Letter from PCP for reconstructive surgery

Oct 26, 2007




To Whom This May Concern:







Jdruski has been under my care since 2003.  One of the many presenting problems has been a re-occurrence of cellulitis in her left leg.  She also suffers from lymphedema in the same leg as well as in her groin area.  Each time that I have treated jdruski for the cellulitis, she has had a temperature of 102 degrees, as well as pain in the leg and groin and severe edema in both.   I have prescribed Ciprofloxacin.         . In November 2005 I had strongly urged jdruski to be hospitalized in order to receive intravenous antibiotics, however, we were able to control the infection and lower the temperature after a month’s dosage of                 Ciprofloxacin.   In December of 2005, she again presented with another breakout in both groin and leg area with a tempeture of 102.   At this point I increased the dosage of Ciprofloxacin.     




In January 2006 jdruski discussed the need and desire to have Gastric Bypass Surgery and we began the steps toward reaching that goal.  Jdruski had the surgery in June 2006 and by December 2006 she had lost 120 lbs. and decided to then look into what was suspected as osteoarthritis.  Upon having an ex-ray of both knees it was found that one knee was completely bone on bone.  In order to alleviate the pain that she was experiencing it was recommended that she begin a series of injections that may help her pain and difficulty in walking.  After receiving the first injection, jdruski came to my office again with another breakout both on her leg and groin area along with a high temperature, severe edema and redness in both areas Again she was given Ciprofloxacin.       .




Jdruski will need to have her knees replaced in the near future.  It is in my opinion that with the reoccurring bouts of cellulitis in her groin area that jdruski would best be served in first having a Panniculectomy to remove her very large hanging pannus, in the hopes that this will help to improve the lymph circulation in her groin and leg. 




Jdruski has gone through a very long arduous battle with her weight and continues to struggle with mobility issues due to the excess skin that she is carrying in her pannus as well as severe bone loss in both knees.  In order to have any quality of life, jdruski is in need of this surgery.




Please feel free to contact me for any further information.





Aug 27, 2007



To say my world has just been completely turned upside down, well, OK, not upside down but definitely not in the direction I was planning.  I had my 1 year follow up last Thursday.  I planned on telling the surgeon what my plan was.  I wanted to lose another 50 lbs. (I had lost 200 to date) and then I want to go for my knee replacement.  Being as I still have 120 lbs to go to my set goal, I need to exercise and bone on bone knees just is too restrictive to what I can do.  Understand, I am 52 years old and I would love to have the body of a 20 year old, it has never been a big deal.


Well, the surgeon started by saying he wants me to go and have a panni, within the next 4 months.  Actually he wanted me to start the procedure immediately but I need to build up some time in work.  His plan and it has been his plan since I was 2 months post-op is too remove the excess belly and mons (sp?) to allow me to move better.  Let me mention that I suffer from lymphedmia in both my left leg and now in my pannis area.    So the hopes of this surgery is that the lymph circulation will improve, allowing me less break outs of cellulits and infections    He is also going to repair a small hernia at the top of the incision point.


I don’t know how to feel as this was not the way I thought that it would go.  This is my second panni, I had one several years prior to my GBS (I do some things backwards), so I know what to expect and I am not afraid. 


The surgeon, I love this man, feels that if I went for the knees and got one of my infections, it might travel to the new knees and cause me to have them removed.  OK, that one knocked me off the chair.  He says this is a completely medical needed reconstruction and is 100% sure the insurance company will pay for this. 


I go to see the PS in late October, back to see surgeon in November and hopefully, by the first week in January 2008, I will no longer be swinging in the wind.


Please send good thoughts my way.  I will keep all posted as the time approaches.



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Philadelphia, PA
Apr 25, 2001
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Letter from PCP for reconstructive surgery