HELP PLEASE : feedback on msi/medicare procedure

Hi I am new to the forum- not new to obesity. I weigh almost 300lbs and I am 5ft tall. I just got back from my drs. today and discovered that msi (my medicare) here in nova scotia will not cover any bariactric surgery in Ontario. My bmi is almost 55. I am only 41 years old have high bp and chronic osteo arthritis in my knees and back....... so I am in pain constantly and I am on a lot of medication including meds for depression. My dr. has gotten other patients approved so she was sure with my bmi it would be no problem however due to the new 2 or 3 drs. opening this new weight loss clinic in halifax - msi replied that I have two options moncton or halifax.......... I am sure the wait even with the new Halifax clinic is going to be very long because of the amount of people who have been waiting such a long time - years! I guess I was kinda stunned that msi rejected me and now tonight I am wondering things like how do I find out how long a wait will it be at the new clinic - my doctor followed msi's instruction and referred me to both clinics- halifax and moncton as per there instruc.......... she is not sure of who the new drs in halifax are - and if there is a clinic as such or if they will just operate out of the QE II Hospital ? Does anyone have any suggestions - my dr. told me to hang tight but I feel like I left her office without getting all my questions answered ......... seeing my family dr again before the next month is impossible she is so busy that May 2nd is the soonest appt I could get. I checked out the QE II website but do not see any bariactric section. Does anyone out there have any advise for a newby............ how do I keep up the fight - I have read some posts that say appeal the msi decision- if they are saying we have 2 options in your province and will not pay for a private clinic in ontario- what grounds do you appeal on? So does anyone have the names of the clinic Drs for Halifax or more info. Those who have been on the Moncton list with Dr. B do you know where you are on the list and how far away that puts you for a surgery date- will they give you that much info? I know a lot of you are past this stage but I so would appreciate the help...... I have read the past posts but nothing is current enough to address all of my questions. Especially now that Halifax is going to have a wls clinic again. I thank anyone in advance for all your advice and experience. Deb trying to start my journey to health

If you read one of the recent posts about getting a surgery date, I think it has one of the Dr's name. Historically the wait for Dr B has been about 6 years. I have been waiting 3 years to see an endocrinologist. Recently NB Medicare decided that pre-approval was not necessary. For me the upside is that I no longer have to wait to see the endocrinologist. The down side for everyone is the waiting list just exploded. I have not been able to find out how they are going to merge the waiting list of those pre-approved and those waiting to be approved. You could check out Maritime_Bariatrics_Patients- it is Yahoo chat site. I didn't know the NS ever paid for surgery in Ontario. NB does not. I want a lap band and i will have to pay for the devise,. even if i am approved! I will have a quick look at the other site for info.

I think one of the surgeons is Dr. Dennis Klassen.

Nova Scotia won't pay for out of province and we always had to pay for the band also. And why should we have to send people to other provinces to get it done, our medicare dollars are streched enough.. Why have to pay for hotels and airfare, when it can be done here.

MCP, which is our Newfoundland Health Care Commission had no problem approving my surgert costs out of province. I wrote one of the head ajudicators and outlined my position, also gave him a copy of my doctors consult to Dr. B. Gastric bypass in an approved procedure in their books- but is not offerred in our province. The reasons why are complicated and I'm sure are mostly financial as well as political. We have surgeons in Newfoundland who are well trained in Bariatric Surgery- just no funding and provincial go-ahead to start a program. I know of 2 others who have gone to NB for Bariatric Surgery and had their costs covered by the newfoundland Health Care System. Newfoundland does not recognize the Lap Band Procedure in their "approved" list- so no funding for that. My advice to anyone who is running into brick walls trying to get seen and on a list for Bariatric Surgery comes in 4 parts. #1- Be sure and confident that you want this. There are lots of resources out there to help you educate yourself and make an informed decision. You need to be 100% sure that you want this. #2- Find out the facts- what is the Doc's name. Get a referral from your family Doctor. Find out if you need medic-aid approval- contact the RIGHT - person there- see what info they require, where you should send it, and make sure they get it. They also really need to know a bit about you, your health history, reasons for wanting bariatric surgery, your plans to keep healthy after. I know most of us don't want to tell complete strangers about our obesity and related issues- but the more they know and understand about you and your particular situation- the easier it is for then to make a decision. If the first decision is NO- don't give up- write again and give more reasons why you need this. Remember- by now you are 100% certain this is for you. If you aren't good at writing/typing letters or putting thoughts down on paper- get a friend or someone to help you. Keep track of when you send and receive correspondence. And always get the names of people you speak to, along with dates and times. Keep copies of all correspondence you send and receive. Contact your government representative to lobby on your behalf. Noise gets results! #3- If your health conditions worsen- make sure your surgeon knows. Be patient and be good to yourself while you are going through this. It seems a daunting task at times to get through all the red tape. But remember you are doing it for YOU> So keep writing, phoning, faxing -whatever it takes. #4- Looking back-I was almost 3 years from the time my Family Doctor here in NL sent the consult to the time of my surgery. It was a hard 3 years. It has cost me significant amounts of money for travel to and accommodations in Moncton over the years. Very small amounts were paid by my personal group insurance I have at work- I think 1 trip I got 280$ back. No way close to covering the airfare, 2 nights in hotel and taxis to and from airport and hospital . Coverage for this is limited to once per year. This year alone will have 4 trips up there. My NL public health coverage does have some provision for compensation of travel expenses- but I still haven't figured it all out yet. Knowing now that there are so many reputable private pay clinics starting up- I think that if I was just starting out now- I would go that route. The wait for provincially funded bariatric surgery is getting longer all the time. And a lot of us don't have that time to wait. Going private entails money up front- but you know what- it's an investment in YOU- what could be a better reason that that. Loans can and will be repaid- and life will go on- with you all the healthier. One word of caution- Research, Research, Research the facility and doctor you will be going to. Talk to former patients as much as you can and see what their opinions are and how they feel about their whole experience. PS-If you are on the list for provincially funded bariatric surgery and the wait time is extreme and you feel you will not be able to wait it out- go to your family doctor or whoever refferred you in the first place and ask him/her to write a letter for you and contact your provincial health plan asking that you be approved to have surgery somewhere else- ?another province- possibly the US- where the wait time is shorter. Do you homework here and find out where these places are. So- godd luck on your journeys- the services are out there- we HAVE to kick, bite, scratch, cry, write, run- do WHATEVER it takes to get where we want. DON"T GIVE UP!!!! Hope this is of some help to at least some of you!

I was approved for surgery in June 2007. I called Dr b.'s office last week (June 08) and was told that she is booking appointments for patients that were approved in 06.She said she still had 4 or 5 patients left for 06 then she would start on patients approved in 07. I figure I will be seen sometime around Feb 09. Sucks I am 5 foot 2inches tall and weigh 298 lbs. I have diabetes, arthritis and cardiac megaly (enlarged heart) from being overweight. I am starting to suffer from congestive heart failure. I feel desperate to get this surgery done. I've been seeing a endocrinologist since Oct 06

Hi Sheila Thank you for the update and I am sorry to hear you are struggling with your health so much. I will say a prayer that things move as quickly as possible for you. My story has changed and needs to be updated ............... After pursuing the wls option in Halifax and with Dr. B's office - my wait was going to be they guessed 5-7 years. So with my declining health and fear of having to have knee replacements at 41 years of age - I cashed in some rrsps and decided to pay for my surgery outside of the province. MSI in the end did approve me and would cover wls outside of the province- however it could not be at a private clinic- so that is basically no good as the wait in Ontario and Quebec for public /hospital surgeries is very long also. So the private route was all I was left with for my situation and my health and I guess I will worry about rrsps down the road. If I chose to wait I may have not made it to retirement. Once I made the decision it moved very quickly for me- I chose to have surgery with Dr. Nicholas Christou in Montreal - he is the top surgeon in Canada for bariatric surgery- he trained Dr. B infact. Not only is he a surgeon but with McGill University and is involved in much of the research that goes on currently. I contacted him around the end of April , first part of May and was shocked how quickly everything moved. I saw him for consultation and evaluation on June 3 and my surgery was supposed to be June 25th- however they called me early and I had Gastric Bypass- RNY- lap. on June 10th- so today is two weeks post op for me. I had some complications with blood loss and my iron is very low and its been a rough ride so far- he has been tremendous and kept me sain through my bumpy ride. I returned home to Halifax on June 16th. So I am not leaping for joy yet as I have been quite sick but I am pleased I had him as a surgeon and feel confident day by day the journey will get easier. To regain my strength and be able to get rid of this weak shaky feeling will hopefully soon come. He has decided that I am going to have to have I.V. iron to bring back up my levels as no supplement can bring me up high enough. Again this is a serious surgery and I knew there could be complications so I am just trying to do one day at a time. I hope you too can have wls and start down the road to better health. Take care, Deb