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AStamps

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Jun 7, 2022
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Hello. My name is Ashanti. I'm 41 years old. I am pre-op and struggling to qualify for surgery. Any advice would be appreciated.
 
Sorry, long Rant. I'm a Kaiser patient.

I feel really discouraged right now. I was referred for Bariatric Surgery in 2018 with Kaiser. I went through orientation, surgery consultation and psych evaluation. I was given a goal weight of getting under 400lbs (at the time I was 468). I discovered that my weight loss goal was set so high because the surgeon didn't believe I would be successful due to my bi-polar disorder. I decided to drop from the program, I no longer felt comfortable working with the program. Fast forward to 2021, my health has declined significantly, my PCP encourages me to try Bariatric Surgery again. I go through the process of orientation, nutrition class, and I was scheduled for my surgery consult today. The surgeon is not the same one from 2018 (I asked for someone else). And the surgeon was like what is that you want? Need? I don't know why they scheduled you. You need to get under 400 lbs. and get your A1C under 9 (my A1C is 9.1, down from almost 12 is December). My response was. I don't know you tell me, your clinic made this appointment. I then expressed to him I wasn't sure what next steps would be because I wanted the DS, and Kaiser didn't perform the surgery. I was just wanting a referral. He then explained the referral process, and my next steps would be another psych evaluation. He then on to say he didn't think I'd survive surgery in my current condition, and he would not approve me for any elective surgery at this point. At this point, if I can lose 100 pounds on my own, why have surgery?
 
Hi and welcome AStamps! It took forever and going through hopes for me to get insurance to cover, so I can empathize. There are some folks here who may be able to help. What state are in - and is your insurance through work? Sounds like you need to get to the right doctor somehow. Hang in there!
 
Hi and welcome AStamps! It took forever and going through hopes for me to get insurance to cover, so I can empathize. There are some folks here who may be able to help. What state are in - and is your insurance through work? Sounds like you need to get to the right doctor somehow. Hang in there!
Hi hilary1617, I'm located in Northern California. My insurance is willing to cover it, I just have to jump through these hoops. I have a Medicare Advantage plan. And thank you for the kind words.
 
of course you are discouraged, this so called "healthcare" system is stupid and the whole point is to keep actual healthcare from you.

My insurance is willing to cover it, I just have to jump through these hoops.
you have come to the right place to get hoop-jumping advice.
 
Hi, and welcome. The hoops are daunting, but if you run into a road block, there are lots of experienced folks here that know what to do. So, after having drs fail me for decades and tell me what can't be done, I'm to a place that a just get as much information as possible, and tell them exactly what I need, and WHY. I often bring printed material from pubmad or relevant studies to leave with them. They may not read it, but they will look at highlighted relavant areas. The reality is you may not get to their goal of 400, but that doesn't mean this surgery won't be life saving for you, and the longer it's put off, the worse your health will be. I'm a fairly quiet, non confrontational person, but not any more when it come to getting medical care from doctors.

I know others with the DS that take meds for bipolar, and the DS hasn't been an issue with those (some have had issues with types of staying on them, but it wasn't related to the surgery).
 
Hi hilary1617, I'm located in Northern California. My insurance is willing to cover it, I just have to jump through these hoops. I have a Medicare Advantage plan. And thank you for the kind words.
Start by posting here: https://bariatricfacts.org/forums/insurance.28/
Give as much detail as you are comfortable giving on an open forum. I will tag the two ladies that can be of help.
 

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