Originally Denied by OHIP for Pannilectomy...... after Appeal OHIP reversed decision

kellybelly333
on 10/12/12 2:58 am - Toronto, Canada

Thanks for that! I have applied for a panni, and the doctor said that it's getting very hard to get approved for people like me (and I guess you) that are borderline.

Yes it looks icky, but most importantly is the back pain i get when I run. Followed by the rashes. Most people would say why bother running? Well, for me, I have a new-found love for running, and did buy some gear to hold me in. I figure it's for my health to run, so I want to. I would like to without pain and rashes.

A panni (I don't believe) will make me look fabulous in a bikini by any means, I just want it off so I can feel a little more normal.

Fingers crossed for me!!!

Surgery March 23/2011. Completed three full marathons and two half marathons, two half Ironman distances. Completed my first Full Ironman distance (4 km swim, 180 km bike, 42.2 km (full marathon) run) in Muskoka August 30/2015. Next Ironman Lake Placid July 23/2017!

Mary A.
on 10/12/12 4:03 am

On October 12, 2012 at 9:58 AM Pacific Time, kellybelly333 wrote:

Thanks for that! I have applied for a panni, and the doctor said that it's getting very hard to get approved for people like me (and I guess you) that are borderline.

Yes it looks icky, but most importantly is the back pain i get when I run. Followed by the rashes. Most people would say why bother running? Well, for me, I have a new-found love for running, and did buy some gear to hold me in. I figure it's for my health to run, so I want to. I would like to without pain and rashes.

A panni (I don't believe) will make me look fabulous in a bikini by any means, I just want it off so I can feel a little more normal.

Fingers crossed for me!!!

when it effects your quality of life then it's most certainly health related and NOT cosmetic, just make sur eyour rashes and pain are documented by your doctor, that was the major key point that did not have to back up my appeal...and if it's a rash and there is pain or an yeast type infection involved do NOT treat it yourself...something else I also did.

You mentioned doctor...do you mean plastic surgeon??? just wondering because a GP for the most part has no training in this type of procedure or submisison. Hopefully the person that you went to is thorough and can give you pointers. LIke i mentioned there are three clear criteria set out by OHIP...if you feel that you fulfill those requirements and if by chance you are denied if you believe you could proove your case to the Health Services and Appeal Board....do it..you have nothing to lose.

All the best

prior to surgery 323lbs....4 years post-op maintaining between 108- 114 lb loss.

life is AMAZING when you continue on the right path~!. Use your surgeons gift to the fullest~!

Mary
surgery done in Duluth, MN

niceeyes72
on 10/12/12 3:09 am

RNY on 03/23/12

That is terrific!!! Congrats!!!

Tam
Highest Weight: 365lbs Clinic Weight: 325lbs Clinic goal:190 lbs Current Weight: 176.4lbs My goal:165lbs
Surgery: Dr. Yelle Ottawa on March 23, 2012

mermaidz
on 10/12/12 3:25 am - Brampton, Canada

Congrats... and especially for holding on to it and sticking it out!

Growing old is mandatory. Growing up is optional.

merly6800
on 10/12/12 3:39 am - Canada

VSG on 07/02/09

Congratulations! I'm glad everything worked out for you!

Megan M.
on 10/12/12 5:49 am - Canada

RNY on 07/22/11

Wonderful news! Any idea when it'll be done? We're going to send in my referral in January, from the bariatric clinic, and hopefully I'll not have to go through what you have gone through.

Had RNY surgery July 22/11, St. Joe's Hamilton, with the awesome Dr. Scott Gmora. Had abdominoplasty August 2/13, Scarborough, with equally awesome Dr. Michael Kreidstein.

Mary A.
on 10/12/12 6:12 am

I just got the letter yesterday and at the moment have another upcoming surgery on Dec 5, so I have to investigate if OHIP's offer has an EXPIRY date.

Didn't know that TBAY bariatric now does the necessary stuff for the above...did you have a consult with a plastic surgeon do the report???

I hope you don;t have to jump through the hoops...all I can say is it is worth it if you get the approval...

prior to surgery 323lbs....4 years post-op maintaining between 108- 114 lb loss.

life is AMAZING when you continue on the right path~!. Use your surgeons gift to the fullest~!

Mary
surgery done in Duluth, MN

(deactivated member)
on 10/12/12 6:20 am - Bumfuknowhere, Canada

When my sister got OHIP approval for a breast reduction she had 2 years to go through with the actual surgery but that was about 10 years ago so things may have changed.

Congrats on getting their decision overturned.

Mary A.
on 10/17/12 1:47 am

On October 12, 2012 at 1:20 PM Pacific Time, Tracey 112205 wrote:

When my sister got OHIP approval for a breast reduction she had 2 years to go through with the actual surgery but that was about 10 years ago so things may have changed.

Congrats on getting their decision overturned.

thanks a bunch Tracey I will call them prior to pulling my appeal notice

prior to surgery 323lbs....4 years post-op maintaining between 108- 114 lb loss.

life is AMAZING when you continue on the right path~!. Use your surgeons gift to the fullest~!

Mary
surgery done in Duluth, MN

Megan M.
on 10/12/12 8:34 am - Canada

RNY on 07/22/11

They actually send the request from the bariatric unit down to SO - there are 3 surgeons that we are dealing with - Dr. Nandagopal, Dr.Tang, and one other whose name escapes me. They simply send the referral and then deal directly with the surgeon. Not really sure what happens beyond that. I am having some pretty intense itching, and scratch myself very deeply sometimes, but have never mentioned it to the Dr. b/c I always manage to fix it up myself. I see my GP on Monday morning, so I guess I'll be undoing the zipper for a little looksee. Unfortunately, it doesn't bother me all the time though. I also have an umbilical hernia that I sometimes feel is being pulled by the weight of the panni, so maybe that'll be an important thing. I guess I'll talk to him about documenting this stuff for OHIP. Apparently Dr. Nandagopal has a pretty good record for getting approvals, and I think he's the one I want to go to. My referral won't go down until my next appt in January, so that gives me some time to get some documentation going. Good advice, Mary. Thanlks.

Had RNY surgery July 22/11, St. Joe's Hamilton, with the awesome Dr. Scott Gmora. Had abdominoplasty August 2/13, Scarborough, with equally awesome Dr. Michael Kreidstein.

Originally Denied by OHIP for Pannilectomy...... after Appeal OHIP reversed decision

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Originally Denied by OHIP for Pannilectomy...... after Appeal OHIP reversed decision