Recent Posts

gingerale
on 8/29/09 10:07 am - Princeton, KS
Topic: RE: question about insurance
hi. I can't believe you have had so much trouble with just getting your surgery underway.  its sounds like the dr in nebraska might be the better way  to go.  my husband and i went up there this summer and stayed in a microtel for a couple nights i think gas and motel only cost $200 if that.  money is tight for us too, but i feel the benefits of the surgery will outweigh the risks of staying the size i am. 
i also went to a seminar in topeka for tallgrass.  I thought they were really good until i went to a dr in lenexa ks.  (minimally invasive surgery hospital, dr kawenski) I think that how its spelled.  anyway. They totally blew tallgrass out of the water. I went to a seminar and had my 1st consult this last wed. This surgeon, Dr K,  spent 2 hours talking to me, getting to know me and asking me probably 100 questions about my health and such.  Her knowledge amazed me.  She told me things about the meds i was already taking that no dr or nurse has even breathed a word about. They have strict rules to follow and *a rewards system* where you can earn free dr visits and even free plastic surgery procedures.  Thats a big plus as far as im concerned.  I could never afford plactic surgery-tummy tuck is one of them. Every surgery they do is done laparoscopically.  tall grass just kinda struck me as in it for the money. ya know. do the surgery collect the money. NEXT!!!  (but i never went to a consult so i could be totally wrong. hope my opinion doesnt offend you, not my intention.)
now as far as the DS  I went to MISH center in lenexa totally set on the ds.  She gave me all my options and now im leaning towards the roux en-y.  which i never thought i would. considering my weight, bmi, age and such I think the ds may be too risky.  the thing that really got me was the frequency of bowel movements and the flatuence.  Dr K said that most ds patients have really bad flatuence and that it can even come out thru our skin.  its doesnt just last for a few months but the rest of our lives.  she has seen patients lose friends over this and even their job and after they lost the weight.  I am a restaurant manager so that would be a very bad side effect to try to deal with while im on the job, ya know. so thats what turned me off from that.  So im stuck between the sleeve and the roux en-y.  If I do the sleeve then i could always go back and do the second part and turn it into the ds.
also thanks for suggesting the link to check out that new ins company.  i'll do that tonight.  Dr K said that if its not in writing don't  believe it.  so ive got some more researching to do.
thanks ginger
Flo W.
on 8/29/09 2:53 am - Kansas via Chicago, IL
MF
on 8/25/09 12:42 am - Sedalia, MO
Topic: Looking for a great PCP...
I am located in Emporia KS... I had surgery in St. Louis, MO in 2002. It is much to far to drive for a good PCP. Can anyone recommend a good PCP that has experience with RNY patients and their needs? It is very hard to find someone who can relate and knows what to do. I am really needing some help at this point.

Michelle
[email protected]
nightowl
on 8/24/09 1:54 pm - Topeka, KS
Topic: RE: question about insurance

That is interesting about the new insurance you are dealing with.  I hope they are legit!  Perhaps you could call or check the website of the KS Insurance Comissioner and they might be able to say.  I went to your profile and see you are interested in the gastric bypass or the duodenal switch.  The costs for these are way, way higher than $7500, such that I know I would have no possibility of paying the difference.  I think the self-pay listed price from Tallgrass in Topeka is $24,000 for the gastric bypass, and they don't even list the price for the DS, but I would think it's more.  Of course, maybe your insurance would have a negotiated rate that is lower, but I still think it's unreasonable of insurance to have such a low limit on how much they will pay for WLS, although, like you say, better than nothing.  Even just the pre-op tests and appointments I would not be able to pay on my own. 
I went to the first seminar interested in the Lapband, but after reading more and more at ObesityHelp, I came to want the DS.  The RNY has never held much appeal to me.  I went to my first WLS seminar in Arpil, the one for Tallgrass.  I had to wait until the Medicare took effect to start pre-op appointments, since BC/BS of KS wouldn't cover them.  But, now it can be a challenge to find providers who accept Medicare, since it can be a lousy reimburser to the professionals.  I had my psych eval first, since I really did not know if I would pass it, and I was not going to do the medically supervised diet (that the contractor who administers Medicare for KS requires here; this varies by state) unless I had passed!  Luckily, I did pass and can proceed.  It stinks to me that at Tallgrass if you have a better private insurance that covers WLS you can get a surgical consultation apt quickly (after attending the seminar and turning in forms), whereas if you have the stinkier Medicare that pays the surgeons much less, we have to jump through many hoops, including a months-long supervised diet, before we can even find out if the surgeon will take us on as a patient.  Then, even after that, there can be more of a wait for a Medicare patient to get scheduled at St. Francis in Topeka.  Bettye said she was told St. Francis Hospital here only lets four Medicare bariatric patients be scheduled there per month.  
I have also watched the seminar-on-DVD from Dr. Anthone in Omaha, Neb., for out-of-area potential patients.  It also came with a packet of articles from his office when I called them.  He mainly does the DS, and takes my insurance.  It says they want the DVD mailed back, so I need to be getting that back to them.  On the DVD, he said he will occasionally do a Roux en Y.  He has 13 pages of mostly excellent reviews here on ObesityHelp.  The reviews on OH and his policies sound like he doesn't treat anyone like a second-class citizen.  There are various pros and cons with the different choices of surgical groups.  Travel costs even just one state away would be an issue to me, but I think I could make it work if I had to.
 

gingerale
on 8/24/09 11:05 am - Princeton, KS
Topic: RE: question about insurance

thanks for the reply.  I have heard this a lot about bcbs.  i got on this website (right here connected to OH) where you can hunt for health ins and companies will call you and give you quotes.  Well the same night i entered my info i got a call from premier healthcare online and they were having open enrollment.  I signed up right then. So i actually got ins that would cover the surgery. At least thats what im being told.  I havent got the ins card yet.  I am meeting with the surgeon this wednesday, so i guess i will find out.  The ins is kinda pricy but its going to pay 90 % up to $7500.  So thats lots better than 100% comin out of my pocket.  My mother thinks it might be a scam or something, but ive had contact with the company over the phone many times and they have always been helpful.  So I'll see. 

Do you have a surgery date scheduled or what step are you at?

htupin
on 8/24/09 8:01 am - Blue Springs, MO
Topic: RE: Hey all!
I am leaning more towards RNY, for a number of reasons.   I think that what it does is more of what I need... and I'm a little squicked out by the "foriegn object in my body" thing. But more than anything, I think RNY fits my needs better.

As for Dr. Hoehn vs. Dr. Kowalski.... I'm still figuring that out :) Right now my main battle has been getting all of my records sorted out and to the doc... success at last!
skay74
on 8/24/09 5:01 am
Topic: RE: Hey all!
Hi Heather.  I am new to the message board and OH.  I am going to the informational seminar on Wednesday of this week.  I have heard good things about Dr. Hoehn, but I am sure that Dr. Kowalski is good too. 

I am just curious if you have made any decisions about which Dr. and which surgery that you are pursuing.   

I am eager for Wednesday to get here!  Perhaps, we can compare notes after my Wednesday session?!?
nightowl
on 8/23/09 10:07 pm - Topeka, KS
Topic: RE: gary baker plastic surgeon ?????overland park???
Will you give an update on if this worked out, or if you are still in the process? 

If you had to go ahead with the gyno surgery without the panni removal, I want to say I have seen at least one reference to Dr. Gary Anthone in Omaha, Nebraska doing a panniculectomy, and I know he takes Medicare.  He doesn't focus on plastic surgery, he mostly does duodenal switches, but he may take your case.  He has a lot of good reviews on ObesityHelp's surgeon section.
nightowl
on 8/23/09 9:20 pm - Topeka, KS
Topic: RE: question about insurance
I had BCBS of KS for years, and they were and are awful when it comes to WLS. I don't know of anyone who has gotten them to cover it.  I've had to wait years and have declining health until I've just now been on disability long enough to get Medicare, which will cover it.  During the years I had to wait, I did once write various KS legislators after reading the info at the OAC (Obesity Action Coalition) about a desire for legislation like some other states have that requires WLS coverage or that the companies at least offer a plan that includes WLS, but I guess there isn't the political will from more people in KS to get this.  Sen. Barnett from Emporia has done some work promoting such legislation, but it hasn't caught on here.  I remember I got a response back from Insurance Comissioner Sandy Praeger, and I think she was opposed to such a law, or maybe didn't state her opinion on it, but said her concern was that mandates like I am in favor of would raise rates.
marylaw
on 8/21/09 6:33 am - Winfield, KS
Topic: RE: Support Group to Meet 8/8/09
Unfortunately, no, but keep in mind that I haven't had my own group for very long (8 months). I would recommend that you post a message here, asking about that. If there are any, you'll surely get a reply. Good luck in finding a support group close enough to fit your needs.
While I know it's not the same, if there's anything I can do, as an OH Support Group Leader and Coach, I'm here for you. You can PM me anytime or call (just ask for my phone #). It know it wouldn't be the same as an in-person group meeting, but if it was all you had, it might work for you.
Blessings,
Mary
"Don't tell God how big your storm is; tell your storm how BIG your God is!"

     ObesityHelp Support Group Leader and Support Group Coach
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