Dr. Pitchford in Eau Claire?
still pre-op. Just started the process. It will take 6 months for me as my surgeons office requires I be pc supervised on a diet that long. Well if that is all it took I would be thin by now! I have been pc supervised about dieting all my life it seems! But they need documentation. So this is truly a long road to travel for me. I am obsessing over it already though. I sit and search this site and others to see what others say. Where are you in your journey?
We have wisconsin laborers health fund. my hubby and I both do road construction. I am not working because I had knee surgery in early March and it didn't go as I thought it would. I have osteoarthritis so bad my knee won't bend right and I have a limp because of it. If I lost weight my ortho surgeon said it would alleviate most of the pain. I told my ins I did ww and lost 73 lbs 2 yrs ago. they want to see my member books but won't let me get away with that. It has to be monthly supervised by my pc in order for it to count. wish I had known about the surgeon you are going to. think I could change this early in the process?? I don't really have a surgeon yet, just the office. have called them a couple of times and have some paperwork started. doesn't 6 months seem so far away? I wrote an email to the one they have listed as a support group leader on here and she never got back to me. sorry this is so darn long. I enjoy knowing someone near me is going through the same things. It helps
I'm sorry Cheryl. I did write to you, just late last night (05/24/06). I don't yet have a meeting space, but as I wrote in the email if you and anyone else from Eau Claire want to do an informal meeting somewhere in Eau Claire, like a restaurant or Oakwood Mall Cafe Court or whatever, we could do that until I can get a meeting space and time arranged. I'd love to do that, just to meet with people before the "formal" meetings can be arranged for!
Nancy E.
Hi Kelly. I have a friend who went through Dr. Pitchford. She had a great experience and said it only took 2 weeks to schedule after ins. approval. I have used him through my work for other surgical consults and heard nothing but good things. Good luck with the insurance switch. They really make you jump through the hoops. I work for Trempealeau County and have the standard plan now. I am going through Gundersen Lutheran in LaCrosse and they seem to be giving me a run around. I may just be touchy, but when I went to see them in February they told me I had to lose 60 pounds and then call them. If I could do that, I wouldn't need surgery. I am working with my pc and have lost 28 of the 60. By the way they are not counting the 20 I lost prior to seeing them. So all told I will have lost 80 pounds pre op. Has to be this year though, I can't afford this insurance another year. Good luck, let me know what happens. Lisa
I'm curious, has the ins. co. been real strict on proving co-morbidities? I'm a little concerned b/c I don't have high BP and my sugar is normal. I just don't want to pay so much more for the standard plan and then not get approved - I'm ready to fight them tooth and nail for it! lol!
WOW - I can't believe you have to lose so much before they will even see you - that sucks! The god thing is that you are half way there - you can do it! I can always lose 50 pounds - the problem is the 60 pounds I gain back! Is there any chance you can use another surgeon who doesn't have that weight loss requirement?
Good luck and keep me posted as to how things are going with you!
I happen to have my book here with me. Here is the excerpt out of the WPS benefit plan book.
a. Benefits are payable for Surgical services for morbid obesity, including gastroplasty and gastric bypass surgery. Benefits are payable only if:
(1) prior authorization is received from WPS; and
(2) the participant suffers from morbid obesity and on of the following: (1)hypertension(diastolic greater than 100 consistently); (2)hyperlipidemia (cholesterol greater than 300); (3) diabetes requiring medication; or (4)joint pain with degenerative changes of joints as evidenced by x-ray;
(3) in the last 24 months, there has been a consistent program that is physician supervised with integrated components of a dietary regimen, appropriate exercise and behavioral modification and support;
(4) there has been a full trial of a lipase inhibitor (such as orlistat) or other medication recommended;
(5) an evaluation has been performed by a multi-disciplinary team with medical, surgical, psychiatric and nutritional expertise;
(6) there has been no previous bariatric surgery performed; and
(7) the surgery would be performed by a surgeon substantially experienced with appropriate procedures and working in a clinical setting with adequate support for all aspects of management and assessment.
There are some types of surgery they do not cover, so are best to do RNY. I told my pcp that I want to go to Eau Claire if LaCrosse makes me wait too much longer. She is really hyped on Kothari because he was her surgeon. She is 18 mos out. Hope this helps. Let me know if you need anything else. Lisa