ABC's of Revision VI "What's up doc?"
So you've done your research. You feel confident that you are well prepared for the next big step; your consultation with the weight loss surgeon for your revision.
The first thing to remember is that YOU are interviewing the surgeon and the weight loss program. You don't have to go with the first surgeon you see. Just like the first time around, be certain that the surgeon talks to you, not at you. Does he/she speak to you in a courteous fashion with a vocabulary that you understand? Never be reluctant to interrupt if you don't understand.
Here are some things you want to be sure to cover. If your surgeon is thorough, you may not need to ask a ton of questions. The first thing of which your surgeon should be aware is your goal and desires. You must find out what surgical options he/she offers for your revision. Has he/she performed many revision surgeries? Is revisionary surgery one of his/her passions or is just another thing that he/she does? What procedure does the surgeon recommend? Why? What are the pros and cons? Ask not only about complications, but as we discussed last week, ask about the consequences you might expect from the recommended procedure.
If the recommended procedure is not the one that you had in mind, find out why it isn't... Does the surgeon have good reasons why that operation is not your best option? Is he/she persuasive? In other words, do the reasons not to perform that procedure make sense to you?
It is imperative that you know about the entire program. Discuss nutrition. What is the protocol for routine follow-up? How long is long term follow-up? Anything less than life time follow-up is unacceptable.
Let's briefly address investigational procedures such as ROSE, ReSTORE and EROS. I have no objection to investigational procedures and protocols. Without such programs we would still be treating pneumonia with leeches and post partum depressions with purges to rid the body of "black bile." If you choose to participate in an investigational protocol, remember that you may then become a placebo patient, the one who gets a sham procedure. Find out what type of follow-up the protocol is offering. If you were the placebo patient and the investigation demonstrates that the treatment is effective, will you "get" the operation?
The next topic is as close to profanity as I will come in these posts: Insurance. Insurance companies do not care about you or your health. Their goal is to collect premiums and show their investors as large a profit as possible. They are short sighted. The fact that they will save money down the road by treating your obesity means nothing to them. The reason is simple. There is no line item for it in their quarterly profit and loss statement. For some of you, with perseverance, you may succeed in obtaining insurance coverage for your revision. For others, insurance may never pay. They will hide behind the argument that you do not "meet the criteria." Be prepared for a long, pitched battle if you are going to try to have them reverse that denial. If you do not meet their criteria, or if you have an absolute exclusion for weight loss surgery on your policy, you may need to seriously consider alternative means to have your revision.
Finally, listen to your "gut." Trust your impressions. If you feel good about the surgeon, the recommended revision, and the follow-up care; GO FOR IT! If you don't have these positive feelings, then look for another surgeon.
NEVER GIVE UP!
CLAIM THE SUCCESS YOU DESERVE!
Eric Schlesinger, MD, FACS
AZ Weight Loss Solutions
The first thing to remember is that YOU are interviewing the surgeon and the weight loss program. You don't have to go with the first surgeon you see. Just like the first time around, be certain that the surgeon talks to you, not at you. Does he/she speak to you in a courteous fashion with a vocabulary that you understand? Never be reluctant to interrupt if you don't understand.
Here are some things you want to be sure to cover. If your surgeon is thorough, you may not need to ask a ton of questions. The first thing of which your surgeon should be aware is your goal and desires. You must find out what surgical options he/she offers for your revision. Has he/she performed many revision surgeries? Is revisionary surgery one of his/her passions or is just another thing that he/she does? What procedure does the surgeon recommend? Why? What are the pros and cons? Ask not only about complications, but as we discussed last week, ask about the consequences you might expect from the recommended procedure.
If the recommended procedure is not the one that you had in mind, find out why it isn't... Does the surgeon have good reasons why that operation is not your best option? Is he/she persuasive? In other words, do the reasons not to perform that procedure make sense to you?
It is imperative that you know about the entire program. Discuss nutrition. What is the protocol for routine follow-up? How long is long term follow-up? Anything less than life time follow-up is unacceptable.
Let's briefly address investigational procedures such as ROSE, ReSTORE and EROS. I have no objection to investigational procedures and protocols. Without such programs we would still be treating pneumonia with leeches and post partum depressions with purges to rid the body of "black bile." If you choose to participate in an investigational protocol, remember that you may then become a placebo patient, the one who gets a sham procedure. Find out what type of follow-up the protocol is offering. If you were the placebo patient and the investigation demonstrates that the treatment is effective, will you "get" the operation?
The next topic is as close to profanity as I will come in these posts: Insurance. Insurance companies do not care about you or your health. Their goal is to collect premiums and show their investors as large a profit as possible. They are short sighted. The fact that they will save money down the road by treating your obesity means nothing to them. The reason is simple. There is no line item for it in their quarterly profit and loss statement. For some of you, with perseverance, you may succeed in obtaining insurance coverage for your revision. For others, insurance may never pay. They will hide behind the argument that you do not "meet the criteria." Be prepared for a long, pitched battle if you are going to try to have them reverse that denial. If you do not meet their criteria, or if you have an absolute exclusion for weight loss surgery on your policy, you may need to seriously consider alternative means to have your revision.
Finally, listen to your "gut." Trust your impressions. If you feel good about the surgeon, the recommended revision, and the follow-up care; GO FOR IT! If you don't have these positive feelings, then look for another surgeon.
NEVER GIVE UP!
CLAIM THE SUCCESS YOU DESERVE!
Eric Schlesinger, MD, FACS
AZ Weight Loss Solutions
Most Active
Recent Topics
