I think this next story is a great reminder to all the sanctimommies to think long and hard before judging anyone. Alexis Shapiro is 12-years old and is average, height-wise – - four foot seven. But Alexis weights 200 pounds. But before you jump to conclusions and blame the parents, understand – What happened to Alexis is not her fault nor her parents. A few years ago, Alexis had a brain tumor removed. The procedure damaged her hypothalmus and caused something called hypothalmic obesity, which is incredibly rare. The only treatment that will work to help her is gastric bypass surgery, but her parent’s insurance company won’t cover it.
According to reports, Alexis is being kept on a restricted diet, but nothing has stopped her from gaining weight. TRICARE, the family’s medical insurance company since her father is in the US military, has repeatedly denied all requests for a Roux-En-Y gastric bypass. The notice reads “Our reviewers have denied your request for Roux-En-Y Gastric Bypass.”
According to an interview with NBC news, Alexis has been steadily gaining two pounds a week. She’s been hospitalized for a kidney infection, and has already developed type 2 diabetes requiring insulin injections. Her doctor, Thomas Inge, believes that gastric bypass is the only solution:
“I think it is disappointing that they cannot see the facts of this case. There is no evidence that doing nothing would be in this child’s best interests. “
The hardest part of this story is reading about the extremes that Alexis’ family must go to in order to stop her from literally eating herself to death. Her father, Ian Shapiro is understandably worried:
“She’s always hungry. In the past, we’ve had to padlock the cupboard.”
TRICARE’s excuse for not covering the procedure needed is that gastric bypass isn’t covered until the patient reaches the age of 18 and/or has full bone growth. According to TRICARE spokesperson Austin Camacho:
“In general, our Managed Care Support Contractors are required to approve or deny coverage based on TRICARE policy. We have an appeals process in place specifically designed to give our medical professionals the opportunity to examine the details of any special cases when coverage is denied.”
Without insurance, the cost of the procedure is a whopping $50,000. The Unless TRICARE reversed their decision, the family’s options are limited. There have been other, similar cases in the past. Kelsie Blackwell, of Indiana successfully had gastric bypass surgery at 18 and lost 100 pounds after being given the same diagnosis as Alexis. The difference being that Kelsie’s insurance covered everything.
Alexis’ family have created a Gofundme account to cover her medical costs. I seriously wish them well. I think this is a perfect example of how messed up the medical industry is in the US. I hope things work out for Alexis, I really do.