Jump to content
×
Are you looking for the BariatricPal Store? Go now!

My kaiser Dr. wouldn't refer me for surgery.



Recommended Posts

So I finally made the first step to start the weight loss surgery adventure. I am a member of Kaiser NorCal. I went to my adult medicine Dr and My BMI was 36. I have had severe joint pain for a couple of years and serious back issues confirmed by a MRI back in 2009. And since high school, I am shrunk 2 inches. I am also a very healthy person when looking at all my blood work. I have no life threatening problems.

My Dr. told me to take the overview class offered by Kaiser. I did and then asked for the Dr. for a referral to Richmond. He said he wouldn't refer me and gave me Phentermine for weight loss and Vicodin for the joint pain. Any suggestions you can give me on where to go from here. I really don't want to have to gain more weight to have the surgery. It's already a struggle standing through a 8 hour work day.

Share this post


Link to post
Share on other sites

I suggest looking at the self pay route. I didn't try to get through my insurance, 2 people I heard about from my company gave up after getting the run around for about a year, one gal I know personally is sitting at 9 months after she started to pursue the insurance route. It wasn't easy to get the money but it was the BEST investment I have EVER made.

There are a lot of sites in the USA that will do self pay for a cash discount, there are many sites in Mexico that offer it at a very steep discount. I had mine done in Tijuana MX last December for ~$5000. I hesitate to recommend the site I went to any more due to safety and health issues that have cropped up recently.

Look around the forum, there are lots of posts about self pay.

Share this post


Link to post
Share on other sites

In the case of many insurance companies, you are not considered morbidly obese until you have a BMI of 40. A BMI of 35.5 to 39.9 are considered morbidly obese only if you have something on the list of co-morbidities. Unfortunately, (and fortunately too) the conditions you have are not considered "co-morbidities". They probably will not cover your surgery. You may need to look at the self pay route. I wish you the best of luck. There is nothing worse than walking around every single day in pain.

Share this post


Link to post
Share on other sites

My Dr. was kind of like that. I have a BMI of around 41 and decided that I was ready for the surgery. When I told her she was like oh well good luck with that. She was not supportive or helpful in how I should go about starting the process. So I switched Dr.'s and I am so glad I did, he is supportive and helpful. If I have any concerns he's there to answer any questions he can. I don't how long you have been with your Dr. but maybe it's time for a change. Really Phentermine and Vicodin how is that going to fix your problem it's just going to cover up the pain and as soon as you quit taking the phentermine you'll gain the weight back. pills are not the answer.

lara

So I finally made the first step to start the weight loss surgery adventure. I am a member of Kaiser NorCal. I went to my adult medicine Dr and My BMI was 36. I have had severe joint pain for a couple of years and serious back issues confirmed by a MRI back in 2009. And since high school, I am shrunk 2 inches. I am also a very healthy person when looking at all my blood work. I have no life threatening problems.

My Dr. told me to take the overview class offered by Kaiser. I did and then asked for the Dr. for a referral to Richmond. He said he wouldn't refer me and gave me Phentermine for weight loss and Vicodin for the joint pain. Any suggestions you can give me on where to go from here. I really don't want to have to gain more weight to have the surgery. It's already a struggle standing through a 8 hour work day.

Share this post


Link to post
Share on other sites

My Kaiser PCP in Roseville refused to give me a referral for about three years and then I was finally able to convince him to send me to the overview class. He sent the referral to Richmond, but it was like pulling teeth to get him to do it. I should have just changed Docs untill I found one that would work with me.

Any way, I really don't understand why your Doc would send you to the overview class if he/she never intended to send a referral to Richmond. That was a waste of your time and it just got your hopes up for nothing. :angry:

You can file a complaint with Member Services and/or switch your PCP. I wish you luck and please don't give up, keep pushing forward til you get what you want!

Take care,

Shell

Share this post


Link to post
Share on other sites

My Kaiser PCP in Roseville refused to give me a referral for about three years and then I was finally able to convince him to send me to the overview class. He sent the referral to Richmond, but it was like pulling teeth to get him to do it. I should have just changed Docs untill I found one that would work with me.

Any way, I really don't understand why your Doc would send you to the overview class if he/she never intended to send a referral to Richmond. That was a waste of your time and it just got your hopes up for nothing. :angry:

You can file a complaint with Member Services and/or switch your PCP. I wish you luck and please don't give up, keep pushing forward til you get what you want!

Take care,

Shell

I really thought when my doctor referred me to the overview, that he was in agreement with my decision. I really love my doctor so I'm torn whether to switch to another Dr. or take it as a sign that it's just not meant to be. I can lose the weight. I just can't keep it off. I was considering going to talk with the gal that gave the overview class. I really liked her and she seemed genuinely interested in the patients, Even in the video they showed, it talked about getting the weight off for osteo arthritis and joint pain. I'm not mad, just disappointed. Thought I'd finally found the help I needed and was on the right path.

Share this post


Link to post
Share on other sites

I really thought when my doctor referred me to the overview, that he was in agreement with my decision. I really love my doctor so I'm torn whether to switch to another Dr. or take it as a sign that it's just not meant to be. I can lose the weight. I just can't keep it off. I was considering going to talk with the gal that gave the overview class. I really liked her and she seemed genuinely interested in the patients, Even in the video they showed, it talked about getting the weight off for osteo arthritis and joint pain. I'm not mad, just disappointed. Thought I'd finally found the help I needed and was on the right path.

What reason did he give you for not placing the referral? You might try talking to him again. I actually poured my heart out in an email to my PCP, that was when he finally agreed to move forward. If you didn't qualify for the surgery I don't think she would have sent you to the overview class (she probably figured you would change your mind). Try again and if she won't budge then consider talking to different doc. I hope this works out for you, I waited for three plus years and just continued to gain weight and become more miserable.

Hugs,

Shell

Share this post


Link to post
Share on other sites

What reason did he give you for not placing the referral? You might try talking to him again. I actually poured my heart out in an email to my PCP, that was when he finally agreed to move forward. If you didn't qualify for the surgery I don't think she would have sent you to the overview class (she probably figured you would change your mind). Try again and if she won't budge then consider talking to different doc. I hope this works out for you, I waited for three plus years and just continued to gain weight and become more miserable.

Hugs,

Shell

Here are the reasons he gave me. 1. Even if I have surgery and lose all the weight, it doesn't guarantee me that my joints will stop hurting. 2. I don't have any of the required conditions that weight loss can correct. and the general reasons like: It's dangerous, it's a drastic move and it's just may not work at all.

I weight 222 and am now 5'6 (used to be 5'8 in high school). The Dr. says, looking at my chart, my "happy" body weight seems to be 206 so he said I just need to drop about 20 lbs and I will feel much better. That's easy for him to say. :)

Share this post


Link to post
Share on other sites

Boy, he sounds as opinionated as my PCP. My Doc has no faith in WLS and doesn't hesitate to share his opinion with me. I plan to stick with him for another 6 months or so (post op care) and then find a new Doc. I don't feel that he should push his views on me and refuse to open his mind to what is best for my health. I hope you will choose to get another opinion because you need to do what is best for your health and your future.

Good luck,

Shell

Share this post


Link to post
Share on other sites

Omg I think thats so horrible. Honestly what is it to him to refer you? If you meet the criterias what the big problem??? My doctor referred me without a problem. I say so your Kaiser research and switch doctors asap, this is your health and well being we are talking about.

Share this post


Link to post
Share on other sites

My orthopedic surgeon put the referral in for me through Kaiser.

Share this post


Link to post
Share on other sites

My orthopedic surgeon put the referral in for me through Kaiser.

I wish I had an orthopedic surgeon. Maybe I can get my Ob/Gyn to refer me. I just picked up a prescription refill from the doctors office. Inside the envelope was a Weight Loss Surgery Cheat Sheet. I just can't figure him out.

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

  • Trending Products

  • Trending Topics

  • Recent Status Updates

    • cryoder22

      Day 1 of pre-op liquid diet (3 weeks) and I'm having a hard time already. I feel hungry and just want to eat. I got the protein and supplements recommend by my program and having a hard time getting 1 down. My doctor / nutritionist has me on the following:
      1 protein shake (bariatric advantage chocolate) with 8 oz of fat free milk 1 snack = 1 unjury protein shake (root beer) 1 protein shake (bariatric advantage orange cream) 1 snack = 1 unjury protein bar 1 protein shake (bariatric advantace orange cream or chocolate) 1 snack = 1 unjury protein soup (chicken) 3 servings of sugar free jello and popsicles throughout the day. 64 oz of water (I have flavor packets). Hot tea and coffee with splenda has been approved as well. Does anyone recommend anything for the next 3 weeks?
      · 1 reply
      1. NickelChip

        All I can tell you is that for me, it got easier after the first week. The hunger pains got less intense and I kind of got used to it and gave up torturing myself by thinking about food. But if you can, get anything tempting out of the house and avoid being around people who are eating. I sent my kids to my parents' house for two weeks so I wouldn't have to prepare meals I couldn't eat. After surgery, the hunger was totally gone.

    • buildabetteranna

      I have my final approval from my insurance, only thing holding up things is one last x-ray needed, which I have scheduled for the fourth of next month, which is my birthday.

      · 0 replies
      1. This update has no replies.
    • BetterLeah

      Woohoo! I have 7 more days till surgery, So far I am already down a total of 20lbs since I started this journey. 
      · 1 reply
      1. NeonRaven8919

        Well done! I'm 9 days away from surgery! Keep us updated!

    • Ladiva04

      Hello,
      I had my surgery on the 25th of June of this year. Starting off at 117 kilos.😒
      · 1 reply
      1. NeonRaven8919

        Congrats on the surgery!

    • Sandra Austin Tx

      I’m 6 days post op as of today. I had the gastric bypass 
      · 0 replies
      1. This update has no replies.
  • Recent Topics

  • Hot Products

  • Sign Up For
    Our Newsletter

    Follow us for the latest news
    and special product offers!
  • Together, we have lost...
      lbs

    PatchAid Vitamin Patches

    ×