trying to qualify with kaiser

Linda B.
on 1/12/12 2:45 pm - CO
VSG on 09/13/12
First of all, I'm new. I've been lurking since I found this site after my husband had VSG on 12/9. I was searching for unflavored protein, and found this wonderful group of people.

After some of the classes and seminars DH had to attend to get his surgery, I decided it might be a good thing for me as well. Trouble is, my PCP at Kaiser says my BMI is not high enough. I'm about a 37-38, have HBP and a scarey family history. Almost all the women on my mom's side of the family wiegh 300+, I'm always between 215-220. I have tried many diets and can usually get rid of 20 pounds, but no more, and it always comes back. Even after explaining this to PCP, he says I don't meet Kaiser's guidlines.

My DH's surgeon suggested I start by getting a sleep test (I snore) and if that comes back clear to write a letter stating my case to PCP and even higher up if needed.

So, now that you have some background, does anyone have any suggestions? I should hear back about the sleep study soon. If I have sleep apnea, I could potentially qualify. I am not in a huge hurry as DH's surgeon is in the reserves and is being deployed to Afghanastan and won't be back for a year. I figured it would take about that long to jump through all of Kaiser's hoops anyway.

Thanks,
Linda
Jackie F.
on 1/27/12 8:57 am - Pico Rivera, CA
VSG on 03/09/12
Do you know what your BMI is?  I have a referance guide and unless your over 5"11 your BMI should be over 39. My Kaiser Doctor said it must be higher then 39 to qualify UNLESS you had other health issues like Diabetes, High blood presure, sleep apnea, High cholesterol, ect,   Im currently in the Kaiser options program and ony have one class left.  I qualified because my BMI is 49.  Im 5'3 260 lbs.
Linda B.
on 1/27/12 2:18 pm - CO
VSG on 09/13/12
Hi Jackie,

I am 5'4" and weigh 216 at the moment. My BMI is 37. My PCP says that Kaiser won't qualify me under 40 BMI with just high blood pressure (even though it takes 2 meds to control it). I did the sleep test and was told I have mild apnea + a heavy snoring problem. I am scheduled for a sleep info class tomorrow. I have to sleep with a special CPAP fro a week that will further record my paterns, then they will determine if I need a CPAP. If so, I think I can make my case. If not, I think I will write a detailed letter about why I think this is the right choice for me.

The bummer is I think Kaiser has stopped using Pacific Bariatrics in San Diego, which means a different surgeon. I was really hoping for the same doc as hubby, but that is not likely going to happen unless I win the lotto and can self-pay. I know I couldn't possibly afford this medical group/hospital on my own.

Congratulations on being almost finished with your classes. Do you know where they are sending you for surgery yet?
Linda B.
on 2/3/12 9:51 am - CO
VSG on 09/13/12
Good news, well depending on how you look at it. Since I have had my sleep test and have to go on a CPAP, my PCP finally agreed to send my referal paperwork in
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