HCW denied my surgery

[Hollyhunny]

Talked to HCW today, they said they heard my case (AGAIN) last week. They have denied me because my sleep apnea is not severe enough. Which is funny because my doctor who diagnosed me and is treating me for it seems to think it is. For example the points system they use, 15 may be mild, 20 moderate, and 30 is classed as severe, well I tested at 65!!! I have a copy of the criteria they use to decide if you qualify for this surgery and I tick all the boxes but still they say no. Anyone ever appealed a surgery denial decision? PS I went to my GP about dr haboubi and as far as i can tell i am on the waiting list which happens to be 10 months now
im not happy- sigh:cry:

 

[dreamofbeingslim]

Aw Hollyhunny I really feel for you. Can your gp do anything for you eg talking to the pct. Has your pct seen the copy of your sleep apnea test? I don't know how many times you are allowed to appeal but maybe somebody different could fight your corner for you. Do you see any other doctors for any other problems? Try and get as many as you can involved. I have everything crossed for you. I am waiting for funding too. I have been waiting since Christmas and was told a decision would be made last Friday but when I rang no decision had been made. Apparently they want more info from my clinician. I don't know what but I hope they hurry up and say yes.

 

[fat-girl-slim08]

I'm so sorry to hear this and its just not fair, I don't really have any advice as I went Private for my Op, But if I was you I would appeal again and get your dr to write something up for you about the sleep apnea, Really sorry I'm not much help, But good luck and (((Hugs)))

 

[quetiapina]

Oh Holly, that is totally unfair and ridiculous. They are putting your life at risk if you have such severe sleep apnea. Dr Haboubi has asked me to talk to our local health board re. WLS at a meeting he has arranged for tomorrow to try and get them to accept that it is a vital area of surgery that Wales fails to provide.
It is so SO unfair and I feel for you, I really do. It is totally wrong. What is your BMI by the way, I could bring up your case as an example of the danger people are being put in by a general ignorance and refusal to help in any meaningful way.
Kind regards to you

Jenni x

 

[Hollyhunny]

Hi jenni,
thanks for listening. My bmi is like 56
this has been an ongoing fight with my referral since oct 2007. it seems to be HCW's job to find everything they can NOT to approve surgery.I have a folder of all the correspondence,i have just requested a full and complete copies of my medical records and am getting ready to go to war with these people.

 

[quetiapina]

Hi jenni,
thanks for listening. My bmi is like 56
this has been an ongoing fight with my referral since oct 2007. it seems to be HCW's job to find everything they can NOT to approve surgery.I have a folder of all the correspondence,i have just requested a full and complete copies of my medical records and am getting ready to go to war with these people.

Good for you, sock it to them you well and truly fulfill the criteria and as you are well organised I think you will probably win through in the end. Keep us updated, it is important for people in Wales to know what to expect and what to do in order to fight this cruel attitude Wales has to WLS.
The very very best of luck to you x

 

[Snowcrystal]

Hi there

I'm sorry as I can't really advise you on this also...But Jenny has a good chance of getting things heard for you.

The only other thing I can think of is lobbying parliament to change this post code lottery.....It's ridiculous....we all pay the NI contributions (regardless of employment or not) so therefore we should get the same blinking treatment in all of our hospitals.

It's really pidling me off lately (sorry for the rant) when I read some of the stuff on here about the way people are treated....

The whole system is riddled with hypocrisy.....Each PCT has their own criteria for WLS and to be honest most of them want you to be in the deadly upper regions of obesity to meet this criteria...however when you meet it you are sometimes deemed not fit for surgery.

It seems you have to put your life at risk to get surgery in order to try and have a healthy and productive life....I mentioned this to my GP the other day as I am desperate to start losing some weight on my own but so so afraid that I will be turned down if I do.

It's about time a petition of some sort (not just about WLS) to make sure we are all treated fairly in the United Kingdom with our NHS....Even this 18 week rule is a farce...I liken the 18 week rule to getting 'Life' imprisonment when we all know really that life can be as little as three years.

whatever you decide to do...I wish you all the luck...use the evidence you have and don't let them wear you down.

~hugs~

 

[Hollyhunny]

I give up. My GP doesnt know what's going on, the HCW dosent know what's going on, I am constantly trying to keep everyone updated on who said what! what are my medical records for? I saw my sleep apnea DR and she sent HCW a letter stating yes my patient does have SEVERE SLEEP APNEA and the test results we already gave you said that as well. I have a copy of the criterion from HCW and I meet all three: high BMI, diabetes and severe sleep apnea. What is their excuse now for denying my surgery?

on another note, is there anyone in Gwent area,Blackwood,Newbridge,Crosskeys,Risca or Abercarn that is interested in getting/being/becoming an exercise buddy? I am physically incapable of doing anything on my own, I am really embarrassed/humiliated in myself to be seen doing anything in public but I think if I found someone or someones who wants to get out and have a walk and a chat at the same time would help us both greatly.

I made my husband and two kids 5 and 2 go for a half hour walk sunday night, yes I had to stop for a minute a couple times just to sit and rest my back, the kids loved it, they have soooooooooo much energy, husband felt like he was being punished, so he isnt necessarily TEAM HOLLY which hurts.. so where else would I post this invitation for my exercise buddy idea??? thanks

 

[Meggie]

Sorry to hear this hun!! I can't offer any nuggets of brilliant info but just wanted to wish you luck!!!!

 

[hayley1983]

Awww Hope you get sorted soon

xxx

 

[thinkbethin]

Keep fighting your case!! Don't give up and get the doc who's treating you to send them a letter. Good luckxx

 

[Antony]

If you have a BMI >50 you qualify for bariatric surgery under NICE guidelines, which I believe are now legally binding. The 'post-code lottery' is no longer in existence, following the Darzi Report, which sets out NHS guiding principles for the next 10 years. You need to contact your primary care trust, and ask to speak to the patient guardian/liason (the person who handles patient complaints). Explain your case, mentioning you meet NICE guidelines for the surgery, and ask him/her to investigate and to send you a copy of the patient pathway for bariatric surgery. Most PPs will say a patient with a BMI >50 or BMI >40 with further health complications (Diabetes/Sleep Apnea/CVD/CHD/etc) qualify for surgery without a requirement of exhausting all other weight loss avenues.
Hope thats of help.

PS What does HCW stand for?

 

[Antony]

Just realised, HCW stands for Health Commission Wales. Didn't realise you are over the border. That may affect the advise I just gave. GIG may not have to follow NICE guidelines, I don't know... But ask to see the patient pathway anyhow.
Nos da cariad!