I need approval advice please

Had have to concur with the gatekeeper theory of receptionists.  When I went to see my PCP, I had already written the letter based on what I found on OH and dsfacts.com.  She wrote on her prescription pad that she concurred and I taped it to the letter.  The letter had all my WL  history out, even explaining about my need for a revision.  The ds surgeon's office and the insurance company both accepted the letter without a problem.

Hugs!
Ratkity

edited for invisible words!

You're letter of necessity for Dr. Pomp's office can come from any of your doctors.  Mine came from my endocrinologist who I'd only seen twice (I was inbetween PCPs at the time).  Do you have a gynecologist?  Gastroenterologist?  Anyone else?

I will gladly send you to my endo (he's great).  He was actually the one that recommended I have the surgery to begin with.

Start by calling Dr. Pomp's office and saying 'this is my situation, we all know I need the surgery - what do I do now?'  They can advise you. 

Just a hurtle, not a roadblock, k?

You're right - When I wrote this post, I was in a panic.  I couldn't see a way around it.  I heard "No" and panicked.

Don't be surpised if I call you this weekend.  I'm going to put together that letter in Word and maybe run it by you, if you'd be so kind as to listen to my gibberish.

Of COURSE!  I'm home all day tomorrow - call me any time!  If I don't pick up, it means i'm upstairs but leave a message and I'll call you right back. 

We need to make 'get together' plans anyway.

I agree with all of the other suggestions, especially Diana's.  Also, I provided my PCP with a 10 + year history of my weight loss efforts.  It showed how committed I had been to becoming healthy most of my life.  She not only wrote a very succinct and supportive letter, but she included my history letter as well.  She was the one to suggest WLS in the first place and had never heard of the DS and at first suggested the Lap band.  After I came back and told her about all of my research and the failure rates of Lap band, she was completely on board!  This is just a minor road block!

O boy! I agree that this sucks. I agree with everyone when they say type it yourself put what you need in it and hope she will sign it. You can also try other docs as well. I typed it for my pcp, faxed it , and asked him to sign and fax to the surgeon and he did. Much easier for them that way. I really don't think she can talk a surgeon out of operating on you when he prob as already done tons of lap band revisions and know how many patients have failed with it.  He knows first hand...she don't. I'm sure it will work out.

I says she is saying no because it is too much work for her. Write you own but have Dr. sign.  I did at the advice of everyone, seemed to work for me.  
I can't take full credit for the letter I think It merge of a few that  read and with my own twist. 
 I had luckily seen the Dr. enough where she did a simple print out of my weight for 5 years with it , Best of luck.

DATE

 

Name: 
DOB:

 

 

 

To Whom It May Concern:

 

YOUR NAME has been a patient of mine since DATE. She had her first appointment with me to start a medically supervised diet. She is morbidly obese with a BMI of ?. 

 

To improve NAME quality of life I feel she would benefit from weight loss surgery.  Please consider this as her number one option.  She has attempted weight loss through diet and exercise numerous times in the past 26 years. She also had tried ( LIST OF EVERYTHING YOU TRIED example: drugs (phen/fen), hypnosis, Weigh****chers, Nutrisystem.  She has never been able to keep the weight loss off.  She has struggled with obesity since age of 10 years old and is currently 36 years old.

 

I suggested weight loss surgery to her in 2005.  NAME advised me she started seriously considering weight loss surgery in July 2008.  She has researched multiple procedures. We have decided together that the Duodenal Switch (DS) would be the best weight loss surgery option for her. Duodenal switch packs a one-two punch against obesity. It does so by combining two surgical techniques: restrictive and malabsorptive.    She has shown to be proactive in her research options, including displaying knowledge of the possible complications, side effects and changes required after surgery.  She has attended bariatric seminars and also communicated with people who have undergone bariatric surgeries of many types.  She has a strong support system of family, friends, and coworkers in place to further increase her chances of success. She has read many weight loss surgery books written by both doctors and patients.

 

NAME: has arthritis and chronic pain in her weight bearing joints whi*****ludes her hips, back, feet, knees, ankles. She is at risk for developing many more chronic medical problems if this obesity is not addressed. Eventually, joint replacement surgery may be needed to relieve the severe pain.  Joint replacement has much poorer results in the obese. Many orthopedic surgeons refuse to perform the surgery in severely overweight patients. The permanent weight loss of weight loss surgery will markedly decrease problems with arthritis and the ever-increasing expenses to the insurance company that will surely follow. 

She also has hypetension which leads to development of heart disease, and damage to the blood vessels throughout the body, causing susceptibility to strokes, kidney damage, and hardening of the arteries. If hypertension is not under control, many complications can occur as a direct result of continued high blood pressure. The weight loss attained by weight loss surgery will cure hypertension.

 

 

Lastly she suffers from stress incontinence and has to wear protective pads at all times. A large heavy abdomen, and relaxation of the pelvic muscles, especially associated with the effects of childbirth, may cause the valve on the urinary bladder to be weakened, leading to leakage of urine with coughing, sneezing, or laughing. This condition is strongly associated with being overweight, and is usually relieved by weight loss.

 

In summary, weight loss surgery is necessary and reasonable for my patient.  Please contact me if additional information is needed to ensure the prompt approval of this surgery.