PCOS, BMI of 35.5, Cary/Raleigh Area

[Palmer's Moma 0]

Hi First time poster here.

I am 27 years old. I was diagnosed with Polycystic Ovarian Syndrome last fall. I am insulin resistant. I began seeing Dr. Toma of the North Carolina Center for Reproductive Medicine, because he specializes in PCOS. I have a now 3 year old, but I would like to one day (sooner than later) have another one.

I had an appointment with Dr. Toma this past week, and my husband was able to go with me. The doctor told us that he thinks I should consider getting a LapBand. I am 5'4 and about 200 pounds, with a BMI of about 35.5.

My concern is that Dr. Toma is in a practice with Dr. Enochs, and that he is only pushing LapBand to get money into the practice. But Dr. Toma is one of the best doctors around, and by reading messages on here and on other sites, Dr. Enochs is also wonderful.

With me being insulin resistant, and having a strong family history of diabetes (3 out of 4 grandparents!), and the PCOS, I need to lose weight, and a lot of it. The LapBand seems like a wonderful tool to help me. I just don't know if it's right for me, or if it's being suggested because of the practice.

It would be about $10,000 out of pocket, because I don't think I would qualify for insurance. (I have BCBS of NC- has anyone been qualified for insurance to cover it with a BMI of 35?) Of course, my hubby said that if people pay that much for a boob job (LOL!), paying that much to make me healthier wouldn't be terrible. He won't even consider having another child until I lose weight. And because of the PCOS, I probably CAN'T have another one until I lose weight

Thanks

[LisaJane 1]

Hi there,

This is my first time posting and I too have PCOS with the same BMI, 35.5 - 29 yrs old. Type 2 Diabetes also runs in my family . I contact my insurance company (empire blue cross bs) and they said the surgery would be covered if the doctor deemed it medically necessary, up to 85%. I was worried if I lost 5% of my weight for pre-op that I would no longer qualify, but I contacted the bariatric coordinator and she said that if my BMI goes below 35 before the surgery, I would still be covered by my insurance, since it's based off of your inital weight when you first see the bariatric specialist. I would definately call your insurance company . I am on yaz and 200mg spironolactone and have been gaining weight steadily. I haven't had a real period in 6 months since the weight has been creeping back on. I excersize regularly but I struggle with keeping weight off. I worry that if I want to have kids - what will happen to my body if stop taking the spironolactone. Plus, I'm sure that I am doing damage to my kidneys taking such a high dose day after day. Anyways, I have an evaluation appointment with a bariatric specialist and I know that PCOS is a definate comorbidity. I pray that getting off this excess weight will help keep the pcos in check. I think lapband will help. Also I like the idea of lapband bc it's not as permanent as actually changing the shape of your stomach by cutting it and sewing it back into a different shape.

[aliciab 8]

I vote that if you can afford it then do it. For some poeple it's just not an option.

However you really need to look at your past history of weight issues. Have you tried other methods? This shouldn't be your first option if you haven't. If you have tried several other methods of weight loss and have gained the weight back over and over again then I would definitely consider it. That is really what the lap band is for, people who can't keep the weight off. We know how to lose weight, we just can't keep it from coming back.

The other thing I would like to bring up is that people will drop $10,000 on a crappy used car in a heart beat, but for some reason they have a real hard time spending it on improving their quality of life. Your health, your future, any possible additional children you may be blessed with, this isn't worth $10,000? You're not worth the price of a used car? I'm pretty sure you are .

[Bluegreen 0]

I live in Oklahoma, but have spent a lot of time in your area! I am a remote employee but my company is located in Cary. That just caught my eye in your post. Anyway, I have BCBS and I know each employers plan is different, but my plan covers a BMI of 40 with no other health issues and a BMI of 35 to 40 with health problems.

I have PCOS and I'm insulin resistant. During my pre-op testing, I also found out I have sleep Apnea. So, these are reasons why the insurance company should cover the procedure. If you have high blood pressue or other weight related problems, this helps get the coverage. On my plan, it is a 6 month process. I have to see my primary care doctor and nutritionist 6 times in 6 months. That's they downside of using insurance. If I were self pay, I wouldn't have to wait so long.

Best of luck to you in your decision. I'm getting close. My last PCP & nutrition visits are scheduled for Sept. If all goes well and insurance approves, I should get banded in October.

[Palmer's Moma 0]

Thank y'all for the great advice! It's nice to know I'm not alone (though I hate for anyone to be going thru this too!)

I was at 223 when I first saw the doctor for the PCOS back in Nov. So I've lost about 23 pounds, which is great. But I've got a lot more to go!

I am taking 1500 mg of Metformin a day. I've also been taking Phentermine. It seemed to help, but I can't take it forever.

My blood pressure is great, but my cholesterol is higher than it should be.

I also have an IUD, so I have no idea if I'm ovulating or not :/ The doctor doesn't think I would be if the IUD was out. He wants me to lose more weight before I even try to get pregnant. He said I could get the band and then start trying 3-4 months afterward.

I'm exicted to hear about insurance covering lower BMIs! The six month wait isn't great, but since we are planning a trip to Disney in late October, I didn't want to have anything done until after then anyways.

I have the State Employees Blue Cross Blue Shield plan, btw.

$10,000 is a LOT out of pocket, but aliciab is right- it's worth it to (hopefully!) be healthier, thinner, and happier! Because I am NOT happy the way I am now. My husband thinks it would be worth it too.

Okay, now I'm off to search BCBS!

[cakegirl 12]

I have similar "stats" to you, including the 3yo child. I was also told that the lapband would help with the PCOS. I think it'll be great if your insurance will cover it or some of it, but if it doesn't and you're able, it could well be something worth spending money on. You'd be investing in your own future, really - the future that has more kids, and a lighter, healthier you.