Medicaid Question

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Ok, I have been approved for weight loss surgery in my state but there is a number of issues. The bariatric department is rude, unorganized, and not that educated. But the biggest issue is My PCP said I need the Gastric Bypass not the sleeve or band. But when I talked to the surgeon he said no I am too big for bypass and plus I have anemia. However my anemia is related to heavy long periods which is related to my obesity. So, I called Medicaid and they said you can not go out of state for surgery unless the out of state Dr. is under Medicaid and there is some paper work they will have to fill out. But when I google it it says something different. I really need the surgery but I want a second opinion. Also, when I asked the bariatric coordinator she said medicaid does not pay for revisions from sleeve to gastric bypass so if I do not make it work I am screwed. I have waited too long and been through too much for something that may or may not work. I am just lost about this entire situation. I just want the right TOOL to help me loose weight and something is telling me the sleeve is not it. Any thoughts?

[SoccerMomma73 1,867]

first concern...too big for RNY?!?!? You'll likely lose less with band or sleeve. That makes no sense at all!!!! Is there not another surgeon in the state?????

HW 312, pre-op (RNY) 255, current weight 202.4

[redone 0]

first concern...too big for RNY?!?!? You'll likely lose less with band or sleeve. That makes no sense at all!!!! Is there not another surgeon in the state?????

HW 312, pre-op (RNY) 255, current weight 202.4

Exactly !!! I thought the RNY was for bigger patients!

[SoccerMomma73 1,867]

I highly highly recommend that your bariatric program be part of a Center of Excellence....good sign that they know what they're doing. And yes RNY has, on average, the highest percentage of weight loss compared to bad and sleeve....thats just weird :/

HW 312, pre-op (RNY) 255, current weight 202.4

[redone 0]

I highly highly recommend that your bariatric program be part of a Center of Excellence....good sign that they know what they're doing. And yes RNY has, on average, the highest percentage of weight loss compared to bad and sleeve....thats just weird :/

HW 312, pre-op (RNY) 255, current weight 202.4

What should I do? I was already approved for the sleeve.

[SoccerMomma73 1,867]

Ultimately it's a very personal decision. WHat's right for me isn't necessarily right for you. If you're not comfortable with what you've been told then I recommend holding off while you get more information and seek a second opinion. I am not your doctor, I don't know your history or know why he said eat he said, but until you are comfortable with it, I would not have surgery. Period. This is a life changing decision. You, and only you, have to live with the consequences ( be they good or be they bad!) you need to be comfortable with that decision going in!

Good luck!!!!!!

HW 312, pre-op (RNY) 255, current weight 202.4

[music1618 879]

I have heard that band is the first step in bypass for people over a certain weight.

With that aside I'm not sure you have confidence in this surgeon .

I interviewed 2 surgeons before making my decision. You will be going to the doctor for the rest of your life. And if you have red flags now they are there for a reason. Take a step back and look at the options best for you.

[SoccerMomma73 1,867]

The sleeve is a portion of the duodenal switch. The band, shouldn't be, ever, in my personal opinion, a first step or precursor to any bariatric surgery, the failure rate is just ridiculous. The DS is an entirely different procedure and much more involved than the others with a slew of side effects, but pretty good weight loss, typically reserved for very large people and not performed by many surgeons....I'm not saying not to do a DS but you sure need to be educated on it before doing it.

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I have done research on the DS. However, I have not found a DS surgeon who will work with ALabama Medicaid. So,my second option has been the Gastric Bypass. This idea was reinforced with by my PCP and my nutritionist. But when the surgeon said "Your too big for the Bypass you are getting the sleeve" it threw me off balance. I have had red flags with this surgeon since i have been going to him. I at first thought I was worried about having surgery, but that was not it. I am not comfortable having a procedure that may not be the right choice for me.

[Jacqueline K 93]

I have done research on the DS. However' date=' I have not found a DS surgeon who will work with ALabama Medicaid. So,my second option has been the Gastric Bypass. This idea was reinforced with by my PCP and my nutritionist. But when the surgeon said "Your too big for the Bypass you are getting the sleeve" it threw me off balance. I have had red flags with this surgeon since i have been going to him. I at first thought I was worried about having surgery, but that was not it. I am not comfortable having a procedure that may not be the right choice for me.[/quote']

I had my bypass done at Trinity Medical center near Birmingham. In the seminar they talked about taking Medicaid. They are a center of excellence. If you can make the trip to Birmingham for surgery- not sure where in Alabama you are then I recommend them. If you need to loose a lot of weight Dr Pennington will recommend the bypass.

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[SoccerMomma73 1,867]

I have done research on the DS. However' date=' I have not found a DS surgeon who will work with ALabama Medicaid. So,my second option has been the Gastric Bypass. This idea was reinforced with by my PCP and my nutritionist. But when the surgeon said "Your too big for the Bypass you are getting the sleeve" it threw me off balance. I have had red flags with this surgeon since i have been going to him. I at first thought I was worried about having surgery, but that was not it. I am not comfortable having a procedure that may not be the right choice for me.[/quote']

Definitely listen to that inner voice. A surgeon should be willing to sit and discuss things with you, not just tell you what he's doing. Best of luck to you! Keep us updated!!

[redone 0]

I had my bypass done at Trinity Medical center near Birmingham. In the seminar they talked about taking Medicaid. They are a center of excellence. If you can make the trip to Birmingham for surgery- not sure where in Alabama you are then I recommend them. If you need to loose a lot of weight Dr Pennington will recommend the bypass.

Sent from my iPhone using RNYTalk

I am looking them up now!. I will also give them a call. I live in Mobile, Alabama. I am willing to travel any distance for my health

[redone 0]

Definitely listen to that inner voice. A surgeon should be willing to sit and discuss things with you, not just tell you what he's doing. Best of luck to you! Keep us updated!!

Thank you. I will keep you guys updated.

[redone 0]

I had my bypass done at Trinity Medical center near Birmingham. In the seminar they talked about taking Medicaid. They are a center of excellence. If you can make the trip to Birmingham for surgery- not sure where in Alabama you are then I recommend them. If you need to loose a lot of weight Dr Pennington will recommend the bypass.

Sent from my iPhone using RNYTalk

Called, They no longer accept medicaid as the primary form of insurance.

[mswisdom 42]

first concern...too big for RNY?!?!? You'll likely lose less with band or sleeve. That makes no sense at all!!!! Is there not another surgeon in the state?????

HW 312' date=' pre-op (RNY) 255, current weight 202.4[/quote']

You cannot lose a Sleeve. They remove part of your stomach and remove it from your body making the remaining portion look like a banana.