No easy lapband surgery because of ESRD

[devon]

I met with the surgeon today who was going to perform the LapBand procedure. We had to call it off because of a bout of diverticulitis.  He said the anesthesiologist also said he didn't want to risk the surgery at the outpatient facility because of my bad kidneys.  So, when I finally do have to do the lapband it must be at a regular hospital.  That adds about $4000 to the tab that my insurance company (United Healthcare) won't pay!

I'm disappointed, of course, but I've always discovered that things work out for the best.

I'm tempted to go ahead with a transplant just to make sure United Healthcare has to pay out the kazoo for all the expenses!  That one, they can't avoid!

Tomorrow I meet with the Gastroenterologist to see what and why the diverticulitis isn't going away as quickly as it should.  That should be interesting.  Personally, I'm not convinced it's diverticulitis.  So, an expert needs to make a determination.

-Devon

[Sluff]

A little setback,    but I'm glad you are not letting that get you down.   

[Psim]

Fingers and toes crossed for you Devon.

[Bajanne]

You just hang in there!  I am pleased with your spirit.  My caring thoughts and prayers are with you all the way.   

[rose1999]

Thinking of you and wishing you the best 

[Romona]

 
Good Luck!

[twirl]

what happened?

[devon]

An update...

It's taken a while but I think I've gotten the Diverticulitis under control.  I had to restart the anti-biotics and take them longer.  The problem with ESRD is that the docs don't want to stress my kidneys with too much antibiotics so they err to the side of caution.  The result is that an infection is more difficult to eliminate.  It didn't get eliminated the in the first pass.

The results of the endoscopy were that it was certainly diverticulitis but nothing worse. Thank the gods. I don't need another scoping for 10 years. Thank them again! That's generally a good indicator.  Uncomfortable as it might seem, I really didn't have a too unpleasant experience.  The worst part was the prep for the scoping.  The scoping itself was pretty non-eventful. 

I hope everyone is doing well.  I am for the most part.  Going to get labs this week to see how the creatinine is doing.  Wish me luck.  Perhaps it will be under 5 again.

-Devon

[Psim]

Whew, that's over! I'm glad they finally got the diverticulitis under control (and gladder still that it's nothing worse).

[kellyt]

Sorry to hear that.  But you're right, things usually do work out for the best.  It's just hard to envision a good outcome sometimes. 

I know a little bit about diverticulitis (meaning I know it has something to do with the stomach  ).  What sort of problems do you have with diverticulitis?
Is it little "pockets" in the stomach or something like that?  I used to work for a general surgeon that would see patients with diverticulitis, but I can't remember exactly what it is or what the complications are.  Can they be lasered out?

[rose1999]

Glad you're doing OK Devon, good luck with the labs.

[devon]

Defining Diverticulitis... a layperson's definition anyway...

it's an infection in pockets in the intestines. In my case, the lower intestine and colon. Diverticulosis is the formation of the pockets.  Digestive material gets caught in there and gets infected, causing Diveritulitis.

Treatment for the infection is antibiotics but eating lots of fiber helps to keep things flowing so it doesn't have a chance to get started.  I got some Benfiber and I've been very pleased with the product.  It will mix with just about everything; milk, juice, kool-aid, etc.  I even tried it in Chocolate milk.  It seemed to clot up with the chocolate milk however but not to a distastful amount. But with everything else, you wouldn't know you mixed it in.  I even put it in cereal.  I also got some high fiber cereal but that tastes like cardboard. I added dried blueberries to make it more tasty. Benefiber mixed with milk or water works for me most often.

Thanks for asking and thanks y'all for the kind thoughts.

-Devon

[Laurie]

I'm glad your doing better. 

[okarol]

I hope you get it under control and can be reconsidered for lap band. How long have you had ESRD? Won't Medicare kick in at some point so you can have them consider payment?

[devon]

Excellent question Okarol! 

I am pre-dialysis so I'm not yet eligible for Medicare.  As I read it, Medicare kicks in 30 months after beginning dialysis.  I figured as soon as that happens I will get it covered by Medicare and United Healthcare can kiss my 

The question is how much damage has been done waiting the 30 months (over two years) for a procedure my docs all agree is "medically necessary".  Once again insurance companies are practicing poor medicine!  But that's a rant for another day!

-Devon

[okarol]

I may be mistaken, but I am pretty sure Medicare eligibility begins when you are diagnosed with ESRD. Anyone know?

[MIbarra]

The social workers told me the same -- 30 months until you qualify for medicare. I think my husband even called medicare (or wherever you call for that) and they told him the same thing.

When I started dialysis I was so confused and out of it, I had nothing to do with insurance, billing, medicare, etc. I'm surprised I remembered what day it was since I had gotten so sick. So hubby had to take care of everything. Poor guy.

[Rerun]

You get medicare 90 DAYS after your first dialysis.  Then if you have another insurance that is primary for 30 months.  After 30 months Medicare takes over as primary insurance and then no doctor will see you or treat you.   "I'm sorry we don't accept Medicare Patients".

[okarol]

When Medicare Coverage Begins
When you first enroll in Medicare based on ESRD
(permanent kidney failure) and you are on dialysis
your Medicare coverage usually starts the fourth
month of dialysis treatments. For example, if you start
getting your hemodialysis treatments in July, your
Medicare coverage would start on October 1.

If you are covered by an employer group health plan,
your Medicare coverage will still start the fourth
month of dialysis treatments. Your employer group
health plan will pay first on your health care bills and
Medicare will pay second for a 30-month
coordination period.

from: www.medicare.gov/publications/pubs/pdf/esrdcoverage.pdf