Gastric Bypass & Medicaid/Medicare Question.

Hi everyone,  My name is gerrit and I am from Idaho Falls, ID.  I was first introduced to bariatric surgery a year ago and at that time the doctors were praising the lapband.  I had pursued the lapband surgery but hit a road block when I was told I had to lose 60 pounds just to qualify and then an additional 20 pounds on another diet to shrink my liver.  I weigh over 500 pounds.  I literally felt like 60 pounds was impossible.  Especially due to my one meal a day and then snacking in bed routine.  I have this issue where it feels like if my stomach is empty I can't fall asleep.  I hate it. 

 

Anyways,  after putting it off for a year I am starting to rethink bariatric surgery.  Especially the Gastric Bypass.  People lose weight fast and that's what I need and want.  My question is,  are the guidelines for qualification the same?  Lose 60 pounds to qualify?  By losing 60 pounds, I was specifically told I had to see a weight loss professional, lose weight with a trainer and see a dietician.  That all seemed impossible.  Anyways,  I am just looking to see what everyone had to do to get gastric bypass surgery. 

 

Thanks. 

 

-Gerrit

The 60lbs was a requirement from the doctor, not medicare or medicaid. Your insurance may require you to do 6 months of diet and exercise before the surgery can be scheduled.

Lapband has a poor long term rate of weight loss.

You may also want to consider DS. I'm still learning too and I also have medicare/medicaid. I am going to start the process soon myself.

Those sound more like the surgeon's requirements, in which case you might see if there is another surgeon that accepts Medicaid/ Medicare. Most surgeons have the same requirements for all the surgeries so it doesn't matter which type of surgery you would look at. You saved yourself a huge disappointment by not getting the band, it is currently showing a 50% failure rate and anyone with as big a BMI as you have really might want to look at the DS, duodenal switch, I believe you can find out more about this surgery at dsfacts.com. My surgeon didn't require any particular weight loss but I did have to do a 30 day liquid diet. I survived it but it was rough! No matter what surgery you have you will have to change current bad habits because they all require a low cal diet except the DS and you can even eat around the DS if you work at it.

None of the surgeries works to change your habits, they just make it easier to change them. You might want to get into some counseling ahead of time or check out Over Eaters Anonymos either in person or I think they have an on line group too. Just remember the more you weigh the easier it is to lose initially so you may find it fairly easy to lose that 60 lbs. Good luck to you!!

Gerrit,

You have gotten some excellent feedback from fellow members.  

We advise you to research all your options for WLS and OH is the right place for that.  Once you have reviewed your options and decided on the right procedure for you, then your next step is to find a surgeon.  We can help you with that too.  

Here are some links that will be helpful in your research.  

·         POPULAR TOPICS

·         RNY Gastric Bypass

·         LAP-BAND® System

·         Duodenal Switch

·         Vertical Sleeve

·         Realize-Band

http://www.obesityhelp.com/articles/choice-of-bariatric-proc edure-a-philosophy-obtained-in-20-years-of-bariatric-practic e-2/http://www.obesityhelp.com/articles/choice-of-bariatric-proc edure-a-philosophy-obtained-in-20-years-of-bariatric-practic e-2/

 

Let us know if you need anything else.

 

Regards,

Member Services

Hi Gerrit,

     My husband is also on medicare.  He had to see a surgeon who was part of the Centers of Excellence in order to qualify for the gastric bypass.  They required him to do lab work and an ekg to make sure his heart could handle the surgery.  They also required him to meet with a dietician and a phsyc. for a three hour test and talk to make sure he was ready for a change in life style.  All of these things are required by other patients as well.  From start to surgery date it will have taken about 3 months.  The surgeon required him to lose 40lbs before surgery by doing a month long liquid protein diet.  Not an easy task, but it is doable.  He was 440 so like you he was up there on weight.  My advise...look around for another surgeon.  Also...we had a couple from Idaho in our class in Coos Bay Oregon.  You may want to check surgeons from other states.  If you want to talk with my husband on how medicare worked for him, you can message me and I will get you in touch with him.  Good luck.

Garrit,

I started with my current doctor in June of this year.  I weighted 561.  He required me to lose 30 pounds and assigned a dietitian.  I researched doctors in my area and found that a lot of doctors had not handled someone of my size.  In fact the first doctor I picked strung me along for almost a year and I finally gave up on him.  The dietitian showed me how to balance protein and carbs and what to eat and what to avoid.  Bottom line I have lost 51 pounds and will have my surgery in 2 days.  By the way I had a lap band 6 years ago and with in 1 year it failed, started leaking and I gained all my weight back and then some.  My current doctor told me he would have never recommended a band for me.  Its hard work and I fully expect it to get harder after surgery but I am going to do this, this time.  I too for years ate 1 meal and snacked at bedtime...no more.  This may sound cornie but at some point I just got mad at myself and the world in general.  I decided that enough is enough.   Look and research for a doctor that will handle you and get you to where you want to be.  Good Luck

So what do you think is going to magically change about not being able to fall asleep if you feel your stomach is empty? Eating to a sensation of fullness before bed is not a success factor with weight loss and WLS typically. 

My advice is to seek some therapy to help you figure out what exactly is driving your eating habits to be so abnormal and to be so in control of your life instead of you being in control of your life. 

Losing 60 lbs is just what, 12% of your weight? Many people here have had to lose 10% of their weight and so that doesn't seem terribly off to me as a recommendation. But presurgical loss is based on each plan as well as surgeon requirements. The last thing I would do is surgeon shop to avoid what you don't want to have to do in the weight loss department. And be sure you are very clear on what your insurance policy requires. 

For the very large, I always hear the DS was the way to go, not RNY. I could be wrong on that count, but you really might want to at least look into it. 

 

Sweetheart, you dodged a bullet. A LapBand is poison for someone with your BMI. (Well, it's pretty much poison for anybody, but especially for high BMIs.)

You need to research something called the Duodenal Switch. www.dsfacts.com.

Medicare does NOT require a pre-op diet, nor does it pre-approve. If you qualify---and you do---they pay. I think the surgeon you saw is a horse's ass.