This gets cited here weekly, usually second-hand, so it is worth setting out what it does and does not establish.
This is the one where the stakes are high and the answer is simple: tell the anaesthetist. Delayed gastric emptying means a stomach that is not empty after a standard fast, and that is an aspiration risk under anaesthesia. Current guidance is broadly to hold weekly agents for about a week before an elective procedure and daily agents for a day, but the decision belongs to the anaesthetic team and they can only make it if they know.
Where I think it is weakest: the population was selected and supported in ways a real cohort is not, so I would read the effect size as a ceiling rather than an expectation.
The narrow version of the question is how long before a procedure people were told to hold, and whether the interval differs between the weekly and daily agents. Tell me what I have not thought of.
HealthEcon_DC said:This is the one where the stakes are high and the answer is simple: tell the anaesthetist.
Agreed, and coverage criteria are plan-specific rather than insurer-specific. Two people with the same insurer and different employers have different rules, which is why "my insurer covers it" is not transferable information.
HealthEcon_DC said:This is the one where the stakes are high and the answer is simple: tell the anaesthetist.
Filing a mild objection. Mild because I might be wrong; an objection because nobody has addressed the case that does not fit. Guidance here is not settled and varies by institution, so quoting one society's interval as the rule is misleading. The invariant part is disclosure, not the number of days.
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View ResultsAnswering the narrow version, because the broad one does not have a single answer. Denials are usually procedural rather than clinical, and the order that works reflects that. Get the denial reason in writing, because it names the criterion you failed. Then supply the documentation that criterion asks for — usually documented BMI with a comorbidity, or a failed prior therapy. Then appeal, and ask for a peer-to-peer review, because a prescriber talking to a reviewing clinician resolves a large fraction of denials that written appeals do not. Manufacturer copay assistance is separate and applies mainly to commercial insurance, and patient assistance programmes are means-tested rather than a discount.
Dr.ObesityLA said:Agreed, and coverage criteria are plan-specific rather than insurer-specific.
Can confirm. Same sequence, different timescale. I had assumed I was the exception until I read this.