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



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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.

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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.

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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.

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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.

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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

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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.

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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

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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. :)

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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

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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.

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

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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.

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      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
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        BTW, the liquid diet sucks, one more day and you are over the worst. You can do it.

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