Blue Cross pulls plug on "DS" Switch

A month ago yesterday Paula and I had our consultation with the baratric surgeon. He recommended a relatively new type of weight loss surgery called the "Duodenal Switch. " For all the details about that day and the procedure read my March 25th post.

Paula has called the surgeon's office a couple of times over the last couple of weeks to find out if there's been any word of approval or denial of the surgery from our medical insurance company.

Today she got the word from the hospital insurance clerk that Blue Cross and Blue Sheild of Alabama, our carrier, does not approve "the switch" operation. The reason given is because it's considered an "investigational" procedure.

I had no idea what that meant so I got on the BCBS website and read about it. The explanation of the BCBS policy on "the DS switch" procedure is this: The procedure "has malabsorptive properties and multiple metabolic complications have been demonstrated. A major complication in the long-term is protein malabsorption. Patients who have this operation must have lifelong medical follow-up since the side effects can be subtle and can appear months to years after the surgery."

Translated it means the insurance company won't pay for this operation because there's a good chance there will be long term complications. They will result in the need for future surgeries or medical procedures and BCBS don't want to pay for those. It may not be written in the text but I've worked for a medical insurance company. Contrary to what all they say in their public relations and advertising they are not in the business of making sure your health needs are taken care of. They are in business to make money. It's all about the money. So with all of that said the bottom line is BCBS had pulled the plug on the "DS Switch" for us.

Finding out about this decision by BCBS was a real disappointment for Paula and I. Paula said she was "disappointed but not discouraged." For me it created a momentary gap in my faith.

The reason I've gone this far with my plans for weight loss surgery is I believe that's what God wants me to do. I believe that he wants me to change my body, my life, and my heart and surgery is the first step. I had been convinced by my surgeon that the "DS Switch" was going to be the easiest way to do it.

But God doesn't always choose the "easiest" way for us. Perhaps "the switch" isn't the way He wants to change our sinful attitudes and behaviors when it comes to food and weight.

The Roux-en-Y gastric bypass, the procedure my sister Shari had in February 2008, is also an effective way of losing a lot of weight. The "DS Switch" provides strong physical solution to the issue of weight control where as the "Roux-en-Y" has a relatively drastic physical element to it but long term successful sustained weight loss depends more on a change in and adherence to a new life style.

So having to accept the insurance company's decision to only approve the "Roux-en-Y" will mean as Paula said "we'll have to work harder." But in addition to that we'll have to change in our minds and our hearts as well.

I believe that this is the path God wants us to take. The "switch" denial by BCBS means that we'll probably have to accomplish our weight loss goals with the aid of the "Roux-en-Y" surgery.

Today while I was praying about the situation I heard God tell me something that assures me of what Paula and I will have to do to achieve our goal of successful weight loss. Very clearly God sent me the message: "I don't just want to change just your body, I want to change your heart."

That more than anything explains to me what God's will is for us as we go through this life changing endeavour. I've been told what God wants me to do, now it's my responsibility to have faith that he's going to make a way and help me to do it.