Portland Post-Op Care and Follow-Up for Self-Payors....

Hi all: I have BCBS Oregon and went to see my primary care doctor today to tell her about my decision to have the DS surgery with Dr. Marchesini in Brazil. She was very negative towards the idea of going out of the country and advised I check all of his credentials, etc (duh!). (She recommends patients only to Dr. Emma Patterson in Portland.) Anyway, I do not get the impression she will be "there" for me post-op in monitoring my labs, etc. and I really want to find a doctor (female, preferrably) to be my general practitioner who will be supportive of my surgery and post-op care. I just want someone *****ally listens to me and not in a rush to get me out the door. Suggestions? How did you all handle your post-op care and labs if you had to self pay for your surgery

Hi Cheryl, I don't have answers for you, but you may want to post this on the OH DS board (link below if you need it) also . We have LOTS of Dr. Marchesini patients on there. I would think a co-operating PCP would be pretty important. http://www.obesityhelp.com/forums/DS/a,messageboard/board_id,5357/ Best wishes to you and yours Isha 366/151/170 sw cw gw -215 pounds gone forever ! www.duodenalswitch.com Eat NORMAL and Lose

Hi Isha: Thanks for your reply! I went ahead and re-posted on the DS forum as you suggested. With the number of people with great experiences abroad, I would imagine there has to be supportive PCPs out there. Cheryl

Dear Cheryl, I had my surgery over 7 years ago and was also self pay. As a RN I would agree with your primary care doctor about surgery out of the country. I work for a wonderful bariatric surgeon in Coos Bay. He did not do my surgery but has performed surgery on 8 of my family members. Emma Patterson is a good surgeon and has performied surgery for as long as my surgeon, at least 8 years. I know the surgeons in Portland are expensive. You should check around. Northwest bariatric surgery has a package price. There is also a Dr. Pletman in Michigan who is reasonable. As for your primary care Dr.I don't know of anyone in your area. You can save money by having your primary care doctor order your labs, EKG, etc. Good luck with your decision. Bariatric surgery has really changed my life. PS: My husband had a Lap Band 4 years ago and is doing great. Lap Band is only $10,000.000 Robin Stephenson

Hi Robin: After all of the research I have done, I am confident in my choice of surgeon, who is also endorsed by some very well known and respected US surgeons. Unfortunately, the insurance industry has in part caused health care in the US to be completely cost prohibitive. I do not agree with my doctor's concerns about the legitimacy of my surgeon's credentials (she was barely aware of what the DS is). Had she concentrated her concerns on flying home two weeks post op, or other more logistical and practical (and legitimate) issues, then I would understand. However, we Americans tend to have an incredibly arrogant viewpoint of anything and everything outside our country as being inferior. What I find inferior is the quality of healthcare that is common in our own country. I have relatives in Argentina and Germany *****ceive nothing but the best of care. I can't say I've received anything comparable to that level of care here in the US. Thanks for the well wishes. I am very excited to begin my new journey! Cheryl Dr. Marchesini Open DS July '07

I'm a little confused. How much less expensive is the surgery in Brazil? Enough to justify the airfare and two weeks stay in a foreign country? I have BCBS Oregon and they do cover RNY (at least on my plan). Is it that you don't qualify for this, or you really need to have the DS instead? I'm not being judgmental, I'm just curious. Inform me, please! Linda

Hi Linda: I don't mind your questions at all! It is a fraction of the cost in Brazil. this is not due to substandard care, but the difference in economy and the fact that our medical care here in the US is so driven by the insurance industry. My BCBS group plan specifically excludes WLS of any kind. Every BCBS policy is different, depending on your group or individual plan. I do have the option of switching to Kaiser (who WOULD cover the RNY after you've jumped through their year-long hoops) during open enrollment, but I decided that I do not wish to have the RNY under any cir****tances. This is not a judgment about the RNY, but simply a decision about what I think is the best procedure for me after taking into consideration all of the variables. My surgery (surgeon and hospital) will be approximately $11-12K in Brazil. I will be spending less than $15K including airfare and hotel. My parents are both coming along (leaving my 13 year old behind with his dad!). To have the surgery here, I have been quoted $45K - $30,000 MORE!! Even the lap band (which was what I'd decided to have before I found out about the DS) was going to cost me $17K here.

Holy smokes! I didn't realize it was that much different. I hope it works out for you and you find a decent doc here to do your follow-up. Sounds like the doc you've got in Brazil is a good one. Linda

Hi Cheryl, I have a doctor who is very open to supporting WLS. PM me if you want her info and I'll be glad to share it.

Hi Cheryl, I had my surgery in Brazil on 4/19/06. I had a RNY with a band....it's a bit different than the RNY in the US. My surgery including all the pre-op testing and consultations was $8500. I was quoted a minimum of $30K in the Portland area. I am very pleased with my results. I had excellent medical care while in Brazil. I am a health care practioner, so I speak from personal and professional experiend. When I did the research, I found the surgeon I chose had performed twice as many procedures as anyone in the Portland area. I am friends with a bariatric surgeon in Portland. He gave me very specific questions to ask. He agreed that the surgeon I chose had impressive statistics. While choosing an out of country procedure isn't for eveyone, it worked well for me! I was in the hospital less than 48 hours. I recovered for several days and then spent a week at the beach. I travelled home 14 days post op with no problem. I would encourage you to look for a PCP that is supportive of WLS. My NP has been great in ordering appropriate blood work for me. While she was a bit apprehensive in the beginning, she is a believer now. I wish you the best of luck! Please e-mail me directly if I can answer any other questions for you. Betsy 237/150/144/140 Surg/Org goal/current/reset goal