Hi all, I'm so excited, I just found out that my appeal of the denial of my panniculectomy was successful, and now my procedure is approved as medically necessary! This is important for me because even though I am only 1/3 of the way to my final goal, my pannus was already quite extended before my surgery, and my weight loss has only exacerbated it - with rashes, back problems, etc. I know I will still need cosmetic surgery when I get to my goal weight, probably a lower body lift, but this will make it a lot easier to exercise and improve my health while I am getting there.

Has anyone on this list had a panniculectory while they were still quite far from their goal weight? Does anyone have any advice for me? Now that it's real I'm starting to get slightly scared, but also excited. I will be so glad to see that ugly pannus gone forever (but probably more skin to be loosened as I continue to lose weight). I will also need that LBL or tummy tuck to tighten the muscles and reposition the belly button as the panniculectomy will not do that.

Sorry to those who asked for pictures that I haven't sent them yet. I ended up with really bad swelling, which turned out to be a rather severe seroma, a pocket of fluid under my skin. My doctor took out a full QUART of fluid on Monday, and another 3/4 of a quart on Wednesday, and I am going back today and probably a few times next week. Plus I am on a dieuretic and antibiotics. So I thought it would make more sense to wait until after the swelling settles down to take my official "after" picture. So I will probably take a picture this weekend or next week and then send them to you. Kathy

Kathy, so sorry about your seroma, that is a lot of fluid to lose....are the giving you IV fluid or are you able to keep up by drinking? I will say a prayer for your speedy healing tonight, if you don't mind.

Mimi

No, no IV fluids to replace the Fluid taken out. He took another 16 syringes out today. That's another full quart. So far he has taken out almost three quarts of fluid from my belly, not to mention the extra fluid that I have peed out from the dieuretic. But my lower belly is starting to look again like I remember it looking right after the surgery, almost sort of flat-ish (not to be confused with the flatlands, these are still wildly rolling hills by comparison, just not rugged Alpine peaks any longer, LOL)

I go back next Wednesday for another withdrawal. Thank goodness my plastic surgeon's office is only a 10 minute drive away. And as a bonus, I have had lots of free consult time. It takes quite a while to suck a quart of liquid through a 12 guage needle! So I have been able to pepper him with lots of plastic surgery questions, LOL!

Mimilou, to more directly answer your question, I don't think it is necessary to replace the fluids lost, per se. This is Fluid that the body no longer needed, it just had no way to get rid of it. It would be the same as if I had been able to keep my drains in longer. Instead of draining out of me, the fluid built up inside me. My doctor didn't give me any special instructions about drinking liquids, but he did tell me to stay on a very low-sodium diet for the next few weeks.

However, any and all prayers are always gratefully appreciated.

Kathy

Kathy, you are a hoot.....I love how you write and your good spirits. Makes me know that if it happens to me it isn't the end of the world or a failure on the doc's part. Please keep posting.

Mimi

Well, I didn't want to get to pointing fingers really, but I do think that there was somewhat of a failure on the doctor's part. I am now convinced that I had the beginnings of this seroma three weeks ago at my last appointment, but he didn't catch it because it was underneath all my fatty peaks and valleys. It was only plainly noticeable to him (and me) once it got so severe. Even today when he looked at my belly before he started he said something like, oh yes, this is looking much better, not much Fluid in there now, probably just 2 or 3 syringes, this will be your last seroma visit... Then even he was surprised as the fluid kept coming and coming and coming... We haven't hit bottom yet because 16 syringes (2 oz each, 1 quart total) is the most he will take out at a time.

So the saga continues. But it is causing me no lasting ill health effects, no lasting skin damage, no pain, very little discomfort (now), and only a moderate level of inconvenience, so it isn't too hard to laugh in the face of this one of life's little trials...

Kathy

I am covered under Blue Cross/Blue Sheild Federal Insurance Plan. I am in need of a tummy tuck and the panni thing. I do get rashes from time to time but never seen my Dr. about this. I always took care of it. I do have lower back problems called Lumbago and that the Dr. did put in my medical records. I also have a big problem with pain in the very lower spine area to where it hurts by just sitting down and when I get up to stand I ahve to go slow because of the pulling and the pain. I just wonder if I could get approved or not? I am over 2 years post surgery and I have lost my weight and I was told that I have been in the maintance phase for about 19 months. I lost my weight quickly and have kept it all off and I exercise daily. Any thoughts or ideas that might help me out. Thanks

I really can't give you any advice except to say ask your plastic surgeon what he thinks your chances are of getting insurance to cover it. One thing I would recommend you do is every time you see your primary care doctor make sure you mention problems with rashes and get him/her to make notations about this in their notes. Because that is a key part of the documentation. If you are quietly taking care of it yourself, then you won't have the documentation you need. On ther other hand, it could be argued that a rash which you can quiety take care of yourself does not need surgery to correct it. I know I had to submit photos of my rash and the pannus from various angles so insurance could judge for themselves how serious it was. Part of the criteria is how low the pannus hangs also. Your plastic surgeon is your best resource on this. Kathy