Guest guest Posted May 15, 2001 Report Share Posted May 15, 2001 , you are amazing! Such a wealth of information you provide. Thanks! Angel --- waterlilys@... wrote: > " what's the best format for a LOMN to be? " > > You might have your DR follow the NIH suggestions > for patient > selection as many insurance co's use this in part as > thier criteria > for medical necessity: > > http://odp.od.nih.gov/consensus/cons/084/084_statement.htm > > > Gastrointestinal Surgery for Severe Obesity > > National Institutes of Health > Consensus Development Conference Statement > March 25-27, 1991 > > This statement was originally published as: > Gastrointestinal Surgery for Severe Obesity. NIH > Consens Statement > 1991 Mar 25-27;9(1):1-20. > For making bibliographic reference to the statement > in the electronic > form displayed here, it is recommended that the > following format be > used: > Gastrointestinal Surgery for Severe Obesity. NIH > Consens Statement > Online 1991 Mar 25-27 [cited year month > day];9(1):1-20. > > Excerpt: > > Patient Selection > These surgical procedures are major operations with > short- and long- > term complications, some of which remain to be > completely elucidated. > There are insufficient data on which to base > recommendations for > patient selection using objective clinical features > alone. However, > while data accumulate, it may be possible in certain > cases to > consider surgery on the basis of limited information > from the > uncontrolled or short-term followup studies > available. A decision to > use surgery requires assessing the risk-benefit > ratio in each case. > Those patients judged by experienced clinicians to > have a low > probability of success with nonsurgical measures, as > demonstrated for > example by failures in established weight control > programs or > reluctance by the patient to enter such a program, > may be considered > for surgery. > > A gastric restrictive or bypass procedure should be > considered only > for well-informed and motivated patients with > acceptable operative > risks. The patient should be able to participate in > treatment and > long-term followup. > > Patients whose BMI exceeds 40 are potential > candidates for surgery if > they strongly desire substantial weight loss, > because obesity > severely impairs the quality of their lives. They > must clearly and > realistically understand how their lives may change > after operation. > > In certain instances less severely obese patients > (with BMI's between > 35 and 40) also may be considered for surgery. > Included in this > category are patients with high-risk comorbid > conditions such as life- > threatening cardiopulmonary problems (e.g., severe > sleep apnea, > Pickwickian syndrome, and obesity-related > cardiomyopathy) or severe > diabetes mellitus. Other possible indications for > patients with BMI's > between 35 and 40 include obesity-induced physical > problems > interfering with lifestyle (e.g., joint disease > treatable but for the > obesity, or body size problems precluding or > severely interfering > with employment, family function, and ambulation). > > Children and adolescents have not been sufficiently > studied to allow > a recommendation for surgery for them even in the > face of obesity > associated with BMI over 40. > > hope that helps, > > mary bmi 68 > corona, ca > pre op 6/27/01 dr rabkin > cigna ppo > > > > > > > > > ---------------------------------------------------------------------- > Quote Link to comment Share on other sites More sharing options...
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