Question:
Angioplasty needed before WLS, but not done due to high weight. Anyone else?

MY Mother has a blockage and needs Angioplasty before WLS. She went for the procedure, and was told her weight of 455 is too much for cath table, which is rated for up to 420. She was told that there 'isn't a table in the country that could accomodate her', and they sent her home. Has anyone here had a similar experience?    — christina K. (posted on February 23, 2003)

February 22, 2003
Get on the internet and phone and start calling around. NEVER accept what someone else says related to this. <p>About 6 weeks before surgery I was having a lot of heaviness on my chest and it was getting worse. I went to my internist who did an EKG, sent me for a CT to rule out pulmonary embolism and also wanted a Cardiolite Stress Test. Well I snuck in under the 450 lb limit of the CT table. The stress test was another story. The technician at the local hospital had the audacity to tell the nurse than no one should be ordering a stress test on someone my size - 432 lbs. Who the he!! was she to decide that. It was my internist, who I have worked with since 1995, that best knows my body and what it can take. Besides there is a medical professional (doctor or specialized nurse) there the whole time. <p>After the nurse "looking" for 2 weeks and my surgery about 2 weeks away they were still struggling with what to do because he wanted to be sure it wasn't the heart. I had already decided it wasn't because I had gotten myself so stressed out trying to get my insurance approval. Once I had that I started to settle down and so did the heaviness. On top of it I was diagnosed with asthma 10 days before surgery, so that certainly would explain it. But my internist wanted to be extra sure. <p>He and a local cardiologist concocted another test that would at least give them a good indication but we were back to the same issue that 432 lbs was too much, but they insisted they would make it work. They were so thrilled when they gave me a date of Feb 5th - 2 days AFTER my surgery! <p>I was ticked so I got on the internet. I'm in WI and am within 75 minutes of Milwaukee and 90 minutes of Madison which has a teaching hospital. The first place I called in Milwaukee had a table that went to 500 lbs and could get me in at the end of the week (2 days later). The 2nd call I made was to a hospital in Green Bay (60 minutes away) and their table went to 400 lbs - close but not quite. If it wasn't for their service agreement they would have done it because I was so close and carry the majority of my weight down low. However, they were very helpful and informed me that literally right in my back yard, in Appleton, that one of the hospitals had a table that went quite high. So I called them and their table went to 500 lbs and they also could get me in that week. So out of three phone calls I found 2 places and it took me a max of 20 minutes, not 2 weeks. I called the nurse at my internist's office and told her to call and schedule it and gave her a piece of my mind. This whole mess never had to come down to the 11th hour if she had done her job and looked outside their network phone book. <p>Fortunately for me I have insurance I can go anywhere, but even if you have an HMO and need a test that can not be provided in network the medical director can/should authorize going out of network. I'm so sick of networks etc. I wonder how many people aren't getting the care they truly need because of contolling costs and not letting people go out of network. I may end up poor but I will avoid an HMO as long as I possibly can. It costs me upwards of $4500 a year out of pocket (but I do it pre tax and it's more like $2500) to have the insurance I do but if I didn't go with it my surgery would not have been covered. The 2 HMO's availabe to us clearly do not cover it. Not to mention I can go anywhere in the world for treatment. <p>Anyway, please do not accept what you have been told. Be your own advocate - you really have to be these days. First find a place that can do it and then let the doctor work out any insurance issues. If this is the thing preventing your mom from getting WLS then do all you can to find a place. All I did was call the main number and tell them what I was trying to find out and they connected me with the labs where the equipment was and people were more than willing to help me. Good Luck! Chris
   — zoedogcbr

February 23, 2003
Chris, good for you for finding a solution for your problem. It's called "taking responsibility for one's self'. It was not the job of the office person to call around and find a place that could accommodate you. I work for an insurance company, and yes, we have a network. If people would look past themselves and realize the insurance company is not there for just you, but tens of thousands of other members, life would be so much easier. You pay for your insurance, but so do other people. ( Right now, our company is paying for quadruplets to be in NICU near here. Two are on ventilators, one has had abdominal surgery, two are facing heart surgery. The family will pay $6000.00 out of pocket this year, and the care of the babies will likely be 100 times that for each baby. Who is paying for that? Every one that pays for the insurance. ) Also, our company will pay for someone to go out of network if the equipment necessary is not available in the network. We work behind the scenes to negotiate rates to keep costs down and get people the care they need. Sounds like the poster needs to make some phone calls - start with the insurance company! I am betting this has come up before and they may be able to tell you who can accomodate your mom, even if they are out of network. Good luck!
   — koogy

February 23, 2003
Susan, thanks for the compliment. However, I disagree with you that it was not the responsibility of the office person to call around and find a place for me. My internist knew after calling the local hospital there was a problem and he instructed his nurse to find a place to do it. When I talked to him 2 weeks later he said they would call Milwaukee etc. So in this particular case she was not doing what she was told. To me there is no excuse for that. <p>When I meant I was sick of networks I only meant in the sense that a lot of times doctors/nurses/clinics are held back from doing their job and looking beyond the standard places because it might be out of network. When I finally talked to my internist to discuss why he still wanted this after my diagnosis with asthma he was confused how it had all changed because the nurse had not given him all the facts. He did not know that the other test they decided to do was scheduled after my surgery. Once he knew that he took control and made sure everything was arranged including if I a needed cathetarization before surgery, because he was going on vacation. <p>Most physician offices have a nurse who's main job is schedule tests and procedures. I'm glad I got it resolved but very unhappy with the effort made by the nurse assigned this task. I have no problem with staying network, although it doesn't apply to my policy, when the services I need can be provided and by the best possible doctor for me. I try to use providers that have a contract with my insurance whenever possible because then I do not face any UCR charges and it keeps costs down. I've even traveled 2 hours round trip in the past to get MRI's at a place that was 1/2 the price of the local hospital because I felt it was insane to pay that much. It wasn't coming out of my pocket but ultimately it would in increased premiums. <p>Just my take on it.
   — zoedogcbr

July 7, 2006
I just found out that I need to have catheterization of the heart before surgery and I was asked how much I weigh because there is a weight limit for the table. Since I'm 298, he said there won't be a problem. I'm not sure what he said the upper limit was. Good Luck. Gloria
   — glojean