ROANOKE TIMES
Copyright (c) 1996, Roanoke Times
DATE: Monday, November 4, 1996 TAG: 9611040096
SECTION: VIRGINIA PAGE: C-5 EDITION: METRO
DATELINE: RICHMOND
SOURCE: Associated Press
``WE DON'T THINK [obesity] is a problem that is best taken care of with surgery,'' the insurance company doctor says.
Brenda Cheatham dreams of watching her two sons grow up and then returning to her job as a nurse. But she might not live long enough to get either wish.
Cheatham, 39, is 5-foot-6 and weighs 324 pounds. Her doctors say she needs gastric bypass surgery to lose weight, but her insurance plan doesn't cover the operation.
At 21, when she was about 180 pounds, she was diagnosed with rheumatoid arthritis and has been on full disability since 1986. For her arthritis, doctors prescribed a drug that caused her to gain weight. She was on the medication four years.
Her obesity has contributed to other medical problems, including heart disease, high blood pressure and asthma.
Cheatham said her condition makes it impossible for her to lose weight because she can't exercise. She is insured through her husband's health plan, managed by CIGNA.
Her insurance plan specifically states that gastric stapling, or stomach stapling as it is commonly called, is not covered.
But Cheatham's lawyer, Neil Kuchinsky, and her doctor, Neil Hutcher, argue that the gastric bypass surgery and stomach stapling are different procedures.
Stomach stapling clamps the stomach and reduces the amount of food that it can consume, Hutcher said. The bypass operation would surgically divide the stomach into two sections, making it smaller. It would also reroute the small intestine to aid in the digestion of certain types of food.
Dr. Douglas Hadley, medical director for CIGNA, said he could not talk about the case because it is confidential. CIGNA has denied Cheatham's claim for the bypass surgery, but she is appealing the company's decision.
LENGTH: Short : 44 linesby CNB