DS at Military Base (MTF)

[DianaCox]

I'm not sure at all how military insurance works, but Dr. Martin in Washington is doing the DS at a military base - see this paper:

Am J Surg. 2012 May;203(5):603-8. doi: 10.1016/j.amjsurg.2011.12.004. Epub 2012 Mar 9.
The duodenal switch for morbid obesity: modification of cardiovascular risk markers compared with standard bariatric surgeries.
Nelson D, Porta R, Blair K, Carter P, Martin M.
Source
Department of Surgery, Madigan Army Medical Center, 9040-A Fitzsimmons Ave., Tacoma, WA 98431, USA.

Abstract
BACKGROUND:
Obesity is associated with cardiovascular risk factors such as lipid levels and increased levels of C-reactive peptide (CRP). We hypothesized that duodenal switch (DS) would show equivalent or superior risk reduction compared with standard bariatric surgeries.

METHODS:
Patients underwent DS, sleeve gastrectomy (SG), or gastric bypass (GB) over a 2-year period. Body mass index (BMI), lipid panel, and CRP were measured preoperatively and then 3, 6, and 12 months postoperatively.

RESULTS:
A total of 130 patients were identified; 42 underwent DS, 40 underwent SG, and 48 underwent GB. All groups had similar sex and comorbidity profiles, but the mean preoperative BMI was greatest in the DS group (mean = 52). At all intervals weight loss was greater in the DS group (P < .01), with a final BMI of 31 for the DS group, 31 for the SG group, and 28 for the GB group. Cholesterol and low-density lipoprotein showed significantly greater improvement at all time points with DS compared with SG and GB (P < .01). Baseline CRP levels among DS patients were double that of SG and GB, but rapidly declined to equivalent levels by 3 months and normalized in 79%.

CONCLUSIONS:
The DS procedure resulted in a superior reduction in cardiovascular and proinflammatory risk markers compared with GB and SG.

 

[Spiky Bugger]

I'm not sure at all how military insurance works, but Dr. Martin in Washington is doing the DS at a military base - see this paper:

Am J Surg. 2012 May;203(5):603-8. doi: 10.1016/j.amjsurg.2011.12.004. Epub 2012 Mar 9.
The duodenal switch for morbid obesity: modification of cardiovascular risk markers compared with standard bariatric surgeries.
Nelson D, Porta R, Blair K, Carter P, Martin M.
Source
Department of Surgery, Madigan Army Medical Center, 9040-A Fitzsimmons Ave., Tacoma, WA 98431, USA.

Abstract
BACKGROUND:
Obesity is associated with cardiovascular risk factors such as lipid levels and increased levels of C-reactive peptide (CRP). We hypothesized that duodenal switch (DS) would show equivalent or superior risk reduction compared with standard bariatric surgeries.

METHODS:
Patients underwent DS, sleeve gastrectomy (SG), or gastric bypass (GB) over a 2-year period. Body mass index (BMI), lipid panel, and CRP were measured preoperatively and then 3, 6, and 12 months postoperatively.

RESULTS:
A total of 130 patients were identified; 42 underwent DS, 40 underwent SG, and 48 underwent GB. All groups had similar sex and comorbidity profiles, but the mean preoperative BMI was greatest in the DS group (mean = 52). At all intervals weight loss was greater in the DS group (P < .01), with a final BMI of 31 for the DS group, 31 for the SG group, and 28 for the GB group. Cholesterol and low-density lipoprotein showed significantly greater improvement at all time points with DS compared with SG and GB (P < .01). Baseline CRP levels among DS patients were double that of SG and GB, but rapidly declined to equivalent levels by 3 months and normalized in 79%.

CONCLUSIONS:
The DS procedure resulted in a superior reduction in cardiovascular and proinflammatory risk markers compared with GB and SG.

Well...I vote for HIM!

 

[Terri]

This is great!

 

[Walter Albert]

military insurance is Tricare , if active duty you have prime, all others can opt into prime, it is a no cost network, care at Madigan or any military hospital is space available to retirees, meaning not available for the most part. I don't know if Tricare is involved in reimbursement for services rendered at military hospitals, the va hospitals are not participating.
military personnel are not permitted to have wls, and would court martialed and dismissed from service, he can only work on dependents.

 

[Bianca]

I actually used to work in a related field. MTFs operate differently than civilian hospitals, even for those on prime. Their prices are fixed by the DOD and are considered part of defense spending. The hospitals also might perform procedures generally not covered by TRICARE Prime at no or very low cost to the individual. I stayed an extra day at the hospital after my oldest was born and TRICARE didn't cover it, it only cost me $17.00. Generally TRICARE won't cover something like removal of excess skin or breast augmentation, but the MTF would. It helps to keep their surgeons proficient in their trade and helps to maintain their certifications.

I'm pretty certain that a soldier would not be Court Martialed for getting WLS, a court martial has the same weight as a felony offense (ie not being able to vote, have a gun, etc...). The soldier would either be barred from re-enlistment or chaptered. WLS would certainly keep a soldier from deploying, and kind of defeats the purpose of being a soldier. I have known of soldiers having WLS at an MTF before they leave the service.

 

[Elizabeth N.]

oh jesus what idiocy. IF a military member had wls it would be in secret, not in mtf and not with tricare because tricare does not cover active duty personnel. IF found out, it would be an article 15 at most and possibly a discharge. god walter just shut the fuck up already lest you sound dumber than you already do.

 

[Walter Albert]

Things have changed since I retired out in 1971, They where still booting pregnant service women then.

 

[Walter Albert]

The only access I have for care at a mtf is west point for my dogs and cats, the hospital doesn't take retirees.

 

[Walter Albert]

Just checked en, Tricare/prime is a option for active duty personnel. Mtf can be far and limited. I was at Offutte Áfb last month and out side of a pharmacy and 9/5 clinic all medical care went to the civilian hospitals in Bellevue or Omaha, I know I needed ambulance service.

 

[DianaCox]

@Walter Albert: You "retired" in 1971? I'm almost 61 years old and graduated from high school in 1971. How long were you in the service? How could you have "retired" in 1971?

On a different note - if your information is over 40 years old, please don't post it.

 

[Elizabeth N.]

*sigh* You really don't know wtf you're talking about. Please just STOP IT.

 

[southernlady]

Things have changed since I retired out in 1971, They where still booting pregnant service women then.

@Walter Albert, in order to retire from the military even at minimum of 20 years, in 1971 you would have had to ENTER the military in 1951. Add 18 to that and you would have been born in 1933 and would be be 81 years old...since I have access to your birthday, this does NOT compute AS you were not even ALIVE until after 1950.

Assuming 1950 for your DOB, that would have made you ONE year old in 1951 to get in a 20 year length of service by 1971.

You need to be a bit more careful when you type things out.

 

[Spiky Bugger]

Things have changed since I retired out in 1971, They where still booting pregnant service women then.

Walter,

Adding to the list of things about which you seem to be convinced you have knowledge but fall a tad short of the target...I was in the military in the early 1970s. Pregnant servicewomen were not "booted out." I know because I was one.

We had options. We could, fairly early in our pregnancy, sign all the papers arranging for care of our child, including temporary custody in case we were deployed to a no dependents area...OR we could opt for an HONORABLE discharge. I took the latter option and if any asshole...even if he WAS old enough to retire in 1971 suggested to my face that I was, in some way, "booted out" of the military, he would discover which of my military skills were still intact.

Unless, of course, he was a retiree based on brain damage or something...which possibility occasionally looms large on the horizon. You know...like...now.

 

[Spiky Bugger]

@Walter Albert, in order to retire from the military even at minimum of 20 years, in 1971 you would have had to ENTER the military in 1951. Add 18 to that and you would have been born in 1933 and would be be 81 years old...since I have access to your birthday, this does NOT compute AS you were not even ALIVE until after 1950.

Assuming 1950 for your DOB, that would have made you ONE year old in 1951 to get in a 20 year length of service by 1971.

You need to be a bit more careful when you type things out.

Well, he COULD HAVE BEEN retired out sooner if, for example, he had brain damage or some other medical reason for retirement. In that case, he would only have needed to be born early enough to be 18-ish by 1971.

 

[Elizabeth N.]

This is the guy who wanted a congressional investigation because Tricare wouldn't cover his DS. He does not understand Tricare at ALL. Don't listen to him. He doesn't know WTF he's talking about.

Tricare Prime is the vehicle through which some active duty service members get medical care where there is no MTF within designated range.....But they do NOT pay the same premiums or copays as their family members do. It's paid for through different channels.

It still has shit-all to do with servicemembers have WLS on the sly.

Tricare has been my exclusive health insurance since 1990, well, with a couple years of having US Healthcare as primary in between and Tricare as secondary. While I do not have all the details of non-Standard plans memorized the way I know my Standard plan, I *do* know how to get that info in moments. Walter doesn't comprehend what he reads.