Thursday, March 29, 2007

MGB vs. RNY vs. Cigna

As we find more about the various gastric bypass surgeries, and the varying and often draconian requirements various surgeons and facilities require, we keep shifting which are our greatest concerns.

The most recent one was that there was a 350-pound limit on all the laparoscopic versions; having to go to an open surgery increases the risk considerably (as well as the recovery time), and it seemed likely I wouldn't go ahead with it if it had to be open, though it's too early to make that decision. Nor was I very positive about the idea of finding a way to lose 130 pounds without any help just to get to the point where I could get the surgery; maybe I could do it, maybe not, but at best it'd mean being miserable for a very long time just to get to the surgery.

However, we've learned that High Point Regional Health System in North Carolina does MGBs (which are always laparoscopic) up to 450 pounds, which is well within reach for me.

The question of finances still looms. While our doctor is confident that we can get this kind of surgery covered, it's quite likely High Point is an "out of plan" facility. There's some very, very, very small chance that we could get it covered anyway if it's only available for us there, but more than likely we'd have to treat it as an out-of-plan facility. That would mean a $2,500 cost to us for each surgery, plus figuring out how to cover the whole $17,000 cost in between the surgery and getting it paid, since the doctors wouldn't bill directly. Financial problems are a factor but not a showstopper; our credit rating ensures that we can deal with these kinds of concerns, even if it's hard, costly, and stressful.

On a more positive front, I'm feeling very strong that I meet the selection criteria for these procedures, and won't have too much trouble convincing the doctors to let me do it. MGB is continuing to look like the best option, as I read more about it and its results, but I'm still keeping an ear out for someone trash-talking it with actual results, not just vague dislike and anecdotal considerations. I'm sure there are facts to be had out there, but it's troubling how much conjecture and bias there is. This is medicine, folks, and medicine is a science.

1 comment:

Alex said...

Medicine ought to be a science and I've no doubt that its still treated as such on some level. Its just that that level is not a level most people will ever have any experience with.

Medicine is a business, commodity, market, and a novelty. But this isn't news anymore. Saying a doctor is educated by pharmaceutical companies and only works for the free golfing packages is as cliché as saying politicians are self-interested hypocrites who do the bidding of any lobbyist with a twenty.

I don't envy having to sift through the tons and tons of dross to find what little gold there is in the medical community.