I'm totally confused!!!!!!!!!!

I think my PCP is wack.  I can't believe what he has in my records.   After three years of waiting I am so worried that  I will get denied.   For 6.5 years I have been his patient, we pretty much see eye to eye on things and I have no problem letting him know when I question something that he says.  After the last year of run around with the supervised weight loss I finally finished in November.  Got all the paperwork and then had to wait for the letter from him to send to Rita.   I hadn't even looked at the paperwork or the medical records til day before yesterday. 

OH MY GOSH, first off you may recall that he wasn't writting in my chart about the talks that we were having about the weight loss so Rita sent me the forms for him to fill out,  how hard can that be.  He listed the date, current weight, beginning weight ( he wasn't and still isn't sure if he uses the weight from June or what my weight was the month before), current BMI, if I lost or gained. and the BP, then there are 5 things that he has to answer.  The first is to list the obesity related comorbidities, he listed high BP, cronic back pain, depression and obstructive sleep apena. THAT WAS ALL, what about the rest of the issues and where did he get depression from.  The second block is my current meds, he has 11 drugs listed, some I have no idea what they are and I know that I have never taken ( I take 4 different med dailey).  He has lasix listed and demadex ( both are water pills and I haven't taken the lasix in over a year because they weren't working).  The third block is diet education discussed, he put "lower calorie intake". THAT IS ALL HE PUT THERE, no details as to what we talked about trying and he isn't mentioning that he already has me on a 1500 calorie diet. In the fourth block where it says exercise/Activity education discussed, he put "increase activity as tolerated" NEVER has he said this to me.  For the last block  where is says to list any behavior/diet goals for the patient, he put continue affort to lose more weight....... No where in these papers does he put that the fluxuation(sp) in weight over the past year may have something to do with the major water retention that gets so bad at times that my feet look like balloons.  Now heres the biggy, he put the same thing on all 6 months, word for word, and they all say depression.....  Then I read the letter that he wrote, mind you that I gave him the letter that was in the packet so he would know what they were wanting to know.  He puts his letter that my BMI is over 55, that my comorbidities are hypertension, chronic back pain, obstructive sleep apena and fibromyalgia ( notice nothing about depression), that I have been obese all my life and have tried to lose weight for over 30 years and can't maintain significant weight loss.  Out of the 53 attempts to lose weight and the 23 different things that I have tried he only listed 5 .... But then says that he thinks that I would benefit from the surgery because my medical condition will become life threatening if I don't get my weight under control.   Like my medical issues aren't already life threatening with a BMI over 55, high BP and obstructive sleep apena.....   When I seen this I was so mad that I called his office and told them that I was coming in and I would sit til I seen him.  I waited 3 hours, thankfully  when I got in the room I was calmed down and I asked him about the depression that he listed he said " well some days you aren't as up beat as other times when I see you", I asked him if he thought that I was depressed " no but I don't think it will take much to push you over the edge sometimes".  I asked about the meds that he listed, what they were and what they were for ( the ones that I didn't know) , I clairified with him what I am taking and pointed out that he has listed that I take two differen****er pills which would cause my kidneys to dry up if I were taking them at the same time, he said " oh well I'll have to change that" kinda like cover his own butt type of thing.  I asked him why he didn't follow the letter that I gave him that they wanted from him, he said that he thought that my issues were bad enough that they didn't need all that information.  I just shook my head and walked out.  I will probably get a letter from him next week dismissing me as a patient.

Why didn't I read the papers before I sent them in, because I was so excited that I was finally moving one step closer to the losers bench.  How do I fix or undo what he has in these records that have already been sent?  Am I going to have to prove that I'm not "depressed"? Not that being depressed is taboo or something, but man if you are going to put a lable on me at least make it something that is wrong with me. Do I get depressed about my weight, HELL YES, but NO  I do not suffer from depression.  Am I going to have to go to a shrink for so many months for him to fill out paperwork to say that I'm not depressed?  Has my PCP just put me back to square one?  

I'm sorry that I have now written a book but it sure helps to get this off my chest.  Thanks for letting me vent and please hold a spot for me on the losers bench because God willing, I will be there!!!!!!!!!!!!!!!!!!!!!!!!!!!!

call the dr office & tell the what you need sometimes you have to just put your foot up there well you know lol!!!!good luck

Don't stress too much about the letter from the Dr. I didn't even have one beacuse my PCM acted like she didn't understand why I needed a letter and she gave me a refferal... I called Rita and she said don't worry about it. My packet is at insurance now and I still don't have a letter. As for your medical file, when you go to see the surgeon you have to fill out another form with you weight loss history. I am at University Surgical Associates and that was the first form I filled out. I wouldn't stress. Wait till you get to your surgeon because they will tell you what your file needs to say for insurance. Whip that Dr into shape and tell him you need exactly what you say you need no other... He has no right to say you are depressed and then he hadn't treated you for depression... I would ask him to re-do it,,


And thats my .02 cents.

This all sounds very frustrating and I hate you had to go through that.
But lets wait and see what happens first.
Maybe the insurance will go ahead and approve you.   Think positive :)

In the meantime, I'd try to work with his office - maybe there is someone that types his letters for him.   Get on his/her good side.   Talk to them and show them what is needed.  Maybe they will revise the original paperwork and re-submit - just in case the insurance will require it.

Good Luck and Keep your hopes up!

Leslie

honey try not to worry until you get a rejection notice...
I bet the records alone will be all you need.. not his letter..
Try not to worry... I know its hard...
Dawn

don't beat yourself up, my dr. didn't even send a letter, and I got approved, and he just wrote in the notes that I need to diet and exercise, and wrote down the weight, I think you shouldnt have a problem with back pain, bp. and sleep apnea, good luck, and keep us up to date!!
                                                                                    Lisa