Overheard
Gastric Sleeve Patients-
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merry1126 reacted to a post in a topic: Harvard Pilgrim Requirements for BMI 35. Will my back injury be enough for a comorbidity?
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Harvard Pilgrim Requirements for BMI 35. Will my back injury be enough for a comorbidity?
Overheard replied to Overheard's topic in Insurance & Financing
Thank you, Merry! -
Overheard reacted to a post in a topic: Harvard Pilgrim Requirements for BMI 35. Will my back injury be enough for a comorbidity?
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Are there any bariatric surgeons/clinics who would go to bat for me for a gastric sleeve operation with Harvard Pilgrim in MA area hospitals? 30 y.o, 5'8", 232 lbs, fluctuates between 225s-240s. Serious yo-yo weight gain/loss between 180-240 over the last 7 years. Pre-Diabetic with frequent urination and low energy, chronic lower back pain (compressed L5/S1 with sharp pain and thrown out pain), chronic knee pain (torn ACL and meniscus), and now I'm getting chronic random toe infections. Numerous missed days due to these issues, especiall the back/weight immobility. I struggling with getting out of bed or even bending down to help my students with classwork. This limits my mobility but not my hunger, and triggers depression more. Attempts: Numerous years of health clubs, trainers, nutritionists, workout and eating plans, yoga and mindful eating, intensive therapy, and even stay away camps focusing on health/nutrition/fitness/therapy. It all centers around the hunger. At the end of the day, I am always hungry and/or exhausted. And the instability is something I can't take anymore. Are there any bariatric surgeons/clinics who would go to bat for me for a gastric sleeve operations with Harvard Pilgrim in MA area hospitals? Thank you for any help or advice that you can provide!
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Overheard started following Massachusetts, Usa
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Harvard Pilgrim Requirements for BMI 35. Will my back injury be enough for a comorbidity?
Overheard posted a topic in Insurance & Financing
30 y.o., 5'8", 230-240 (fluctuating weight) Weight and Weight-Loss Attempt History: Been overweight since I was 19. Went up to the 220s-230s for years. Pre-diabetic and fed up .. was able to get down to 180, but that was with an unsustainable schedule for myself: 1.5 hours workout in the morning followed by a 2 hour workout in the evening. Plus a calorie restriction. I was constantly exhausted, unsatisfied, and unhappy. Since, the weight has come back and I'm back to the 220s-240 range. I've tried yoga. I've had therapy. I've had trainers. I have had online trainers and nutritionists. I have had logs and trackers. I have been trained in mindful eating. I went to a stay away weight loss / therapy / nutrition / physical therapy program for over a week. Through it, it became clear I love working out and eating well, but it is very hard to feel full. It takes a lot more food to feel full, and I feel full for less long. I heard many others talk about how they eat because they don't know what hunger or fullness feels like. I totally know! Insurance: I called a Center for Excellence here in Boston (Mount Auburn), and at first they said Harvard Pilgrim requires a BMI ≥ 35 and a co-morbidity. At first, Mount Auburn said that HP wouldn't accept it. However, after calling HP, they told me that they accept apps on a case-by-case basis, and that Mt. Auburn should submit all relevant info with the application. Compressed discs (L5/S1) as a result of an initial and repeated injuries as the result of domestic violence. I have had numerous visits to the E.R. and my primary care physician. All she could find was a compressed disc. However, my back - especially since my weight gain - has made life difficult. I throw it out frequently, miss numerous days of work, and am unable to enjoy healthier activities. Above all else, it prevents me from working. I'm a teacher, and have to sit, lie down, or stay home. Sitting up from bed or even bending over to look at my students' work feels like a strain on the back, and can sometimes send shooting pain through my back/leg. Every doctor has said there isn't anything to do. So at this point, combined with my weight, my health and quality of life is worsening. I feel stuck. I can follow a program, but every program I try is not sustainable because at the end of the day I am just hungry. And the gastric sleeve seems like the teammate I need to help with the hunger, while I take care of everything else. QUESTIONS: Has anyone had similar experiences, or experiences with HP? What do you think my chances are? What - if any - documentation or details should I provide to Mt. Auburn so they can submit it to HP? Anyone know for sure what HP's requirements are? Thank you all for any help, and I hope you all find assistance and help in here too!