yorkiegal
Baxter's mum
I'm not going to send my letter until I've run it by the surgeon but would appreciate any advice from you all. I'm worried that my reasons are too emotional. The pct generally only hears appeals if they are based on a change in clinical need, a mistake in the original funding request, an appeal on ethical or moral grounds or the assessment of opportunity/costs balanced against evidence are considered incorrect. Not sure what that last one means.
Anyway here goes. I pinched a bit at the start from another appeal letter here on the site so thanks for that lol.
Dear Sir/Madam
Thankyou for your prompt response to my request for funding for weight loss surgery. I am however, understandably disappointed at your refusal and wish to appeal against the decision. My main reason for appealing is that I feel you were perhaps not fully aware of the reasons behind my need for weight loss surgery and the effect that not having surgery will have on myself and my family. I have added below, other relevent evidence which I hope may strengthen my appeal.
Side effects of medication: I have suffered from depression and anxiety for many years now and have been diagnosed as having borderline personality traits. I’ve worked very hard during therapy to conquer my mental illness, but it is only since I began taking Quetiapine Fumerate that I have finally been able to stabilize my moods. This medication works extremely well for me and I will be taking it for life. Unfortunately 2 of the major side effects are weight gain and fatigue. I have gained over 3 stones in weight since I began taking the medication 3 years ago. My cholesterol levels are also increasing. The fatigue adds to the problem as it makes it difficult to stay active. An alternative medication is not an option as the other anti psychotics in this class also cause weight gain. So as you can see, I am at a serious disadvantage when it comes to losing weight.
Physical symptoms of obesity: I am in near constant pain from my knees and ankles which I feel can be directly attributed to my weight problem. I can no longer get out of the bath unaided and find it difficult to perform simple tasks such as putting on a pair of socks or doing any housework which involves bending. I easily get out of breathe, my posture is bad with the weight causing my knees to turn inward and prevent me standing flat on my feet. I also have bladder incontinence which is getting worse. I live alone so this makes it very difficult to keep on top of things and I worry very much about how I will cope in the near future if my general health deteriorates.
Lack of self confidence and low self esteem. Over the years I have had varied types of counselling and psychotherapy, including a year of full time therapy at a therapeutic community. Whilst this has helped immensely with my mental health issues, along with the medication as I mentioned previously, I have still lacked the confidence to find and remain in work. My weight problem has been ongoing since I was in my teens and I have been morbidly obese for around 18 years. Whilst my weight and eating disorder were initially a symptom of my mental illness, I now find myself in the position where my weight has now become a cause of my mental distress. I feel trapped by my weight and unable to socialise or to face the prospect of even a job interview, let alone actually go to work. At my last job as an assistant manager at a charity shop, I was too unfit to cope with climbing the stairs or even just standing for more than a few minutes, and therefore had to quit.
My role as carer to my father and stepmother: My father is terminally ill with cancer and my stepmother is elderly and infirm. As the only one of my siblings who does not have the responsibility of childcare and work commitments, it falls to me to take care of my parents. My father increasingly needs more help and this situation will only worsen over the coming year. Although his diagnosis is terminal, he is still having treatment and will hopefully be with us for several years. Whilst it would be possible to apply for help from social services to attend to them both, they are very reluctant to have strangers caring for them and I need to be fitter and healthier so that I can help them both continue to live independently at home. At present I find it very difficult to cope with the everyday tasks they need help with, such as housework, because my weight makes me feel so tired and my back and legs hurt so much. I worry that tasks such as lifting my dad in the future will be impossible without my losing weight.
My commitment to having the surgery. I have spent £1800 on private cbt therapy this year following the request of the bariatric team that I have treatment to deal with binge eating. The therapy has been very successful in that I am much more able to prevent myself overeating in response to emotional stress. It has also helped to prepare me for any possible dips in mood which are common in the months post surgery. I feel this shows my strong commitment to having wls. I am living on disability benefits and spending this amount of money on therapy was very difficult but I was determined to prepare myself as much as possible for the surgery. I had hoped that the therapy on it’s own might even be enough to help me lose weight without requiring surgery, however this hasn’t proved to be the case. I am so overweight now that just following a normal healthy eating plan is not enough.
Previous attempts at losing weight. I have a tendency to be able to lose weight very quickly over a short period of time, but am unable to keep it off. Each time I regain the weight and more. I have tried appetite suppressants, weightwatchers many times, slimming world, atkins, and most recently, Lighter Life where I lost 3 stone but regained 4. I am very aware of what I should be eating and try my best to stick to a healthy diet, but become demoralised because I have so much weight to lose. I firmly believe that a gastric bypass is my last and only chance at losing weight and becoming healthy.
If you were to approve this procedure you would be allowing me the chance to become a productive member of society who could contribute economically rather than living on benefits. Without this operation I fear that in the near future I will only cost the NHS more as I develop comorbidities. I do qualify for surgery under the NICE guidelines and would ask that you reconsider your decision in view of that and the above points I have made.
Thankyou for taking the time to read this letter. I hope very much that I will hear from you soon with a favourable outcome.
Kind Regards
Anyway here goes. I pinched a bit at the start from another appeal letter here on the site so thanks for that lol.
Dear Sir/Madam
Thankyou for your prompt response to my request for funding for weight loss surgery. I am however, understandably disappointed at your refusal and wish to appeal against the decision. My main reason for appealing is that I feel you were perhaps not fully aware of the reasons behind my need for weight loss surgery and the effect that not having surgery will have on myself and my family. I have added below, other relevent evidence which I hope may strengthen my appeal.
Side effects of medication: I have suffered from depression and anxiety for many years now and have been diagnosed as having borderline personality traits. I’ve worked very hard during therapy to conquer my mental illness, but it is only since I began taking Quetiapine Fumerate that I have finally been able to stabilize my moods. This medication works extremely well for me and I will be taking it for life. Unfortunately 2 of the major side effects are weight gain and fatigue. I have gained over 3 stones in weight since I began taking the medication 3 years ago. My cholesterol levels are also increasing. The fatigue adds to the problem as it makes it difficult to stay active. An alternative medication is not an option as the other anti psychotics in this class also cause weight gain. So as you can see, I am at a serious disadvantage when it comes to losing weight.
Physical symptoms of obesity: I am in near constant pain from my knees and ankles which I feel can be directly attributed to my weight problem. I can no longer get out of the bath unaided and find it difficult to perform simple tasks such as putting on a pair of socks or doing any housework which involves bending. I easily get out of breathe, my posture is bad with the weight causing my knees to turn inward and prevent me standing flat on my feet. I also have bladder incontinence which is getting worse. I live alone so this makes it very difficult to keep on top of things and I worry very much about how I will cope in the near future if my general health deteriorates.
Lack of self confidence and low self esteem. Over the years I have had varied types of counselling and psychotherapy, including a year of full time therapy at a therapeutic community. Whilst this has helped immensely with my mental health issues, along with the medication as I mentioned previously, I have still lacked the confidence to find and remain in work. My weight problem has been ongoing since I was in my teens and I have been morbidly obese for around 18 years. Whilst my weight and eating disorder were initially a symptom of my mental illness, I now find myself in the position where my weight has now become a cause of my mental distress. I feel trapped by my weight and unable to socialise or to face the prospect of even a job interview, let alone actually go to work. At my last job as an assistant manager at a charity shop, I was too unfit to cope with climbing the stairs or even just standing for more than a few minutes, and therefore had to quit.
My role as carer to my father and stepmother: My father is terminally ill with cancer and my stepmother is elderly and infirm. As the only one of my siblings who does not have the responsibility of childcare and work commitments, it falls to me to take care of my parents. My father increasingly needs more help and this situation will only worsen over the coming year. Although his diagnosis is terminal, he is still having treatment and will hopefully be with us for several years. Whilst it would be possible to apply for help from social services to attend to them both, they are very reluctant to have strangers caring for them and I need to be fitter and healthier so that I can help them both continue to live independently at home. At present I find it very difficult to cope with the everyday tasks they need help with, such as housework, because my weight makes me feel so tired and my back and legs hurt so much. I worry that tasks such as lifting my dad in the future will be impossible without my losing weight.
My commitment to having the surgery. I have spent £1800 on private cbt therapy this year following the request of the bariatric team that I have treatment to deal with binge eating. The therapy has been very successful in that I am much more able to prevent myself overeating in response to emotional stress. It has also helped to prepare me for any possible dips in mood which are common in the months post surgery. I feel this shows my strong commitment to having wls. I am living on disability benefits and spending this amount of money on therapy was very difficult but I was determined to prepare myself as much as possible for the surgery. I had hoped that the therapy on it’s own might even be enough to help me lose weight without requiring surgery, however this hasn’t proved to be the case. I am so overweight now that just following a normal healthy eating plan is not enough.
Previous attempts at losing weight. I have a tendency to be able to lose weight very quickly over a short period of time, but am unable to keep it off. Each time I regain the weight and more. I have tried appetite suppressants, weightwatchers many times, slimming world, atkins, and most recently, Lighter Life where I lost 3 stone but regained 4. I am very aware of what I should be eating and try my best to stick to a healthy diet, but become demoralised because I have so much weight to lose. I firmly believe that a gastric bypass is my last and only chance at losing weight and becoming healthy.
If you were to approve this procedure you would be allowing me the chance to become a productive member of society who could contribute economically rather than living on benefits. Without this operation I fear that in the near future I will only cost the NHS more as I develop comorbidities. I do qualify for surgery under the NICE guidelines and would ask that you reconsider your decision in view of that and the above points I have made.
Thankyou for taking the time to read this letter. I hope very much that I will hear from you soon with a favourable outcome.
Kind Regards