February 2008 - Insurance/Vitamin D/Patient Seminar

Greetings! Anyone reading this that has Horizon Blue Cross of New Jersey mayhave run into difficulties getting an approval because Blue Cross recently mandated that they would not approve benefits for weight losssurgery unless a patient had a five year history of morbid obesity. Ibelieve I have discussed this in previous newsletters and how absurd itis. Well we have heard that Blue Cross may reverse this policy,but they will continue to require patients do a 6 month pre operativeprogram. This hasn’t been confirmed yet but I am keeping my fingerscrossed. If you have any questions about how this will affect youpersonally you can email Dominga at dominga@gsbwc.com. If you are required to do a 6 month program I have started offeringthis thru the office. It means you would meet with either me, Joan (myPhysician’s assistant), or a nutritionist once a month for 6 months.This should meet the insurance company’s requirements for the preoperative program. You can call the office, or email Dominga to find ifyou need to do the six month program. If you do it is best if you do itthru my office as sometimes patients who have used their Primary CareDoctors ended up having problems with proper documentation and thengetting a denial from the insurance company.

If you are someone who has been to the office but hasn’t had surgeryyet and is still “thinking about it”, I would recommend you make upyour mind soon. Many employers are eliminating benefits for weight losssurgery from their health care policies. This is a short sightedattempt to save money but they are doing it anyway. If you have thebenefit in your policy you should take advantage of it, while you can.If you have questions about the surgery that I can answer to help youmake up your mind you can always come back in for another appointmentor email me. Something else which is sometimes helpful for patients isto go to a support group meeting to talk to patients who have actuallyhad the surgery. You can find a schedule of support group meetings onmy website https://www.gsbwc.com/ under “events”.

Vitamin D (let’s get off the insurance topic for a while)

The official daily allowance for vitamin D from the Institute ofMedicine is 200 IU (international units) for people 50 and younger and400 for those 51-70 and 600 for those over 71 or older. Manyresearchers feel these recommendations are too low and feel most peopleshould probably get between 800-1000 IU. For patients who have hadweight loss surgery I would recommend an absolute minimum of 400 IUparticularly during the winter months. When you are shopping for asupplement, read the fine print it should be D3 (also calledcholecalciferol). Few foods supply Vitamin D, milk is fortified andfish such as salmon, tuna, and sardines are naturally rich in vitaminD. The reason I am talking about this is because vitamin D deficiencyis by far the most common vitamin deficiency I see in my practice. Alsoas I have mentioned in previous newsletters you need to get the levelmeasured which requires a blood test every 3-6 months.


I’m sure you have heard the advice, from me and others to exercisebut what is the right amount of exercise? Much depends on theindividual patient, how fit you are to begin with, and how old you are.This makes it difficult to make “one size fits all” advice. We canstart with the 2007 guidelines from the American College of SportsMedicine and the American Heart Association; they suggest moderateintensity exercise for 30 minutes five days a week or vigorous exercisefor 20 minutes three times per week. Moderate intensity exercise isenough to break a sweat, raise your heart rate but still be able tocarry on a conversation. Brisk walking is the most practical, safestform of moderate exercise. You can exercise in shorter bouts (but atleast 10 minutes). Three ten minute bouts is as good as a single 30minute workout and may fit better into your schedule, for exampleduring a lunch break. Even if you can’t meet the guidelines any amount of exercise of anyintensity is better than none and has heath benefits. What is thepayoff? Exercise lowers blood pressure, improves blood cholesterollevels, improves mood and can even help alleviate depression. Regularphysical activity helps develop and maintain healthy bones, muscles,and joints.

I will be having my next patient information seminar at the RobertTreat Hotel in Newark on Saturday February 23rd at 10 am. The addressof the hotel is 50 Park Place, Newark, NJ. If you know anyone who isinterested in finding out about the surgery I will be discussing boththe gastric bypass as well as the band. It is open to the public.

End Quote (The spirit of this quote is that having this surgery often involves a lot of ups and downs)

“The greatest glory in living lies not in never falling, but in rising every time we fall”

Nelson Mandela

Thanks for reading and trusting me with your healthcare

Michael Bilof, MD


Contact Information

web site address: https://www.gsbwc.com
phone: (973) 736-8300

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Please excuse my prolonged absence from writing these newsletters. As anyone who has been to the office recently knows I was on vacation until last week.