Looking for some advice

Hi! I've been lurking on OB for a while now, but never really made any posts. I'm in Denver and thought who better to turn to for this question than those right here at home. I've recently had to switch general practitioners as my previous one went back into teaching. I love my new dr. She's fantastic. I met with her for the first time a couple weeks ago and immediately brought up WLS after talking about my history and what not. She was very open to the idea, but her hesitation was in how healthy I am. I don't have any of the comorbidities but I've always met the BMI requirements. So she had me come back in today to run some tests and see what if I was borderline anything (Hypertension, diabetes, etc). I'm not. I have a underactive Thyroid so I've been upped in my dosage of medication for that. That's it. Between my last visit and this visit I've managed to fluxuate in weight by about 5 pounds (I was starting my period at the last visit). This 5 pounds has suddenly given her the thought that I would be successful in losing weight. I've done this many times. Lost the weight and then gained it plus some back (much like the rest of us). It's been a constant struggle since childhood. I've never known what "healthy weight" is even during those times I was able to lose weight. My insurance is UHC and they'll cover 100% of everything with NO prerequesites other than a dr stating it's medically neccisary. I was active with Curves for 9 months and did not lose any significant weight, though I did tone up some. I even went through their program for a 6 week diet. I can understand her being new for me and wanting to try everything again, I'm just not sure I can bring myself to jump through the same hoops I have already time and again, to have the same results which is short term minimal success. Has anyone else been successful at getting this surgery with out the comorbidities? Who was our general practitioner? Did they support the decision or did you speak with a surgeon first? I'm not sure if it's proper to make an appointment with a surgeon or not. I know that the referal is not needed for my insurance, but do surgeons allow it? I'm just so frustrated right now. Any advice would be helpful. -Cole-

If you qualify according to your insurance and do not need a referral try and find a well referred surgeon and call to see if he is accepting new weight loss surgery patients and accepts your insurance. Your insurance company might even be able to suggest someone. It would be great if you could talk to your doctor and have their support especially for after your surgery, but your surgeon can help you out. I have had a few normal doctors be quite up front that they do not like weight loss surgery for anyone and that I should just go lose the weight on my own. Well if it was that easy no one would be overweight. Don't take it personal...most of them have never had to deal with our issues. Find a doctor that is pro-weight loss sugery or is at least not against it. Just because you do not have comorbidities now doesn't mean that you are not a candidate for the surgery. You should talk to a surgeon. Most weight loss surgery programs entail alot of hoop jumping. Classes to take and tests to take. It's a very personal choice to have weight loss surgery and everyone should make sure they are ready for it and that it is the right choice for them. I think it's good that the doctor wants you to try other less invasive ways to lose weight it's only after them proving not to work that surgery is more of an option. But if you've already done that let the doc know and how you feel your medical needs are best met. By the way, I can fluctuate in weight 10 lbs in a day. It's water retention, not real weight loss. Good luck with everything and keep positive! ~Christal/dionysus_star

Christal, My PCP was completely against WLS. He told me that this was how God made me and I needed to learn to live with it. I decided to seak the advice of a professional. Many of the surgeons in the metro area will give you a free first visit to just come in and talk about the options. If you don't need the referal, and your insurance will cover then so much the better. I don't know where you are in Denver, but my doc, Frank Chae, at Sky Ridge is awesome. You may want to call Suzie, his insurance person and see if they take your insurance. If not, she may be able to point you in the direction of a doctor who does. The phone number for his office is 303-662-1191. The biggest hurdle I think that obese people have to overcome is the perception that you are they way you are because of a character flaw and not because of a "real" medical issue. Most PCP feel this way. But stop and think about this.... if someone needs triple bypass surgery for blocked arteries, isn't that their fault due to poor eating and exercise habits also? Some of their problems might be due to genetics, but if they took better care of themselves wouldn't they be healthier. It's not different for obese individuals. Some of our issue may be due to a lack of self control, but there are many, many physical issues that are completely unrelated to a character flaw in the person themselves. As for comorbidities, have you had a sleep study? Apnea is a common CM, but people rarely know they have it. Does your family have a history of any CMs? My father's family does, but I didn't exhibit the signs of them prior to surgery, however having them run in the family is something that many insurance companies look for. I have diabeties, heart attach, breast cancer and sleep apnea. I myself, only had sleep apnea, but it was believed that I would become diabetic like all my aunts and my father. I would advise that you seek the advice of a professional who knows about WLS. If you had another issue you wouldn't hesitate to do so. When my daughter tore her ACL I took her to the appropriate doctor, not her PCP. Good luck! We're here to help! Laura Smith

Hi! I live in Highlands Ranch and my insurance didn't require a referral either so I just called Dr. Frank Chae and made an appt. I saw him about a week and a half ago and my surgery is scheduled April 2nd. I have to attend a nutrition class on the 25th then pre-op on the 29th. My PCP doesn't know anything about this yet. I am sure she would be fine with it but it just seemed like an uunnecessary step to me since the surgeon is the one who beleived me to be a good candidate. Good Luck to you! Lori

Hi! I too have insurance that doesn't require a refferal so I just contacted Dr. Frank Chae in Lone Tree and made an appt. I saw him about a week and a half ago and he said I was a good candidate for the surgery so now I have a nutrition class on the 25th and preop on the 29th and surgery on the second. I don't think my PCP would have any objections but seemed an unneccesary step to go see her first. I probably won't see her until after the surgery. Since this is a new Dr for you there isn't any way for them to know you peronally and what you have been going through for any length of time. Good Luck to you! Lori

Cole, I had no co-morbidities, but I had a BMI over 50. I think that was the kicker. I too have UHC, and they gave me no problems whatsoever. I can't tell you where to go or who to talk to in the Denver area as I'm in the Springs. I hope, whatever you decide to do, it works well for you! Good luck!