|
|
Post by sherbearmama on Jan 16, 2012 21:10:13 GMT -5
I sent an email to my surgeon's office stating that I would like to have my labs completed locally--his office is more than a 4 hour round trip from my home. This is the letter I sent: "Hi Dr. Belzberg,
I'm doing well, lots of energy, eating--though struggling to get my protein in since I eat so little, but staying hydrated. You wanted me to come back for a visit with the nurse practitioner about 8-10 weeks from my last visit. I would like to avoid the 2 hour drive all the way out to you unless I'm actually going to see YOU. I realize the depth of your understanding of the DS and what I should or shouldn't do following the procedure. However, it's been fairly obvious that no one else I have encountered seems to have much knowledge about it and thus I'm treated as an RNY patient. Would it be possible for you to order the lab work here (Thousand Oaks facility or Woodland Hills) --and perhaps there is someone i can see locally to discuss my status. Or perhaps your nurse practitioner could call me?
When you have a moment, please let me know."I guess I'm naive because I actually thought my email was reasonable. But this is the response I received: "call for appointment
To:
Sheri ******
From:
SUZANNE ********* PA
Received:
01/16/2012 4:30 PM
Please call Care managers: (310) ***-**** and arrange appointment with us at S Bay. We are familiar with DS patients and recommended vitamins and labs. You will have a one hour appointment with the NP or PA and dietitian. Please bring all your vitamins with you to appointment. Once we are sure you are clear on vitamins and diet, we can consider discharging you closer to home, but since we are familiar with this procedure, it is best to see us first.
Suzanne ******* PA
Weight Management Program
310***-****
Care managers: (310) ***-****"So, they'll CONSIDER letting me see a closer Kaiser provided IF I come see them first. I'm trusting Vitalady's vitamin regimen and I know for a fact that I'm not supposed to start it--the surgeon said I should take chewable vites, some calcium with D, and a sublingual B12--and NOTHING else until my first set of labs at 12 weeks. I asked if i could become deficient in that time and then have trouble catching up and he said "No, that shouldn't be a problem." Of course I'm not following his instructions because I don't want to fall behind and then have to catch up to get healthy again. So, when I come in, they'll tell me to quite taking so many vitamins. Next, I'll sit down with another NUT who will tell me to eat lower in fat, lots of veggies, and 250g of carbs a day (yes, that's what they told me before). The surgeon himself admitted to me that DS patients know much more about the procedure, the aftercare, and the diet and vites than most nurses, doctors, and nutritionists. There is no way in hell that I'm making that drive to have some condescending nurse tell me misinformation. So, I responded to the email with "Please have Dr. Belzberg contact me directly." And when he does, I'll let him know that I'm going to be seeing my primary physician for labs and that we've already discussed that I understand the DS diet--and the food progression we'd spoken about in a previous appointment. There is no need to "consider discharging me" to a closer facility since it my choice who I see and who I don't see. And I'll have my labs sent to him for review. Maybe this shouldn't surprise me and maybe it shouldn't upset me much but it does. Should I have put this on the R and R board--because I'm definitely ranting right now. Thanks for listening. Vets, please tell me if I'm way off base here? Sheri  |
|
trxxyy
Full Member
Your Mom
Posts: 202
|
Post by trxxyy on Jan 16, 2012 22:12:25 GMT -5
Sheri,
I am sure this makes you want to pull your hair out! Hopefully you can get Dr. Belzberg to pave the way for you to handle your labs through your Kaiser PCP. I know Belzberg is confident of your DS knowledge and as long as you keep him in the loop (send him copies of your labs). If not, you might be stuck playing their game for that first visit. List the supplements they suggest and try like hell to fight for all the labs you need. Maybe then you can at least get back to a doctor closer to home and get labs done that way.
I know I can't offer much support regarding this particular issue but I will be more than happy to be your cheering section.
This is one of the many reasons Kaiser drives me batty and I would fight tooth and nail never fall under their care. My health care should be directed by me and my doctor, not some flawed bureaucracy.
-shelly
|
|
|
|
Post by Band to DS on Jan 16, 2012 22:25:03 GMT -5
Sounds very frustrating! Hopefully you'll be able to speak with Dr. Belzberg directly & he'll be more reasonable. I hate my insurance company too.
Shelli
|
|
|
|
Post by Gail R on Jan 16, 2012 23:20:23 GMT -5
Your request is totally reasonable. You are dealing with a staff that probably sees people who are truely ignorant of how to take care of themselves with the lapband, RNY, VSG or the DS or whatever Kaiser decided to stick them with.They are giving you a standard answer. Kaiser has been very good to me in Northern CA, probably because I took them to the state insurance board to make them give me the surgery I knew would save my life.
Keep protesting.
|
|
|
|
Post by sherbearmama on Jan 17, 2012 1:20:10 GMT -5
Gail, what's crazy is that Dr. Belzberg has only done a handful of DS procedures here at Kaiser in the past few years or so. They really only want to do the Sleeve and they'll push the RNY for Diabetic patients. But we did get to choose our own surgery--and luckily, I happened to know that they offered the DS. I didn't have to do much fighting--just had to meet with this specific surgeon and convince him that I knew my sh*! about the DS and he agreed. However, just because they had a surgeon who knew how to perform the surgery, doesn't mean they had ANY knowledge of how to take care of me afterwards or to teach me about vitamins and nutrition. I've been very vigilant with my research and I read everything I can find--and of course I have you great people here to help along the way!!!
Anyway, I KNOW that Belzberg's staff has only met with just a few DS patients. At least 2 of the last DSers haven't gone back for the 12 week check. S. Bay's bariatric program doesn't know what they're talking about. But, on the brighter side, I did speak with my PCP who said she'd be willing to run any labs I suggest. One other Kaiser DS patient here on the board also decided not to see Belzberg's PA and NUT and just had her PCP run the labs. So I don't think it'll be an issue. They can't MAKE me drive out to him since I've already had the surgery and they won't make patients drive past a certain amount of miles--they reimbursed me for my drive for the pre op, for the surgery day, and for the post op, but they won't do any more reimbursement. So I think I'm going to have a pretty easy time here. But I'd like to at least speak with Belzberg and let him know I'll be sending him the results. He is always worried about his patients (especially the DS patients) and I know he'll be concerned if I drop off the face of the earth. So, let's just hope he backs me up and makes life easier.
|
|
|
|
Post by sherbearmama on Jan 17, 2012 1:22:19 GMT -5
Sounds very frustrating! Hopefully you'll be able to speak with Dr. Belzberg directly & he'll be more reasonable. I hate my insurance company too. Shelli I think with insurance it's just hit or miss! I do think he'll be more reasonable when we speak. Thanks! |
|
|
|
Post by sherbearmama on Jan 17, 2012 1:24:37 GMT -5
Sheri, I am sure this makes you want to pull your hair out! Hopefully you can get Dr. Belzberg to pave the way for you to handle your labs through your Kaiser PCP. I know Belzberg is confident of your DS knowledge and as long as you keep him in the loop (send him copies of your labs). If not, you might be stuck playing their game for that first visit. List the supplements they suggest and try like hell to fight for all the labs you need. Maybe then you can at least get back to a doctor closer to home and get labs done that way. I know I can't offer much support regarding this particular issue but I will be more than happy to be your cheering section. This is one of the many reasons Kaiser drives me batty and I would fight tooth and nail never fall under their care. My health care should be directed by me and my doctor, not some flawed bureaucracy. -shelly Thanks for the kind words Shelly! YOu know, I'm not sorry i went with Kaiser--it got me the DS worry-free and the cost was covered 100%. I just hate feeling like I live in some sort of communist society where I am not supposed to make any decisions for myself. So, I'm one of the black sheep that run around the system--I know of at least one other (and you know her too!). Hoping to see you soon! Sheri |
|
Deleted
Deleted Member
Posts: 0
|
Post by Deleted on Jan 17, 2012 1:52:36 GMT -5
I had Kaiser for many years, both in SoCal and in NoVA, and while it was OK for most routine stuff - kid visits, OB-GYN - if you are NOT something they want to deal with, THEY ARE HORRIBLE!!! In my case, it was my first husband - he was mentally ill and had substance issues. They simply would NOT provide adequate mental health treatment in the 80s and 90s. In particular, in NoVA, they had a bifurcated treatment program - you were in their substance abuse program OR mental health. And in SA, you were NOT allowed to take any meds - it was all "group therapy" - while if you were in MH, it was med pushing - the cheapest ones possible (no SSRIs in the 90s) and NO therapy. There was no such thing as dual diagnosis.
And the SOB who was the head of the psych dept and I got into it, and he utterly dismissed my efforts to help my husband get appropriate treatment as "enabling" - which was the universal brush-off to any family members who disagreed with their anachronistic, penny-pinching, short-sighted treatment options.
We ended up having to pay for his mental health treatment outside the system.
I HATE Kaiser.
And yet Kaiser played a key role in making me who I am. My parents were among the earliest adopters of Kaiser, in the early 60s. When I was 9 years old, I cut my foot open on a rock at the beach we went to for my birthday. I had been getting interested in science and medicine, and was doing my summer reading of the Cherry Ames books and a Reader's Digest story about a kid my age who died of leukemia, but first had volunteered to take an experimental drug. I was thinking about becoming a nurse or being a research lab assistant.
When we got to Kaiser, the doctor and nurse came in to sew my foot up, I was gobsmacked - the doctor was a WOMAN and the nurse was a MAN! Never was the possibility suggested in my Cherry Ames books! Kaiser was started with one of the tenets being that doctors wanted to have family lives, with regular schedules, and the patients would be willing to pay less to get whatever doctor was available, rather than expecting "their" doctor to come see them when they were ill. And that attracted "non-traditional" doctors and nurses, like female doctors (which in turn made the male nurse possibility also acceptable).
From that moment on, I knew I could be the DOCTOR or the RESEARCHER. I knew I could be whatever I wanted to be. And it was Kaiser that gave me that.
So in some ways, I especially HATE that Kaiser made me HATE them.
|
|
|
|
Post by sherbearmama on Jan 17, 2012 2:20:54 GMT -5
Thanks for the story Diana. I hate them too--but I love them for my DS. For that I'll be grateful-- but I won't stay with them any longer than I have to. I had no idea Kaiser had been around so long! I'm still not sure how their mental health is. I know they are overfilled with MH patients and so the wait to see doctors is longer than what is legal. I had the DMHC force them to get me an appointment to get my meds managed because the soonest Kaiser was willing to give me was a month and a half away. Apparently I qualify for therapy sessions--one on one--but I'm not sure how many a year. And, I know that Kaiser has been very lax about my medication management since the first time I saw the Psych. He has since allowed me to adjust my own meds and communicated with me strictly through email--which in a way is nice, but I preferred that my old Psych outside of Kaiser actually wanted to sit down with me and see exactly how I was doing at the time.
I feel like a number in Kaiser--I feel like I don't matter--except when I'm making a fuss. But I know that I was able to get my surgery and I know that my surgeon cares greatly about me--and that's a great feeling. SO, we've got positives and negatives--but overall I despise the bastards.
Sheri
|
|
|
|
Post by Girlrocker on Jan 17, 2012 4:47:22 GMT -5
I have no experience to offer in this regard, but applaud you taking them on, sorry you have to. I think you posting this will help others who might experience something similar. I hope you get this resolved, driving 4 hours for labs is insane, especially in California.
|
|
|
|
Post by Sandra C. on Jan 17, 2012 14:02:59 GMT -5
Sorry Sherri for your frustrations. All of us seem to have extenuating circumstances to go through during our early D.S. experience, which would be enough by itself.
I also drive 4 hrs round trip to see my doc, and all his team. Two times a week I go to their lectures, and once a month for D.S. support group with Dr. K. My labs are drawn here at home with my endocrinologist/internist. Results are sent to both practices. All the docs determine what they would like changed within their specialities. No one here in Kzoo has any experience with D.S. I am educating quite a few of my docs here. Shows me how important being educated about the D.S. really is!!!
Some of my trips to the D.S group and docs are not very informative for me, but usually I take home valuable ideas to make my D.S. life more enriched. Driving up there with a few extra hours to shop in different stores than we have, makes the trip seem worthwhile.
Early in my recovery I remember feeling exasperated often about the littlest things. I wanted to be in control of everything. It could be residual from anesthesia, or rapid weight loss. Usually I am very easy going and relaxed. Hope things work out for you the way you want them to. ;-)
Sandra
|
|
|
|
Post by pumpkin on Jan 17, 2012 14:31:58 GMT -5
You live REALLY close to me Sheri and I HATE FUCKING KAISER. I'm out just as soon as open enrollment comes around.
They won't pay for Cymbalta for my fibro pain, but they will prescribe me Methadone, Morphene, and Fentynal.
Meh
|
|
|
|
Post by sherbearmama on Jan 17, 2012 22:29:20 GMT -5
Sorry Sherri for your frustrations. All of us seem to have extenuating circumstances to go through during our early D.S. experience, which would be enough by itself. I also drive 4 hrs round trip to see my doc, and all his team. Two times a week I go to their lectures, and once a month for D.S. support group with Dr. K. My labs are drawn here at home with my endocrinologist/internist. Results are sent to both practices. All the docs determine what they would like changed within their specialities. No one here in Kzoo has any experience with D.S. I am educating quite a few of my docs here. Shows me how important being educated about the D.S. really is!!! Some of my trips to the D.S group and docs are not very informative for me, but usually I take home valuable ideas to make my D.S. life more enriched. Driving up there with a few extra hours to shop in different stores than we have, makes the trip seem worthwhile. Early in my recovery I remember feeling exasperated often about the littlest things. I wanted to be in control of everything. It could be residual from anesthesia, or rapid weight loss. Usually I am very easy going and relaxed. Hope things work out for you the way you want them to. ;-) Sandra Hi Sandra. You've got a great attitude with regards to jumping through hoops and with keeping your chin up when dealing with adverse situations. It reminds me of how it was for me pre-DS surgery. I had to make a trip about 2 hours for Kaiser classes each week--plus had to drive in for labs, x-rays, and meetings with NP on a regular basis as well--and the classes had NOTHING to do with the DS. I had to sit there quietly and just listen because I'd already been in conflict with them about taking classes that didn't pertain to my surgery--even the teacher admitted that. So I sat there, kept my mouth shut, and ate it because I KNEW it would lead to my surgery. I also had to make the 4 hour trip to the surgeon's office multiple times. At first it was hard, but I totally got used to it and was even excited because I knew it was leading up to the surgery (and I did learn some good info on protein). But now that I'm post op, I have no one to please but myself. And making a 4 hour drive for labs (I can get those done at the Kaiser that's 10 minutes from my house) and so some NUT can tell me I'm taking too many vites and eating too much fat and that I should up my carbs---that's insanity. I just won't do it. I know 2 others who refused to do it as well. My primary doctor is only 15 minutes away, I can also do labs at that Kaiser facility as well--I'm not wasting any more time. This particular surgeon does maybe one DS a year--the staff knows NOTHING about DS life--they'll be of no help. So, I'm officially on my own! Wish me luck. Im 6 weeks out yesterday so I'll be back in for labs at my PCP in 6 more weeks! THanks for the input! |
|
|
|
Post by sherbearmama on Jan 17, 2012 22:38:32 GMT -5
You live REALLY close to me Sheri and I HATE FUCKING KAISER. I'm out just as soon as open enrollment comes around. They won't pay for Cymbalta for my fibro pain, but they will prescribe me Methadone, Morphene, and Fentynal. Meh Do you live in the San Fernando Valley near the Woodland Hills facility? I can't wait to leave Kaiser either--But I promised myself I'd stay until I was a least a year out from surgery--just in case something serious happens within that time frame. Since they won't pay for Cymbalta for the fibro, have you considered going to the DMHC to fight that? Or going through their psych program (also in Woodland Hills down the street from the hospital) to get it prescribed? Since depression often goes along with Fibromyalgia maybe that's a viable channel to explore??? My brother fought tooth and nail to get his medicine that he needed for his Myotonia Congenita (a type of muscular dystrophy)--they said they didn't offer that particular medicine but they'd give him something else that "Would work just fine." He went to the DMHC and forced them to get him his meds. Seriously, it's such a crapy system--unless you're a sheep and don't mind following the heard. If you live close, we should meet!!!! It would be great to have some local support!! S  |
|
|
|
Post by bookfaerie on Jan 19, 2012 15:37:50 GMT -5
I don't dislike Kaiser per se. They are a beaurocracy like any other. You just have to know how to work the system.  You know me Sheri. I'm a total PITA! LOL |
|
|
|
Post by sherbearmama on Jan 19, 2012 16:39:29 GMT -5
I don't dislike Kaiser per se. They are a beaurocracy like any other. You just have to know how to work the system. You know me Sheri. I'm a total PITA! LOL If you're a total Pita (Peeta...) then I'm a total Katniss. LOL ;D   |
|
|
|
Post by bookfaerie on Jan 20, 2012 20:35:51 GMT -5
OMG Sheri! I exalt thee for thine excellent Hunger Games reference!! ROTFLMAO
|
|
|
|
Post by sherbearmama on Jan 20, 2012 20:57:49 GMT -5
Glad you got it! Right back atcha!
|
|
You know me Sheri. I'm a total PITA! LOL
