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 Introducing Myself - Sydney

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aussiearies
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Number of posts : 894
Location : Sydney
Registration date : 2014-03-20

PostSubject: Re: Introducing Myself - Sydney    Fri 25 Mar 2016, 10:47 am

Not doubting what you were told Todds, it might be relatively new as there was nothing that came up on my search for such situation. But that may be an agreement between the doctors and the health funds and could also be why some doctors have a BMI figure that if you are under that they won't operate.

In any case I suspect most doctors would not offer the surgery unless there was a good reason for it, especially if the person's BMI was low.

Anyway it is good that you have the documentation you need, not that it is good for you to have those risks though.

Good luck with it.
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Toddsinoz
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Number of posts : 46
Age : 43
Location : Castle Hill
Registration date : 2016-03-24

PostSubject: Re: Introducing Myself - Sydney    Fri 25 Mar 2016, 5:58 am

Hi There - Dr Roy said it was a fairly new thing - Auditing by Health Funds. Not sure when Health Funds started Auditing but Dr Roy said the minimum BMI was 35. He said the Health Funds are now doing random audits and if caught they make you pay back what they contribute towards the op which he said was around $20,000 odd thousand. I think they also do it to keep the Surgeons honest - but that is only my opinion. Anyway I am so stoked I have been approved for the op. I am so looking forward t getting back on track and healthy.
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Fat-to-Fit
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Number of posts : 255
Location : Melbourne
Registration date : 2016-01-05

PostSubject: Re: Introducing Myself - Sydney    Fri 25 Mar 2016, 5:13 am

Hi Toddsinoz

I know there are guidelines for bariatric surgery, as well as exceptions to the rules, but I have never heard of health funds having aa absolute  'cut off' for GS surgery, or that you would have to pay back $20K if your surgeon were audited..????!!!

I was 45 (now 46), weighed 90.1, 165.5cm tall, BMI 32, with cholesterol of 7.2 and high insulin, & my dad died of a heart attack at 60, & brother died of insulin related cancer. Because of my blood work & family history ,my surgeon said the sleeve was totally appropriate - he never mentioned Audits & pay backs!!

I was sleeved in November last year, and have now lost all of my excess weight , and feel far healthier and less likely to face the issues I was probably headed for . It is by no means a quick fix, easy answer, but it certainly is a good tool - sounds cliched, I know, but it's true !

I'm glad you are thorough the waiting to find out part and that you can look forward to building a healthy, happy future with your family!
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Box of Jewels
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Number of posts : 637
Location : Nth Qld
Registration date : 2015-01-14

PostSubject: Re: Introducing Myself - Sydney    Fri 25 Mar 2016, 2:35 am

Welcome!  Best of luck with it all.
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Toddsinoz
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Female
Number of posts : 46
Age : 43
Location : Castle Hill
Registration date : 2016-03-24

PostSubject: Introducing Myself - Sydney    Fri 25 Mar 2016, 12:23 am

Hello  I am new to this site so I thought I would introduce myself and also say THANK YOU. I have done hours of research and found the forums/threads on here so helpful and encouraging. It was through reading posts on this site that made my mind up for me. So thank you!

I have my Sleeve op booked in for the 15 April 2016 and I am so excited. I keep feeling like it is too good to be true. My surgeon is Dr Roy B from Circle of Care and from what I have read I am in good hands.

I went to see Dr Roy as I am obese and need to do something as I have tried every diet known to man - in fact when I had to complete the online registration I was asked to tick the diets I had tried - I asked for extra space to write diets I had tried that weren't even listed  Boggled . My BMI is 32 and I weigh 81KGs - which for my small frame and height of 156 and my ongoing back issues, is a lot for me. I am carrying an extra 30KGS. Pre kids I was happy, healthy, and my normal weight, which I have been most of my life is 50kgs. My cholesterol is 6.2 and I feel like I am heading down a one way road and I feel miserable!

I was absolutely gutted when I waited almost 2 months for an appointment to see DR Roy only to be told that the minimum BMI for Health Funds to cover the op is 35 and my BMI is 32. Dr Roy agreed that I am obese for my small frame and my on going back issues are as a result of my weight. BUT he said that if he were to be audited I would have to back pay $20,000 to the health fund - That is a risk I literally cannot afford to take. I left Dr Roy's office in tears. On the way out his office he said only patients with a history of heart disease in the family would be given consideration. Well "Lucky" (in this instance) we have a hectic family history of heart disease in our family - on both sides. Both grandfathers died at 56 and 70 due to heart attacks (with a few near fatal attacks along the way). Gran had a double bypass, dad had a triple bypass, aunt is an angina suffer and other aunt died at 52 from a heart attack. So this meant a trip to the heart specialist for me and several tests later - I am at a high risk due to my weight and cholesterol and family history.

Given all of this my Healthfund has considered me high risk and because of this Dr Roy has now agreed to do my surgery and I will be covered. My operation is booked in for the 15 April 2016 - I am so excited I am beside myself.


I did have doubts about whether this op was too drastic, but given my back problems and my inability to exercise because of my back and my high cholesterol I believe I am doing the right thing. I was to do a talk at my daughter's school - she is six - when I told her I was coming to her class to do a talk she said "Mommy I hope the other kids don't think you are fat and talk behind your back and laugh at me!"  OK I have to remind myself that she is ONLY 6 and has no filter - BUT I don't want to be like that for them -an embarrassment! That is when I knew I was making the right decision for me.


Anway that is how I got here today. I am so excited to getting healthier and slimmer and reading your posts - I know I am doing the right thing.
I have made sure I am busy every weekend from now up until my surgery date so  the time flies as I feel like it is going to drag!
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