Need advice immediately

I had my bag for 8 months. Then step 2 (creating the pouch). Then I had to wait another 3 months for step 3 (take down). I don't think you are going to get the process completed before the end of the year.

I am sure they will fix the government healthcare website soon. But, I know where your anxiety is coming from.... I am currently on COBRA which coincidently runs out in Jan. 2014. Fortunately, I live in California and we have our own state exchange and when I called, I got help immediately. I have not signed up just yet, but it does not seem like it will be as much of a problem as the rest of the nation.

As a precaution against this uncertainty with my health insurance, I am pushing to get my hernia operation before the end of the year. It has been 2 weeks since I met with the surgeon and I am still waiting for a referral/approval from my HMO.

It depends on what shape your body was and is in as to when the timing of your surgeries occurs. I had mine done in 2 steps and 8 weeks apart. I'd met my deductible and my surgeon was on board to complete mine by the end of the year. My takedown was December 29, 2010 and I was discharged 1/1/2011. Nothing charged to the year 2011. My surgery wasn't done in an emergency situation so the operations could be done close together.

My BFF had problems with the website as it wasn't programed right for her. She is on social security disability but not long enough to be on Medicare and she also has LTD insurance benefits has too much income to get Medicaid. The website it kept telling her she was on Medicaid etc. She was instructed to print out the screens and her Congresswoman's Office has gotten her problem all the way up to the proper powers that be to get this solved.

There are counsellors in my area that help people through the Affordable Health Care Act process as well. They were talking about them on the local TV news.

I hope you are able to go forward with your surgeries and to obtain insurance as you need it as well!

Situations vary a lot. I'd echo the reassurance that you'll surely be able to get signed up in advance of the Jan. 1 transition. I'd also advise that for many of us it's best to simply ignore the deductible. If you are likely to exceed your deductible during the year (I do every year), then it's useful to consider it money you'll have to spend in any case, and just choose the care that's right for you, at the time that's right for you. In this case it doesn't matter at all what services you spend the deductible on. OTOH if you really think you might be able to stay under your deductible for 2014 then it might be a reasonable thing to include in your decision-making, as long as you stay within sensible medical boundaries.

Depending on your policy you still may have a significant amount to pay even after meeting the deductible. When surgery is involved it is often the "out of pocket maximum" that is more important. That represents the most you can pay in the year for services. Insurance is tricky. The Kaiser Family Foundation site has a lot of info including costs and is easier to navigate than the Government site
Depending on your existing policy and what is available in your state it could actually work out better for you financially, knowing your going into surgery, to go with the ACA (Obamacare) and pick a low out of pocket maximum policy. That said I agree it is best to deal with medical issues first and insurance second.

Thank you everyone for the advise. I did see my surgeon and she wants me to get my new insurance lined up and she said if I really want to get rid of my bag then she's gonna recommend me seeing another surgeon cause she's not comfortable doing the rest of my surgeries. And I'm suppose to lose some weight I guess being 250lbs is to big to do the rest of my surgeries. Don't understand that. Has anyone heard that before

My surgeon suggested, strongly, to lose weight before takedown would be done. I waited 3 months but due to complications the weight fell off. Infact my takedown was moved up because my system could not function with the bag. Weird I know but I did get better after takedown. Unfortunately I gained about half my weight back also. Not recommended!

Big abdominal surgeries are much riskier and more difficult for obese folks. Getting closer to a normal weight tends to substantially improve outcomes. This is about the only situation in which temporary weight loss is well worth the trouble. Permanent weight loss is still more valuable, of course, if it's achievable.

Matt, did she give you any other reasons other than your weight for not wanting to proceed with your surgeries? If I were you I wouldn't be concerned with the deductible now as much as my health. She obviously is unwilling to do your surgeries and whatever her reason she is not going to perform it. How experienced is she in doing j-pouch surgeries? If I were you I would want to check out any other surgeon that would be taking over and completing the surgeries as well. It is very important to have the best surgeon you can to do your surgery. Maybe she hasn't done many or doesn't do many of these surgeries a year and you will be better off waiting until you loose weight. It could be that you might be better off changing doctors as well.

I don't know what kind of research you did when selecting her to do your surgery. For instance I went off of my GI and Internist's suggestions plus looked into his training, at the Cleveland Clinic, his experience with j-pouches and his record with the state licensing board. I wish I would have learned more about types of procedures but would have had what I did had I done.

I thought current insurance companies weren't going to cancel insurance policies for ill people and it sickens me that your insurance company has done so to you. Did they also cancel it for the healthy people on their plans? They are eligible for the Affordable Health Care Act Insurance coverage too. You are in the middle of your surgeries and the roll out of the Affordable Health Care Act is a nightmare for many. You don't need all of this stress.

I disagree with everyone else. I don't think 250 is necessarily too obese. It depends on how tall you are plus other factors. I brought up my weight with my surgeon before the surgeries and he was not concerned about it. I did not have any weight related problems, such as heart disease, diabetes etc. I never could loose the prednisone weight I'd gained while ill. I've lost 75 pounds since my surgeries and am at my pre prednisone weight. If I'd had to loose the weight before surgery I would have ended up with emergency surgery for a perforated colon.

The weight loss issue isn't finger-wagging, and it's not anti-fat-people prejudice. If you'd ever witnessed abdominal surgery on an obese patient you'd encourage obese folks to try anything they're able to do to shed some pounds before surgery. Sometimes it's just not possible, of course.

Surgeons vary in their sensitivity, their arrogance, and their eagerness to operate. *No* surgeon can eliminate the excess risk an opese patient has during surgery.

Thanks again for everyone's input. I am fairly tall at 6'2" and yes the surgeon says I'm to big at 250lbs. But I feel comfortable at this weight. I don't feel like loosing everything I've paid for already , as far as reason the surgeon doesn't want to do my next surgeries is because she's just not comfortable with doing it and I'm not exactly sure how many j pouches she has done in the past. When my GI dr referred me to the surgeons office he was not familiar with the surgeon I have. He was more familiar with another surgeon but I would've waited almost 3 months at the time just to get in and see him and GI dr didn't want me waiting long. I seen the other surgeon within a couple weeks and when I seen her I was very sick going to bathroom close to 30times a day and she admitted me in ER and the following Tuesday had me in surgery.

If I were you I'd look for a new doctor and/or try for an appointment with the doctor you were originally referred to in her group. 250 pounds at 6'2" is not 100 lbs overweight, needing gastric by-pass surgery over weight. I don't even know if that is even classified as obese. She is not willing to operate on you for that reason and/or there may be other reasons. I think it is a good thing that she is unwilling to proceed if she has any doubts what so ever. You do not want an arrogant doctor, as Scott stated, that would proceed and mess up your surgery. This is major surgery and I've found out from frequenting this site just how many things can go wrong!

I think it's quite the opposite, an arrogant doctor would go ahead and do a surgery she's not actually experienced or confident with...

250 lb at 6'2" is technically obese and as mentioned upthread, without getting judgey about it the hard truth is that obesity is a huge risk factor for abdominal surgery. It sounds like you have only had a colectomy so far, so you would most likely need two more surgeries (one to build the j-pouch and one to reverse the ileostomy).

First of all, it is TOTALLY ok to switch surgeons for the next surgery. Colectomies are *relatively* simple, common procedures whereas j-pouch constructions are more complex and far less commonly performed. It is totally your prerogative to interview surgeons and pick one who has performed a ton of j-pouch surgeries and is confident working with you (and vice versa). It is not a faux pas to ask how many j-pouches your surgeon has constructed and he or she should be able to tell you or at least ballpark it. I would personally not want to have a surgeon work on me who hadn't done a few hundred in their career.

Second of all -- you will have to make the decision for yourself about weighing the obesity risk against your desire to go forward at this time. None of us are you or know your history so I won't say you should do this or that. All I'll say is that you should know that the risks of abdominal surgery in an obese population are not about weight shaming, it's about actual mechanical issues and difficulties. This is true not only of the procedures themselves but especially in constructing and living with a loop ileostomy. Loops are notoriously difficult to pull forward to the surface and even in the best of conditions can end up flush with the skin and cause lots of leaking, skin damage, and pain. If it were me I think I would want to a) find a surgeon who is confident and experienced and b) work with someone (either that surgeon or another doctor) to understand your options and risks and decide to either proceed at your current weight or explore medically supervised weight loss options.

FYI - I was saying she "was not arrogant" because she wasn't going forward with the procedure.....that an arrogant doctor would do the surgery. I hope that is clear now. She is doing the correct thing in not proceeding as she has reservations.

250 pounds on a 6'2" tall man is not the same as 250 pounds on a 5'8" man. Sure if you look this up on a chart he's not in the normal range but there are some of us with UC that did not become underweight. Some of us gained weight that we could not loose. Prednisone really messed up my metabolism and I have a new appreciation for over weight people that I didn't have before. I am sure there are plenty of skilled surgeons that can proceed with Matt's surgeries.

I sent you a PM Matt.

I spent several years working an abd. surgery floor as a RN. It may be how you are carrying your weight.If you carry the extra weight in your abd,that may be why it is such a problem. Stitching fat does not work so well. I am sorry that sounds so bad but it is just the way the body works sometimes. This is not always the case, unfortunately, you would not know until after surgery if you would be the unfortunate one.I remember times when wounds were open and packed because the layer of abd fat would just not hold stitching. This does not happen often but it is a problem when it does. This would definately prolong your recovery. My surgeon discussed abd weight with me with my first surgery. He also cautioned me greatly about gaining abd. weight after the surgery. I know that this is not always the case for everyone. Sometimes it is hard to hear this from the docs but I would rather have a surgeon tell me straight up what would give me a best possible outcome.