What are the qualifications? What if your insurance doesn't cover MGB?

RockiesRN
on 1/15/10 5:17 am - Englewood, CO
Hello everyone!

I'm new to this board.  I'm seriously considering MGB, and was hoping that some of you could help me.  I'm pretty sure my insurance won't cover any bariatric surgeries.  If that is the case, could I still pay myself to have it done?  Also, what are the qualifications?  I'm slightly confused.  It sounds like you have to be under age 30 and less than 250lbs.  Can anyone confirm this?

Thank you SO much!  I hope I get to share my experience in the near future.
shoutjoy
on 1/15/10 8:15 pm - Culpeper, VA
Hi there!

Yes you can pay out of pocket.  No, you can be  most any age.  You have to be at least 75-100 lbs overweight.  The top end is evaluated on an individual basis. The other qualification is to complete the packet which does take awhile.  If you go to the http:clos.net website, you will see a tab on the left side called "start here" in yellow highlighter.  You will then be given instructions on how to start your packet.  I wish you the best of luck!


Clueless about weight loss and weight loss surgery of any kind.

    

        
nnnancy
on 1/26/10 10:33 am - Peyton, CO
Howdy!
I notice you're in CO. My surgeon (down in Canon City, south of Colorado Springs) does what he calls a Simplified Gastric Bypass; it is the same same surgery that Dr. Rutledge performs, but he has a patent on the name and no other doc can call his surgery by that name. He revised me from a band 3 years ago and I couldn't be happier with the results. Not quite as many hoops to jump through as on clos.net (although they are an excellent surgical group, from what I can gather)!

Let me know if you'd like more info, and good luck woth your journey!


Nancy

RockiesRN
on 1/26/10 12:08 pm - Englewood, CO
Howdy NNNancy!

Thank you so much for your response!  I would definitely like more information on the SGB.  If I don't have to travel to get the help I need, the better off I am!  My insurance won't cover it, so I'm going to have to pay myself.  Is there anyway you could tell me approximately what the surgery cost?  Just give me all the gritty details!  I'd really appreciate it!

Thank you so much!
nnnancy
on 1/26/10 11:23 pm - Peyton, CO
Hi, Rocky!

Hmmm, it's been a few years, and I can't quite remember how much we actually wound up paying; seems like it was right around 16K for everything. Dr. Brown uses St. Thomas Moore Hospital in Canon City, where I stayed two nights and had the most excellent nursing care I have ever received!

Dr. Brown is a stellar surgeon and his office staff is wonderful. The only thing I found lacking was his follow-up care (at the time, his office did not have a nutritionist; I understand they do now). I use a lot of the advice on supplements and after-care from the clos.net website. I have my primary care doc look after my blood-work (which has been excellent, by the way!)

I lost weight pretty steadily and without too much effort the first few months til I got to my goal, then maintained. I do "dump" like many RNY patients, but I can avoid that by staying away from sugar - still hard for me! Too many white/refined carbs= wicked, room-clearing gas (hey, you asked for the gritty details!) My weight has now bounced back up by about 10 lbs, and I do have to really pay attention to what I eat to keep it from going up any higher. (I'm okay with the 10 lbs, BTW, as I think my face looked older at my lowest weight....)

You can find Dr. Brown's website at http://www.coloradochoicebariatrics.com/

Hope this helps! Give me a holler if you are ever down in the Colo. Springs area; maybe we can meet up!

Yours,
Nancy

Nancy

RockiesRN
on 1/26/10 11:42 pm - Englewood, CO

Nancy!

Thank you so much for your honesty!  I know what dumping syndrome is, and I hope I never experience it!  :D  16K isn't horrible.  I'm thinking of selling as much as I can to pay for this surgery.  How bad is the scar?  Did your nails and hair become brittle?  That's seriously one of my biggest fears, which is stupid, I know!  My health is far more important!!!

Thank you so much for the website and info!  I will definitely get in touch with you when I get down there!  I'd love to meet up!  :D Once I figure out how to PM people (if that's even an option, I'll send you my email!)

Thank you so so so so much!!

Sincerely,
Tiffany 

nnnancy
on 1/27/10 12:03 am - Peyton, CO
Tiffany, the scars are almost unnoticeable - not that I'll ever be in a bikini; too much loose skin and not enough $$ for plastic surgery! (I wear spandex garments from Lipo in a Box and, with my clothes on, I look like I've had plastics; I highly recommend them!!)

My nails were in pretty good shape (I attribute that to all the vitamins), but now I get them "done"; it's one of my perks! My hair stayed in good shape, although like most, I did have some hair loss. i have pretty thick hair, so it really wasn't noticeable - except on the shower floor!

Good luck with everything! To post a private message, just click on "contact" at the bottom of the message!

Yours,
Nancy

Nancy

RockiesRN
on 1/27/10 12:13 am - Englewood, CO
Yes, that was another thing I worry about, loose skin.  Is it horrible?  Did you work out after you got the surgery?  I have friends that have had the surgery, but didn't work out and that's why they have the loose skin.  

I'm glad to hear that your nails and hair didn't suffer much.  I think I have pretty decent hair, so if I loose some, it won't be the end of the world.

Thanks again!  I'll PM you my email!

Tiffany
kylee
on 5/11/10 9:56 pm
All I know is you should have a compliance letter, Psychological evaluations and clearance. Recorded histories of obesity ranging from two to several years, accompanied by weight loss attempt documentation is also needed.
Health is important!

DelsJen
on 5/12/10 12:26 am
What is the difference between the mini and the RNY?  Also, you will need that Behavioral Modification Journal.  That is what I'm having trouble with.  Do you know how to put one together?  Maybe we could help one another?  I'm new on this sight.  Send me a friend request and I will gladly accept!

Jennifer
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