Amanda H.

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My Love and I on our Wedding Day


The 2 main reasons I want to have Surgery!



 

I just wanted to say how thankful I am for this site.  I know I can come here and be myself and not be afraid to be myself.  Everyone knows and understands what I am going through on a day to day basis because like me, you all have lived the life of a morbidly obese person.  It's lonely.  I have a wonderful husband and son, a loving family, a great support from my religion, and God, and that helps.  But, for some odd reason I still feel lonely.  I look at myself in the mirror, and I see a woman who is going to accomplish great things.  I can almost see that woman I am meant to be!  I wonder what she will look like.  I try to envision her, but it's hard, because I am not there yet.  I keep wondering what I will be doing and what will I look like at this time next year.  Everything is still uncertain.  Will I still be MO?  I don't think so.  Regardless, if I get approved or denied, I will be a thinner, more healthier person.  I am making myself that solemn vow.  I am pretty sure I will have an answer from UHC this week.  And I think I am going to be approved!  I have a great feeling inside me.  A peace.  A small glimmer of hope that I will not be forgotten...once again by another insurance company...Goodnight!  Manda

     This is just really bothering me.  Ihave been in this insurance process for 2 months now, and they have denied me twice, and I'm on my second appeal.  Well, my Doctor finally wrote the right letter.  She listed all my diagnosis's like the insurance wanted and also she wrote that I have potentially fatal co'morbs, like the obstructive sleep apnea, and that in her opinion, this surgery was medically necessary for me!  Soo, I am hoping that this time they will approve me, because I have sent my sleep study results too.  Here is a list of my co-morbs: Multi-level Degenerative Disc Disease, Spinal Stenosis, Osteoarthritis of the knees, gallbladder disease, hypothyroidism, varicose veins, morbid obesity, high cholesterol, depression, GERD, and obstructive sleep apnea.  Isn't this enough for them???!!!  I have met all their requirements.  And with my back problems, it's either going to be back surgery or gastric bypass surgery.  I am still just trying to be patient...Manda

Well, I have been in extreme pain for 2 weeks now.  I had an MRI on Tuesday Sep 16.  The results showed that I have Multi-Level Degenerative Disc Disese, and the XRAY showed I also have narrowing of the spine aka spinal stenosis!  These are 2 painful things that usually  50 or 60 year old people get!  I am an old woman at 26!  This can't be cured only managed with physical therapy, steroid injections, NSAID's or surgery. My whole right leg and foot are still numb and very painful to walk.  I think the nerves are compressed.  I have been getting around on 2 crutches, and I had to borrow my grandma's walker with 4 wheels that she is not using to get around the house!  I had to quit my job and apply for disability again. I have an appt. at the SS office on October 6th. The Doc said I need to lose this weight and I will be so much better off.  Everything that I am getting is really weight related.  I called Insurance today, and my appeal is still under review.  I should be hearing something within the next 2 weeks.  I am just trying to hang in there and praying a lot that God will be with me and help me to endure this pain. I have lost around 10 lbs in the last month or so.  I might be getting the epidual steroid injections if this physical therapy my doctor prescribed does'nt work.  I have included some info about the conditions I was diagnosed with.

Spinal Stenosis is a narrowing of the spaces in the spinal column that causes compression of the spinal cord and/or nerve roots.

There are many causes. Any condition that involves structural changes or inflammation of the spine may cause compression of the spinal cord or nerve roots.

*Compression of a nerve is often referred to as a "pinched nerve."

The spinal cord (a bundle of nerves) is protected by the vertebral column (spinal column). The spinal canal refers to the space in the vertebral column for the spinal cord and its nerve roots. Nerve roots exit the spinal cord through small openings between each vertebra.

More than one area on the spine may be affected. Symptoms depend upon what area or areas of the spine are affected. There may be back pain and/or there may be pain, numbness, weakness, and cramping in the legs (when the lower spine is affected) or arms (when the neck area is affected). Symptoms often develop gradually.

Causes

Though the causes vary, this condition is most commonly caused by gradual degenerative changes in the spine that occur with aging. Spinal stenosis is most common in people over age 50. With age, bones and ligaments may thicken and disks between the vertebrae become thinner and may bulge. These structural changes may result in a narrowing of the spinal canal.

A major cause of progressive degenerative changes in the spine is osteoarthritis. In advanced osteoarthritis, bone spurs (bony growths) may form on the spinal joints and compress nerve roots. There may be inflammation in advanced osteoarthritis of the spine, narrowing the spinal canal.

An injury, scoliosis, a congenital narrow spinal canal, and a host of other conditions may also result in spinal stenosis. Scoliosis, an abnormal side-to-side curvature of the back, may cause compression of the spinal cord or nerve roots if the curve is severe.

A fracture of a vertebra can cause a piece of bone to chip off and protrude into the spinal canal. A vertebral fracture or vertebral degeneration may also result in one vertebra slipping over another (spondylolisthesis) and the misaligned vertebrae may protrude into the spinal canal.

Symptoms

The lower back (lumbar spine) is the area of the spine most commonly affected by spinal stenosis. Pressure on a nerve root (a "pinched nerve") in the lower spine may result in sciatica. Sciatica refers to pain along the sciatic nerve - pain that often radiates from the back, hip, or buttocks down the back of the leg and is often accompanied by numbness, tingling, or weakness in the leg and sometimes the foot.

People with spinal stenosis in the lower spine often find that leaning forward while walking or lying with knees drawn up relieves the symptoms. This is because bending forward enlarges the spaces between the vertebrae and relieves pressure on the nerve roots.

If stenosis occurs in the neck area, there may be neck and shoulder pain. It may cause headaches - usually at the back of the head. There may also be numbness, weakness and tingling in the arms or hands and sometimes legs. It can also affect balance and cause an unsteady gait.

In severe cases, nerves to the bladder or bowel may be affected. A loss of bladder or bowel control warrants immediate medical attention.

Because the symptoms of spinal stenosis can be caused by other conditions, an MRI, CAT scan, or special x-ray may be required for a diagnosis.

Treatment

Treatment involves treating the pain, any inflammation, and the condition that is causing the stenosis. If conservative treatment does not bring relief or there is severe neurological impairment surgery may be necessary.

If symptoms are mild, over-the-counter pain and anti-inflammatory medications may help relieve the pain. In cases of severe pain, a physician may prescribe stronger pain medications.

Back Exercises are usually recommended. A physician should always be consulted before staring an exercise program. Activities may have to be restricted if there is severe neurological impairment. Do not do too much too soon to avoid injury.

Exercises to strengthen the muscles that support the spine (back and abdominal muscles) and stretch back muscles help to keep the spine in good alignment. Shortened muscles in the lower back increase the curve in the lower back and decrease space between the vertebrae, causing more pressure on the nerve roots.

Aerobic exercises increase circulation and help keep the spine healthy. Low-impact aerobic exercises such as swimming, walking, using elliptical trainers or stationary exercise bikes are easy on the joints. Riding a stationary exercise bike may be preferable to walking as the bent over position increases the space between the vertebrae in the lower back to take pressure off nerve roots.

Some people find pain relief using complementary treatments for pain such as acupuncture, hydrotherapy, and TENS.

An epidural steroid injection, an injection of corticosteroids (powerful anti-inflammatory medication) and a local anesthetic into the epidural space (the space between the membranes covering the spinal cord and the wall of the spinal canal) may provide weeks to months of relief. The number of injections is limited due to potential side effects. Many people are frightened of corticosteroids, as they know of people who have had serious side effects from the long-term use of oral steroids such as prednisone. A local injection ensures a high dose of steroids are received where most needed while only a small amount of medication is absorbed into the blood stream. There are rare but serious risks involved with the injection itself.

The symptoms of spinal stenosis may worsen over time. If the pain becomes severe and chronic and conservative treatment does not provide relief, surgery may be recommended. Most surgery for spinal stenosis is elective surgery.

*If there great difficulty in walking or there is a sudden loss of bladder or bowel function, emergency surgery may be necessary to relieve the pressure on the spinal cord or nerves and avoid permanent nerve damage. Fortunately, this is a rare occurrence.

Degenerative disc disease (DDD) is part of the natural process of growing older. Unfortunately, as we age, our intervertebral discs lose their flexibility, elasticity, and shock absorbing characteristics. The ligaments that surround the disc called the annulus fibrosis, become brittle and they are more easily torn. At the same time, the soft gel-like center of the disc, called the nucleus pulposus, starts to dry out and shrink. The combination of damage to the intervertebral discs, the development of bone spurs, and a gradual thickening of the ligaments that support the spine can all contribute to degenerative arthritis of the lumbar spine.







When degenerative disc disease becomes painful or symptomatic, it can cause several different symptoms, including back pain, leg pain, and weakness that are due to compression of the nerve roots. These symptoms are caused by the fact that worn out discs are a source of pain because they do not function as well as they once did, and as they shrink, the space available for the nerve roots also shrinks. As the discs between the intervertebral bodies start to wear out, the entire lumbar spine becomes less flexible. As a result, people complain of back pain and stiffness, especially towards the end of the day.

Symptoms
The most common symptom of degenerative disc disease is back pain. When DDD causes compression of the nerve roots, the pain often radiates down the legs or into the feet, and may be associated with numbness and tingling. In severe cases of lumbar DDD, where there is evidence of nerve root compression, individuals may experience symptoms of sciatica and back pain, and sometimes even lower extremity weakness.

Diagnosis
The diagnosis of degenerative disc disease begins with a complete physical examination of the body, with special attention paid to the back and lower extremities. Your doctor will examine your back for flexibility, range of motion, and the presence of certain signs that suggest that your nerve roots are being affected by degenerative changes in your back. This often involves testing the strength of your muscles and your reflexes to make sure that they are still working normally. You will often be asked to fill out a diagram that asks you where your symptoms of pain, numbness, tingling and weakness are occurring.

A routine set of X-rays is also usually ordered when a patient with back pain goes to see a doctor. If degenerative disc disease is present, the X-rays will often show a narrowing of the spaces between the vertebral bodies, which indicates that the disc has become very thin or has collapsed. Bone spurs begin to form around the edges of the vertebral bodies and also around the edges of the facet joints in the spine. These bone spurs can be seen on an X-ray, where they are called osteophytes. As the disc collapses and bone spurs form, the space available for the nerve roots starts to shrink. The nerve roots exit the spinal canal through a bony tunnel called the neuroforamen, and it is at this point that the nerve roots are especially vulnerable to compression.

In many situations, doctors will order a MRI or a CT scan (CAT scan) in order to evaluate the degenerative changes in the lumbar spine more completely. A MRI scan is very useful for determining where disc herniations have occurred and where the nerve roots are being compressed. A CT scan is often used to evaluate the bony anatomy in the spine, which can show how much space is available for the nerve roots and within the neuroforamen and spinal canal.

Treatment
Your doctor will be able to discuss with you what your diagnosis means in terms of treatment options. For most people who do not have evidence of nerve root compression with muscle weakness, the first line of therapy includes non-steroidal anti-inflammatory drugs and physical therapy. A soft lumbar corset is often prescribed in order to allow the back to have a chance to rest. Surgery is offered only after physical therapy, rest, and medications have failed to adequately relieve the symptoms of pain, numbness and weakness over a significant period of time.

     My back has been hurting me since the last part of July, and then last Friday, I was washing an older friend's hair and cutting it for her, and I was bent at an odd angle, and thats when the pain starting getting really bad, to the point of unbearable.  I knew it was'nt muscle spasms, because I've had those before.  It was a pain going down the right side of my lower back and down my leg.  Well, I toughed it out over the weekend, and I went to my PCP.  She did X-RAYS and thats it, and said it might be a herniated disc.  So, she gave me some Darvocet and Flexiril.  Well, that was Monday, and these did not even touch the pain, just made me reel groggy.  So, I went to the ER last night, and the Doc said that Darvocet is the weakest pain medicine out there, and that he was going to give me some percocet, and some steroids, and if that does'nt help, I will have to have an MRI, to see if it is indeed a herniated disc.  He pushed on my sciatic nerve, and it was SOOO PAINFUL!!!  So, if im not better by next week, I will schedule an MRI.  I am so sick of this.  I just want to lose this weight, and have a somewhat pain free life.  I have had this chronic back pain since I was 14, and it's due to me being morbidly obese.  Still waiting to hear from the insurance.  I think I am going to call them right now.   Manda

Well, I hurt my back again.  Doc thinks it's a herniated disc.  So, I am taking it easy.  I got sick and tired of waiting around to hear something on my appeal, so I got on the phone with UHC, and they said my case had been turned over to my husband's employer in Lebanon TN.  They gave me the #, so I called and it was the same lady I talked to a couple of weeks ago.  So, she said she has my sleep study results, but she is still waiting on the doctor's letter.  My Doc already wrote one letter and sent it to them, and they say they have'nt recieved it.  So, I call my doc and ask if she wrote the 2nd letter, she told me on Monday when I went to see her for my back, she would write it by Wednesday, because she was going out of town.  Well, this woman named Tabitha answers and I ask her if it has been faxed to UHC, and she says no it's not in my chart and I will have to wait until Monday.  Well, I knew it was probaly just sitting up there waiting to be sent, so i decide to drive up there and have the nurse practiconer check for me.  I got there and of course Tabitha is sitting on her butt, not doing a thing, she was mad I came up there but I dont care.  I asked to see the nurse practiconer, and Tabitha says shes seeing patients.  Well, she asked what I needed, and I said, "just a copy of the 2nd letter, and sure enough she walks back there to look for it, and it's on the nurse's desk.  She said she would fax it.  So I ask for a copy because Im not gonna trust her to fax it right away, because the insurance lady is waiting on it, and she was real huffy and throwing papers around, and she made me a copy.   She would'nt even get off her lazy butt when I called her to go check to see if the letter was done. Made me so mad!!!  Well, I faxed both letters to the lady that is working on my case, and the letter is awesome.  It says that I have serious medical conditions that are potentailly life threatning and that this surgery is medically neccessary for me!  So, they can't deny me now.  They have everything they have asked for.  Now, I am just playing the waiting game...once again.  I am going to call every day until Im approved.  I WON'T GIVE UP!!! 

     Well, they are still reviewing my appeal.  I was diagnosed with obstructive sleep apnea, and I sent UHC both of my sleep studies.  They are also asking the sleep center where I had my sleep study for diagnosis codes and all that stuff.   I have left the appeal in God's hands, and I am trying not to worry about it.  I just know I will be approved.  There is no way they can deny me this time, because I have met all of their requirements.  I will update when I know more!  Manda

Well, they denied me.  No "serious" complicating medical conditions.  Just another way of taking the cheap way out, not paying for it.  I am going to fight UHC tooth and nail. I am in the middle of my appeal.   I wrote my own letter, and my PCP and chiropractor wrote a letter also.  I just know I will be approved eventaully.  I have to believe that.   I won't give up.  I can almost see that skinnier, more healthy me if I look close enough in the mirror.  I have my sleep study tonight.  I am almost wishing I do have sleep apnea, because they conside that serious.  So, I will know by tommorrow morning if I have it or not.  Love, Amanda

I called UHC today, and they have recieved my pre-determination letter.  They said I will have an answer in 15 business days!  So, I am super excited I have to admit!  So, please pray for me everyone!  If it is Jehovah God's will for me to have Gastric Bypass, then I will be approved.  Manda

Well, I now have UHC insurance through Cracker Barrel.  I called them because I wanted to make sure they cover gastric bypass, and they do!  They do require a 5 year weight history, so I had my medical records sent to Dr. Gibbs office.  Carrie is in the process of writing my pre-determination letter, and she is gonna fax my records along with that to UHC.  So, now I am in the hurry up and wait stage.  Im still staying positive, but Im not getting too excited yet.  Arghhhhhhhhhh!!!!!!!   OK I CAN'T HOLD BACK IM REALLY REALLY EXCITED!!!  Ok im done.  I'll update when I find out if im approved or denied.  Manda