Question:
What more can I do to get my arms approved for reconstructive surgery?

My insurance has approved me for reconstructive surgery for my breasts, stomach and knees. They denied my arms saying the photos did not show evidence of functional impairment, clinically significant redundant tissue or secondary yeast infection. The plastic surgeon's office said they already said everything they could. I've asked my dematologist to submit a letter regarding the rash under my arms. I don't know if he will do it or when. I am faxing a letter to the insurance co. saying the photos did show the rash. I have the same problem under my arms that I have under my breasts, stomach and bends of my legs. Soap burns it (as does plain water), it stinks no matter how often I cleanse it, it hurts from the infection, is very diifcult to shave due to the rash and my arms ache from the hanging skin. I have been treated for sensitive skin for years and break out easily. The rubbing hanging skin exacerbates the situation. The dermatologist has me using 2 different creams. If they had to carry around the extra hanging skin, it would seem like a significant amount of redundant tissue to them. What else can I say or do to be approved?    — jan M. (posted on February 26, 2003)

February 26, 2003
Forst of all take more pix before you clear up the rash. The best tried and true method of getting rid of that awfull smell is to use a removable shower messager head so you can get a good direct stream on it and use Liquid antibotic soap, and dry real good and use PURELL liquid hand sanitizer it burns like he**, but trust me it WORKS. It will kill the bacteria that is causing the smell if you use it morning and night for a couple of days it will go away. if it burns too bad add it to the soap or dilute it with water and gradually make it stronger. :0)
   — wizz46

February 26, 2003
Forst of all take more pix before you clear up the rash. The best tried and true method of getting rid of that awfull smell is to use a removable shower messager head so you can get a good direct stream on it and use Liquid antibotic soap, and dry real good and use PURELL liquid hand sanitizer it burns like he**, but trust me it WORKS. It will kill the bacteria that is causing the smell if you use it morning and night for a couple of days it will go away. if it burns too bad add it to the soap or dilute it with water and gradually make it stronger. :0)
   — wizz46

February 26, 2003
Take some clear pictures of your underarms. Don't happen to have a rash right now? Whereever you normally get your rash, take a harsh rag or washcloth or those brown paper towels you get in a rest room and rub thoroughly. You'll get a nice redness that should do the trick when taking some photos. Don't overdo it though or it will look fake! Good luck!
   — Lynette B.

February 26, 2003
Lynnett, watch out about giving advise that borders on the line of insurance fraud.
   — Sarah S.

February 26, 2003
I am still pre-op, but my thought was also along how clear the pictures were. If you have a camera that puts a date on the pictures, I would take pictures every time you have the rash. I'd also suggest journaling. It's a long shot, but at least it's a shot. You won't be able to get them done along with the rest, but hopefully they'll get the picture (no pun) and understand it is a recurring and painful issue. OR...what would the doc charge if you had it done at the same time as the others? Is that an option?
   — Diane S.

February 27, 2003
Everything you just said above needs to be put in a letter to the insurance company by you. Send a letter from your dermatologist. If you don't think he'll send it, ask him for a copy for your files. That way he HAS to write it. Then send the letter in yourself. Have them take pictures where it shows the rash and send those pictures in. I pulled the skin on my upper arms to show how much excess skin I actually had and made the doctor take a picture of it. YOU need to be your own advocate for your health care. Stay on top of the doctors and get copies of the letters and pictures that they send so you can make sure there saying and sending in the right things to get your surgery covered.
   — Patty H.