What issues should I tell my doctor to get approved...?

youtalk · 04-21-2007, 01:37 PM

I'm looking to get the LAP-BAND^® procedure done, but before making any mistakes, I want to know what issues I should tell the doctor to get him to proceed with the procedure. I'm on the borderline of the BMI scale, so I don't want him to just think I want it for cosmetic reasons.

**FairyFacade** · 04-21-2007, 05:55 PM

Tell him the health concerns for why you're wanting it. Why do you want it? Ta-da :)

youtalk · 04-21-2007, 06:33 PM

Quote:

Originally Posted by lauraj23

Tell him the health concerns for why you're wanting it. Why do you want it? Ta-da :)

Well I'm over weight, I have a history in my family of heart disease, and I'm just sick of worry about my weight. I want to make sure the doctor just doesn't think its all for cosmetic, I'm concerned for my health too.

youtalk · 04-22-2007, 10:39 PM

what about things like, how many times I tried dieting?? HELP...

youtalk · 04-25-2007, 07:05 PM

does anyone else have any ideas............?

**Wheetsin** · 04-25-2007, 07:09 PM

Just tell the truth. Are you worried that you have a condition that will prevent you from being able to have surgery? Or that you don't have enough medical reason to have it?

I would advise against "making up" conditions. The doctor will only make the referral, at best. If the surgeon is told of medical conditions, chances are you will be sent for medical testing to verify (sleep studies, bloodwork, endoscopies/upper GI, etc.)

If your'e self-pay, which you would pretty much have to be to get this done with a BMI under 35 and no significant comorbidities, then it won't matter. Surgeons won't require the same maladies that insurance companies will.

dwarden · 04-25-2007, 09:50 PM

Some conditions that help(?) with getting approved are arthritis, especially in knees, hips, or back, and reflux. It's not just about heart disease and diabetes.

Before I got my band, I couldn't walk down a flight of stairs, and I drank Maalox for breakfast. Now, my knees don't hurt all the time, I can play baseball with my kids, and I haven't had a day of heartburn at all.

youtalk · 04-26-2007, 08:41 PM

I think part of the problem is insurance companies should be letting people get the procedure before they get to 35 BMI or higher. That's why I'm trying to get it done myself before I get to that situation. I know my family history of heart disease, and obesity, so thats why I want it done.

**FairyFacade** · 04-27-2007, 02:41 AM

LOL Was...
Reitterating, don't make anything up. Tell them your concerns, we can't tell you what your concerns are!
I had heartburn and chronic back/disk problems from my weight. I still have both, but those are MAJOR factors why I *needed* the surgery. Plus severe history of diabetes, obesity, heart disease, etc. in my family. I'm nipping all that in the butt now before I get to those problems. Frankly, I'm extremely lucky I DON'T have diabetes. It's kind of a phenomenon, all my doctors have been waiting. I'm more overweight than anyone in my family in 3 generations. And the 2 generations above me are full of diabetes, and EARLY diabetes.
Anyway..good luck :)
And like they said, if you're self-pay (like me, my insurance wouldn't cover it no matter what), they will certainly ask why you want it, and if your doctor does psych screening, they want to make sure you can handle the change.. and you're off.

youtalk · 05-06-2007, 06:31 PM

So you think if I have issues and family history, and if I'm self-pay they'll be ok with it..? I mean my BMI is 32-33, and my father had his first heart bypass when he was 45 from heart disease. I went to the doctors seminar last week and I think I'm more ready now then I was before. I guess it's all about learning how to eat small proportions.

ladijane3 · 05-07-2007, 12:33 AM

Your doctor should be well trained to ask you the kind of things that support the co-morbidities part of insurance requirements. Surely, a doctor who is ethical will choose not to even submit insurance request if he feels you don't qualify, but you also have to remember they want to do surgeries...its how they make their money. Just let him/her be a part of that process, don't worry about trying to impress them. Definitely DON'T make anything up, as everything will have to be medically documented and will just slow you down later. Most common issues for people is diabetes, high blood pressure, high cholesterol, asthma, joint/bone/mobility issues.

Let me give you an unrelated example. Many years ago I was evaluated for breast reduction surgery. My surgeon gave me a list of things that I may have experienced, and all of them were included in the report for insurance pre-approval. You'd be surprised what was on that list (frequent pimples/blemished on my chest!!??!!) and lots of things I hadn't even thought of (dents in my shoulders from the bra digging in). If I had made up that list on my own it would't have looked nearly as good.

Try not to worry.