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This fundraiser ended on 01/23/11

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Dennis has always been the person his friends could count on to help them. He never asks for anything in return. Now he needs your help...

First things first, my email is dyates424@gmail.com
Phone: 972-795-4902
This is me, not a scam... and the decision for this site was not an easy one... I am not a begger and this is very difficult to do.
In order to clarify our goal in doing this: We were thinking that if 1 person told 5, then they told 5, and so on, we will reach enough people to get the surgery I really need in no time at all. The internet is like wildfire sometimes, and if the 225 people that viewed the site the first day had given $20, it would have been $4500 in one day! Sounds like an exciting challenge, huh?!?! At this point, we will lose a lot more if I don’t try something. I have written every government official all the way to Washington. I have tried every insurance and TRS avenue. That is the main reason for waiting so long. We have been trying to give the people that should be helping, an opportunity to do the right thing first. The system doesn’t work very well when you need a quick decision. I am fortunate this is not terminal. Now, all I have left is you and God…
I believe God works through people. That is why I never looked for a pat on the back when I worked on the Church roof, played bass in the praise band, or helped someone on the side of the road. It’s my duty as an effort to be a good man and show my appreciation for what has been done for me; paying it forward. Like the saying of Rev. Graham, "They will know we are Christian by our love". I cannot carry out my duties in the future if I do not get the ADR. That means I cannot be me, and I actually LOVE yard work…. Monique has always bragged about my ability to fix anything for her and take care of her. What now? I am feeling that useless feeling we see our grandparents go through, and every man will the first time they can’t be their wife’s hero, except I am only 38.
I have let my pride prevent me from asking for help sooner as well. Now, I am in a bind and need a miracle. My foolish pride got me here, and I am truly humbled by the responses we have already received from several people that called and emailed with donations today, and over Christmas, outside of this site. I want to thank them right now as well. Our thinking is with just a little from a lot of people will make a huge difference..
The appeal letter that is sitting on the TRS desk collecting dust right now is below. There are also 150 pages of successful ADR documentation with it. The doctors will not accept payments for the artificial disc replacement surgery. This is our last try to raise the money. Banks won't loan money to an average person in a down market with no job. I hope you understand... This is a bad circumstance that I pray none of you ever have to go through... If we do not reach our goal to get the ADR completely done, we will replace the discs we can, fuse the rest, and pay our bills during recovery. With one fused level, recovery time can easily triple as well. It is "estimated" at $17,000 per artificial disc for the hospital and $7000 for each actual disc implant. I'll have to figure out how to pay the taxes on your generosity next year…

This is the appeal letter to the insurance company:

Dear Distinguished Panel,
I am writing this letter for the purpose of an exception/ appeal to the recent denial of coverage from Blue Cross Blue Shield of Texas. I am requesting the doctor’s predetermination of surgery be approved as written, as a multilevel artificial disc replacement. I am submitting all of the documents that were previously submitted to the insurance for your review. I know you will contact BCBSTX and request copies as well. That is why I have provided a medical information release form to assist you in this if needed. My purpose for sending a good copy is so you can read it clearly without fax and copy distortion. Even though I need you to consider my personal circumstance, I want the positive facts available to you clearly. Then there will be no question in your mind that this is the best option on how to give me and my family’s life back.
In addition, I am providing more documents showing the success of multiple level artificial disc replacement (ADR). It also includes ten cases of precedent, where BCBS, Aetna, HealthNet, and even Cigna have paid for the multilevel ADR procedures. As you are probably aware, neither ADR nor multilevel ADR is new to the medical industry, and Dr. Jack Zigler is known worldwide for being one of the absolute best in the United States and the spine surgeon community worldwide.
I have done a lot of research on these procedures. In fact, that is why I have waited so long to get this surgery. I have been waiting for the technology to be proven to me before I became willing to do it. Really, it didn’t take too long to decide it is the best option. I just waited for the insurance companies to agree. However, it is becoming more apparent to me that the managed healthcare industry, as a for-profit business, is going to do deny the best options to me as long as they can to save a few bucks, without concern for my current or future pain and suffering.
The excuse is that multilevel ADR is “experimental, investigational, and unproven”. I have to question the intended use of the phrase “experimental, investigational, and unproven”. It seems to me that phrase is being used in a financial manner of liability, not a stance of medical quality or legality. My point being that I called several surgeons from the TCRS- Active Care PPO provider search and found that many of the surgeons that performed back surgery, offered single and multilevel ADR surgery as well. I am also including a Cervical Disc Arthroplasty Technology Overview adopted by the American Academy of Orthopedic Surgeons Board of Directors on March 8, 2010. This is a must read, as it is a study of all ADR options, not just a sponsoring company’s view. Yet it still supports what surgeons are saying around the world as to its effectiveness in single and multilevel artificial disc replacement. This clearly shows the overwhelming popularity and acceptance of multilevel ADR in America, and the fact that so many surgeons are performing the surgeries on a regular basis. My point being; if a procedure is so experimental and dangerous to the public, how can it not be illegal to perform them; and if it is not illegal why won’t insurance companies pay for them when they are necessary to maintain a full and productive life without future, almost certain complications created by fusions.
I think it is obvious at this point, that anyone in my condition would want the very best medical attention available, so they would not have to suffer through the never ending pain that I have gone through again. It is as if the government and the insurance agencies have sentenced me to a slow and agonizing death sentence, filled with lots of pain, in the most resourceful country in the world….
My name is Dennis Alan Yates II. I am 38 years old. My wonderful wife of almost 19 years is Monique Yates, a reading specialist for the Lewisville Independent School District. She helps at-risk children with dyslexia and other learning disabilities, and is the actual member of TRS. She has specialized in changing lives. She teaches kids to read that other teachers leave behind. She has for many years, with many more to come. We have two boys, ages 13 and 17. One aspires to be an aeronautical engineer, while the other wants to attend SMU and become a lawyer. We are members of Trinity Presbyterian Church in The Colony, and I am a member of the Saint John’s Lodge #51 in McKinney. I tell you this because I did not come from the best family environment, but Monique and I are trying our very best to be good, productive people with the goal leaving a legacy of good productive people.
My mother passed away when I was thirteen. By fifteen, I had moved to Florida on a Greyhound bus with a guitar in my hand. I made it back to Lewsiville, Texas and met my wife. We married and a little over a year later, we had Preston. Being that I had acquired a pretty strong work ethic providing for myself so young, we decided that I would work to support the family while she went to college. She worked as well, but we both agreed on what her main focus should be. In fact, I was offered a scholarship to the SMU engineering department in 1998, but turned it down because Monique was still working toward her master’s degree.
I worked extremely hard to learn the transmission industry trade and ended up learning all facets of the business and became a shop owner before I was thirty years old. My first back pain incident occurred when I was 26. I wasn’t doing anything strenuous; I just developed a sharp pain in between my shoulder blades one day while talking to a customer on the phone. I went to my family doctor and she prescribed pain pills and muscle relaxers like all doctors do at first. It seemed to come and go over the years, but came back with a vengeance in 2003. That is when I went to see Dr. Blumenthal, had an MRI, and then steroid injections. I went to a chiropractor, did massage therapy, physical therapy, and then another set of steroid injections. I even have a tens unit to stimulate my muscles at home. Shortly after, I had to shut down my transmission shop because I could no longer manage the day to day business with the pain I was experiencing. I went to work for one of my vendors doing inside sales and self medicating myself with Tylenol, Advil, B.C. powder, etc., hoping to resume a normal life. I finally gave in and went to see Dr. Zigler in 2006. At that time, I had another MRI and my first Discogram performed. Afterward, he recommended surgery because I was in so much pain. However, the only thing available was disc fusions. Artificial Disc Implants were in trial studies since 2002, but no approvals with anyone yet. I learned that after fusions, more times than not, you have to have more surgeries. If not on the same disc following the surgery, then it would be a lower disc that could not hold up the pressure of the huge, solid bone mass created with a fusion. Usually within 6-8 years. At the time of my visit, I was 34 years old. So, you should understand why that option scared me, thinking I might be on my second surgery by forty (two years from now). Do the math: If I live to be a conservative 75, I will have approximately four more surgeries. That is a total of five if I have a fusion, not to mention the fact that it is in my neck. Therefore, each surgery will cause that much more stress going down my spine. That did not sound like a good idea since I was able to tough it out a little longer with medication. Even still, I ended up losing my job in 2008 because it was becoming more difficult to sit in the car during long commutes to and from work. I began doing real estate so I would have flexible hours to accommodate my daily struggle with the pain but the market crashed and I had to get another job. However, within a year, it was getting so bad, between the pain and the effects of the medications, I was in worse shape. So I used all my savings to purchase a franchise, hoping it would generate enough income for my family with the flexible workload to accommodate my high levels of pain. That did not work. Now, here I am with another bad disc above the others, without any source of income, and I cannot even get a job until I am healed.
To give you an idea of what I go through each day with no strenuous activity. If you have a pen in your hand, tap it lightly and slowly on the desk while you read this. I will start at night so you can get an idea of the mental and emotional strain that comes with the constant feeling of lying on a golf ball between, but just above the middle of your shoulder blades, and one strapped at the base of your skull where it meets your neck. I go to bed between 11 and 12, knowing that complete exhaustion is my ally in this battle. It keeps me asleep longer through the pain. Then, I wake up at 2 with both arms having that achy, numb, tingling feeling, and the two golf balls on my back and neck. After half a pill (they have to last) and about thirty minutes, I go back to sleep. Then I wake up again at 5:45 with the same thing, and once again, I go through the motions. Sometimes it takes up to two hours to get back to sleep. Keep tapping your pen, there is a reason… At 7 in the morning I get up and divide up the remaining seven pills I have for the day. Then try to decide if I can wait a little longer before I take one. I want to go to work, but have no job. I want to go find a job, but I can’t do physical labor or even nonphysical labor for extended periods. I can’t sit too long, walk to long, drive to long; you get the picture. Plus, no one will hire me knowing that I need surgery. I am a liability waiting to happen and not dependable in their eyes. There went my self-esteem. I can’t play with my kids. It’s even hard to play video games anymore because my hands don’t function very well. There goes their self esteem. The medication is affecting my memory and motor functions like you would not believe. The other day, I could not even remember my family doctor of fifteen years. Speaking of the medicine; the reason I count my pills every morning is because my dose is so high that if I take too many, I could die. If I drink alcohol or even take Tylenol, I run a huge risk of shutting down my liver. Due to the opiates, I have no intimate desires. How do you think that affects my wife’s self esteem? The rest of the day I try to feel useful by searching the want ads for after the surgery and try to find a remedy to my pain.
Ok, the tapping pen… The slight click of the pen tapping against your desk is the same sound I hear with each step I take. It doesn’t matter if I am barefoot, in boots, tennis shoes, on carpet, long or short distances, whatever. Consider how much you walk each day. You really don’t know how damaging that is to a person’s psyche coupled with the pain, suffering, and sleep deprivation. Similar to Edgar Allen Poe’s Tell Tale Heart; except it is a real noise, depicting a real problem. When the kids go to school, and my wife goes to work, I sit and cry wondering how I am going to recover from this when I’m not even allowed to be healed. How am I going to provide for my family? How will I keep my house? How can I look my wife in the eye and tell her she may never be able to retire now; and she will have to take care of me physically at the same time.
This is not just a letter of appeal. It is a very personal request not to punish me to a slow and painful death sentence when there are better resources available than what have been offered to me. Fusions are a permanent sentence with future problems guaranteed and irreversible. The multilevel artificial disc replacement is a permanent ticket to the American Dream, which is Life, Liberty, and the Pursuit of Happiness.
If this were about money, you would also realize that with the potential of several surgeries over my lifetime, for this one area of my body, it is going to cost you hundreds of thousands of dollars in the long run. This can be reduced by making the right decision the first time. Especially since my wife is a vested teacher that loves the children too much too leave. She and I both invested our lives to her becoming the best reading specialist in town, and don’t plan on moving out of state. So this will be your problem again. However, I really don’t feel like it is about the money at your level. This surgery is a drop in the bucket compared to what you deal with on a daily basis. This is about the humanity in allowing me the dignity to walk tall again, and take care of my family. I am only 38. I don’t deserve this life of pain, suffering and loss of hope for my future; not to mention the burden my family has had to bear.
Day in and day out you go to work, shuffling papers, crunching numbers, and making the decisions for the greater good. The good thing is that you have a daily grind day in and day out. However, today you have an opportunity to stop the daily grind and be heroes. It is that simple. Your decision will change the world for one family; and bring hope to a woman who lost her soul-mate and couple of kids that lost their dad… That is the truth. Between the pain, suffering and medications, I have been losing myself and it’s hurting more than just me.
I have included many facts in this packet to go with the original doctor’s request to BCBSTX for the multilevel ADR. Even though the evidence is solid and holds merit, this is not about statistics or the bureaucracy of getting a procedure approved for the masses. It is about one man being allowed the opportunity to regain and live a good and productive life of dignity. What would you do if it were you and your family going through this? How would you feel? I think you would plead for mercy as well.
Please help my family…. Please make the exception this time….
Most Sincerely,
Dennis A. Yates II
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