Need orthopedic doc, or physical med/rehab doc in Cincy

Here's my situation - weight has been stable for months. Along the way, I have developed lower back pain. I have done exercises and tried support garments with little to no relief. I believe my back pain is the result of the "deflated" abdominal tissue I now have. I saw a plastic surgeon, who wrote a very nice letter, and I also wrote a letter requesting reconstructive abdominoplasty (as cosmetic procedures are not covered by my insurance plan). My request was denied - but it is to go before the QI committee (9 physician panel plus a rep from HR) in May for consideration. In order to strengthen my case, I think a statement supporting my case from an ortho doc or a PM&R doc might go a long way. Has anyone in the Cincinnati area seen a doctor in either specialty who might be sympathetic to my situation, and might be willing to write a statement to back me up? I hope someone out there can help me out. (I have sort of been through this before - I wrote my husband's letter that not only got him approved for WLS with a BMI less than 40, but the criteria was changed for our policy to include folks with a BMI less than 40 with co-morbids "and so forth"). Hope someone can help! Thanks in advance. (By the way, if this works, I would be willing to share my letter so maybe someone else can get a much needed abdominoplasty covered!) Sue

SUE, go to main message board and look up somthing by " Tooter ". Then look at her profile. She has some really good stuff listed that might help you. Good luck Judy

Thanks - I checked her profile and read her letter. I don't have problems with rashes or an or skin problems, so I am trying to get my abdominoplasty approved on the basis of impaired function. I have a 3cm by 15 cm diastasis recti, and included some references in my letter that talk about how the abdominal muscles help support the back, as well as the fact that 10 lbs of adipose tissue put the equivalent of 100 lbs of strain on the lower back muscles. To be honest, my letter is a bit more succinct and includes statements from the AMA decribing the difference between cosmetic and reconstructive surgery. The other thing is that the medical director *****viewed this is, essentially, my boss. "Chris D." responded on the Q&A board about how she got her TT approved on the basis of impaired function, also. The real kicker is that I found a loophole in my insurance plan, so I am hoping that gets me covered. I am just thinking that between now and May 25th, if I can get an MD to back my statements up, that may make my case stronger . (What do I know - only been a nurse for 25 years!) Sue

Susan, I'm not from Cincinnati but our son was referred to Dr. Sammarco to see what was going on with his ankle. Its a long story but the local ortho TOTALLY missed what was going on-actually trying to pass it off as "simply a sprain-loose the weight and all will be well". Well, after getting Dr. Sammarco involved, he left no stone unturned and diagnosed our then 17 year old son's problem. Thanks to the local ortho who blew it, he now had severe arthritis due to the ligaments in the subtalar joint being injured/damaged and left untreated. Dr. Sammarco was very sympathethic and never once put our son down due to his weight (yes, he is his mother's son where weight is concerned). Our son eventually had to have that ankle fused and all along, I felt totally comfortable with Dr. Sammarco and our son was given the best of treatment and care by him. He also wrote letters on our son's behalf when requested. Beth