Guest guest Posted August 5, 2005 Report Share Posted August 5, 2005 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__________________________________________________ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 6, 2005 Report Share Posted August 6, 2005 Thanks, Pam - and all the others who've responded. I only have a chance to check my mail once a day right now, so I'll probably be " quiet " on the list till school starts in Sept. - but I read everything, and I appreciate the info! Cathy > > > 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 > > > > > > > > > __________________________________________________ > Quote Link to comment Share on other sites More sharing options...
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