Anyone Have Experience with Kaiser?

Kate93 · September 25, 2020

So I had my surgery out of the country about 2 years ago and am now 7 weeks pregnant! I had my first prenatal appointment, which confirmed that I’m pregnant and all is well. I am with Kaiser and they enrolled me in a program they have for people who are pregnant after bariatric surgery. They are going to make me speak to a dietician once a month. Has anyone done this? Is it useful? I don’t know if I can opt out, but I’ll try if it’s just going to be monthly phone calls where they say “Keep taking your Vitamins. Eat healthy. That’ll be $200.” I don’t know if this service will be covered or how much it will cost, but once a month calls seem unnecessary. TIA for any advice!

The Greater Fool · September 26, 2020

Welcome to the forums.

You don't indicate which WLS you've had which can change how such could impact pregnancy.

I don't have experience with Kaiser. Nor do I have experience with pregnancy after WLS.

I'm just here to keep you company while you are waiting for the informative replies that are soon to show up shortly. In the meantime... how about a little chit-chat?

I can completely understand insurance wanting to ensure you are supported if you've had any of the malabsorption surgeries (RNY, DS). It's important that everyone involved understand this aspect of surgeries and how you will have to compensate for the health of your fetus.

If you've had a restrictive surgery (RNY, sleeve, most current varieties of DS [I'm told]), then it is a matter of getting all the standard and special nutrients that are hard to achieve when one is eating small volumes of food. Effectively, you will have to figure out how to eat around your surgery now through a couple years post-pregnancy without continuing it when you don't want to.

So, speaking with a dietician, though I would go for a nutritionist, would be a monthly meeting well worth going forward with even if you keep all your benefits if you opt-out. Once the meetings get repetitive and you are not getting anything out of them then you might consider opting out.

Be careful if they say it's OK to opt-out. Be sure you clarify that an order of 'opt-out is up to you' does not come with a side of 'we won't cover pregnancy costs we think are related to WLS."

Good luck,

Tek

Kate93 · September 26, 2020

Thank you for the response! I had a gastric sleeve and eat a normal amount of food for someone my height who never had surgery (1200-1700 calories a day depending on workouts, and I’m on the short side). I’m maintaining at a bmi of 23 and have had no issues with Vitamins - all are at or above recommended range. I just don’t know what they can tell me and don’t know what benefit this is going to give me. They also sent me these recommendations that clearly were geared to people who have had malabsorption surgeries.

If I took the Vitamin amount they recommended, I would be getting way more than 100% of the Vitamin A daily value - not even counting food. The amount they recommend can cause birth defects, so they must be working under the assumption that I won’t absorb all of it. I’m not comfortable with that, which made me really distrustful of their recommendations.

The Greater Fool · September 26, 2020

25 minutes ago, Kate93 said:

Thank you for the response! I had a gastric sleeve and eat a normal amount of food for someone my height who never had surgery (1200-1700 calories a day depending on workouts, and I’m on the short side). I’m maintaining at a bmi of 23 and have had no issues with Vitamins - all are at or above recommended range. I just don’t know what they can tell me and don’t know what benefit this is going to give me. They also sent me these recommendations that clearly were geared to people who have had malabsorption surgeries.

If I took the Vitamin amount they recommended, I would be getting way more than 100% of the Vitamin A daily value - not even counting food. The amount they recommend can cause birth defects, so they must be working under the assumption that I won’t absorb all of it. I’m not comfortable with that, which made me really distrustful of their recommendations.

I hate when that happens.

I've never gotten decent information form a dietician. Dietitians are about creating menus. Nutritionists are about, well, nutrition. They are typically better educated and better informed.

Sounds like you are doing well with your post-op life. It also sounds like you've done research into your situation, which I tend to value more that general knowledge a dietician might have.

As long as not going doesn't impact your insurance coverage, you sound like you are in good hands (your own, if that wasn't clear).

With all this support I'm giving you, I think 'Tek' would make a good name, don't you?

Good Luck,

Tek