Plastic Surgery

Okay. . .I will be a year out in July. I am down from 343 to around 227 (measure at Curves yesterday only lost 10lbs this month.) I am starting to look at the plastic surgery issue. I know that to get it covered by the insurance it has to be deemed necessary. Document any rashes, irritations, treatments and the like. I am already starting a few irritations especially itching and sweating, not a good combo. Plus back pain and chest pain are worse now. My question is, does anyone have any recommendation of how to document this? I know that I have to do it with my doctor. But what can I do at home to document it so that I can bring information to the doctor? I hope that makes sense. Thanks Lisa

Lisa: I just got approved for a panniculectomy by my insurance. One of the things I did was take my own pictures, because as they say... pictures are worth a 1000 words! Any time you get any kind of irritation or infection, take a picture of it yourself. Have them printed out and when you are ready to have your plastic surgeon submit to insurance, give him the photos to include with his letter and his own photos. Also, any time that you get a prescription filled to treat the irritations/infections, keep a copy of it to also include with your paperwork to insurance. This shows that you have been actively treating the issues that are stemming from the excess skin. I also wrote my own letter to insurance explaining why I was requesting coverage of the panniculectomy & clearly stating why it was medically necessary and not cosmetic. I think these things helped to get me the approval, along with the letter my wonderful surgeon wrote- because it's well known that UHC does not like to cover plastics- even those deemed medically necessary by our doctors. Good luck to you! Angela 229/144/134 lap RNY 07/28/04 arms 06/14/05 TT 08/25/05

How did you document it all, other than photos? I have just started itching in fold(s) especially if I get too warm. That starts the rashes. . .or I itch it raw. Plus, as sick as it sounds, if I get too warm the folds get humid and require extra showers. I have tried several OTC creams, lotions and sprays but nada. I see my doctor in June so will start then. Lisa

Hey Lisa: Other than going to the doctor (and having him document my issues in the chart notes of my medical file), I didn't really document anything other than the photos. However, since you said you've been self-treating it with OTC stuff, you might want to start keeping copies of the receipts from the creams/ointments that you purchased just as backup. I would give those receipt copies to your doctor to submit with the rest of the paperwork to insurance too- it can't hurt! Every little bit of documentation you have can only make your case stronger. I have also heard of some people keeping a paper journal of their skin/infection issues and submitting that with their paperwork too. If you do that, make sure you log it by date, what particular issue you are having, and what you have done to treat it. I know what you mean about the extra showers! My fold(s) get all moist and icky too! And stinky ;p heh. So yeah, lots of showers, powder, and a camisole & long girdle to keep everything tucked in and not touching helps while you wait for approval. -Angela 229/144/134 lap RNY 07/28/04 arms 06/14/05 TT 08/25/05

Hey Lisa, You look great we are surgery date buddies....I am hoping to get my TT covered by my Insurance Co and the arm lift wish me luck...... Good Luck with your plastics I hope recovery is quick and pain free...... Cecilia 250/131/1?? Lap RNY 7/58/04