will find a solution but genuinely appreciate the input. Thank you.

[Jack 855]

APRPro4U: The little details are annoying like rocks in our boot; we must keep moving in the direction we chose, even if we have to stop to take our boot off now and again! cheers in your journey