About Insurance and the surgery
I am not new to the site, I have been here before when I was contemplating surgery. I have tried like many of you so many diets and have no success. I have kaiser Permenente and I asked several months ago my primary care physIcian said that I cannot I am 270lbs and I am 5'6 I am also in menapause at 42 so I just keep putting on the weight. Is there anyone that has any experience with or has had any experience with this sort of situation? I live in Fredericksburg, VA.
At 5'6" 270lb, your BMI is 45, so you certainly do meet the criteria for weight loss surgery (as set by the Nat'l Institute of Health Consensus Panel), even if you don't have any health problems like diabetes, etc. So your PCP is in error, unless he knows of some other reason you don't qualify.
I have dealt with Kaiser before (when I performed WLS out in California) so I know they do put up barriers to WLS; this may include a 12-month MD-supervised diet program as well as an obligatory weight loss of 10% of body weight (27 lb in your case). The Kaiser PCP's are encouraged to dissuade patients from specialty care like WLS, so you either have to a) be persistent in dogging your PCP to get the care you need and deserve for the sake of your health, or b) consider a self-pay option outside of Kaiser (there are 2-3 in Northern VA as well as 3 here in Richmond, including our own at HCA Parham Hospital).
Feel free to call if you have further questions, & best of luck!
I have dealt with Kaiser before (when I performed WLS out in California) so I know they do put up barriers to WLS; this may include a 12-month MD-supervised diet program as well as an obligatory weight loss of 10% of body weight (27 lb in your case). The Kaiser PCP's are encouraged to dissuade patients from specialty care like WLS, so you either have to a) be persistent in dogging your PCP to get the care you need and deserve for the sake of your health, or b) consider a self-pay option outside of Kaiser (there are 2-3 in Northern VA as well as 3 here in Richmond, including our own at HCA Parham Hospital).
Feel free to call if you have further questions, & best of luck!
David C. Elliott, MD, FACS, FASMBS
Bariatric Surgeon & Bariatric Medical Director
Parham Doctors' Hospital
Richmond, VA
Bariatric Surgeon & Bariatric Medical Director
Parham Doctors' Hospital
Richmond, VA
Hello Chrissylyn,
I have Kaiser Permnente. My primary care is in the Woodbridge Center. I was 5'4 and 267lbs and my primary care suggested the surgery to me. I had thought about the surgery before but was always scared of it because I had heard so many horror stories and had seen coworkers that had gotten the surgey and than regained the weight.
Once I told my PCP that yes I wanted the surgery, she walked me through the entire process. I had to see a nutritionist for 6 months and lose 3% of my weight. It was just that simple. Even know she still checks up on me to see how I'm doing with my weight loss.
I'm under the Federal Govt. Employee Kaiser Program, don't know if that makes a difference, but the requirements for the surgery were the following; BMI over 40 or a life threatening or disabling condition related to your weight; which could be diabetes or high blood pressure. 6 month program with nutritionist; which consist of classes that tell you about the surgery and lose 3% of weight within the 6 months with the nutrionist program.
Kaiser has been great through the entire process. I have not had any problem with them at all.
Timeframe;
8/2008 - My PCP suggested the surgery and I accepted. PCP sent in referral
9/2008 - I started my 6 month nutrionist program; consisted on seeing the nutrionist and attending different classes preparing you for the surgery.
2/2009 - I was approved for the surgery
6/2009 - I had my RNY. The reason for the delay from when I was approved and when I actually had surgery was because of the surgeon that I chose. He was Dr. Paul Lin at George Washington Hospital in DC and his schedule is very full. He is excellent and his staff is also wonderful. He has a very good reputation for this surgery. He also has a program that he requires you to do. Which consist of going to severall classes at George Washington Hospital preparing you for the surgery and meeting with his nutrionist and nurse pratictioner.
What I recommend is that you ask you PCP again and if she wont put in the referral for you and help you with the process than find another PCP. If you would like, send me a private message and I will give you the name of mine at the Woodbridge center. She is great.
Best of luck to you and your journey.
I have Kaiser Permnente. My primary care is in the Woodbridge Center. I was 5'4 and 267lbs and my primary care suggested the surgery to me. I had thought about the surgery before but was always scared of it because I had heard so many horror stories and had seen coworkers that had gotten the surgey and than regained the weight.
Once I told my PCP that yes I wanted the surgery, she walked me through the entire process. I had to see a nutritionist for 6 months and lose 3% of my weight. It was just that simple. Even know she still checks up on me to see how I'm doing with my weight loss.
I'm under the Federal Govt. Employee Kaiser Program, don't know if that makes a difference, but the requirements for the surgery were the following; BMI over 40 or a life threatening or disabling condition related to your weight; which could be diabetes or high blood pressure. 6 month program with nutritionist; which consist of classes that tell you about the surgery and lose 3% of weight within the 6 months with the nutrionist program.
Kaiser has been great through the entire process. I have not had any problem with them at all.
Timeframe;
8/2008 - My PCP suggested the surgery and I accepted. PCP sent in referral
9/2008 - I started my 6 month nutrionist program; consisted on seeing the nutrionist and attending different classes preparing you for the surgery.
2/2009 - I was approved for the surgery
6/2009 - I had my RNY. The reason for the delay from when I was approved and when I actually had surgery was because of the surgeon that I chose. He was Dr. Paul Lin at George Washington Hospital in DC and his schedule is very full. He is excellent and his staff is also wonderful. He has a very good reputation for this surgery. He also has a program that he requires you to do. Which consist of going to severall classes at George Washington Hospital preparing you for the surgery and meeting with his nutrionist and nurse pratictioner.
What I recommend is that you ask you PCP again and if she wont put in the referral for you and help you with the process than find another PCP. If you would like, send me a private message and I will give you the name of mine at the Woodbridge center. She is great.
Best of luck to you and your journey.
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