Appeal letter what do you think?

Hi Guys and gals....here is a letter I typed in regards to an appeal for a belt lipectomy. It is kinda graphic in nature so be warned first.What do you think? Some of it is mine and some from someone elses. Hugs Chris To Whom it may concern, This letter is written to appeal a decision of denial for a Belt lipectomy (abdominoplasty) by Dr. Samuel Shatkin In January of 2006, I underwent Roux-en-Y gastric bypass surgery. This surgery has proven to be a great success. My blood pressure is now within normal limits and I no longer need prescription medication to maintain a healthy blood pressure. I no longer suffer from sleep apnea nor acid reflux. My blood sugar levels are now within normal limits allowing me to live a healthier lifestyle. The gastric bypass has helped me to lose over 140 lbs and my BMI has greatly improved. It started at 52 and is now 25. I have successfully maintained my weight loss of 144 lbs for over 6 months by following a healthy diet, keeping my nutrition levels high with daily supplements and walking everyday. Due to my significant amount of weight loss, I have been left with a huge amount of excess abdominal/back skin that hangs below my pubis, causing numerous skin rashes and irritation (see attached photos). I have tried numerous home remedies like, Gold bond powder, Corn starch, baby powder, Hydrocortisone creams, Desitin ointment, and finally have gotten a prescription for Nystatin cream to help control the rashes/irritations. None of these prevent the irritation and needless to say they only work for awhile. I do take extra care with keeping the area clean and dry as frequently as I can, sometimes using a hair dryer to dry the area and placing gauze between the skin folds. I apply the creams frequently to prevent chaffing and notice that through out the day the cream rubs off onto my under garments causing the rashes/irritations to reappear. The areas cause excessive itching and sometimes produces a smell that causes embarrassment for me. I suffer from low back pain as well as numbness in my right hip/leg area. I am on Lyrica for pain as well as Ultracet. Aside from the skin problems I am also experiencing other problems in my life, like when I walk upstairs or down stairs you can hear a slapping sound from the excess skin slapping my upper thigh area. Making me more aware of when others are around me. I experience difficulties when I go to the restroom, having to lift my excess skin to properly clean myself, causing discomfort in my arms, neck and back. During sexual relations with my husband of 20 years I face sexual dysfunctions on a regular basis due to the large amounts of skin hanging on my stomach/back and surrounding my labia area. It is both causing psychological pain through embarrassment and physical pain by needing to manually hold the excess abdominal skin up while engaging in sexual activity with my husband. The excess skin is a direct result of my weight loss is a detrimental outcome to sexual activity in my personal life. I am finding that the excess skin prevents sensation in my vaginal wall as well as my clitoris. The amount of years I spent morbidly obese caused the skin to over stretch and no amount of exercise will reshape the skin leaving it looking deformed. So I feel there is a need for reconstructive surgery and should in no way be considered cosmetic in nature. Now that I am no longer morbidly obese, I need to live my life under healthful conditions for its entirety. Removal of the excess skin will greatly reduce my need for future medical attention to rashes, chafing and infection along with emotional pain, physical pain and discomfort. I am writing as a plea to reconsider this Belt lipectomy (abdominoplasty) by Dr. Samuel Shatkin. Sincerely, Christine Broderick

The letter sounds good to me, Chris. Hopefully it will be accepted!! Hugs, Anna

Oh, Chris, I feel your pain. I listen to your skin slapping story and can relate. Your letter sounds great. It details what effect the excess skin has in your everyday life and what you are doing to try to avoid more rashes. I think it will work. I will keep my fingers crossed for you. Once your excess skin is removed you will feel a world of difference. Trust me I do. I still have to get around to posting my before and after pics. I am a little embarassed because I feel like a fat cow still. Good luck! ~Norma~

Thanks Norma, I bet you look great. We all have problems with feeling like a "fat cow" My husband gets mad at me when I say it. He doesn't understand the "fat" thinking anymore because he just sees me as skinny..... I made some of the letter up because I figured the more graphic the better for my chances.....Thanks for the good wishes... Hug, Chris

Your letter sounds great. You included a lot of good information for the insurance company to consider. Hopefully, you'll get approved! Karla

Thanks Karla, How you feeling? I hope not too much discomfort....Hugs, Chris

Its so sad I bet they stamp it approved before they even finish reading it...... GOOD LUCK TORI

Thanks Tori.... Hugs, Chris

Sounds good to me Chris.

Chris, You did a great job. I think what would also help is letters from your surgeon, pcp and maybe a dermatologist to support the reconstructive procedure. Maybe even a psychologist would help. Any extra amo is a good thing. Keeping fingers crossed for you Ronna