DENIED!! DENIED!! crosspost
Hi
I was turned down today by my provincial health care provider for the vsg. They (OHIP) turned me down a few months ago for the ds.
I started this wls journey last summer with an unsupportive PCP, and that hasn't helped (I can just hear him saying today "I told her she wouldn't get this"). I applied initally for the DS and hoped to get it. I was then turned down - not fat enough - I couldn't believe it- and I appealed. I withdrew my appeal because I thought, and others thought, that the vsg would be a better fit for me. I didn't apply for the RNY because I take ibuprofen daily for my back.
Here are the reasons that I wanted the wls/vsg
* I am 58 f-ing years old and my body is beginning to break down (knees, back, etc) from years of carrying around too much fat
* I am 58 f-ing years old and want to have wls before I am too old or my body breaks down to the point that it is not feasible
* I am a breast cancer survivor and realize that the probability of cancer returning is higher if I remain fat/obese. I am one of 3 sisters who have been diagnosed with breast cancer - it is rampant in my family and I am afraid of its return.
* I have had degenerative disc disease for years and can barely get myself into my employer's front door on some days and know that the extra 80-90 lbs. makes my back much worse than it would be at a better weight. I teach, so I stand for much of the day and it is hell.
* I was involved in an accident when I was 7 (in 1958!!!) and my right foot is twisted at both the ankle and the pad just before the toes - walking is hard at any time, but on 240 pounds, the pain is mind numbing
* I come from a family that has suffered from heart disease - my mother had her first heart attack when she was younger than me and half my size
* I WANT MY LIFE BACK!!!!!!!!!!
Sorry. I am frustrated and beginning to believe that I won't be able to work much longer unless I can get this weight off permanently. I am divorced and there is no one who will pull up the slack should I not be able to work.
I have already been referred to the MIS group (in Toronto - but it takes up to 2 years to get into a bariatric operating room here in Ontario) and am waiting for an appointment, but I'm not holding my breath. I realize that we all want to have wls yesterday, but I believe that I am pretty much at the end of my rope, and I am scared that it will never happen, and that is a very dismal thought for me to have. I am 58, for God's sake. Pretty soon it will be now or never.
I will probably appeal, but I won't count on winning it.
Sorry to be such a downer today. Thanks.
Margaret
I was turned down because "... has a bmi of 37.9 and does not have any significant comorbidities. Therefore she does not meet the criteria." all I can say it "BS"
I was turned down today by my provincial health care provider for the vsg. They (OHIP) turned me down a few months ago for the ds.
I started this wls journey last summer with an unsupportive PCP, and that hasn't helped (I can just hear him saying today "I told her she wouldn't get this"). I applied initally for the DS and hoped to get it. I was then turned down - not fat enough - I couldn't believe it- and I appealed. I withdrew my appeal because I thought, and others thought, that the vsg would be a better fit for me. I didn't apply for the RNY because I take ibuprofen daily for my back.
Here are the reasons that I wanted the wls/vsg
* I am 58 f-ing years old and my body is beginning to break down (knees, back, etc) from years of carrying around too much fat
* I am 58 f-ing years old and want to have wls before I am too old or my body breaks down to the point that it is not feasible
* I am a breast cancer survivor and realize that the probability of cancer returning is higher if I remain fat/obese. I am one of 3 sisters who have been diagnosed with breast cancer - it is rampant in my family and I am afraid of its return.
* I have had degenerative disc disease for years and can barely get myself into my employer's front door on some days and know that the extra 80-90 lbs. makes my back much worse than it would be at a better weight. I teach, so I stand for much of the day and it is hell.
* I was involved in an accident when I was 7 (in 1958!!!) and my right foot is twisted at both the ankle and the pad just before the toes - walking is hard at any time, but on 240 pounds, the pain is mind numbing
* I come from a family that has suffered from heart disease - my mother had her first heart attack when she was younger than me and half my size
* I WANT MY LIFE BACK!!!!!!!!!!
Sorry. I am frustrated and beginning to believe that I won't be able to work much longer unless I can get this weight off permanently. I am divorced and there is no one who will pull up the slack should I not be able to work.
I have already been referred to the MIS group (in Toronto - but it takes up to 2 years to get into a bariatric operating room here in Ontario) and am waiting for an appointment, but I'm not holding my breath. I realize that we all want to have wls yesterday, but I believe that I am pretty much at the end of my rope, and I am scared that it will never happen, and that is a very dismal thought for me to have. I am 58, for God's sake. Pretty soon it will be now or never.
I will probably appeal, but I won't count on winning it.
Sorry to be such a downer today. Thanks.
Margaret
I was turned down because "... has a bmi of 37.9 and does not have any significant comorbidities. Therefore she does not meet the criteria." all I can say it "BS"
I'm sorry they are being so pig-headed about this. I had the same comorbidities as you ... degenerative disc disease, arthritic knees, and yes, they were considered comorbidities ... but I wasn't a breast cancer survivor at all. I didn't have diabetes, I did have borderline high blood pressure but nothing else. I was approved (my BMI was much higher ... I weighed 347 pounds two weeks before surgery).
I know if I hadn't had this surgery my back would've gotten worse, my discs would've compressed even more ... my back is bad enough as it is, but I know I have improved my health because of it. Arthritis is a progressive disease, but at least I have helped my knees and back ... I too felt my body was breaking down (in fact, my pain doc told me if I didn't lose weight, I'd be in a wheelchair ... I may still end up there with the knees and back, but at least I've forestalled it a few years).
You must appeal! Fight the *******s. Try for a different surgery if you can. Maybe it's the type they're not approving. I had the RNY even though I knew I couldn't take ibuprofen again ... and still my back is better.
Cancer is rampant in my family too on my father's side ... colon cancer in particular (which is closely related to breast and ovarian, so I have to really be careful with my weight).
Don't give up hope. Fight with everything you have. I understand about being alone ... I am single, live alone, my family is 4 hours away from me. I have to fend for myself too.
I agree with the decision. It's definitely BS
I know if I hadn't had this surgery my back would've gotten worse, my discs would've compressed even more ... my back is bad enough as it is, but I know I have improved my health because of it. Arthritis is a progressive disease, but at least I have helped my knees and back ... I too felt my body was breaking down (in fact, my pain doc told me if I didn't lose weight, I'd be in a wheelchair ... I may still end up there with the knees and back, but at least I've forestalled it a few years).
You must appeal! Fight the *******s. Try for a different surgery if you can. Maybe it's the type they're not approving. I had the RNY even though I knew I couldn't take ibuprofen again ... and still my back is better.
Cancer is rampant in my family too on my father's side ... colon cancer in particular (which is closely related to breast and ovarian, so I have to really be careful with my weight).
Don't give up hope. Fight with everything you have. I understand about being alone ... I am single, live alone, my family is 4 hours away from me. I have to fend for myself too.
I agree with the decision. It's definitely BS
Thanks Eileen. It's good to have people who understand what I'm going through. This is a tough battle to wage on my own. I waited for the letter to come and knew when I had it in my hands that it was a denial. I was on my way to work (I teach) and worried that my bad mood was going to affect my teaching. However, when I entered the classroom, my students, who are in their twenties, were yelling at each other and acting out, so I went right into my teacher mode and forgot for a few hours about the denial. Gotta love my students! LOL
Thanks again Eileen. I think that after I quit feeling sorry for myself, I will pull up my socks, put on my big girl panties, as Margo says, and appeal.
Margaret
PS my big, rescued German shepherd is in my office with me right now. What a relief he and my other German shepherd are to me - I know that you and other animal lovers on this forum can understand.
Thanks again Eileen. I think that after I quit feeling sorry for myself, I will pull up my socks, put on my big girl panties, as Margo says, and appeal.
Margaret
PS my big, rescued German shepherd is in my office with me right now. What a relief he and my other German shepherd are to me - I know that you and other animal lovers on this forum can understand.
Margaret, I am so sorry for the hassle that you are having to go through. It doesn't seem fair at all. Maybe there is another form of the surgery that would be alright for you? Maybe like rny or even the lap band? I know just what you are saying about the degenerative disc problem. I have that and have since I was 26 years old. I think that I would talk to the wls doctor and see what he has to say about this whole thing. I am sure that they have come across this before. I wish you luck and will keep you in my prayers/good thoughts.
I understand just what you are saying about the furbabies. I have felt the same way many many times. They are a big comfort to us in our times of need.
I understand just what you are saying about the furbabies. I have felt the same way many many times. They are a big comfort to us in our times of need.
It's not what you gather, but what you scatter
that tells what kind of life you have lived.
What a drag, Margaret. I'm sorry that you must appeal. I needed to have a BMI over 40 and have at least 100 pounds to lose before approval. You are very close to that. It's a bummer that we have to think this way but maybe the stress of the appeal will bring your weight and BMI into the ballpark. Good luck, my friend.
Carmel Valley Linda
Carmel Valley Linda
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