Re: I had my consult (very long)

[Guest guest]

Hi ,

Congratulations on a successful first consultation. I

hope you get all your insurance problems worked out.

I will be crossing my fingers for you. I am still

pre-op until 01/09/02. But everyday I am thankful

that things are going well for me. I never believed I

would be approved as fast as I was. I hate it when I

read how someones life is put on hold because of

insurance company's. So Good Luck & I hope you have a

Merry Christmas!

--- sassenachwench wrote:

> Well, finally after months of jumping through hoops

> and then waiting,

> I had my consult with Dr. Scholten today. And I'm

> happy to report

> that my anxiety was unnecessary.

>

> First I had to watch a pretty generic WLS video,

> which was totally

> boring. Then the nurse (Renae, they have a new

> nurse who is " helping

> out " Dr. Scholten and Kay, and she's really

> nice) weighed me on

> one of those BMI scales and took my vitals. On

> their scale I weighed

> in with a BMI of 43. And despite the fact that I

> had taken my BP

> meds 90 minutes earlier, my BP was 163/97 and my

> pulse was racing at

> 126 bpm!

>

> Then I was put in another exam room to wait on Dr.

> Scholten. The

> wait was only about 15 minutes. When he came in, he

> had a resident

> with him that he's teaching and asked my permission

> to have the

> resident in on the consult. I said sure. The fact

> that he was a

> cutie had no bearing on my decision, I swear! ;o)

>

> Anyway, I told Dr. Scholten before he had a chance

> to go into his

> explanation of the surgery that I had done months of

> research and

> wanted the DS. He said that it wasn't his job to

> convince me one way

> or the other which surgery to have, he'd explain

> both the DS and the

> RNY and after that my decision was my decision... so

> he did just

> that.

>

> As Renae predicted in our previous thread on Dr.

> Scholten, despite my

> asking directly, he wouldn't be pinned down to

> absolute numbers for

> the length he will make the common channel. He said

> he wouldn't be

> able to tell until he got in and measured as the

> final common channel

> length is a percentage of the total. All in all he

> gave me a very

> balanced presentation on both surgeries, their

> upsides and

> downsides. The sense I get from how he explained

> the two surgeries

> to me, and this is completely inferred by me -- he

> never said this in

> as many words -- is that he prefers the RNY surgery

> for the majority

> of his patients because, by it's very nature, it

> more or less

> enforces patient compliance. He said, without

> saying, that he is

> only comfortable doing the DS on patients who really

> understand the

> DS and its long-term implications and have the

> self-discipline to do

> the proper follow up maintenance with regard to

> nutrition and

> supplements.

>

> I guess I met his standards because by the end of

> the consult the RNY

> papers were all tucked away and he told me he'd love

> to do the DS on

> me if I can get it approved. Then he grinned like a

> kid and said he

> likes doing the DS, that it's a " fun sugery. " Yup,

> the man

> definitely loves his work. He said he'd do more DS,

> but he's found

> that insurance companies are still too resistant to

> approving it.

>

> I also found out he trained with Dr. Hess, which was

> VERY

> reassuring. Bottom line is I _like_ Dr. Scholten.

> He's very

> personable, has a nice sense of humor and projects a

> genuine concern

> for his patients and wants them to do well. But

> when doing the DS I

> think he may tend to err on the side of caution when

> deciding common

> channel lengths because, as he said, the only way to

> fix the

> excessive malabsorption if the common channel is too

> short is a

> revision.

>

> Then I spoke with Amy, who is in charge of battling

> with the

> insurance companies, and she told me that they use

> the exact same

> codes when submitting the DS for insurance approval

> that Dr. Hess'

> office does. She also said that UHC is usually very

> quick to get

> back with a yes or no.

>

> At this point my LOMN submission is on hold. I got

> my COBRA letter

> from UHC... $700 a month to continue coverage under

> COBRA for me and

> my two kids. So... I have to come up with $1,400

> for the December

> and January premiums and send it off to UHC before

> we can submit my

> LOMN and then pray for approval. Then, if I'm

> approved (please God),

> I have to get the surgery done before April; that's

> the beginning of

> the next plan year and when changes to the policy

> are made. It would

> be my luck for them to revise it to exclude WLS.

>

> Anyway, there is waaaaaaaaay more than you wanted to

> know about my

> consult. ;o)

>

> I may not post often, but when I do I sure make up

> for it by packing

> it into long posts, don't I? LOL Thanks for

> reading all through

> this.

>

>

> Grand Rapids, MI

> BMI 43

> Dr. Scholten

> On hold pending COBRA payments

>

>

>

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