Worth The Wait

Patience

is not 

the ability to wait

but

how you act

while waiting

                                                        -Joyce Meyer

Waiting is always difficult.

It usually involves expectations unfulfilled, and adds at least temporary disappointment to the physical act of having to pass the time, a delay until what you wanted to happen, does.

We've had a couple of interesting situations in the office this week, instances that do happen from time to time, but I thought I'd mention them here in this Blog.

Qualifying for surgery by insurance-reimbursable standards follows the NIH guidelines as mentioned earlier in this blog.  That part is fairly concrete.  

The sometimes more challenging part of the equation for the patient is the acceptance that surgery is the next best necessary option, and coming to grips with the decision to actually go through the process to have surgery.  

Yes, Surgery... because "I have to", or "I need to", or "I don't have any other option" is what we commonly hear.

That can be quite a stretch for some, and appropriately so.  

It's not unusual for our secretarial staff to have patients shed tears of joy when we call them with a date and time to set up their initial visit after they have attended our Bariatric Surgery orientation session.  Or be so excited after that session that they go gung-ho, and lose some weight to get a running head start on the 10% they are required to lose preoperatively...

Thereby causing an issue.

We saw two such patients last week that barely qualified by BMI and comorbidities prior to their orientation, and were just underweight at the time of their intake H & P.  Unfortunately, that's the exact time when the note goes in to their insurance to initiate the approval process for weight loss surgery.

You might say that they probably really didn't need surgery in the first place... But how about this one?

52 y/o Male

Uncontrolled DM2 x 7 years on Lantus, Levmir, Metformin

Last glyco 7+

OSA. HTN, Dyslipidemia, Weight bearing Joints with OA

5' 4"  195  (BMI 33.5)

The better question to ask is , "Where will he be without surgery?" if not done soon.

It surely puts us in the awkward position of spelling out options, although, honestly, in this metabolic scenario, the result of surgery (Bypass / Sleeve) is much better for quicker impact and likely longer duration,  than even the same weight loss achieved via the traditional means.

In case you are wondering, the option he chose was to find the few pounds he lost recently, and get the ball rolling toward surgery.