Hello from Central California!

[julie]

Hi. My name is Julie, I'm 35, I live in Stockton, CA and I want to have the DS surgery.

I've been going to Dr. Coates here in Stockton since September, but just found out last night that I was going to be given a SADI-S instead of a DS and possibly without ever being told. I am very upset about this and plan to start searching for a new surgeon tomorrow. I am close to 500 pounds and do not feel a SADI-S is going to help me in any way possible.

I have been reading a lot the past 2 days and see that a lot of surgeons are doing this bait and switch with DS patients. They go in thinking they are getting a true DS and walk out with a SADI-S.

My insurance is Health Plan of San Joaquin (under Medi-Cal). If you know of a DS surgeon who takes this insurance, please let me know.

 

[newanatomy]

Hi and welcome. Good luck in your search. I hope you find good answers soon.

 

[more2adore]

Welcome, @julie! Thank goodness you did your own research. I'm 506 pounds, so I understand where you're coming from - only I can't get the DS, unfortunately. My surgeon (the only vetted DS surgeon in Australia) will only do it in two stages for someone my size. All the vetted US surgeons seem perfectly happy to do it in one stage, though. Best of luck! I'm sure someone will be along with a recommendation for you soon.

 

[southernlady]

Welcome @julie SO glad you are doing your research. Best options are Dr. Keshishian or Dr. Rabkin, BOTH located in California

 

[DianaCox]

Julie, you need to focus on how to get to a QUALIFIED DS surgeon, given your insurance situation. Stop looking for newbies who are not experienced enough for dealing with someone your size, even assuming they are not hacks like I think Coates is (MY OPINION), or newbie-nobodies like Shadle.

I assume you are Karen Waters' daughter, so you should know about Keshishian. Why haven't you mentioned him? While I don't know for sure whether he takes straight Medi-Cal (he DOES take MediCare), have you asked him? You do know that you can get out of your MediCal HMO by getting an exemption, right?

MediCare would be easier, of course - at your size, have you applied for SSDI?

 

[star0210]

Aren't there 2 Dr. Coates? Father and son?
It seems I read the older is doing the traditional DS and the younger has been doing the Sadi.

 

[aaa]

Welcome.

 

[julie]

Julie, you need to focus on how to get to a QUALIFIED DS surgeon, given your insurance situation. Stop looking for newbies who are not experienced enough for dealing with someone your size, even assuming they are not hacks like I think Coates is (MY OPINION), or newbie-nobodies like Shadle.

I assume you are Karen Waters' daughter, so you should know about Keshishian. Why haven't you mentioned him? While I don't know for sure whether he takes straight Medi-Cal (he DOES take MediCare), have you asked him? You do know that you can get out of your MediCal HMO by getting an exemption, right?

MediCare would be easier, of course - at your size, have you applied for SSDI?

Yes, Karen is my mom. I would LOVE for Dr. K to do my surgery. I emailed him about the situation with getting a SADI-S instead of the DS and he agreed it won't work for me and that I need the DS. If I need to get an exemption, I am 100% willing to do so. I talked to my insurance earlier and they don't actually cover any bariatric surgeons automatically, I have to be referred by my PCP to one and then it goes through. I have an appointment with my PCP on March 3rd and plan to give her Dr. K's office info to send him a referral/authorization/whatever else is needed to get me to see him.

I'm glad you mentioned Shadle as I came across his website last night, but could not find any reviews on him performing the DS. He's getting crossed off my list right now if he's that new. I'm not looking to be a guinea pig.

I am currently fighting a denial for SSDI and am working with Binder & Binder to win my case, but we know how long those can take.

 

[julie]

Aren't there 2 Dr. Coates? Father and son?
It seems I read the older is doing the traditional DS and the younger has been doing the Sadi.

There are 2 Dr. Coates, Patrick (the dad) and Matthew (the son). Because I knew he had been doing bariatric surgery's longer, I was going to have Dr. Patrick Coates do my surgery. They both work out of the same office, one in Stockton and one in Modesto.

 

[DianaCox]

You and your PCP PROBABLY need to fill out this form http://www.healthcareoptions.dhcs.ca.gov/HCOCSP/Enrollment/content/en/forms/MU_0003383.pdf requesting an exemption from your current in-county Medi-Cal HMO, due to reason "I" - unless your HMO can refer you out JUST for bariatric surgery. And you need to be able to provide your PCP with ammunition to substantiate the assertion that the DS is the only surgery that is likely to durably get someone of your size to a reasonable BMI and permanently resolve your comorbidities, and that there is nobody in network qualified to do one on someone with your high BMI, in one operation, and only Keshishian or Rabkin are sufficiently experienced, in-state.

 

[JackieOnLine]

Hi Julie, glad you found out before you got a surgery you didn't want.

 

[brooklyngirl]

Good luck with the surgeon hunt and insurance battle, but it sounds like you're being proactive enough to fight it out

 

[newanatomy]

There is someone on the old site, named "DMP", who is going to Dr. Coates for a "DS". I hope they know what they are actually getting.

 

[DianaCox]

There is someone on the old site, named "DMP", who is going to Dr. Coates for a "DS". I hope they know what they are actually getting.

I sicc'ed someone on the task of informing her.

 

[julie]

Thank you for the pdf Diana. I have an appointment with my PCP tomorrow and will have her fill out her portion. I also called and confirmed with Dr. K's office that they do not accept my insurance. The woman said they are not contracted to accept Medi-Cal even with authorizations, so I expect to be in for a fight, but I am 100% willing to do it.