Hi! My name is Angie. I just posted a pretty in depth question in the Drs and Hospital forums. I am posting here to see if I can get any uplifting hope! Basically I have a group consult scheduled for Oct 4th with Dr Christopher Evanson in Indianapolis, Indiana. I have Medicare and he is the only Lap Dr that is really close enough for me to see since Medicare requires that I go to a Center Of Excellence. This is a good thing and Dr Evanson has an impeccable reputation. While talking to his office manager this morning she told me that Dr Evanson doesnt normally do lap on someone with a BMI higher then 35. What the heck? I am 5' 4' and weigh 290lbs. My BMI is 49 I told her that I might as well cancel then because I am in no way interested in Bypass! She talked me into coming and hearing him out. She said I might even be able to pursuade him to do it.

I do not get this at all. I have read a lot of testimonials from people who have lost 150 to 200 lbs with Lap. When I asked her why he had this rule she said it was because people with higher BMI's usually get frustrated because the weight isnt coming off fast enough and that they often end up wanting the bypass afterall. I am totally ok with losing the weight slowly. I have the rest of my life to lose this weight. As long as the numbers are going down I am happy! I am so depressed over this.... Just needed to vent.

Go to the consult and hear what he has to say. I cant see anyone refusing to do a lap band if their bmi is over 35!! Lots of insurances won't even consider paying unless it is 39/40 or over! Try not to be depressed until you have at least talked to him.

That doesn't sound right to me. All the research I've done indicates that a lap-band is called for when BMI is between 40 and 50 (or above 35 with co-morbidities). I think you should go to the consult and stick with the lap-band. Gastric bypass has 10x the morbidity and is irreversible. A friend pointed out to me the advantage of having a reversible procedure, namely, that if medical science advances in your lifetime and alternatives are developed, you have the option of removing the lap-band. No such option exists with the Gastric bypass.

You should go and have an honest talk with the doc about the band. Try to convince him and show him that you are pretty conscious of the effort the band will demand and that you don't mind even if it takes quite some time to loose that extra weight you need.

Do lots of research here at LBT and try to make a list of all those reasons why you consider the band is ideal for you, instead of the bypass. Take that list with you when you go see your doctor. That will help you showing your doc that you're very focused on the band and that you have well thought about pros and cons.

God knows how hard this is being for me to loose weight. I started with a low BMI of 35 and I am loosing very, very, slowly. I have my band for 2,5yrs. and even so, I still believe that's the best thing I ever did for myself. What if I take more time than most banded people to loose weight? that doesn't mean the band is a failure or that I'm giving up this fight. I'll get there, it will just take me some more time.

Hang in there. No use getting depressed in advance and a good talk with your doc might make all the difference.

best of luck,

niki

Stick to your guns!! Yes it is true that Lap banders lose slowly at my 6 week appt i lost 33 pounds on a lap band and they were shocked saying I should have lost only 12 pounds or so. So no fill for me yet. Get what you want it may be slower but you wikll be happier in the end. Just remember that a lap Band requires alot more self control than bypass if you have any doubts on your ability to give alot up then have the bypass. Good Luck!!

Sounds like whoever you talked to was confused..

Typically they won't do a lap-band if your BMI isn't AT LEAST 35.. and for that you need 2 comorbidites unless your BMI is 40+. (This is for insurance purposes, and whether or not the doctor feels the same way).

But under 35 seems like she said it wrong.. I'd go to the consult to clarify

Thanks so much for all the support. I do feel better. I am going to that consult and standing my ground. I am wondering if the office manager wasnt confused. I went on obesity.com and found about 5 people this Dr did Lap band on who had BMI's over 35. One women's BMI was 55! I didnt find anyone recent tho. The last one was in 2006. I am hoping this isnt a new rule of his. It just doesnt make sense to me. I could see if he had some safety concerns. But to say I wont lose fast enough just doesnt cut it with me!

Find a doc that is a little more educated in bariatrics.

Seriously, the higher your BMI the more risk there is for surgery. Would you want a patient with the most risk having the riskiest procedure or the procedure with the LEAST risk?

I mean, common sense has to kick in at some point.

Check out revision stats. Typically it is NOT bandsters getting a bypass revision, it is bypass getting a band revision.

The reality is that docs make a LOT more money doing a bypass procedure than they do banding. They are business people running their business and they are looking to make money.

There are very few times that I personally would advocate bypass over banding. I can see it happening every once in a great while but my personal opinion (and I'm not a doc) is that banding is superior to bypass in so many ways.

As with any WLS YMMV.

I seriously doubt that you need to find a new Dr. I would be willing to bet that the receptionist, was mistaken in her numbers. As Laura stated above, many Dr.'s will not consider WLS on a patient with a BMI below 35-40, and many require co morbidities with a lower BMI.

I would go to the seminar, it is after all your first chance to show this Dr., that you are interested, and willing to do what it takes to be banded. Then if need be schedule an appointment with him to discuss it one on one. It is a less risky surgery, and the results are initially slower as a general rule, but in the end, the loss is about equal.

I began this with a BMI of over 42, with several co morbidities. I had no problem finding a Dr. willing to do my surgery, as I fell in the middle range of what most of them willingly operate on. I have heard that Dr.'s refuse some patients with BMI's over 50, without proven weight loss prior to surgery...but the BMI cut off of 35 is ridiculously low, I would be willing to bet money she is confused, or got her tongue twisted, or something and he does not do them on patients under 35 BMI without other issues involved. Give the Dr. a chance, go to the seminar, and I bet you come back releived!!

Welcome to LBT---we look forward to hearing what you find out!!!

Kat

I had a friend who had the gastric 3 1/2 years ago lost weight very fast, skin hanging dramatically, well the interesting thing is her "new" stomach has stretched out and her doctor is recommending the lap band on her new stomach. So she went through this major surgery 3 1/2 years ago and practically died and now they want to do the more sensible choice on her.

Interesting!!

Linda51