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I thought that I had better start up my own journal of having, (or not), reconstructive surgery following massive weight loss instead of hijacking kazbo's! So have gone through my posts both on bandingtogether.com and gastricsleevesupport.com to which I also belong (same username and profile photo lol!). So here goes: CATCH UP POSTS 30/09/2015 gastricsleeve.com Just discovered this site - and hopefully this gives those of us who have excess skin from weight loss as opposed to post-pregnancy (different Medicare items) hope: http://www.plasticsurgeryhub.com.au/medicare-revoking-tummy-tuck-funding-item-30177/ I am going to see a plastic surgeon tomorrow (!) re my saggy, baggy, wrinkly tum and my arms - I'm not just talking "tuck shop" or "bat wings" or "ta ta's", I am talking the upper ie visible surface of them on the upper arm - BAD crinkles. (I seem to have lived the last 20+ years in 3/4 length sleeves *sigh* to hide my upper arms. ALWAYS had big arms ) Dr Sam Cunneen, West Perth. I am also having a nurse consult at another practice next week - this is the practice that my bariatric/hernia surgeon is affiliated to, so I guess that if he is affiliated to them, and if they give me a GOOD discount, then I'm going to have it done while I still have some Medicare and top level Medibank rebate, 'cos when I move back to NZ (whenever that may be) - I would NEVER be able to afford it there. On full Disability Pension now too, And I have already gone above the "Safety Net" for Medicare this year, so should get more back as rebates, hopefully. Dr Hanh Ngeyen, Nedlands. Will keep you posted... 01/10/2015 QuirkyQuaintrelle gastricsleeve.com “Best of luck with your appointment Denzel! From what I can gather, the upcoming changes aren't going to effect patients with massive weight loss so fingers crossed I'll still qualify when it's my turn when my PHI kicks in next year. I'm greedy and want my tummy, thighs and bum all taken care of! Make sure you let us know how you go - good luck!” 01/10/2015 Thanks QuirkyQuaintrelle! I didn't end up going today as I had a really upset tummy...but will re-schedule as he seems quite cheap. 12/10/2015 bandingtogether.com Oh wow Kazbo!!! I am so excited for you!!! I am looking at having a tummy tuck and arms lifted. Later on a breast uplift and thighs lifted Quotes, note neither of these include the Anaesthetist: "Thanks for your website enquiry to Dr Sam Cunneen through WhatClinic. Your arms and tummy are certainly something we can help you with. We would need to see you at least twice for consultations prior to booking surgery for you, as there is a lot to consider with these procedures and especially given your medical history. As a rough idea of costings for surgery you would be looking at around $6500 - 7500 for Dr Cunneen' surgery fee with anaesthetist and/or hospital fees on top of that." I have been in contact with them querying that cost as it seemed remarkably cheap to me. I had an appt, but had to post-pone due to a ghastly tummy upset, so have reappointed. Sculpt Surgery - really lovely, I went there and had a long consult (free) with the nurse consultant Theresa Chung. I felt totally comfortable with her and she went though everything in detail. "Attached is your quote as requested. If you do not wish to have the circumferential lipectomy (being cut around the back) then the surgeon fee is $12000 for the abdominoplasty and the arm lift." OK, here is my latest research. I rang Medibank to find out of the hospital costs are for Items 30177 and 30171 are covered - yes, for me (I have top-level cover and have well and truly met qualifying period) IF the surgeon fills out a "Specialist Exemption Form" otherwise the procedures are considered cosmetic, and therefore no hospital cover. Here is the Medicare info: Category 3 - THERAPEUTIC PROCEDURES 30171 Group T8 - SURGICAL OPERATIONS Subgroup 1 - GENERAL LIPECTOMY wedge excision of skin and fat, not being a service associated with items 45564, 45565 or 45530 and not being a service to which item 30165 applies, 2 OR MORE EXCISIONS (H)Multiple Services Rule (Anaes.) (Assist.) Fee: $691.75 Benefit: 75% = $518.85 See para T8.8 of explanatory notes to this Category) Category 3 - THERAPEUTIC PROCEDURES 30177 Group T8 - SURGICAL OPERATIONS Subgroup 1 - GENERAL LIPECTOMY radical abdominoplasty (Pitanguy type or similar), with excision of skin and subcutaneous tissue, repair of musculoaponeurotic layer and transposition of umbilicus, not being a service performed within 12 months after the end of a pregnancy and not being a service associated with a service to which item 45564, 45565 or 45530 appliesMultiple Services Rule (Anaes.) (Assist.) Fee: $985.70 Benefit: 75% = $739.30 (See para T8.8 of explanatory notes to this Category) Category 3 - THERAPEUTIC PROCEDURES T8.8 Lipectomy - (Items 30165 to 30177) Multiple lipectomies, e.g., both buttocks and both thighs attract benefits under Item 30171 once only, i.e. the multiple operation rule does not apply. Medicare benefits are not payable in respect of liposuction, except in the circumstances outlined in Items 45584 and 45585. Lipectomy items 30165 and 30177 may not be claimed for patients if performed within 12 months after the most recent pregnancy. Lipectomy items 30165 to 30177 cannot be claimed in association with items 45564, 45565 or 45530. Where the abdomen requires closure with reconstruction of the umbilicus following free tissue transfer (45564, 45565) or breast reconstruction (45530), item 45569 is to be claimed. Related Items: 30165 30168 30171 30174 30177 Multiple Operation Rule The fees for two or more operations, listed in Group T8 (other than Subgroup 12 of that Group), performed on a patient on the one occasion (except as provided in paragraph T8.2.3) are calculated by the following rule:- - 100% for the item with the greatest Schedule fee plus 50% for the item with the next greatest Schedule fee plus 25% for each other item. Note: (a) Fees so calculated which result in a sum which is not a multiple of 5 cents are to be taken to the next higher multiple of 5 cents. (b) Where two or more operations performed on the one occasion have Schedule fees which are equal, one of these amounts shall be treated as being greater than the other or others of those amounts. (c) The Schedule fee for benefits purposes is the aggregate of the fees calculated in accordance with the above formula. (d) For these purposes the term "operation" only refers to all items in Group T8 (other than Subgroup 12 of that Group). This rule does not apply to an operation which is one of two or more operations performed under the one anaesthetic on the same patient if the medical practitioner who performed the operation did not also perform or assist at the other operation or any of the other operations, or administer the anaesthetic. In such cases the fees specified in the Schedule apply. Where two medical practitioners operate independently and either performs more than one operation, the method of assessment outlined above would apply in respect of the services performed by each medical practitioner. If the operation comprises a combination of procedures which are commonly performed together and for which a specific combined item is provided in the Schedule, it is regarded as the one item and service in applying the multiple operation rule. There are a number of items in the Schedule where the description indicates that the item applies only when rendered in association with another procedure. The Schedule fees for such items have therefore been determined on the basis that they would always be subject to the "multiple operation rule". Where the need arises for the patient to be returned to the operating theatre on the same day as the original procedure for further surgery due to post-operative complications, which would not be considered as normal aftercare - see paragraph T8.2, such procedures would generally not be subject to the "multiple operation rule". Accounts should be endorsed to the effect that they are separate procedures so that a separate benefit may be paid. Extended Medicare Safety Net Cap The Extended Medicare Safety Net (EMSN) benefit cap for items subject to the multiple operations rule, where all items in that claim are subject to a cap are calculated from the abated (reduced) schedule fee. For example, if an item has a Schedule fee of $100 and an EMSN benefit cap equal to 80 per cent of the schedule fee, the calculated EMSN benefit cap would be $80. However, if the schedule fee for the item is reduced by 50 per cent in accordance with the multiple operations rule provisions, and all items in that claim carry a cap, the calculated EMSN benefit cap for the item is $40 (50% of $100*80%). Related Items: 13506 30084 31539 31542 31545 34527 34528 34530 35518 35614 36851 37217 37339 41884 48660 48663 48666 48669 48672 48675 48684 48691 48692 48693 14/10/15 bandingtogether.com I met with Dr Hanh Nguyen at Sculpt Surgery today, along with his nurse Theresa, who I had met at my last consultation - she is so lovely, and I feel relaxed with her. I am a "good candidate" for the proposed procedures - circumfrential abdominoplasty and bilateral brachioplastys as I have little fat, but lots of skin! She will be getting back to me with updated costs - she is going to talk to the surgeon and they are going to try to bring it down due to my financial status. Then had my GP appt later, she doesn't want me to do anything until my weight loss has reversed and I start putting on some weight - she wants me back up to 45 kg (I had dropped to 42.5). Got some 'results' back from some recent 'tests' and have got a gut infection - no wonder I've had a problem with diarrhoea and loss of appetite lol!. She also wants me to re-visit the dietician, who I don't think will be able to offer me any advice than what I had discussed with her last time - ie ongoing weight loss and diarrhoea *sigh*. 15/10/15 jellybelly89 to me bandingtogether.com “Have your surgeons confirmed if you're still eligible for Medicare Denzel? There is so much conflicting information on what the new criteria is, have they given you anything?” 15/10/2015 me to jellybelly89 No, I looked it up on the Medicare site - the surgeon gave me the item numbers. Update: The nurse has just rung me with new, improved costs, having discussed it over with the surgeon and the anaesthetist. She confirmed that they have received an email from Medicare re rebate for abdominoplasty and the changes aren't expected to take place until the middle of next year. They have brought the cost for bilateral arm lift and circumferential abdominoplasty down to $13,000.00, and which I'll get a rebate of Fee: $691.75 Benefit: 75% = $518.85, so Medibank will pay approx. $172.00. And there will be $1,000.00 gap for the anaesthetist. Because I am having both bilateral arm lift and circumferential abdominoplasty it will be about a 7 hour op. 15/10/2015 leya22 to me bandingtogether.com “I remember Theresa from my days at Hollywood too, she is super lovely. . . . I hope you go ahead with Sculpt, they are a really fantastic team!” 15/10/2015 Oh wow leya22, thank you for the above feedback! Theresa is super lovely, she is so easy to be with that she feels like an old friend! Yes, I am going ahead with Sculpt, with Dr Nguyen operating, and Theresa being a support person. She even visits her clients in hospital post-op! I'll be operated on at Hollywood. Hope that the staff there are better than the ones at Murdoch. - ferkin' scary there. We are looking at November 27th that gives me time to get some stuff organised in my personal life ie sale/no sale of my house and that then impacts on me moving/not moving back to NZ, get over my gut infection, and put on a couple of kgs - GP is quite concerned about that and doesn't want me to have surgery until I do). 15/10/2015 leya22 to me bandingtogether.com “Hanh is a really great surgeon, his follow-up is fantastic, and as you mentioned Theresa will visit you on the ward post-op and change your dressing etc. they provide a really great service!! I worked on John Carroll ward at Hollywood, which is where you will most likely stay, there has been a few staff changes since I left but quite a few that are the same and they are a really great team of nurses, I actually really miss working there! I look forward to hearing of your progress with the surgery :-)” 16/10/2015 Me to QuirkyQuaintrelle gastricsleevesupport.com Honey, you aren't greedy! You'll be pleased to know that the changes in Medicare won't happen until the middle of next year - the nurse from where I have decided to go - "Sculpt Surgery" confirmed that. I met with Dr Hanh Nguyen at Sculpt Surgery on Wednesday, along with his nurse Theresa, who I had met at my last consultation - she is so lovely, and I feel relaxed with her. I am a "good candidate" for the proposed procedures - circumferential abdominoplasty and bilateral brachioplastys as I have little fat, but lots of skin! She got back to me with updated costs - she talked to the surgeon and they are going to try to bring it down due to my financial status. I also had that consult bulk billed. Then had my GP appt later, she doesn't want me to do anything until my weight loss has reversed and I start putting on some weight - she wants me back up to 45 kg (I had dropped to 42.5). Got some 'results' back from some recent 'tests' and have got a gut infection - no wonder I've had a problem with diarrhoea and loss of appetite lol!. She also wants me to re-visit the dietician, who I don't think will be able to offer me any advice than what I had discussed with her last time - ie ongoing weight loss and diarrhoea *sigh*. I am delaying having it done until 27th Nov, gives me time to sort out things here IN CASE my house sells, or not, which then impacts on me moving back to NZ. + to get my gut back on track, and put on a couple of healthy kgs. I have had some good feedback from another forum I am on re who I am going with, and the hospital where I will be operated at. "Hanh is a really great surgeon, his follow-up is fantastic, and as you mentioned Theresa will visit you on the ward post-op and change your dressing etc. they provide a really great service!! I worked on John Carroll ward at Hollywood, which is where you will most likely stay, there has been a few staff changes since I left but quite a few that are the same and they are a really great team of nurses, I actually really miss working there!" 16/10/2015 me to leya22 Thank you so much for this leya22, great to hear positive and reassuring things (I'm a nurse as well, so know the difference between good care and poor care). 16/10/2015 4:29:02, kazbo said: “Now I've made the decision, I'm starting think that it'll be a great opportunity to get a few other things done (like my double chin lipo'ed and lifted and the stubborn fat on my soccer ball hips lipo'ed). I wonder how many people go through this "oh well seeing you are going to be working on me you may as well...[insert cosmetic items here]" 16/10/2015 Later I would like a thigh lift and breast (what is left lol - I used to have biggies, not anymore!) lift. Don't want an enhancement there, I would be happy just to have small perky ones! 'Cos I am little, with little fat, they are able to do my arms and circumferential abdominoplasty all in one go. Some bigger folk, they can't do the circumferential abdominoplasty in one op. 16/10/2015 Ohhhh, Sam Cunneen in West Perth is much cheaper, by about $6,500 . I'll keep my appt I had made with them for next Thurs. Mind you, I could always save a heap of dosh and do a "do-it-yourself" tummy tuck lol! 22/10/2015 I went to my 1st appt today with Sam Cunneen, was very impressed with him. Here I am having a 3D photo.
To catch you up: My house did not sell.Mum (in NZ) had to put the unit that she had bought on my behalf (in Orewa) , on the market (obviously, due to financial reasons). https://www.barfoot.co.nz/533537 Mum, and my sister Pam) put a lot of effort into this place, and it had remodelled kitchen, bathroom, repainted, new carpets etc etc etc.Yes, it looked wonderful.Yes, the Orewa lifestyle would have been magnificent.That unit sold. (Settlement was 11th/12th Jan this year, I don't know exact dates). Current Medication: Before Breakfast: 2 paracetamol/2 Panadol Osteo (depending on what day I have ahead of me...) for... your choice...: ME/CFS, Fibromyalgia, Osteo arthritis hips etc ...I can't stand...feel horrendous, have muscle pain, and "post-exertional malaise" (believe me, that sends you straight to bed) lasting into the next couple of days...50 mg Lyrica (Fibroymyalgia)Duloxetine 60 mg (Fibromyalgia/ME/CFS - works wonderfully!) Put on this by my Rheumatologist, Dr Antonia Cole @ Hollywood Specialist Medical Centre, Nedlands. Bless her!!!Moduretic 50/5 (Menieres Disease, to reduce the fluid in the inner ear)+/- "Serc" (Menieres Disease - too ferkin' expensive), "Seniere" (also expensive) 16 mg Betahistine dihydrodrochloride as needed+/- "Panadeine Forte" (prescribed. I haven't used, I believe that I have - thankfully - a pretty high pain tolerance)+/- "Stemitil" (Prochlorperazine) 5mg (poxy Menieres Disease...) Post Breakfast (which tends to be about 1030 am:) 1 general multi-vitamin/mineral6000 mg Gingko Biloba (just recently, as I have given myself haemorrhagic gastritis in the past - this was pathology taken from a gastric endoscopy done September 2013, taking 2000 mg Gingko biloba on an empty stomach) - to increase the blood flow to my inner ears. This was recommended to me by my ENT - Paul Yuen - surgeon in relation to the Menieres Disease...). Benefit - now I am back on it, I have noticed...that my poxy memory has started to improve again. I managed to combine menopause + ME/CFS + Fibromyalgia 2014/2015 lol! And lost my job with DPaW! "Employer Initiated Retirement On The Grounds Of Ill-Health".)"Nature's Way" "Joint Restore Triple Action" Glucosomine + Chondroitin + MSM, x 1, for Osteo arthritis hips, (+ mainly left hand - c/o Complex Regional Pain Syndrome/ Reflex Regional Sympathy).+/- OTC Ibuprofen 200 mg + Codeine Phosphate 12.8 mg in view of prospected day ahead...+/- OTC "Nagestic Forte" Curcumin 6.074 mg if I remember... If I know that I am going to have a REALLY physical day...+/- Ventolin puffer (prescribed) when I remember, or when I am REALLY having problems...+/- Becotide puffer (prescribed) when I remember, or when I am REALLY having problems...+/- And...this is really slack on my behalf..."Flo CRS" Nasal Irrigation followed by (prescribed) "Nasonex" (prescribed) nasal spray...when I remember...when my nose is REALLY bugging me oe O can't breathe through my nose....at all... "Meniett" machine $2,500.00 to try to relieve poxy Menieres symptoms... when I remember... ( Sleep study showed that "Mandibular Adjustment Splint" - $2,500.00 - become redundant...didn't control UARS/Sleep Apnoea...). Throughout the day: [*]+/- OTC Ibuprofen 200 mg + Codeine Phosphate 12.8 mg in view of prospected day ahead... [*]2 paracetamol/2 Panadol Osteo (depending on what day I have ahead of me...) Night-time: 7.5 mg Mirtazapine (prescribed) - to sleep. The Duloxetine "revs" me up too much. And I don't. Sleep. + WAY TOO MANY sleep behaviour disorders! (Diagnosed on sleep study. STILL have Upper Airway Resistance Syndrome). I sleep "like a good baby" on this lol! 1 x Night-time part of multi-vitamin/mineral ("Nature's Own - Restore Multivitamin Day and Night Formula For Women"). So. I am still here (24 Ward Cres, Kelmscott WA 6111).And the unit in Orewa would never had been 'mine' . Mum (turning 85 this coming March!!!) and my sister, had put too much work into it. "Entitling" them to call it "Theirs" and ...dictating... what I could do, and what I couldn't do. "Things happen for a reason". My life is no longer "on hold", as it was from January 2015.Spiritually, I got given, "The timing wasn't right".I have "Moved On" in many ways.I have "Taken The Leap Of Faith".Gone on with 'plans'. I had plastic reconstructive surgery with Mr Hanh Nguyen & team at Hollywood Hospital 4th December 2015 (arms, abdominoplasty, and "belt lipectomy"). "Sculpt Surgery".I can not fault them (just only a couple of niggles with Hollywood, but nothing outstanding as at Murdoch SJOGH)."Sculpt Surgery" - Theresa and Hanh - were fantastic.And have adopted a boy foster Rescue Greyhound, Zumba, the day before Christmas (I hads fostered him for four months, so knew his personality).Also, have gone back to fostering Rescue Greyhounds. I am doing well, and very, very happy that I had had the Gastric Sleeve. 12 Month Measurements 2/02/2015 2/02/2016 WEIGHT70.44 KG155.4 LB43.36 KG95.6 LBBODY FAT %42.5 17.9 BMI30.5 18.4 BUST108 CM42.5"82.5 CM32.5"WAIST 92.5 CM36.5"67 CM26.5""APRON/ILIAC CREST"101 CM43"75 CM29.5"HIPS100 CM40.5"81 CM32"RT THIGH66 CM26"46 CM18"LT THIGH66 CM26"45.5 CM 18" MonthDateWeightBMIBody Fat %02nd Feb70.4830.542.512nd Mar63.3227.439.326th Apr59.6925.8335.134th May55.8824.1832.941st June53.9723.3530.456th July48.8921.1226.463rd August46.5320.1323.677th September45.9919.9920.685th October43.5418.819.292nd November43.6318.8817.2104th December43.6 111st January 201643.918.6317.2122nd February 2016 43.3618.417.9