Just getting started. all help appreciated

Hi, My husband is wanting to have wls. His doctor recommended that he sign up for disability because of venious insufficency (sp?) and edema and he has had 2 ulcers on his lower leg. Otherwise he is healthy. I had read that medicare would pay for the surgery but have seen on here that they may not. I mentioned thinking they paid for the surgery and our family doctor said he would help anyway he could to get things going. i would appreciate any advice you can give us. We live in north east Arkansas. Jonesboro is the closest large city to us. My husbands exact weight is unknown, but we know it is over 400 lbs possibly over 450. Has anyone signed up for disability? If so should we get an lawyer? when? any things we can do to help speed up the process of getting approved for disability/ the surgery? sorry i seem like i am pushing to get hubby on the surgery table but it is more nerves then that. I hate having the unknown hanging over my head!! I have never had a single stitch and the idea of surgery scares the crud out of me! He is the only one working here also, since I have been a stay at home mom for 4 years , since moving to AR. So finances are also a concern. He has been on winter layoff because he works construction. thanks for any help you can give us Jason and Troy (I'm Troy--probably the only female one you've met..lol)

Hi, I am on Medicare and they are paying for my surgery. From what I understand you need 2 years worth of medically documented weightloss attempts. They will sometimes pay for the surgery if you don't have the weightloss attempts but you have other sever co-morbidities. I didn't have the weightloss attempts but I am 28 and have Chronic Obstructive Pulmonary Disease, Severe Obstructive Sleep Apnea and other problems. What I did was looked up for all the surgeons in my area and started calling them one by one asking lots of questions till I found one that would see me. Good luck and I hope you find a surgeon.

My boyfriend is going through AR Rehab Services. My suggestion is just to call them and ask who you would need to speak with re: weight loss surgery. They'll put you in touch with a counselor who will set up an appointment for you guys to come in and get more info. You guys are in Craighead County, right? Here's the Jonesboro office's contact info: Jonesboro 2920 McClellan Drive Jonesboro, AR 72401 870-972-0025 Fax 870-972-1129, TDD 870-972-1204 e-mail contact: [email protected] Good luck!! Heather

by all means he should contact Ark Rehab. They will put you off for a year, requiring that you go on a program of their choosing to try to lose the weight. Of course, we know that even if one was to lose the weight, keeping it off is a whole 'nother thing. I know this because I'm currently in their program. They require a bmi of 55 to start and mine was 46, so meeting their first criteria means that I'd have to gain another 50lbs and I met their disability criteria. That can't happen because I could hardly move at all as it is. My counselor is VERY anti- wls anyway - even tried to tell me that there is only a 4% success rate with WLS, which is BS. At any rate, I am in their program. They will put you in a diet/exercise/counseling program even if you're not wanting wls. And, to tell the truth, I do not think it's such a bad thing to have time to work on food habits and getting stronger, to do LOTS of research about every possible aspect of wls, and to get to know other people who have had it and build a personal support system. If I'd been able to just apply to the ins co, get approved, and hop into the local surgeon's office, I probably would have just jumped into RNY and never discovered that there is a procedure head and shoulders above RNY called duodenal switch that will work permanently, not just during a honeymoon period, to help me end battling my weight once and for all. I wouldn't have met the wonderful people at the DS forum, or gained the tons of knowledge about all of the most common procedures in order to make an educated choice. I wouldn't right now be in a diet and exercise program which is helping me get physically rehabilitated enough to get a job with insurance to cover the DS surgery that I STILL plan to have, hopefully early this summer. I wouldn't be putting myself in the best possible shape and muscle tone for an uneventful surgery and quick recovery. I wouldn't know in advance that there is an exercise program (Curves) that I just love and will be itching to get back on. You should know that they have good reason to be anti-WLS. For people with really high BMI's, RNY is definitely not the surgery that most guaranteed to get them the very best results. And it does seem like an awful lot of people who have an easy time of getting surgery go into it without knowing NEARLY enough about what to expect or showing that they, indeed, can be compliant with the post-surgical program. What that has meant to them is that they've had a lot of people who had the surgery and weren't helped, either because they developed complications (dumping and stomal complications, which are not present in DS because there is no stoma, are too common) or because they haven't received enough counsel and follow up to sucessfully and healthily find the new ways to define their new selves. Ar Rehab's program supporting wls has had a very mixed bag of results - there's just been a whole lot of disappointment. They used to cover anyone who qualified for wls. Then they moved the BMI requirement up to 40, then 50, and now it's 55. They don't want to pay for it unless there is absolutely no other option, and they will exhaust every possible effort to avoid wls. That said, I am grateful that they are working with me. I am just about in a place to be able to hold down a job, and if their insurance will cover it, I'll have the DS. If not, I'll stay with the diet and exercise as long as they are paying for it ( I couldn't afford it on my own.) They are also working with me for vocational rehab, and I will be going back to school in the fall to get a degree that I can put to use doing something I will absolutely love. You can't really fault a program who is so willing to walk you to health and life success. Denise

thanks both of you for your help. I would love the idea of having help with the eating after surgery. I honestly like not rushing into surgery, but he feels so miserable now I dont know what he will think of waiting a year. (but it would be longer if we had to pay ourselves) I am about 60 lbs over weight. I feel I can loose it if only I got my butt moving and ate better, so any information would help us both. He was talking yesterday about being realllly disappointed in himself. He is working still and we just dont know what to do! He has been told that it is unlikely he will get disability while still working and we cant afford for him not to work. If I got a job I still wouldnt make enough to support a family of 5, especially since I have no real job training. If need be I will get a job, him quit and file for public assistance. I rather do that then watch him die over money. Our family doctor is being great about it. Said anything he could do just let him know. I will get ahold of AR rehab and see what we can do. He doesnt have 2 years documented diet/weight loss with any doctor. I wonder what kind of exercise program they would try to put him into. he cant stand or walk any real distance because of his feet and legs swell so badly. We saw a cardiologist and he said that, at jason's weight, surgery was about the only option- he is the one who diagnosed jason with veinious insufficiancey (sorry cant spell today!)- but otherwise his heart was healthy.our family doctor recommended he get on disability because his legs swell so much and he has starting to get ulsers. Jason just saw a pediatrist (sp?foot doctor) about cracks on his feet (thick caluses)and put on medicine and was told as long as he was heavy it would be a re-accuring problem. I called AR rehab last year and the woman I spoke to was very negative and told me it would be a waste of time to set up an appointment because he didnt have document proof of supervise diet by a doctor for at least a year. Well, his health has gotten worse and I am going to get pushier. Any suggestions on what to do to get an appointment? ps it wasnt the jonesboro office. I didnt know there was one there so I called one in Russelville, I think it was, just to get information. I will try the office given in the other email. thanks for help tz (jasons wife)

You might want to contact Dr JOhn Lambert in Batesville. He is a wonderful surgeon. My wife and I both had our surgeries with him and we drove down from West Plains , Missouri. You might want to contact a lawyer for getting helpl to get disablity. If your husband is over 50 it is easier to get approved under 50 it is harder. If you get a lawyer who is a former social security worker they help a lot. I got on ssd pretty easily but I have a very bad heart and I think they thought I was going to die soon so they didnt think they would pay out much or very long. I fooled them that was over 5 years ago and since my lap rny I have gotten much better. Not carrying around all that weight sure helps a weak heart.

Hi! I don't live too far from you! I too am on Medicare. The correct requirements for them to cover Gastric Bypass is this:You must have had doctor supervised dieting for 12 of the last 18 months. Due to changing doctors, and the fact I could not afford the medications they prescribed, I didn't have that documentation. I had started with Dr. Lambert in Batesville, and had surgery scheduled. Because I did not have a letter by my physician stating I had in fact been under his care dieting for the past 12 months, I could not have surgery. My mother opted to pay for the surgery for me instead of eventually paying for a funeral. However, certain doctors say it is fraud if you pay cash and are a medicare beneficiary and they a provider. So, with much disappointment, I went to a doctor named Dr. Clay Wellborn in Little Rock. I could have opted for Gastric Bypass but went with the LapBand instead. He is the first in Arkansas to do this, and is very talented. Medicare will not pay for this under any cir****tances. Sorry for the let down. My doctor could not say if my hernia would have held out to diet another 12 months or not. Guess it is a chance you take, but I am so proud that I went to him, and that it is finally behind me, after trying for 3 years. Email any time you like. Good luck and God Bless!

We havent done much but say we are going to do something. I think alot of it is nerves. Jason went to work a couple of days and was miserable and his legs swelled up huge and he ended up running a fever. Any time he works overtime or alot of hours in a few day he gets a fever and chills. We went to our doctor and had blood test run after the last time he worked and test came back "unremarkable" except slightly low iron. And they recommended he see a ...(trying to read doctor scribbles ...) "rhemmatologist regarding inflamation test". We decided to set up an appointment with a lawyer who specializes in social securtity disability. I am afraid we will do something to harm our case by saying or doing something wrong. From what i have found out online he's not eligible because he makes more then $700 a month. BUT he isnt making it working, he is getting it from unemployement checks(seasonal layoff) so I am not sure how that will effect it. I have heard it can take a long time to get approved and he will have to go back to work before long so I am kinda kicking myself for not pushing him to make a decision sooner so that he would have the whole winter off ahead of him. We have the appointment with the attorney on the 16th so hopefully he will have some good news. troy

I know how hard that can be, I applied for disability while I was working also. I didn't need the money, I needed medical coverage but they WILL NOT help you while he is working. I had to quit my job before I could get disability. I heard that it takes 3 month for approval, so I save enough money to cover my bills and it did take 3 months for approval. The problem now is with the new Medicare policy and finding a Center of Excellence. Lia