OT: 700-pound man battles weight and insurance company
jan_49
700-pound man battles weight and insurance company
03/20/2002
ENUMCLAW - He's only 25 years old, but Jed Rodarte of Enumclaw weighs nearly
700 pounds.
Diets and drugs haven't worked.
"I've tried everything," he said. "The low fat diet. The high protein diet.
Everything. They all worked - for awhile. Then the weight came back."
Jed was a normal baby, and he was active in sports throughout school, even
as his weight balloooned.
"In 10th grade I weighed 300, 350 pounds, by 11th grade 400, 450," says Jed.
Rodarte wants to have gastric restrictive surgery, a procedure in which
doctors will create a small sac from his stomach and shorten his intestine.
The small sac will limit the amount of food he can take in. The shortened
intestine will limit the calories his body absorbs.
Dr. S. Ross Fox, Rodarte's physician, has been performing gastric
restrictive procedures on the morbidly obese - those who weigh 100 pounds or
more over their ideal weight - for nearly 40 years. Fox says the procedure
isn't cosmetic - it's about saving a life.
"The surgery will save his life," says Dr. Ross Fox, who predicts Jed has at
most 10 years to live otherwise. "He has very serious bone, joint and muscle
problems. He can't walk very far. He can't climb more than two steps without
being out of breath. His major organs - heart, liver, kidneys - are very
stressed."
"I'm worried about my survival, I'm afraid one night I will go to bed and
not wake up," says Jed.
But Jed's health insurance carrier won't pay for the operation.
"Weight reduction surgeries are excluded regardless of diagnosis" according
to Regence Blue Shield, which terms it a cost issue.
Jed says that leaves him with little hope.
Family and friends are raising money to help cover the $35,000 operation,
and establishing the Jed Rodarte Fund at Columbia Bank in Auburn.
Jed Rodarte's friends and family are organizing a series of fund-raisers to
help him get money for gastric restrictive surgery.
- A car wash is scheduled at 1 p.m. Saturday, March 23, at the Auburn South
branch of Columbia Bank, 4101 A St. S.E. in Auburn.
- Another car wash is scheduled at the Columbia Bank location at 1 p.m.
Saturday, April 13.
- A barbecue is scheduled Sunday, April 28, at Koong Thong Thai Cuisine, 709
Auburn Way S. For further information, or to help with the fund-raising,
call 206-841-8024.
The Associated Press contributed to this report.
--
Jan
Atheist #2028
Maggie
>
>700-pound man battles weight and insurance company
>03/20/2002
**Well, *obviously* this guy just doesn't know how to deal with insurance
companies.
Maggie
"Human beings, who are almost unique in having the ability to learn from the
experience of others, are also remarkable for their apparent disinclination to
do so."--Douglas Adams.
JonesieCat
"Maggie" <maggi...@aol.comSPAMBLOC> wrote in message
news:20020320231715...@mb-fo.aol.com...
Why do you say that?
(And I think the insur co ought to pay for the surgery, btw. Even tho even
it is not a guarantee to keep the weight from coming back.)
JC
Maggie
>Why do you say that?
>
>(And I think the insur co ought to pay for the surgery, btw. Even tho even
>it is not a guarantee to keep the weight from coming back.)
***Oh, it was just a joke. Td and desi have been ragging on Rusty Yates for
not handling his insurance company in a way to make them do what he wanted them
to do.
JonesieCat
"Maggie" <maggi...@aol.comSPAMBLOC> wrote in message
news:20020320231715...@mb-fo.aol.com...
Why do you say that?
(And I think the insur co ought to pay for the surgery, btw. Even tho even
it is not a guarantee to keep the weight from coming back.)
JC
RichardOHara41
it is not a guarantee to keep the weight from coming back.)
JC
>>
It'd be cheaper than Twinkies.
PH
Ronald Helm
<cj_m.rm@thiswontwork> wrote:
>>Dr. S. Ross Fox, Rodarte's physician, has been performing gastric
>> >restrictive procedures on the morbidly obese - those who weigh 100 pounds
>> >or
>> >more over their ideal weight - for nearly 40 years. Fox says the
>procedure
>> >isn't cosmetic - it's about saving a life.
>> >
>> >"The surgery will save his life," says Dr. Ross Fox, who predicts Jed has
>> >at
>> >most 10 years to live otherwise. "He has very serious bone, joint and
>muscle
>> >problems. He can't walk very far. He can't climb more than two steps
>without
>> >being out of breath. His major organs - heart, liver, kidneys - are very
>> >stressed."
This obesity surgeon doctor has likely lost his medical license by now
as he has been under the scrutiny of Washington State Quality
Assurance Commission for several years that I know about.
Ron
jan_49
"Ronald Helm" <drs...@earthlink.net> wrote in message
news:d6ok9u0tpfk0pliqu...@4ax.com...
Well, this article --dated this week -- refers to him as a current
physician. So I think it's safe to assume he hasn't lost his license.
--
Jan
Atheist #2028
PattyC
Maggie:
**Well, *obviously* this guy just doesn't know how to deal with insurance
companies.
JonsieCat:
Why do you say that?
(And I think the insur co ought to pay for the surgery, btw. Even tho even
it is not a guarantee to keep the weight from coming back.)
Maggie:
**Well, *obviously* this guy just doesn't know how to deal with insurance
companies. ***Oh, it was just a joke. Td and desi have been ragging on
Rusty Yates for
not handling his insurance company in a way to make them do what he wanted
them
to do.
*Well I thought your were serious. The fact is this guy is the poster child
for one who would be eligible for this surgery. There is either more to
this story, or this guy sure does NOT know how to deal with insurance cos.
(I am familiar with a woman who gained 95 pounds after a back injury. SHE
had this surgery (which I thought was absurd and should not have been
approved at that time by the insurance company... she was not overweight
enough, for long enough, there were obvious reasons why she'd gained weight,
she hadn't tried enough other methods, etc., etc.). Anyway, THIS guy, with
some additional effort, could certainly get this approved under most health
insurance policies.
PattyC
--
???
"Maggie" <maggi...@aol.comSPAMBLOC> wrote in message
news:20020321102420...@mb-fo.aol.com...
Every9man
It's possible that the insurance company listed this procedure as a limitation
when they signed the contract. I dont think you can fight it.
Why do you say it's no guarantee that the weight doesnt come back JC? This is
stomach stapling isnt it?
My understanding and I've only known two people who have had this done, is
that the only give is that the stomach you have left after most of it is
stapled off may stretch some but I didnt think it can stretch that much without
bursting.
Barbara
>
>
>
>
>
>
>
>
Ronald Helm
>My understanding and I've only known two people who have had this done, is
>that the only give is that the stomach you have left after most of it is
>stapled off may stretch some but I didnt think it can stretch that much without
>bursting.
>
>Barbara
Any obese person can overcome the stapling procedure by going to high
caloric liquid diets, and most level out at about 100 pounds of weight
loss.
Ron
Maggie
>>
>>(And I think the insur co ought to pay for the surgery, btw. Even tho even
>>it is not a guarantee to keep the weight from coming back.)
>>
>>JC
>
>It's possible that the insurance company listed this procedure as a limitation
>when they signed the contract. I dont think you can fight it.
***Well, you'll have to fight this one out with PattyC. She says she thinks
this guy *doesn't* know how to deal with his insurance company.
Every9man
>>>(And I think the insur co ought to pay for the surgery, btw. Even tho
>even
>>>it is not a guarantee to keep the weight from coming back.)
>>>
>>>JC
>>
>barbara said:
>>It's possible that the insurance company listed this procedure as a
limitation
>>when they signed the contract. I dont think you can fight it.
>
>***Well, you'll have to fight this one out with PattyC. She says she thinks
>this guy *doesn't* know how to deal with his insurance company.
>
>Maggie
>
No need to fight it out, I dont know on what basis they are denying payment.
Insurance companies often refuse payment--their philosophy is that much of the
time people just dont know any better than to fight them.
you really have to check out the contract. It may *not* be listed as a
limitation or exclusion.
barbara
Barbara
RoseTower
Every9man wrote:
They could be fighting it on the basis of a "pre-existing condition"?
Eve
JonesieCat
"Every9man" <ever...@aol.com> wrote in message
news:20020321193623...@mb-cr.aol.com...
For one thing, recently I read Carney Wilson's book (she's Brian Wilson's
daughter) about her own experience with this type surgery (a number of these
type surgeries used to be called stomach stapling). It's way interesting.
Carney's didn't involve removing part of her intestine (unless I've
forgotten that part), but it did block off much of her stomach off -
forever. She says most of the weight one is going to lose comes off in the
first 6-9 months, and after that, it's more slowly, and still requires
exercise, proper diet and so forth. Eventually you get so you can have
normal sized meals, and you can indeed overeat at some point down the road,
without too much discomfort, apparently, after your body adjusts to the
smaller stomach. Now I don't know if this means you could physically eat
enough to be at big as you were in the first place, but seems like maybe you
could if given enough time, and the severity of the eating disorder and/or
malfunctioning metabolism.
JC
mothra...@hotmail.com
> Why do you say it's no guarantee that the weight doesnt come back JC? This is
> stomach stapling isnt it?
> My understanding and I've only known two people who have had this done, is
> that the only give is that the stomach you have left after most of it is
> stapled off may stretch some but I didnt think it can stretch that much without
> bursting.
The New Yorker had an article about this some months ago, and there are
people--I don't know what percentage--who have this procedure done and
who then regain the weight they've lost. I think the stomach probably
can stretch a great deal without rupture, if the stretching occurs
gradually and over a long period of time.
My daughter's bus driver had this done, and I feel sure that his
insurance paid for the surgery--I can't imagine that he makes enough
money to have paid for it out of pocket. I'll ask, though. (He had it
done in late December and had lost 90 lbs as of late February.)
Martha
Every9man
>From: RoseTower rose...@aznet.net
I thought that insurance companies were no longer legally able to deny coverage
based on pre existing conditions. Maybe it's only in New York?
barbara
Every9man
>This
>is
>> stomach stapling isnt it?
>> My understanding and I've only known two people who have had this done,
>is
>> that the only give is that the stomach you have left after most of it
>is
>> stapled off may stretch some but I didnt think it can stretch that much
>without
>> bursting.
>>
>> Barbara
JC:
>For one thing, recently I read Carney Wilson's book (she's Brian Wilson's
>daughter) about her own experience with this type surgery (a number of these
>type surgeries used to be called stomach stapling). It's way interesting.
>Carney's didn't involve removing part of her intestine (unless I've
>forgotten that part), but it did block off much of her stomach off -
>forever. She says most of the weight one is going to lose comes off in the
>first 6-9 months, and after that, it's more slowly, and still requires
>exercise, proper diet and so forth. Eventually you get so you can have
>normal sized meals, and you can indeed overeat at some point down the road,
>without too much discomfort, apparently, after your body adjusts to the
>smaller stomach. Now I don't know if this means you could physically eat
>enough to be at big as you were in the first place, but seems like maybe
>you
>could if given enough time, and the severity of the eating disorder and/or
>malfunctioning metabolism.
>
>JC
It *is* interesting.
thanks for the info.
Barbara
Every9man
I'm not surprised that his insurance paid for it if it did. I guess it depends
on what type of policy you have and how much you pay in premiums, even for
group insurance---the better policies are more lenient with everything.
Barbara
Melissa
versions of bariatric surgery. The most popular now is the Roux En Y which
staples your stomach to 2 oz and bypasses five to six feet of intestines so
that not only do you eat less, but your body absorbs about 20% less of the
food you do eat. The 2 oz pouch eventually expands to about 4 oz, but
that takes about 1- 1 1/2 years. In that time people lose as much as 100-200
lbs. For the very heavy 400+ they sometimes take out a section of
intestines for an even more radical wt loss. Supposedly as you near your
final plateaus, you will put back on a small amount of weight 10-20 lbs. I
have heard that if you are "determined" you can gain all the weight back,
but that is rare. I think the stats are less than 5%.
"Stomach stapling" of 20 years ago is a whole lot different than today.
They used to just cut you open and staple your stomach up by stomach by 50 %
or so, but for some 50% still isn't enough to lose weight they need to. They
must get down to 600-800 calories a day in order for it to be effective.
Now for some, depending on size, the surgery can be done laproscopically
...about a 350-400 lb limit. I know of one Dr. that is doing that surgery
on 23 hr outpatient status . I didn't read the original article, but at 700
lbs, the risk of death, is tremendous with or without the surgery.
Melissa
"Every9man" <ever...@aol.com> wrote in message
news:20020323142156...@mb-mf.aol.com...
JonesieCat
informed - I'm interested in this your comment of yours: "...at 700 lbs, the
risk of death, is tremendous with or without the surgery." Just how risky
would the bariatric surgery of this type be for the guy? Would death be a
real possibility? Would there be any other safer alternatives for him?
JC
"Melissa" <m...@ro.com> wrote in message
news:L16n8.13985$To6.4...@e420r-atl1.usenetserver.com...
mothra...@hotmail.com
Yes, and this guy's health clearly was compromised by his weight--he's a
young man and must've weighed over 500 lbs. It's such a joy to see him
losing weight week by week--couldn't happen to a nicer fellow.
Martha
Melissa
"JonesieCat" <cj_m.rm@thiswontwork> wrote in message
news:KX8n8.18372$uR5....@newsfeeds.bigpond.com...
> Thanks for the info, Melissa. I find this stuff fascinating. You seem
quite
> informed - I'm interested in this your comment of yours: "...at 700 lbs,
the
> risk of death, is tremendous with or without the surgery." Just how risky
> would the bariatric surgery of this type be for the guy? Would death be a
> real possibility? Would there be any other safer alternatives for him?
>
> JC
Once someone has reached such a high weight, the damage to vital organs such
as the heart, liver, and pancreas is severe. When complications arise, 3-20
% of the time depending who you listen to, people with serious coronary
artery disease or other diseases related to obesity, cannot endure the
additional stress on those organs. Surgery alone puts stress on those
organs. Most Dr.'s claim the risk of death is about 1% across the board, but
the data is insufficient. If someone drops from 700 to 500 a few months
after surgery, they are still a ticking time bomb. It's hard to determine if
they died,because of the obesity or the surgery? The CDC says the morbidly
obese only have a 3% chance of ever getting to a normal weight and
maintaining it through diet an exercise. The rest will give up or die
trying. In answer to your question, there would probably not be any safer
alternatives for him.
Melissa
(still hoping to invent an "at home liposuction machine")
JonesieCat
The guy Martha knows, the bus driver who lost 90 lbs, in a little over 2
months, how does that work? The body burns off the fat, but at the rate of
over a pound of fat a day? So does one just sweat that out?! Even tho I know
the size of the weight-loss is true, it just doesn't seem possible. I know a
certain amount in the beginning is fluid (right?), but still, is that a
relief for the liver and kidneys? or does that mean there is greater stress
on them during such drastic weight-loss?
Re the 700 lb guy. *Theoretically*, wouldn't it be physically safer if
someone just locked him up in a clinic or something, controlled his diet (eg
to whatever he'd eat if he had had the surgery), and *then* reduced the size
of his stomach via surgery (after he'd lost quite a bit)?
Anyway, not that it would be practical, but it seems logical to me.
JC, would luv do-it-yourself lipo (if it didn't hurt) (maybe) (or at least
I'd like to own the patent!)
Barbara
> It all depends on what type of surgery you have. There are about 6 different
> versions of bariatric surgery. The most popular now is the Roux En Y which
> staples your stomach to 2 oz and bypasses five to six feet of intestines so
> that not only do you eat less, but your body absorbs about 20% less of the
> food you do eat. The 2 oz pouch eventually expands to about 4 oz, but
> that takes about 1- 1 1/2 years. In that time people lose as much as 100-200
> lbs. For the very heavy 400+ they sometimes take out a section of
> intestines for an even more radical wt loss. Supposedly as you near your
> final plateaus, you will put back on a small amount of weight 10-20 lbs. I
> have heard that if you are "determined" you can gain all the weight back,
> but that is rare. I think the stats are less than 5%.
>
> "Stomach stapling" of 20 years ago is a whole lot different than today.
> They used to just cut you open and staple your stomach up by stomach by 50 %
> or so, but for some 50% still isn't enough to lose weight they need to. They
> must get down to 600-800 calories a day in order for it to be effective.
>
> Now for some, depending on size, the surgery can be done laproscopically
> ...about a 350-400 lb limit. I know of one Dr. that is doing that surgery
> on 23 hr outpatient status . I didn't read the original article, but at 700
> lbs, the risk of death, is tremendous with or without the surgery.
>
> Melissa
>
thanks for all the information Melissa. I was going on what I knew of
it from back in the early 90's. I didnt know it was so much more of a
sophisticated procedure now but I'm happy to hear it.
Barbara