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Reasons to be denied surgery?



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I have my consult with a surgeon next week and was just curious if anyone had experienced being denied for outrageous or really unexpected reasons?

To give you a quick background on myself, I am a 24 year old female who has struggled with my weight since I was 10 years old. I do not smoke and recently had bloodwork done confirming I have elevated cholesterol levels (not to the point of being considered a risk). I have a BMI of 47 and currently sit at 310 lbs on a 5"8 frame. I do not have diabetes or heart-related issues. In essence I meet all the criteria. I have the finances for the surgery already covered and looked after (so I know that is one thing they wont say no about)

From my own research, I can see no reason to be denied, but I have this awful fear that the surgeon will tell me no. Has anyone, who is similar in health condition and meets the criteria for surgery been denied? If so, please let me know. I dont think I could take hearing no from the surgeon when I know this is the path I must follow.

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There are reasons to be "denied" that relate to insurance, and then reasons to be denied that are medical. I'll share with you a saying my granny used to say "Don't borrow trouble". Which means, don't worry about it unless you need to.

No, most people do NOT get denied for "outrageous" reasons. If you meet your insurance criterion and do not have a disease you didn't disclose, why would you be denied? No surgeon will deny you "on a whim".

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I think the general rule of thumb for the lapband procedure is that if you have a BMI less than 40 (but higher than 35) you need to have at least one accompaning weight related health issue (as per the official lapband website: http://www.lapband.com/get_informed/about_lapband/right_for_me/). As I havent had my consultation yet and my own cholesterol has not reached the high risk category, I honestly cant give you an answer on whether cholesterol counts as such. I will keep it in mind for when I have my consultation though and will post my surgeon's answer here. It would be silly not to consider high colesterol as a comorbidity of obesity, but I am not the professional in this field :tongue_smilie:

Edited by Juwel

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Is high cholesterol a reason to be given an exception to the 40 BMI rule?

That would depend totally on what your insurance requires.

Many policies differ about what they require before they'll pay for the lap band procedure.

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    • Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 0 replies
      1. This update has no replies.
    • Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 1 reply
      1. summerseeker

        Life as a big person had limited my life to what I knew I could manage to do each day. That was eat. I hadn't anything else to look forward to. So my eating choices were the best I could dream up. I planned the cooking in managable lots in my head and filled my day with and around it.

        Now I have a whole new big, bigger, biggest, best days ever. I am out there with those skinny people doing stuff i could never have dreamt of. Food is now an after thought. It doesn't consume my day. I still enjoy the good home cooked food but I eat smaller portions. I leave food on my plate when I am full. I can no longer hear my mother's voice saying eat it all up, ther are starving children in Africa who would want that!

        I still cook for family feasts, I love cooking. I still do holidays but I have changed from the All inclusive drinking and eating everything everyday kind to Self catering accommodation. This gives me the choice of cooking or eating out as I choose. I rarely drink anymore as I usually travel alone now and I feel I need to keep aware of my surroundings.

        I don't know at what point my life expanded, was it when I lost 100 pounds? Was it when I left my walking stick at home ? Was it when I said yes to an outing instead of finding an excuse to stay home ? i look back at my last five years and wonder how loosing weight has made such a difference. Be ready to amaze yourself.

        BTW, the liquid diet sucks, one more day and you are over the worst. You can do it.

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    • KimBaxleyWilson

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