Poor Trust Fund Princess Part 2

The real fun begins....

As I expected...the self written letter (which was a sample insurance letter i got from OH), & 2 letters from Dr.'s concerning my health  and morbid obesity.  Were STILL not enough to have the MEDICAL & Educational Trust Fund pay for my Gastric Bypass operation.  I spoke with my Trust officer on Fri. (she had received all my paper work the previous Fri.)  Her first words to me were... " you do realize this is a big life style change...."  "NO ****!!!," I said.... (*just kidding, I really, really wanted to though.*) =O) She asked me if I had considered the Lap-Band.  I quickly explained to her the reasons I choose to have the Gastric Bypass.  She explained to me the Trust Committee needed additional information before this could be paid. 

(Remember, this money was left to my mother, me and my brother in a trust from my Great Aunte who had no children and A LOT of money, enough for 100 Gastric Bypass surgeries... do the math.) 

She continued to request that I get a letter from my mother & brother giving their approval for the surgery & a letter from my Primary Care Physician (again) explaining the importance of this surgery.  EEEEGGGGGHHHHH!!!!!!!

She went on the let me know that their (The Committee) main concern was my health and if I die.... (*cough... bull****)   I quickly mentioned how the surgery was ok to have when the insurance was paying for it.  Then I explained how I had been doing research on this surgery for over 2 years now and was prepared and ready.  Then she replied that I present ANOTHER letter, explaining my research and continuing education on this surgery.  So I am SUPER FRUSTRATED!!! but extremely proud of myself for remaining very professional!   I will have this week to get

1.) Letter from Primary Care Physician. 2.)Letters from my Brother & Mother. 3.) My "Research Paper"  

If anyone had any suggestions or comments I would love to hear them...!  Thanks for listening...  =O) 

 

 

Hey Sweetie, I don't know what to tell you but to keep positive and I will pray for you.  In the meantime get the letters they are asking for maybe even ask them to have it in writing what they are looking for so that when you get it they don't go aroud and request something else.  I wish you luck and stay positive when you least expect it things will turn in your favor. xoxoxo Liliana

People kept telling me for the last 3+ years that it was a series of hoops...Jump through one...then get ready because the next one it ritght there!  Just give them what they want...jump through the hoop...  I know how frustrating it is to think that you cleared the hoop only to find out that your foot hit the edge of it on the way through....so just go back to the starting line....run with all of your might and jump!  Jump however high they want and whenever they want! YOU CAN DO THIS!!!!!! Colleen

I read your stiory and it really pissed me off! After going through all of this and understanding and appreciating the benefits of WLS it really aggrevates me that some people still attach such a stigma to this procedure. There is a lot of information on my clinic's website, dukewls.org ...they are a university program so there is a real focus on advancing the practice, not just profits.. Here is an excerpt from the site that may be very helpful to you for your "report"...good luck! Mike

Why Surgery?

With the failures of medical management, significant improvements in surgical care and techniques, the astonishing results of several high profile celebrities who have undergone modern day surgery (Al Roker, Randy Jackson – People Magazine November 2002 and January 26, 2004), and publication of major long-term follow up studies, public interest is turning to surgical management of morbid obesity. The scientific community is also changing attitudes and beginning to refer patients in ever increasing numbers. The following are some of the developments swaying opinion:

• In 1996, the National Institutes of Health conducted a Consensus Conference on the Management of Obesity to define clear management options for the next decade. The conference of experts, including nutritionists, psychologists, internists, surgeons, exercise physiologists, and basic scientists, concluded with the following statements:

• Surgical intervention is the only method proven to have a significant long-term impact on the disease of morbid obesity.
• Less invasive methods have failed to have any significant impact.

Other reports include:

• In 1995, long-term success in maintaining significant weight loss following a surgical procedure was published by the group at East Carolina University. Walter Pories and co-workers documented loss of greater than 50% excess weight in 80% of their patients for up to 14 years.
• A ten-year study, published from the University of Virginia, reported similar results with loss of 60% of excess weight at 5 years and in the mid 50% range for up to 6 to 10 years following surgery.
• Multiple other authors have reported 2 to 6 year follow up with similar weight loss.
• The mortality risk is now in much better focus and quite low when the surgery is performed by experienced centers of excellence. In 2004 Buchwald H., et al. published resultes of a review of 136 scientific reports on weight loss surgery totalling 22,094 patients. The average operative mortality 0.5% [Buchwald H., et al: Bariatric Surgery: A systematic review and meta-analysis. JAMA 292:1724-1737, 2004].
• The Buchwald paper also confirmed the dramatic improvement in morbidity with the following rate of improvement or resolution of problems:
  • Diabetes Mellitus: Complete resolution 76.8% Resolved or improved 86%
  • Hyperlipidemia: Improved 70%
  • Hypertension: Resolved 61.7% Resolved or improved 78.5%
  • Sleep Apnea: Resolved 85.7%
• In 2004, McGill University compared five-year survival of 5,746 morbidly obese patients managed medically with 1,035 patients who underwent surgery, matched by sex, age, and length of being obese. Five-year mortality was 6.17% in the medical group. Five-year mortality was only 0.68% in the surgical group (p < 0.001). [Christou NV, et al.: Ann. Surg., 240: 416-422, 2004]

With recognition of the outcomes from surgery, more and more patients are seeking surgical intervetnion. In 2004 over 200,000 surgical weight loss procedures were performed and the number is expected to double in 2005. Even with the increase in trained surgeons and development of Centers of Excellence, our current limited ability to provide the necessary care to the some 10 million possible candidates is now recognized as a medical crisis in America.

Here is another good source...http://www.asbs.org/Newsite07/patients/resources/asbs_rationale.htm