Help me get it together...please

Ever since I was denied reconstructive surgery, I have fallen into a depression. I have tried to stay optimistic but just as I was going to try to appeal their decission my physician of many years burned down along with all my medical records. And to make it all worse. I no longer have the same insurance. (Is that a good thing? will my chances increase with a new insurance company? Should I try with the new company and not mention the denial?) I worked so hard to lose the weight and actually hit my goal with a year and a half. I have so much extra skin that no amount of exercise will make it budge ( well yes it wiggles and flops around everywhere) , but it wont firm up. I cant bring myself to wear short sleeves or shorts, my shirt tucked in, or even a belt. Hense the depression. Does anyone out there have any suggestions

Jeanie, The good news is that the medical records that you need for reconstructive surgery probably weren't with your regular physicians office. It may also be a blessing that you switched insurance carriers. I wouldn't mention the denial to the new company. I have more questions than answers right now, but I'm sure Reenie or someone can chime in and help out. Are you working through a surgeon's office or are you trying to get approval first? Does your wls have any recommendations for plastic surgeons? Do you have the benefits coverage book for your new insurance carrier? Let's start with these questions and maybe we can help you work through this. Also, have you checked out the Plastic Surgery board? There are a bunch of gurus there who can help. Connie

Jeanie, I grew up in St. Clair Shores!!! We'll have to talk! So glad you posted, and welcome to the most wonderful Board of folks out there. Listen, Stacy Posner is an attorney based in NYC who can give you great advice about this. She is a post-op who had to fight her own insurance battles. Go to www.wlslifestyles.com to find out more about her. I don't know her web site, but this is a good place to start. Who is your new insurance carrier? I agree with Connie, don't mention anything about your previous denial to this new insurance company, not until you talk to a legal expert like Stacy. The trick is to convince the insurance company that your redundant skin is causing health problems (depression certainly qualifies as a health issue); start documenting any health issues caused by the skin - if depression, start seeing a therapist who will support your claim; have your doctor prescirbe an anti-depressant specifically to address your depression related solely to the problems associated with redundant skin. Start thinking of this in terms of reconstruction, not plastic surgery. Start telling yourself you DESERVE a high quality of life and that means getting rid of the skin. But you must get other medical professionals to go to bat for you. Your PCP must document your medical conditions. Any rashes? Provide proof, with photographs, and visits to your doctor. He/she needs to prescribe creams and/or medications to clear up the rashes and when this doesn't work (never does with all that skin), your doctor needs to recommend surgery to remove the skin causing the medical issues. Don't feel you have to go this alone! In fact, if you don't have medical professionals who will highly recommend reconstruction surgery to get rid of your medical issues, chances are very high that you will not get coverage. Start with researching how Stacy can help you and contact her. She is a very strong advocate for reconstructive surgery and will give you good advice. You're not alone, start pulling your team together and start believing you DESERVE this and the insurance companies OWE this to all of us in this situation.

All I can say is elcome to the board & Keep Fighting!! You need this for YOU Marilyn, the Bearlady

Hi Jeanie, I, too, had a lot of skin issues and just could not get rid of it either. After my insurance denied me, I had a long talk with my plastic surgeon and guess what? He said something to me that made a lot of sense. He told me that the lower body lift I needed would cost the same as a used car! He was right? Would you deny yourself a used car if you truely needed one? I took out a loan and had the surgery 1-1/2 years ago and haven't looked back! It was the best $11,000 I ever spent. And it will be paid off in just a few years. Nothing is worth more than you!!! So even if you can't get the insurance to pay, many plastic surgeons work with finance companies that will loan you the funds at low interest rates or you can go to your bank. I personally took mine from a home equity line of credit. Just a thought, Karen

Jeanie, how are you doing? Your anniversary is coming up, the March board would love to hear from you. How's life? Listen, we're all struggling but hanging tough for each other. I hope you will post and let us know how you are. Maureen (I'm the one that grew up in St. Clair Shores - where did you have your surgery? I grew up on Culver, a street off of Ten Mile Road. I'm 51 now, so this is really taking me back. How is the town these days? Where abouts do you live?)