Monday, July 31, 2017

Insurance Company Denial of Dads injections

Today's blog is more of a bash at the Affordable Healthcare Act.  This "act" has now denied my dad multiple times for crucial health care that he needs.  I am posting a copy of the appeal that I am writing to the insurance company below.  I have edited out the personal information but left the details.  I am hopeful the insurance company will reverse their denial.

To Whom It May Concern

He has had many health issues in the past 3 years. This year in particular you have denied multiple claims and denied him healthcare that he has needed. The last straw was when my mom got an email on a denial because of the “Affordable Healthcare Act”. I have included a copy of the email.

This “Healthcare Act” has done nothing but deny people vital healthcare that they need.

My father has lost over 25 pounds in a manner of 3 months. This leaves him weighing 96 pounds. He is unable to eat and is in need of vitamin supplementation in order to get his body back to where it will be able to function properly again.

Through out the process of trying to find the underlying problem his B1/Thiamine test came back so low it was not detectable. When the doctor tried to get him on injections you denied him.

For a test to come back so low it is undetectable I would consider that a critical low, I know just a little about medical issues as I am a certified EMT and worked Radiology. I have included a copy of the lab results so you can see for yourself the level it came back.

What I am asking for today is an approval for the injections he is needing to raise his B1/Thiamine levels. With these injections His body will have the vital vitamins it needs to function properly and help him be able to eat again.

I have all the information that you may need and I have permission to speak on my parents behalf.

I am also including some information about just what a whipple procedure does to a patient and why it is important for the injections, not just oral supplements.

Thank you for your time

What is a Whipple Procedure?

The Whipple procedure involves removal of the "head" (wide part) of the pancreas next to the first part of the small intestine (duodenum). It also involves removal of the duodenum, a portion of the common bile duct, gallbladder, and sometimes part of the stomach. Afterward, surgeons reconnect the remaining intestine, bile duct, and pancreas.

What does this mean for absorption of oral medication?

Most Whipple patients do not have the pancreatic enzymes for the breakdown and absorption of food or oral medications following a Whipple. Because of this most oral medications will pass to quickly through the digestive tract and not be properly absorbed or even broken down. Most supplements should be taken in a liquid form, but if this is a critical low an injection would be the best way to boost the levels quickly and then go to the oral form to keep them at proper levels.

What can a B1/Thiamine deficiency cause?

B1/Thiamine is a coenzyme used by the body in order to metabolize food for energy and maintain proper heart and nerve function. Thiamine is used to turn nutrients in food into usable energy. Without the proper levels certain proteins cannot be properly used by the body.

A deficiency can cause weakness, fatigue, heart complications, and nerve damage. It can also cause rapid weight loss, poor appetite, ongoing digestive problems, decrease in short term memory, and confusion.
If a Thiamine deficiency is left untreated it can lead to Beriberi. Beriberi has 2 types: wet and dry. Wet beriberi affects the heart and circulatory system and can lead to heart failure. Dry beriberi damages the nerves and can lead to decreased muscle strength and eventually muscle paralysis. Beriberi can be life-threatening if left untreated.

Symptoms of beriberi:
Wet: Shortness of breath during physical activity, waking up short of breath, rapid heat rate and swollen lower legs
Dry: decreased muscle function particularly in the lower legs, tingling or loss of feeling in hands and feet, pain, mental confusion, difficulty speaking, vomiting, involuntary eye movement, and paralysis.

How is beriberi treated? By oral or inject able thiamine supplements. In severe cases and IV may be administered. You may have noticed that in the symptoms listed some are in italics. These are symptoms that my father is already having, and has been having for a month or better. They are progressively getting worse. Without any treatment he is headed down the dangerous path of having major health issues. I am hoping you can understand the severity of my fathers case. Not only is he deficient in a crucial vitamin, he also lacks the proper digestive system to absorb nutrients the proper way. This is why it is crucial for the injections to get his levels where they need to be. Once they are there we can look at weaning off injections over to oral supplements, but there is a possibility he may need to remain on the injections if his body can not absorb them properly.  

Insurance denial email

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