Feeling discouraged

[STLoser 1,087]

I have lost over 200 pounds. WLS was excluded from our insurance when I had it done, so I paid out of pocket, which I had to dip into my 401k to do. As is the case with most people who have lost a lot of weight , I have tons of loose skin. I'm cool with most of it, except my pannus, because it's uncomfortable, out of proportion to my body causing my clothes not to fit right, and I have rashes and always have to use powder. panniculectomy is normally covered under the insurance we have so I saw a surgeon and was pretty excited at the thought of possibly having this large amount of lower stomach removed. I was prepared to hear that I didn't qualify or whatever.I was prepared to may maybe have to repeal a rejection. I was NOT prepared to hear that it was EXCLUDED from our plan. Now of course, I should have checked myself, but I didn't even think to since often times this surgery is medically necessary. I stupidly assumed it wouldn't be excluded. Stupid me.

I am so angry and bummed about this. I feel like I've done all this work just to be left with this bowling ball hanging from my body, and since I wiped out half my 401 it's not like I can pay out of pocket again. I'm not asking for a total body makeover or even for my body to look good (it does not lol). I'm 51 years old and my most attractive days are far behind me. I was never in this for looks. I just wanted to have my life back and feel good and be active and have a chance to live longer. I just want this discomfort removed and I don't think that's too much to ask. I have a skin condition called hydradenitis supparativa that really can't be fixed except by removing the affected area and under my stomach is where it's the worst. I'm tired of living with this awful skin condition. I've had it for like 30 years now, but it became much worse as my pannus grew.

I'm scared to death I'll gain all my weight back and I know people who do skin removal have a better chance of not gaining it back.

I'm just so frustrated and angry and probably rambling about this but I had to vent.

I'm feeling sorry for my self too and thinking how unfair things are which I know, as my mother always told me, life is not fair. But that doesn't mean I should have to be ok with that!

Anyway. Thanks for letting me vent. My husband, always the optimist, did make me feel somewhat better but I knew people here would also understand.

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[kcuster83 1,503]

CONGRATULATIONS ON YOUR LOSS!

Sorry, insurance sucks!

You mentioned a husband, are you on his insurance or him on yours?

Is it possible to look into the other persons insurance and maybe switch over if it is covered under the other's plan?

Just a suggestion.

Edited September 27, 2022 by kcuster83

[KimA-GA 540]

i have a very minor case of HS (armpits only, occasional with minor tunneling which heals and a little bit of scarring), i can’t imagine the issues you have with it more severe…

have you talked to your derm about getting the pannus removed due to the HS? sometimes it’s all in how it’s coded, not what is actually done

[Spinoza 1,235]

That does feel really unfair. Is there no way it could be considered skin removal primarily to treat your medical condition and, if so, could the surgeon call it something else? I'm sorry I don't know anything about how insurance works. I'm so sorry you've been left with this after all your hard work. Absolutely amazing loss.

Edited September 27, 2022 by Spinoza
typo

[Spinoza 1,235]

1 minute ago, KimA-GA said:

i have a very minor case of HS (armpits only, occasional with minor tunneling which heals and a little bit of scarring), i can’t imagine the issues you have with it more severe…

have you talked to your derm about getting the pannus removed due to the HS? sometimes it’s all in how it’s coded, not what is actually done

Ah - Kim just said exactly the same thing except in five fewer sentences

[SleeverSk 627]

I agree with the others you should be able to get it done as you suffer a medical condition. Are you being treated by a specialist? if not maybe look into that and have them document how long you have had the condition and that surgery is necessary. Good Luck

[STLoser 1,087]

Thank you everyone. I don't know what I'd do without this board and everyone's support! I really appreciate all of your comments and suggestions. I haven't seen a specialist for this in years because nothing ever really seemed to help it, so I just kind of learned to live with it. Maybe it's time to go back so I at least have that record. I have had other infections that my pcp has treated so there is a record of that.
As far as insurance, right now there is not option other than my husband's. I'm holding out hope they'll change it. In 2020 when I had my wls it was excluded, but my husband just had his wls done in May and they cover it now. So I won't give up.
I know in time I could pay out of pocket if I have to, but since I'm not getting any younger I'd like to do it asap.
But now that it's later in the day I've had time to think and put things in perspective and I do believe everything happens for a reason. It's just not meant to happen at this moment, and I'll be OK.
Regardless, my life is infinitely better than it was 2 years ago, and even the hydradenitis is better than back then.


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[STLoser 1,087]

I should clarify that I have had other infections in this area that my Dr. Has treated.

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[loli_lotus 64]

I'm currently in a drug study for HS, the research is gaining a lot of steam now so maybe you can find a dermatologist in your state that can vouch for you.

[summerseeker 1,923]

I have had HS for so long. I was never told what it was called, I just thought it was the same as my father suffered fr. In my late 30' s and early 40's I suffered with stress and depression, and it seemed to make the condition so much worse. Use every avenue to get your surgery. Good luck