| My health had been deteriorating for over a year when my primary care physician (PCP) first suggested that I might benefit from weight loss surgery. His biggest concerns were for my asthma, high blood pressure, and insulin resistance. He referred me to a surgeon who could perform the procedure. I thought surgery was far too extreme for my situation, but went to the consultation in December 2002, anyway. After that visit, I said, "It will take a life-threatening condition to make me have that surgery." Be careful what you ask for. In March 2003, my legs began to swell with retained fluid and blood. After two weeks of hospital tests to rule out more sinister causes such as heart disease and pulmonary embolism, I was diagnosed with venous insufficiency. This meant that the veins in my legs had been under too much stress from excess weight and other factors (including long-term steroid use for asthma), and they had stopped working effectively. The condition put me on a diuretic, blood thinner, and in anti-DVT medical compression full-time. The full-body effects of this vascular condition (fatigue, poor blood gas exchange, swelling, pain, and high risk for infections) made the prospect of living with it at this severity for the rest of my life most unappealing. The threat of developing a blood clot at any time qualified this as the life-threatening condition I tempted fate to give me. My best chance of having any quality of life, and a long life at that, was to take the risk of weight loss surgery. I went to three groups of surgeons before making my decision as to where to have gastric bypass surgery. The first surgeon at a local hospital would do the procedure, but claimed that because I've already had other laparoscopic surgeries for endometriosis, I could only have this procedure open. I really believed it was a matter that he didn't have the skills to perform it laparoscopically. That combined with the fact that their group had only done about 300 of these procedures prompted me to move on. The second group I looked at is heavily advertised on TV and endorsed by Carnie Wilson, The Wish Center. My husband and I went to the informational seminar and felt pretty good about this place. I scheduled my consultation, but cancelled it when I discovered there were things about their business practices that made me uncomfortable. My good friend was also preparing to have the surgery and she was proceeding with this group. After her first marathon visit (they did the psych evaluation, nutritionist, ultrasound, EKG, blood work, etc. in one day), they wanted a deposit on the surgery. After hearing this, I verified with my insurance company that while the surgeons were in network for me, they could pick and choose the procedures for which they will take the insurance. The Wish Center takes insurance, but it is out of network for everyone. That is, in the best scenario, your insurance will pay 70-80% of what they deem fair and reasonable (usually far less than the actual medical bill), and then the rest is on you. They aren't held to the negotiated rates that the insurance companies secure with their in-network providers. Of course, they have financing options, but they will want their deposit up front. This practice communicated to me that their motivation was money and not necessarily the overall well-being of the patients. In fairness, The Wish Center has a comprehensive program with lots of support. It costs a lot because you truly are receiving valuable services. My friend had her surgery in June 2003 and has been doing great every since. My decision not to go with them was based larely on a difference of philosophy. Had I not found their business practices to be objectionable, I would have very possibly had my surgery through them. The third group didn't advertise, but had a sizable waiting list built on word-of-mouth. The first time I heard Dr. Kane's name was when my PCP suggested I might want to see him after the first disappointing consultation. I did more Internet research on the surgery and surgeons and his name came up repeatedly. I discovered that his practice works through Weight for Life and has a comprehensive program similar to The Wish Center. I attended their informational seminar and found it head and shoulders above that which The Wish Center provided. I was impressed that an actual surgeon put in a few hours on a Saturday morning to talk to a room full of people, most of whom will not actually pursue the surgery. Dr. Guske, who presented that day, actually ended up being my surgeon. Suburban Surgical Care Specialists as a practice had performed over 1500 laparoscopic Roux-en-Y procedures without any deaths, they had a higher than average success rate, and they were in-network for my insurance. My friend and I continue to compare notes, but so far each of us is happy with our decisions to have surgery, as well as with whom we had it. |
| The Big Decision |
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