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getting a referral for surgery

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Ulcerative Colitis
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Posted 5/14/2012 4:55 AM (GMT 0)
How do you get a referral to see a surgeon. I have UC and have been hospitalized about 8 times and I have tried everything including REMICADE infusion. I work for 3 or 4 months and then I flare. This causes bleeding, joint pain, blurred vision, fatigue, and a host of other problems. I keep requesting to be referred to a surgeon for a colectomy, but the request keep getting denied.
Posted 5/14/2012 10:09 AM (GMT 0)
Hi,
Do you need a referral for insurance purposes? For my insurance I didnt need a referral and luckily my GI dr referred me to a wonderful surgeon although I interviewed 2 others before picking one. Sounds like you have had a rough time....is it your GI doctor that will not refer you to a surgeon? You do not need your GI's approval if you decide to have surgery. Most GI doctors aren't much help with that since they are in the business to treat. (I went thru several Gi doctors) Could you switch GI docs or even talk to your GP if you need the referral for insurance? You can research on the Internet for a surgeon. Where do you live? Sorry you are having a hard time getting help.
Posted 5/14/2012 12:42 PM (GMT 0)
     I didn't need a referral either.  At the time, I had Personal Choice, Pa Bl Cross and Bl Shield.  My GI doctor refused to refer me to a colorectal surgeon rolleyes .  He said he didn't "know" any...yeah right.  After 6MP, Remicade AND Humira all failed and I was prednisone dependent for two years straight (not counting the numerous times I was on it during the twelve years I suffered with UP ...mine was proctitis), he STILL wanted me to try more and more drugs.  I was 63 yrs old and heading for the grave fast.

     What I did was go online and find a reputable colorectal surgeon in Philadelphia.  I live in south Jersey and don't trust the hospitals or surgeons in this area to perform major surgery.  Luckily, I found Dr. Robert Fry, head of colorectal surgery at the Univ of Pa Hospital.  He has been in practice over 30 yrs and trained at the Cleveland Clinic.  I was not a candidate for j-pouch because of my numerous health problems.  When I told him I had no problem with the idea of having a "bag", I was just so sick of being sick, he told me to schedule a tentative surgery date.  I had to pass an echocardiogram before he would even consider operating and be off the Humira at least six weeks.  I was not able to taper off the prednisone completely, as I would always flare, but I did manage to get down to 20 mgm at the time of my operation.  It was not a walk in the park, I had a few blips, but it was soooooo worth it.

     If your GI doctor will not refer you to a surgeon, see if your family doctor will do so.  The best of luck and health to you!

Posted 5/14/2012 1:10 PM (GMT 0)
If you are in the US you can have surgery. Just schedule a consultation with a CR surgeon within your network. You do not need a referral from your doctor, but if your GI is denying your request, you need to call your insurance company. It's not your GIs decision whether or not you qualify for surgery. It's your choice.

Sue
Posted 5/14/2012 11:12 PM (GMT 0)
Thank you for all your responses. I, for whatever reason, was under the impression that I needed a referral from my GI doc. Anyways, she gave me a referral today and explained why she has been hesitant. She thought my problems were due to adrenal insufficiency, or at least some of them. My endocrinologist has done all the test and didn't see anything wrong with my endocrine system. I'm disappointed that the surgeon can not see me until June 27th, but I am glad that I have an appointment with a surgeon, finally!
Posted 5/14/2012 11:23 PM (GMT 0)
ByeByeUC,

I live in Omaha, NE., the surgeon I was referred to is Dr. Jennifer Beatty, I could not find much on her doing a Google search. I want someone with experience performing J-pouch procedure. Any advise would be appreciated.
Posted 5/14/2012 11:46 PM (GMT 0)
I'm glad you got your referral. I did a quick google too and I all I found on her was a page with patient survey in which she got a 5 star rating. When you go talk with her make sure you ask how many j pouch procedures she has done. Obviously the more the better. Also ask if she does it laparoscopically or open. If you are a candidate for lapo and she does it, your recovery time is usually quicker. You will also need to ask how many steps you will have it done in... Two or three. You can also go to jpouch.org and in the general forum ask if anyone is from Nebraska and knows of this surgeon. You can do a search of the forum there too. Best wishes to you. :)
Posted 5/14/2012 11:50 PM (GMT 0)
ByeByeUC,

Thanks you for the advise.
Posted 5/14/2012 11:56 PM (GMT 0)
You're welcome. I also wanted to add that if you have the means to, a lot of people make the trip to the Cleveland Clinic in Ohio because they are the gurus of the j pouch procedure there. I had to travel a bit myself to go to a really good surgeon. The success of your j pouch weighs heavily on the skill of your surgeon.
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