Complications Kaiser SoCal

[treatcheri 4]

I had rny in 2004 in MN and lost 167 pounds. In 2009 I started having pain and went back to my bariatric dr who did no tests but said I probably had ulcers and put me on meds. Several months passed with no relief but dr said keep taking meds, no tests. I went to my primary dr who sent me for an upper endoscopy. They found no ulcers and said I was fine but I was still in pain. He gave me pain meds but no followup tests or suggestions for correcting the issue. Long story short 3 years go by in constant pain and 3 doctors later I decided if I didn't leave MN I would die. I moved it CA and started the whole process again only to be told nothing showed on any tests so they sent me to a general surgeon for exploratory surgery. At this point I had zero quality of life, I lived in extreme pain and no medication helped. I knew my days were numbers. The surgeon asked me when I wanted to do the surgery and I said TODAY. He laughed and said he had a cancellation that day or he could do it in 2 weeks. I said I won't live 2 more weeks. He did the surgery that day and afterward he told me I wouldn't have lived 2 more weeks. I had strictures that had closed off the release of acid from my disconnected stomach and it was ready to burst and I also had a strangulated hernia. 2 years later I was back in surgery for the same issues. My primary Dr with Kaiser refused to refer me to a bariatric doctor. He said Kaiser doesn't do that. The Pain is now back with a vengeance. I requested a new primary and asked him to refer me to a bariatric doctor. Now I'm getting the run around and am wondering if anyone else has had issues with Kaiser in SoCal no allowing rny patients to be seen my a bariatric doctor. I'm 99% sure I will need surgery again and I would rather have this handled by a bariatric doctor. Why do I have to see a PA to get a referral to bariatrics when I've proven the need with my past history? Is there anyone I can contact to get help?

[Sosewsue61 3,185]

Oh man...so sorry you are experiencing these extreme medical issues, also the extreme azzhats in the insurance industry. Maybe call the Lt Governor's office, and any insurance commission. Get your PCP to write documentation on these ongoing problems, get all your records of the first repair surgery and submit for appeal. There has to be an agency somewhere that can help with this.

[Mattymatt 491]

I am so sorry you're experiencing this. You've just highlighted one of the fundamental problems with healthcare in America: private insurance. It's set up to deny healthcare because providing it is, well, expensive and takes away from profits. Keep up fighting the good fight. @Sosewsue61 has some good ideas. I am just curious: are you considering going after your original surgeon? I wonder if he f*cked up.

[lamoore1216 25]

File a complaint with the Hospital Administration and get legal representation.

Sent from my LG-M153 using BariatricPal mobile app

[treatcheri 4]

I consider going after my first surgeon every single time I'm in agony but he's got a 5 star rating and to be honest I liked the guy. I just think I had rny before there was much long term issues documented but at the same time I think they blew me off when it first started hurting as to not document any kind of failure.

[RickM 1,753]

Perhaps you can go back to the surgeon who did the exploratory (is he Kaiser, too?) and see if he has any pull, Were you satisfied with his work and would you want to go back to him?

Unfortunately, this is often how Kaiser is - they do things their own way. In CA, the Dept. of Managed Healthcare is the regulating agency and is who one appeals to when one has exhausted the appeals process within the healthcare company, though I'm not sure if they will do anything yet (they aren't refusing you care, just what you want...) That said, people who want or need the DS instead of an RNY or VSG have to go through the DMH to force Kaiser to provide it from an outside surgeon since they don't do it in house, so it is worth touching base with them to see what your options are from their side.

As for "going after" the original surgeon, after this much time it would be hard to determine if there was anything wrong or defective with the original surgery vs. the way something evolved in your body. It might be worth going out of network and paying out of pocket (if you can) to see an outside bariatric surgeon for a second opinion, and use that (assuming it goes your way) as part of filing an appeal through DMH.

Longer term, given your history, both physically and with Kaiser, it may be worth exploring switching to another health plan like a PPO that gives you more flexibility in choosing specialists - it's these tight restraints that Kaiser imposes that keeps their rates lower.

Good luck...

[Changing4me1 83]

I consider going after my first surgeon every single time I'm in agony but he's got a 5 star rating and to be honest I liked the guy. I just think I had rny before there was much long term issues documented but at the same time I think they blew me off when it first started hurting as to not document any kind of failure.

Which area are you in ? Are you near the West la Kaiser on cadalac ave?






Lapband 9/11/07 227 pounds
Vsg 2/13/18
Pre op diet 188
Sd. 180
Cw 167.4 Dr. scale says says one pound less
First goal 169 2/26/18
Second 150
Goal weight 138

[treatcheri 4]

I had my rny in MN and not with Kaiser. Kaiser wants my records and MN is giving me the run around...but of course!

[Changing4me1 83]

I had my rny in MN and not with Kaiser. Kaiser wants my records and MN is giving me the run around...but of course!

I asked about your Kiaser location for here because I was done though west la facility as revision my original was not thought them either. They only have Baratric doctors at certain facilities so after emergency room visit they had me drive to la to see one as local Kiaser did not have surgeon in that specialty.






Lapband 9/11/07 227 pounds
Vsg 2/13/18
Pre op diet 188
Sd. 180
Cw 167.4 Dr. scale says says one pound less
First goal 169 2/26/18
Second 150
Goal weight 138

[treatcheri 4]

Just wanted to update this post. I've been to the preventative medicine intake meeting. The guy I talked to there was very proactive and started making calls while I was sitting there to get things rolling. They've already requested all my medical history records, ordered and completed all my labs and I'm waiting to hear back from the surgeon to find out what tests I need to have done prior to meeting with him. In the meantime I'm on a liquid/pureed diet (which I actually put myself on prior to them telling me to since it is all I can tolerate without being in agony). At this point I am feeling positive that this will not be too horrible. Hoping it's not just wishful thinking.

[creativenarelle 0]

I had rny in 2004 in MN and lost 167 pounds. In 2009 I started having pain and went back to my bariatric dr who did no tests but said I probably had ulcers and put me on meds. Several months passed with no relief but dr said keep taking meds, no tests. I went to my primary dr who sent me for an upper endoscopy. They found no ulcers and said I was fine but I was still in pain. He gave me pain meds but no followup tests or suggestions for correcting the issue. Long story short 3 years go by in constant pain and 3 doctors later I decided if I didn't leave MN I would die. I moved it CA and started the whole process again only to be told nothing showed on any tests so they sent me to a general surgeon for exploratory surgery. At this point I had zero quality of life, I lived in extreme pain and no medication helped. I knew my days were numbers. The surgeon asked me when I wanted to do the surgery and I said TODAY. He laughed and said he had a cancellation that day or he could do it in 2 weeks. I said I won't live 2 more weeks. He did the surgery that day and afterward he told me I wouldn't have lived 2 more weeks. I had strictures that had closed off the release of acid from my disconnected stomach and it was ready to burst and I also had a strangulated hernia. 2 years later I was back in surgery for the same issues. My primary Dr with Kaiser refused to refer me to a bariatric doctor. He said Kaiser doesn't do that. The Pain is now back with a vengeance. I requested a new primary and asked him to refer me to a bariatric doctor. Now I'm getting the run around and am wondering if anyone else has had issues with Kaiser in SoCal no allowing rny patients to be seen my a bariatric doctor. I'm 99% sure I will need surgery again and I would rather have this handled by a bariatric doctor. Why do I have to see a PA to get a referral to bariatrics when I've proven the need with my past history? Is there anyone I can contact to get help?

PLEASE CONTACT Rob Peterson in Bariatrics .... call any Kaiser number and pester them until they find him. He is either at Sunset or on Cadillac.
I had Roux en y 13 years ago and ZERO problems ..... lost 160 lbs and kept it off all these years.
I will forever be grateful to Kaiser and at that point they outsourced to Scripps in SA N Diego..... Dr Rumsfield is my hero and the kindest, most graceful Dr. I have ever met. He treated us as "normal" whether we were 500lbs or 120lbs. [emoji170][emoji170][emoji170][emoji170] Please mention me to Rob.... he knows me well and he will advocate for you. 🤗🤗🤗🤗


Sent from my SM-G935V using BariatricPal mobile app

[tjohnson3 0]

Hello I have Kaiser currently and I just completed my 12 week classes, seen the mental health Dr, took all my blood tests, sleep apnea test, stress test, and I attend my support group tonight, the last thing I have to do is get my blood pressure under control over the next couple of weeks then I can get an appointment with the surgeon. But my question is which Kaiser Permanente do you go to? I see a bariatric team at the Kaiser Permanente Fontana at their bariatric program which includes surgeon, dietitians, counselor, case manager, nurses and clerk's that all monitor you through out your program and after

Sent from my Z981 using BariatricPal mobile app