Out Of Country (OOC) – A Real Story

The BC Ministry of Health authorizes “Out Of Country” surgery when a BC resident can’t receive timely surgery in BC. Since VIHA funding cutbacks for bariatric bypass surgery, more and more BC residents are taking the OOC to route. It puts them back on the road to good health and significantly shortens their wait time for surgery. OOC not only gets their weight challenges back on track, but also reduces co-morbidity risk complications that increase with longer surgery wait times.

The following account is the personal story of one of our WL&S Support members who took the OOC journey as the only option left to her. To respect her privacy, I’m going to call her Heather (becasue I’ve always liked that name). Heather has been overweight for many years and as you’ll read in her 1st person account, she reached a BMI of close to 50 when she finally made the choice to regain her health. So, to read about a real life OOC journey…

Ron

“Gotta tell you, I was so glad I went the OOC route.  I started the first step of this process around last May with a visit to Dr. Tang.  I did the home oxemetry test and was waiting for the hospital overnight visit when I heard of the reductions in funding for bariatric bypass surgery by VIHA. As they are the only Health Authority in BC that does bypass surgery, I knew I was in trouble.

I had read here on WL&S Support about the OOC program and promptly called Dr. Tang who in turn completed the OOC form indicating his recommendation for surgery.  I sent that off to the BC Ministry of Health contact,  Kelly.Braithwaite@hibc.gov.bc.ca with a letter from me explaining why I needed the surgery.  I told her I’d tried several weight loss programs, had always been overweight and of course after trying to diet countless times, ended up gaining more weight than I lost.  I told her I wanted to start the next part of my life’s journey in a healthier place.  I included my co-morbidities, which really weren’t that many – started b/p medication about 6 months prior, had the usual achy knees, feet, back, GERD, sleep apnea.  Last but not least, I gave her my BMI which I think was hovering around 50, told her of my biking 18 kms per day, and other activities to try and get my health back.

That was sent to Kelly in October and about 3 weeks later she phoned with the good news that I was approved for OOC.  I could have started the process in Seattle, Washington in December but as that was my last month of work before retiring, chose to wait until January 2010.  I did one appointment in January, and another in February at the Virginia Mason hospital in Seattle, then surgery on March 16th.  Dr. Chang used my home sleep apnea results so I did not need to do the overnight/hospital visit.  I did not need the scope done (although I noticed on the statement mailed to me a nuclear medicine charge that may have been for scoping at the time of the surgery because I didn’t go to any nuclear appointments while I was there!).  I also did the psych and dietitian appoints in February.  Picked up ‘Bariatric Advantage” meal replacement at the hospital pharmacy while there so I could do the 2 week liquid diet before surgery.

Flew down to Seattle on the morning of March 16 and checked myself into Virginia Mason.  Had the surgery around 1:00 and was in my room later that night.  I never even thought of checking the time (or if I did, the drugs made me forget).

Only problem I had was a sharp pain on left side which I found out was from the gases dissipating from when they expanded my abdomen.  I had to stay one extra day as I expereinced complections with some internal organs.  So surgery on Tuesday, flew home Saturday.  I was prescribed oxycontin and liquid tylenol but never had to take either of them.  There was no pain from the incisions (6 small ones) at all; only from the muscle hit by the heparin shot.  They send you home with 3 weeks of heparin injections which were pure joy to inject (note the sarcasm here…..I would never make a good junkie!!)  Only good thing is I have a spot below where my gallbladder was which has nerve damage so I could inject myself there quite nicely and never feel the pain.

The staff at Virginia Mason were fantastic and very professional.  Their cafeteria has your dietary requirements; you phone them any time between 7 am and 11 pm and tell them what you want to eat from your dietary menu and it’s delivered.  So easy!

I did notice they use more grains than what’s recommended here.  I could start off with Cream of Wheat or Rice and Cream of Potato or Tomato soup, custard, jelly and that’s about it.  They don’t use cottage cheese or eggs until later though.  By the time I had a few meals at home I was sick of both those items so after talking to some friends who had WLS surgery in BC and looking at websites, added egg and cottage cheese to my diet.  mmmmm!!!  Added Source yoghurt as well as it fits into the 5-5-5 rule.

I then added fish ( I was so craving any type of fish that by the end of my second week was eating shrimp and seafood sauce (nutritionist at Virginia Mason advised OK to eat when I went back for my 2 week check up on March 28th), then added scallops, salmon and tuna.

I’m now 4 weeks post and at last weigh-in (over a week ago, had lost 31 lbs).

I would have been so depressed if I had to wait 3 – 4 + years to get surgery I don’t now what I would have done.

I feel so much better already, although a little tired  at times. (not surprising, being you are drawing the fat from your body mostly) but a little afternoon siesta never hurt anyone!!!!   I have mixed some of the US and Canadian rules regarding grains to come up with something I’m happy with.  I don’t believe in totally eliminating the grains as when you do go back to them (as you most likely will in the future) you may not react well to them.  Instead I am choosing not to have them and if I do have some, no big deal.  In that respect, for dinner last night I had about 2 tbsp of ‘dirty rice’ – rice and beans, a small piece of sole and 2 small slices of avocado.  Full to the tippy top!!!  I will be sticking to quinoa, brown rice etc if I choose to eat them.

I am reading labels like crazy and sticking as closely to the rule of 5.  Found several protein bars that fit these parameters and one from Thrify Foods (Protein32 bar) that has, surprisingly, 32 g of protein and low sugar and fat.  I cut bar into 1/3 as that was all I needed to replace a meal and it filled me nicely.

So what I am saying through this long and convoluted message is I would definitely advise anyone to try for OOC if they don’t want to wait too long!  The total bill was around $10,000 for the surgery, which included anaesthetics ($2080 x 2 for that for some reason).  Dr. Chang’s portion showed at $5,000 for the actual surgery and 2 visits to her were billed separately.  The rest were psych, nutrition, and nuclear medicine. The bills are sent to me and I send them onto the BC Ministry of Health for direct payment. In the end, I expect to pay approx $500 that isn’t covered by the BC Govt. plus my travel expenses.

Hope this is helpful to you.  If you don’t try, you’ll never know if you could have had your surgery sooner.  You might want to talk to your doctor and ask to be left on his list until you hear if you are approved for OOC and if approved someone else will get your spot.  Depends on what you (or anyone else) feels about waiting, loyalty, life, etc.

I think I made a good decision and appreciate Dr. Tang signing my forms so promptly.”

Related posts:

1. Tummy Tuck & Breast Lift Journal – The Real Story Before we get to the plastic surgery part, let me...
2. BMI Doesn’t Tell The Whole Story – WHR May Be Better! The scientific community has admitted to the shortcomings of BMI...