How do I tell my doctor I NEED this done?...

[PammyC 0]

I posted a very very long time ago about how to go through the process of getting a lap band, but that's all lost somewhere on this wild internet.

I just have a question about how to start the process going. I went to my doctor a few months ago and asked about getting the lap band. She told me to "come back in 6 months" and signed me up for, what I believe was, a one time class. Which I didn't get to go to.

I've lost a few pounds on my own, but nothing really significant. So my question is what do I do now? I'm not sure what she is expecting from me, or what to expect from her. Do I go back and tell her that I really want to have this procedure done? Or just ask for a referral? Or maybe circumnavigate my doctor and somehow find a surgeon first, and go through their requirements.

Anyway, I guess it all comes down to this...I think my doctor may be resistant to this, but I feel that it's really the only thing that can help me after years of battling with my weight. How do I get her to go along with it? And to make it worse, the clock is ticking, my insurance will be up in a little over a year, so I'd like to get the big stuff out of the way while it's still covered.

by the way, I have Kaiser Permanente and I'm in SoCal.

[SuzanneG 1]

I went straight to a bariatric surgeon and didn't involve my Primary Care doctor until I needed a letter from him for my appeal. If you don't have to involve him, then don't, it's easier that way.

Otherwise, ask for the referral and be prepared to stand your ground and defend your decision.

Best of luck to you!

[HappyMom 1]

I agree with Suzanne about just going to the bariatric surgeon. I really don't technically have a primary care doctor. I have a ob-gyn and a diabetes specialist nurse. I told the diabetes nurse that I was going to pursue this, but didn't ask for a referral....just made an appointment with the bariatric program and got started. She wasn't resistant to me meeting with the bariatric team, but it was just that she didn't know too much about the band surgery and if I really needed it.

I did eventually have to get a referral letter (which was just a "refer for LapBand surgery consultation" written on a prescription pad) for my insurance needs and a copy of my medical records from the diabetes nurse, but that was it. She is now on board with me getting the surgery and is very supportive.

If I were you, I would just meet with the bariatric team and get things going. The only reason that you would need your primary care physicians approval is if your insurance company required a referral prior to seeing a bariatric doctor.

I wish you the best of luck with this!

[patsal 1]

I was unsure if my PCP would be open to the idea, but I did a ton of research. Went to my regular appointment armed with knowledge and information about myself and my weight fluxuations. I shared what worked for me and what did not, I shared how I could lose only to gain even more, how I thought I was the only person in history to follow WW and gain weight, how much real exercise I do and and the fact that I have no idea what full feels like. I take my eating cues from others--I stop when they stop because otherwise I'm certain people would point and laugh. After a very honest conversation I asked if he thought that maybe bariatric surgery could be a tool that would work with me. He talked candidly with me, looked through my history, acknowledged my concerns and gave me a refferal. Before he let me head home though he made me talk with two of his staff. One sucessful with WLS and one who was not. Both shared with me what they did, how they live now and why it worked or did not work for them. I felt like I went in with my eyes wide open on what to expect and what not to expect. I went in for my regular visit 6 months later and he wasn't sure I was going to go through with the surgery because I had lost 25 pounds...a mere drop in the bucket when you have 150 to lose! I told him I was practicing the lifestyle change before going through with the surgery because I wanted to be successful. He checked my labs and other pre-op tests and signed off saying with my attitude that I should be successful, and to call if I needed anything before my next visit.

Now I do experience what feeling full feels like, I do not have restriction yet as I was only banded on the 12th of Feb, but I am prepared to do 70% of the work and let the band do 30% hoping that this time I will finally be successful.

Ask, you may be surprised how supportive your Dr. and his staff can be!

[mimi368 0]

I talked to my GYN at my yearly checkup about the lapband and he was all for it. He referred me to my surgeon. My particular surgeon has to have a referral either from a primary care doctor or GYN. Good Luck!

[agiudice 0]

:rolleyes2:my primary is very resistant to me having this done, I just circumvented him all together and went straight to the bariatric center

[BetsyB 9]

I just went down the path with the bariatric surgeon, bypassing my PCP altogether. I wasn't really avoiding his response, though I wasn't sure how supportive he'd be.

There simply was no need to involve him. My insurance required 3 months supervision, and that clock started ticking when I first saw the surgeon. (I had documentation of years of visits addressing weight with my PCP, as well as of WW membership; they didn't care. The clock started ticking with the surgeon.)

When I did tell him, though--when I was in the office for another reason, and was in the waiting-for-final-approval phase--he was very supportive.

[Butsy 0]

I, too, did not go to my regular doctor first. I went to my Bariatric surgeon's newcomer meeting to find out more. I also researched the procedure and the surgeon. My insurance company required my regular physician to sign off on it. He just answered the required questions and signed off. I don't think there was a question that said "are you for or against the surgery". They were generic questions about my health.

[PammyC 0]

Thanks for the responses everyone!

Now my only question would be how to find a surgeon in my area that is covered by Kaiser. I could swear I a forum category about difference insurance options, but now I cant find it.

So yes, that's the question. Where do I go to find out what doctors are available that are covered by Kaiser Permanente's insurance. Again, I love in SoCal.

[pmommy 0]

Thanks for the responses everyone!

Now my only question would be how to find a surgeon in my area that is covered by Kaiser. I could swear I a forum category about difference insurance options, but now I cant find it.

So yes, that's the question. Where do I go to find out what doctors are available that are covered by Kaiser Permanente's insurance. Again, I love in SoCal.

I would just locate some local surgeons and call their offices to see if they take your insurance. I am in LA and am using Dr Michael Feiz. I've also heard good things about Dr Helmuth Billy and Dr Waldrop but they are in Ventura county.

ALL the lap-band doctor offices will be very informed and aware of your insurance requirements, and will call to check your benefits. They let me know this information before I even went in for my seminar/consult.

Good luck.

[tazzyinheels 0]

I have Kaiser in Hawaii so it may be similar.

I needed a referral and there was a waitlist.

Some doctors are resistant but others are willing so I would encourage you to ask your PCP and if that doesn't work try someone else at Kaiser before giving up. Once I went to orientation, it took 5 months to finish the process (dietician x 4 once a month, behavior classes x 4, 2 exercise classes before consult with team. I had my surgery after 6 months was on waitlist for almost a year before orientation. I lost 65 pounds while waiting for surgery as I wanted to be sure I could live the lifestyle. Kaiser paid and it only cost me about $2500 for everything (visits, surgery, opitfast, and fees). Fills are only $15 under my policy. So before you go outside, please see what your Kaiser can offer you. I have found the support very helpful. My PCP was very supportive and has known me a long time. I do have friends that got resistance from their PCP's. Hope you find this helpful

[BetsyB 9]

Pammy, can you access your insurance contract online? That's what I did---and I read its specifications regarding bariatric surgery.

I found that I was required to use a Bariatric Center of Excellence. That narrowed things down for me. A simple Google search identified a couple in my area. I visited the websites of the bariatric surgeons at those facilities, got a bit of a feel for them, and chose one group's seminar to attend for starters.

I ended up LOVING them---just really, really impressed with the surgeon's manner. I found out that the same surgical group had banded the father and grandfather of one of my son's best friends--and they gave glowing reviews both of the group and the hospital.

I know LOTS of the area hospitals intimately--the one they used was one I was not familiar with. I would not have been inclined to choose it if I hadn't done this research--not because of reputation or anything, but because it's human nature to go with things we're already comfortable with.

I am SO SO SO glad I read the contract, found out my options, and went in the direction I did. My experience has been nothing but positive.

So...what it all boils down to is finding out what is specified within your insurance contract, then doing a simple search to find surgeons who meet the necessary criteria. It seems daunting, but the field narrows itself pretty nicely when you know what criteria you have to meet.

Good luck!

[shj 0]

There is a "find a doctor" resource on the offical lapband website.

Find a Surgeon - LAP-BAND®

Put in your zip code and how far you want to travel. Then, when you have your list, start researching them to find one that not only takes your insurance but also has recommendations on here.

I also want to add that I think the nutritional meeting set by your PCP may have been the start of your INSURANCE REQUIRED counseling. Most insurance requires you to participate in some counseling prior to approval.

The lapband takes a lot of aftercare. You need to make your appointments. If your doctor wants you to do the counseling, you need to do it. Not trying to finger wag, but so many people focus on the surgery and ignore their need to change their habits. Making your appointments is going to be a habit you need to keep.

[Manda87 3]

I went to my PCP first, but I basically spent a $20 co-pay for her to tell me to go find a surgeon, lol. I told my OB-GYN about it, and from just hearing her attitude, I feel as though she I couldn't do it. Oh well, I only have to see her once a year.