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N.L. men lose hundreds of pounds, but province won’t pay for ‘loose skin’ surgery

By Amy Chung, Postmedia News
October 28, 2011

Andrew Murley,32, of Gander, Nfld., who lost over 200 pounds. He now has layers of excess skin that droops, weighing heavy on his chest. The province said they will not pay for surgery to remove the loose skin that is at risk for infection.

Andrew Murley says he was standing on a scale meant for handicapped people, weighing in at 404 pounds, when he decided he wanted to change his life.

“I thought, ‘This is foolish.’ The scale was for handicapped, wheelchair-bound people,” he told Postmedia News on Friday.

The man from Gander, N.L., went on to find the change he was looking for. Using countless diets and workout regimens, he lost nearly 220 pounds over the course of four years — going from a waist that was 58 inches to one that’s now a trim 34 inches.

He now weighs 180 pounds — but the loose skin that lingers on his chest, which he estimates is six to eight pounds, continues to restrict him.

It’s a condition he says he’d like to rectify through surgery — but the provincial government won’t pay.

Murley is one of two men in Newfoundland and Labrador who are sharing their similar stories of how the provincial government won’t pay for surgery that would eliminate the baggy skin that droops over their chest and abdomen.

“If I want to run or engage in any kind of physical activity that is more strenuous, I have to wear some kind of restrictive garment, such as an elastic bandage or spandex shirt,” Murley said.

“Even with these aids I still experience a lot of motion and bouncing, which can hitch, pull, rub and jar my neck and put stress on my neck and back,” he said.

“A good comparison would be a female running without a bra or sports bra.”

Under the province’s health insurance plan, the surgery is considered to be cosmetic unless proven to be “medically necessary.”

“Policy governing surgical removal of excess skin stipulates that there must be significant symptoms associated with the condition to be insured, e.g. chronic skin breakdown, recurrent infections, ulceration, etc.,” the Newfoundland Health Department wrote in an email.

“Cases that do not meet the definition of ‘medically necessary’ will be considered to be cosmetic in nature and therefore not insured.”

Other procedures, such as breast reductions, are covered if there is indication of infections under the breast or neck, or back pain.

“Individuals who want excess skin removed for cosmetic purposes would have to have this surgery completed at a private clinic outside of the public health-care system,” the statement said.

Kevin Carter, 34, of Botwood, N.L., lost 207 pounds in one year and said the saggy skin folds below his groin area weighs approximately 12 pounds and his belly button is infected every few weeks.

The surgery to remove it, he said, was quoted to him at a cost of $15,000 by a private clinic in Toronto.

He is now 185 pounds.

“I have a pannus, a layer of fat that hangs over that used to extend to my knees,” he said.

“It’s hard to move, hard to get comfortable to sleep, I need a cloth to go between the fold to help prevent infection.”

Both men say their weight loss probably saved the health-care system a lot of money. But despite the emphasis on the need for Canadians to lose weight to curb the obesity epidemic, the men say they are being offered nothing to help them with their recovery.

Toronto plastic surgeon Dr. Mitchell Brown said he conducts at least three or four surgeries a month for patients who had dramatic weight loss and said the cost of the procedure for loose-skin surgery ranges between $7,000 and $30,000.

In the United States, it can cost patients as much as $100,000.

He said surgery is the only way to treat this kind of loose skin.

“Once skin is damaged, it’s an irreversible problem,” said Brown.

“In Ontario, there is an operation called the panniculectomy, and it’s an operation to remove the pannus . . . the big roll of excess skin and fat that can appear in the lower abdomen and one requires (Ontario Health Insurance Plan) approval,” he said, but a medical necessity like a rash or infection needs to be proven and documented before the province will pay for the procedure.

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