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Good morning Cathy, I am glad that you decided to

post. I am not sure how they determine who will be

assigned where. I know some people that live in

Sacramento that were assigned to Richmond while others

in that same area were assigned to South San

Francisco. I am really not sure. I personally live

in Fairfield and was assigned to Richmond.

When I was going through the 10% weight loss phase,

they did recommend using the 1200 calorie diet because

it is very similar to the way you will be eating post

op (not immediately but a little further as you get

out). Second, its more health and balanced rather

than doing these quick fix it diets. I personally did

Atkins because I did not believe that the 1200 calorie

diet would work for me and I knew Atkins would. I had

24 pounds to lose. My first 15 fell off in two weeks.

The next five I lost simply consuming two protein

shakes a day and turkey with slice cheese for my

dinner (no snacks and I only drank water). My last

four pounds were very hard but I stayed at it and it

came off. It took six weeks and it seemed like the

longest six weeks ever.

I also tell people to try the 1200 calorie diet even

though I didn't because you want to do things that are

healthy for you and there really is no race here. I

know it sounds hypocritical but you learn as you go on

about what is sensible and whats not.

As for your other question(s), I am not sure I can

answer them. I did however talk to a gentleman named

Kirk at Kaiser in the plastic surgery department

yesterday because i am 27 pounds away from my goal

weight. He quoted me some prices ($13,000.00 for my

breast & tummy tuck), etc. I am going to pay for my

reconstructive surgery because I am not having any

medical issues and that is probably because I don't

have too much sagging skin. As a matter of fact, you

can't even see the sagging skin from my stomach

through my close...but I know it is there. Even

though I only have 27 more pounds to reach my goal

weight (130), I won't be able to have surgery until

Feb 2006 because you have to be at least a year post

op. Kirk did say however there is a possibility given

my body composition that I might not have to wait

until my one year anniversary for surgery. I don't

have a lot of extra skin but then I weighed 222 when I

went into surgery.

Maybe some of the veterans will chime in shortly with

some answers to your question. Take care and Welcome

to the group.

Pam Marsh-6months post op/KP Richmond (Dr. Park/Baggs)

Orientation: 249.5

Surgery: 222

Today: 157 (total loss 92.5)

Goal: 130 (27 more to lose)

--- Cathy catic15@...> wrote:

> Ok, after semi-lurking for a while, I've got some

> questions - I know

> I'll know more after my initial appointment next

> month, but I'm

> impatient about waiting for answers. . .

>

> 1. Which program do patients from the South Bay end

> up getting

> assigned to generally - I'm near Santa Clara; would

> I be more likely

> to be sent up to SSF or Fremont (or is there one

> closer?)

>

> 2. While you're trying to lose the 10%, are you

> advised to use the

> standard 1200-calorie diet or can you use any diet

> that works? The

> only way I've ever managed to make a 1200 calorie

> diet work for me was

> with really heavy exercise, which isn't realistic

> right now and won't

> be till I lose some weight (that's part of the whole

> problem -

> arthritis!) However, Atkins has worked fairly well

> for me in the past

> as a " kick-start " to lose 30-40 pounds, which would

> get me down the

> necessary amount for surgery.

>

> 3. For those of you with joint problems who've made

> it to the other

> side - did it really make a difference in your

> mobility/pain? I know

> that use of NSAIDs is prohibited after surgery, and

> I've been on heavy

> doses of Motrin for several years now for pain in my

> knees and heels.

> If I keep using them till I'm told to discontinue

> before surgery, am I

> increasing my risks of ulcers, or should I be trying

> to stop sooner to

> reduce complications later?

>

> 4. Finally, I know Kaiser doesn't cover plastic

> surgery after weight

> loss in most cases. Has anyone had it covered for

> medical reasons? If

> you have it done, and it's not covered, did Kaiser

> do it? And what's

> the ballpark figure for costs if it's not covered

> (very roughly)? If

> I'm going to have to save up I'd like to know what

> I'm looking at in

> that area, as well.

>

> I know, I'll probably find all this out eventually -

> but like I said,

> I'm impatient for information! Thanks -

>

> Cathy

>

>

>

__________________________________________________

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Good morning Cathy, I am glad that you decided to

post. I am not sure how they determine who will be

assigned where. I know some people that live in

Sacramento that were assigned to Richmond while others

in that same area were assigned to South San

Francisco. I am really not sure. I personally live

in Fairfield and was assigned to Richmond.

When I was going through the 10% weight loss phase,

they did recommend using the 1200 calorie diet because

it is very similar to the way you will be eating post

op (not immediately but a little further as you get

out). Second, its more health and balanced rather

than doing these quick fix it diets. I personally did

Atkins because I did not believe that the 1200 calorie

diet would work for me and I knew Atkins would. I had

24 pounds to lose. My first 15 fell off in two weeks.

The next five I lost simply consuming two protein

shakes a day and turkey with slice cheese for my

dinner (no snacks and I only drank water). My last

four pounds were very hard but I stayed at it and it

came off. It took six weeks and it seemed like the

longest six weeks ever.

I also tell people to try the 1200 calorie diet even

though I didn't because you want to do things that are

healthy for you and there really is no race here. I

know it sounds hypocritical but you learn as you go on

about what is sensible and whats not.

As for your other question(s), I am not sure I can

answer them. I did however talk to a gentleman named

Kirk at Kaiser in the plastic surgery department

yesterday because i am 27 pounds away from my goal

weight. He quoted me some prices ($13,000.00 for my

breast & tummy tuck), etc. I am going to pay for my

reconstructive surgery because I am not having any

medical issues and that is probably because I don't

have too much sagging skin. As a matter of fact, you

can't even see the sagging skin from my stomach

through my close...but I know it is there. Even

though I only have 27 more pounds to reach my goal

weight (130), I won't be able to have surgery until

Feb 2006 because you have to be at least a year post

op. Kirk did say however there is a possibility given

my body composition that I might not have to wait

until my one year anniversary for surgery. I don't

have a lot of extra skin but then I weighed 222 when I

went into surgery.

Maybe some of the veterans will chime in shortly with

some answers to your question. Take care and Welcome

to the group.

Pam Marsh-6months post op/KP Richmond (Dr. Park/Baggs)

Orientation: 249.5

Surgery: 222

Today: 157 (total loss 92.5)

Goal: 130 (27 more to lose)

--- Cathy catic15@...> wrote:

> Ok, after semi-lurking for a while, I've got some

> questions - I know

> I'll know more after my initial appointment next

> month, but I'm

> impatient about waiting for answers. . .

>

> 1. Which program do patients from the South Bay end

> up getting

> assigned to generally - I'm near Santa Clara; would

> I be more likely

> to be sent up to SSF or Fremont (or is there one

> closer?)

>

> 2. While you're trying to lose the 10%, are you

> advised to use the

> standard 1200-calorie diet or can you use any diet

> that works? The

> only way I've ever managed to make a 1200 calorie

> diet work for me was

> with really heavy exercise, which isn't realistic

> right now and won't

> be till I lose some weight (that's part of the whole

> problem -

> arthritis!) However, Atkins has worked fairly well

> for me in the past

> as a " kick-start " to lose 30-40 pounds, which would

> get me down the

> necessary amount for surgery.

>

> 3. For those of you with joint problems who've made

> it to the other

> side - did it really make a difference in your

> mobility/pain? I know

> that use of NSAIDs is prohibited after surgery, and

> I've been on heavy

> doses of Motrin for several years now for pain in my

> knees and heels.

> If I keep using them till I'm told to discontinue

> before surgery, am I

> increasing my risks of ulcers, or should I be trying

> to stop sooner to

> reduce complications later?

>

> 4. Finally, I know Kaiser doesn't cover plastic

> surgery after weight

> loss in most cases. Has anyone had it covered for

> medical reasons? If

> you have it done, and it's not covered, did Kaiser

> do it? And what's

> the ballpark figure for costs if it's not covered

> (very roughly)? If

> I'm going to have to save up I'd like to know what

> I'm looking at in

> that area, as well.

>

> I know, I'll probably find all this out eventually -

> but like I said,

> I'm impatient for information! Thanks -

>

> Cathy

>

>

>

__________________________________________________

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Guest guest

Hi Cathy,

Well, I can't answer all of your questions, but what I can I will inline:

Cathy wrote:

> 1. Which program do patients from the South Bay end up getting

> assigned to generally - I'm near Santa Clara; would I be more likely

> to be sent up to SSF or Fremont (or is there one closer?)

I think mostly Fremont, but SSF is a possibility. No, there isn't one

closer. In northern California, right now the only centers doing WLS are

SSF (the oldest program), Richmond (started in 2003), and Fremont (I

think started early this year, but not sure on that).

> 2. While you're trying to lose the 10%, are you advised to use the

> standard 1200-calorie diet or can you use any diet that works? The

> only way I've ever managed to make a 1200 calorie diet work for me

> was with really heavy exercise, which isn't realistic right now and

> won't be till I lose some weight (that's part of the whole problem -

> arthritis!) However, Atkins has worked fairly well for me in the

> past as a " kick-start " to lose 30-40 pounds, which would get me down

> the necessary amount for surgery.

Probably depends on which program you're assigned to. I don't really

think they care though how you lose it.

> 3. For those of you with joint problems who've made it to the other

> side - did it really make a difference in your mobility/pain? I know

> that use of NSAIDs is prohibited after surgery, and I've been on

> heavy doses of Motrin for several years now for pain in my knees and

> heels. If I keep using them till I'm told to discontinue before

> surgery, am I increasing my risks of ulcers, or should I be trying to

> stop sooner to reduce complications later?

BIG difference! I was fortunate in that I didn't have a bunch of

comorbidities before my surgery, although my family history indicated

that it was probably just a matter of time. The one comorb I did have

was " prearthritis changes " in both knees, and I had started having

problems with my knees. They are MUCH happier now that they aren't

having to carry the equivalent of six 25 pound bags of potatoes in extra

weight with every step. I won't claim that I never have any knee pain,

but MUCH less than before, and it's pretty rare.

> 4. Finally, I know Kaiser doesn't cover plastic surgery after weight

> loss in most cases. Has anyone had it covered for medical reasons?

> If you have it done, and it's not covered, did Kaiser do it? And

> what's the ballpark figure for costs if it's not covered (very

> roughly)? If I'm going to have to save up I'd like to know what I'm

> looking at in that area, as well.

It's going to be very hard to give you numbers, because how much skin

you have where will depend on a bunch of factors. How old are you? How

stretchy is your skin? How stretchy is the skin of family members (this

will help indicate how much you can expect your skin to snap back)?

Where do you carry your excess weight?

In general, Kaiser can kinda be coerced into covering abdominal skin,

but generally not arms or thighs. Bust depends on a lot of different

factors, which didn't apply to me. Never really had none myself, and

even less now!

> I know, I'll probably find all this out eventually - but like I said,

> I'm impatient for information! Thanks -

Educating yourself NOW is an excellent idea! I'm frequently appalled at

how many people research buying a new car a lot more than they do the

surgery. You're probably not going to have the car in ten years, but

hopefully you'll have the body for decades, and you want to make sure

it's in good running order for as long as possible!

Feel free to ask any questions you want! You can also e-mail me

privately if you want. My private e-mail address is eo@....

That address doesn't get publicized, so I don't have spam filters on it.

--

Eleanor Oster

eleanor@... (personal address)

www.smallboxes.com/gastricbypass.htm

San , CA

Open RNY (100 cm bypassed) 07/15/2003

P. Fisher, M.D., Kaiser Richmond (CA)

~5'9 " tall

05/09/2003 319 Orientation

07/15/2003 ~290 Surgery

Current 150-155 Goal until plastics?

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Hi Cathy! KP will not cover the cost of "plastic surgery", but will perform what's called a pannicelectomy, (sp?), if medically indicated. A pannicelectomy is the removal of excess skin (or what is referred to as a pannus in the medical industry). You know, all of the skin that hangs down and sits on top of your thighs. IT IS NOT TO BE CONFUSED WITH A TUMMY TUCK, however, as the plastic surgeon will not tighten your muscles around your tummy, nor "move" your belly button so that it sits nice and pretty in the middle of your tummy. The surgeon simply "cuts" and removes the skin then stiches you back; (I'm sure that it's a little more complicated than that:))

The criterion for the procedure is that your pannus hangs down so far over your thighs that it interferes with your mobility, and/or that you suffer from recurring infections under the pannus that cannot be healed by medication alone; (and the infections must be documented by a KP physician in your medical record). This, at least, was the criterion when I worked for KP. (I used to investigate Grienvance Appeals and Medicare for Kaiser, and have had more than my fair share of requests from patients for both WLS as well as for pannicelectomys after the weight loss.)

Hope that this helps, and should as long as the KP policy has not changed in the three years that I have been gone.

PamCathy wrote:

Ok, after semi-lurking for a while, I've got some questions - I know I'll know more after my initial appointment next month, but I'm impatient about waiting for answers. . . 1. Which program do patients from the South Bay end up getting assigned to generally - I'm near Santa Clara; would I be more likely to be sent up to SSF or Fremont (or is there one closer?)2. While you're trying to lose the 10%, are you advised to use the standard 1200-calorie diet or can you use any diet that works? The only way I've ever managed to make a 1200 calorie diet work for me was with really heavy exercise, which isn't realistic right now and won't be till I lose some weight (that's part of the whole problem - arthritis!) However, Atkins has worked fairly well for me in the past as a "kick-start" to lose 30-40 pounds, which would get me down

the necessary amount for surgery.3. For those of you with joint problems who've made it to the other side - did it really make a difference in your mobility/pain? I know that use of NSAIDs is prohibited after surgery, and I've been on heavy doses of Motrin for several years now for pain in my knees and heels. If I keep using them till I'm told to discontinue before surgery, am I increasing my risks of ulcers, or should I be trying to stop sooner to reduce complications later?4. Finally, I know Kaiser doesn't cover plastic surgery after weight loss in most cases. Has anyone had it covered for medical reasons? If you have it done, and it's not covered, did Kaiser do it? And what's the ballpark figure for costs if it's not covered (very roughly)? If I'm going to have to save up I'd like to know what I'm looking at in that area, as well.I know, I'll probably find all this out eventually - but like

I said, I'm impatient for information! Thanks -Cathy__________________________________________________

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Share on other sites

Guest guest

Hi Cathy! KP will not cover the cost of "plastic surgery", but will perform what's called a pannicelectomy, (sp?), if medically indicated. A pannicelectomy is the removal of excess skin (or what is referred to as a pannus in the medical industry). You know, all of the skin that hangs down and sits on top of your thighs. IT IS NOT TO BE CONFUSED WITH A TUMMY TUCK, however, as the plastic surgeon will not tighten your muscles around your tummy, nor "move" your belly button so that it sits nice and pretty in the middle of your tummy. The surgeon simply "cuts" and removes the skin then stiches you back; (I'm sure that it's a little more complicated than that:))

The criterion for the procedure is that your pannus hangs down so far over your thighs that it interferes with your mobility, and/or that you suffer from recurring infections under the pannus that cannot be healed by medication alone; (and the infections must be documented by a KP physician in your medical record). This, at least, was the criterion when I worked for KP. (I used to investigate Grienvance Appeals and Medicare for Kaiser, and have had more than my fair share of requests from patients for both WLS as well as for pannicelectomys after the weight loss.)

Hope that this helps, and should as long as the KP policy has not changed in the three years that I have been gone.

PamCathy wrote:

Ok, after semi-lurking for a while, I've got some questions - I know I'll know more after my initial appointment next month, but I'm impatient about waiting for answers. . . 1. Which program do patients from the South Bay end up getting assigned to generally - I'm near Santa Clara; would I be more likely to be sent up to SSF or Fremont (or is there one closer?)2. While you're trying to lose the 10%, are you advised to use the standard 1200-calorie diet or can you use any diet that works? The only way I've ever managed to make a 1200 calorie diet work for me was with really heavy exercise, which isn't realistic right now and won't be till I lose some weight (that's part of the whole problem - arthritis!) However, Atkins has worked fairly well for me in the past as a "kick-start" to lose 30-40 pounds, which would get me down

the necessary amount for surgery.3. For those of you with joint problems who've made it to the other side - did it really make a difference in your mobility/pain? I know that use of NSAIDs is prohibited after surgery, and I've been on heavy doses of Motrin for several years now for pain in my knees and heels. If I keep using them till I'm told to discontinue before surgery, am I increasing my risks of ulcers, or should I be trying to stop sooner to reduce complications later?4. Finally, I know Kaiser doesn't cover plastic surgery after weight loss in most cases. Has anyone had it covered for medical reasons? If you have it done, and it's not covered, did Kaiser do it? And what's the ballpark figure for costs if it's not covered (very roughly)? If I'm going to have to save up I'd like to know what I'm looking at in that area, as well.I know, I'll probably find all this out eventually - but like

I said, I'm impatient for information! Thanks -Cathy__________________________________________________

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