SF WLS- NEWBIE HERE! some insight please?

[Moniquew123 23]

Hey everyone. I just joined. Am very happy to have found this community. My name is Monique and I'm in the beginning stages of the journey that many, if not most of you have been through. I have been considering having weight loss surgery for about 2 yrs and am finally going through with it. We had to switch insurance because what we had before did not cover WLS. Now that we have finally switched at the beginning of the year my doctor has finally sent my referral. I had to take a class before I got referred and had a sleep test done, the sleep test showed I had mild sleep apnea. The bariatric surgery center is in South San Francisco, I live about 30- 45 min away, I was curious to know if any of you had gotten your surgery done there? Or can anybody explain to me how the process goes from here? Or if anybody has Kaiser California Northern? All my doctor said was that the bariatric surgery center would call. But I heard it could be awhile before they do. Could anybody give me insight. Anything would be helpful. thank you so much.

[pinksjo1 137]

Welcome! I was very pro-active during the stage that you are in now. I called/emailed the center at least once a week to see if they needed anything else from me, how the process was going, etc. I basically did all the leg work myself as my assigned person wasn't that great. Also, nothing wrong with checking with your insurance company - mine was extremely helpful (BCBSIL)when you have questions. I started at one hospital, stuck with them until I got my approval and switched to another as I never felt comfortable with the first hospital.

Also, post questions, this is a great group and a lot of very useful information.

Good luck!

Joan

[Lady VS 1,147]

Which surgery are you considering?

[Moniquew123 23]

I think I will have to call my insurance company and see what they have to say. All my doctor said was that the bariatric center would contact me. But I'm not sure when that will be or what I should be doing in the mean time. Maybe I'm getting carried away but I would just like the process to go as quickly as possible even though I know quick is not what it will be.

Thank you for your suggestions.

[Moniquew123 23]

I'm not exactly sure I'm still on the fence. I'm hoping when I finally am able to meet with a surgeon that he/she is able to help me make the decision.

[Lady VS 1,147]

Okay

[Bluesea71 698]

Hi Monique!

I am a newbie too! I've been lurking on this site for about a month now but this is my first post! I am also going through the South San Francisco Kaiser Bariatric department. I can share with you what my experience has been so far and my understanding of the process. I knew attanding an evening information class was required before my PCP would submit a referal to the bariatric department, so I attended that class on 1/13/14. I then had an appointment scheduled with my PCP on 1/17/14. I came to my apointment well informed thinking I would have to work hard to convince my PCP to refer me. Turned out not to be an issue. I had a history of being overwight, but my BMI is around 37-38. I have PCOS and mild asthma during the winter months, so that was enough for me to quality even though my BMI was under 40. My PCP submitted the referral electronically from her office. I received a call from the SSF Bariatrics department on 1/28/14 (11 days after it was submitted.) Once a referral is submitted, a team reviews the request and looks over your medical history. If you meet the criteria, they call you to book the orientation meeting. The orientation meeting is offerred every Tuesday from 8:30-12:00. Here is where I will give you a bit of advice to speed up the process. When I spoke to Terry to schedule the orientation class (She teaches the information class, so you likely met her) I asked her if it was possible to schedule any of the other appointments I would need ahead of time. In addition to the orientation class (which I attended this morning 2/18/14), I was able to schedule the medical evaluation with John "Kirk" Phillips today right after the class. This appiontmrnt lasted about an hour and he took my vitals and reviewed my medical history. I was also sent down to have blood work done. I also scheduled the two other required classes Nutrition 101 (offerred every Monday at 9am) and Lifestyle class (offered Mondays at 11am) ahead of time to do back to back on 2/24/14. To clarify, You only need to attend each of these classes one time. At the medical evaluation today, they scheduled two more future appointments for me: a visit to the bariatric psychologist and an appointment with my assigned surgeon (Both for 3/26/14.) Whomever is assigned to you, is the surgeon who will perform your surgery and provide your post-care. While everyone is different, it seems likley that they will require you to loose some weight prior to surgery. How much is determined by your assigned surgeon at your appointment. Kirk predicted that the surgeon would require 15-20 pounds from me. I think they want to know that you are committed to making the lifestyle changes that will be required for long-term success. Regardless, it's best to start this process now. Your first recorded weight from your PCP when you were referred is what they use. So it is possible to be at your goal weight when you meet with your surgeon. The process seems to be quite speedy at the SSF Kaiser. Because I don't have any complicated comorbidities (uncontrolled diabetes, undiagnosed sleep apnea, etc.) Kirk thought I could have surgery in 6 weeks! YIKES! I am choosing to wait until mid-June as it works better for my work/family schedule. I also want to lose 20 pounds on my own to prove to myself that I can make the long-term lifestyle changes that will lead to my success. One thing I have learned from lurking on this board, is all of us will lose weight with WLS. The real definition of success is keeping the weight off. I want to increase my chances that I will keep it off 5, 10, 20 plus years from now.

Good luck with your journey and keep in touch!

K

To summerize the process:

1) Attend Information meeting

2) Request PCP to submit referral

3) Bariatric department calls you to schedule Orientation class (offered Tuesdays 8:30-12)

4) Attend Medical evaluation with John "Kirk" Phillips, Nurse Practitioner

5) Attend Nutrition 101 (offered Mondays at 9)

6) Attend Lifestyle class (offered Mondays at 11)

7) Psychiatric evaluation

8) Consultation with surgeon

9) Surgery

Edited February 19, 2014 by Bluesea71

[Moniquew123 23]

Hello K,

I can't thank you enough for all the information you have given to me. Now I will know what to expect and I have basic knowledge of the process we must go through when at SSF Bariatric Center.

So if I read correctly, when you were called to go to the orientation at the bariatric center you were also able to sign up for other classes and appointments? You did this to keep the process going. Speed it up. Am I correct? I will definitely try to do the same.

A bit more of my story, I met with my PCP on 1/20/14, and talked to her about WLS she said I did not have a BMI of 40 but a 38 so I was not qualified. She advised me to still take the WLS Introductory Seminar that is required before a referral. That class was on 1/12/14. She also had me take a sleep test which was done on 1/7/14.

The day after the WLS Seminar (1/13/14), I went in to try and get a referral from my PCP. She again said I did not have the right BMI, which I knew but I was hoping. My sleep test had not come back yet so she said if it came back positive she would send out the referral. I have to admit, I left feeling hopeless. On 1/15/14, I received an email from my doctor letting me know my sleep study showed I had MILD SLEEP APNEA. Which is not good at all but, she did send out the referral. I was told someone from both the sleep lab and the Bariatric Center would contact me. But that is as much as I know.

That's me. I'm SUPPER thankful for your post. I learned a ton. I hope to keep up with your process. It sounds like you have a great mindset about this journey and I am sure you will do great!

[Bluesea71 698]

I'm glad I could help, Monique. To clarify, I did ask if I could sign up for any other required classes at the time they called to schedule the orientation. I think most people sign up at the orientation as there were sign up sheets at the orientation prompting attendees to sign up for the nutrition/lifestyle/medical evaluation appointments. I plan my work schedule weeks in advance, so it was helpful for me to be able to schedule everything ahead of time.

Keep me posted about your progress. From what I learned from the bariatric staff, you may have a delay with the process if you need further assessment for your sleep apnea and/or require a CPAP machine first. According to the pre-operative criteria sheet in the booklet they gave us at orientation, it states, "a BMI 35-40 with a serious obesitity- related health problem such as type 2 diabetes, coronary heart disease, or severe sleep apnea (will consider severe HTN, DJD or increased lipids)

It's up to the Bariatric staff to determine whether of not you qualify. I will keep my fingers crossed that you do! I know that waiting was the worst! I did some research on my own and hoped having Polycystic Ovarian Syndrom would help me qualify due to insuline resistance and weight gain. Turns out it was enough!

Edited February 20, 2014 by Bluesea71

[Moniquew123 23]

I got the "long" awaited phone call today from SSF, specifically Terry who you mentioned. She said I had made it into their bariatric program and needed to sign up for an orientation which I did for 3/4/14. I asked if I could sign up for any other classes or do anything else in the meantime but she said I would have to wait to attend orientation for that. I'm really excited but I know that this still doesn't guarantee surgery will happen, at least from what I read. I can't wait to get this all done with. Since this is the easiest part.

[Bluesea71 698]

Congratulations! Take a deep breathe, the committee has reviewed your chart and said YES! The hard part IS over! The only set back is they may require you to get your sleep apnea under control before they will allow you to have surgery. I remember Terry asking people during the orientation how long they had their CPAP machines stating a period of time (a few months?) needed to pass before they will allow surgery. Regardless, time is going to pass anyway. You are one step closer to your goal! Hooray 4 you!

[Moniquew123 23]

Ahh well that's good to know. I had heard that it wasn't always for sure until you meet with the surgeon. But I see that isn't true. I heard back from the sleep lab today. They said I have mild sleep apnea so I do not require the CPAP Machine. They did say that my sleep apnea could be fixed with weight loss, exercise, etc. So I'm very hopeful that they will not extend the wait because of my sleep apnea but we will see.

Your nutrition and lifestyle classes are on Monday. Good luck with them. Let me know how they go!

[Bluesea71 698]

It's good news you don't need a CPAP machine! I'm curious though, if it isn't sleep apnea, what co morbidity then qualifies you for the bariatric program?

They had me do a bunch of blood work at the medical evaluation last week. Everything came back normal except..... My Vitamin D levels are really low! Normal range is 20-79ml and mine was 11. So I was prescribed 50,000 units of Vitamin D to take once a week for 12 weeks! Not sure if I have to complete the cycle before surgery. I guess it's a good thing I wasn't planning on having surgery until June!

[Moniquew123 23]

Well I do have sleep apnea just, MILD sleep apnea. I guess that was enough to qualify me. I looked back at my medical records and my BMI is 39.3 so I don't know if that made a difference also.

Was that blood work done after the orientation?

Wow that is slow but that is a lot of Vitamins you will be taking. I guess that will be preparing you for post surgery when you are required to take many Vitamins as well.

I hope to get my surgery done this summer if everything goes smoothly as well. It's the only semester I can take off from school. But we will see.

[Bluesea71 698]

Hi Monique! Any updates? I thought I would check in. I attended the nutrition and lifestyle class last week. I had my appointment with my surgeon moved up to 2/28 and found out I was able to schedule my surgery as soon as my surgeon had an opening in mid April! What? What?! What?!? I was expecting him to tell me to loose weight first. Nope. The 5 pounds I've lost since orientation was enough! There is no pre-surgery liquid diet to follow except the normal pre-surgery no liquids/food past midnight the night before. So the whole experience from my PCP submitting a referral to the surgery is just a little over 3 months. Crazy! My BMI is at 36 and I don't have any comorbidities except PCOS, so that might be why I don't have to loose weight and am being fast-tracked. Wow. I wasn't expecting all of this to happen so soon. I'm still kind of in a state Of shock!