Finding out surgery was denied when there were 2 days left of the countdown was hard to take...but there was an ounce of hope. A peer-to-peer review was requested from the insurnace co with my surgeon, who normally doesn't participate in them. When the countdown hit 1...the peer review was done. . .and yet, they still denied it. Surgery was cancelled. All post op appts cancelled.
Simply put, I'm completely devastated. I've cried for three days. I'm angry. I'm numb. I'm lost. Totally at a loss on the moving forward.
Right now, I should be in the hospital, recovering from an extensive surgery. Nine months ago today, I was in the hospital recovering from my first lumbar surgery. But instead, I'm sitting in my own bed, eyes drained of all my tears, completely lost. I don't even know how to describe what I feel right now.
I've spent the last two days trying to file an appeal online, which I'm told, is my right. However, their site doesn't load that page. I've talked to customer service and technical support - been told I can file an appeal online and that i can't.... I've lost all patience w/ this insurance company, their employees, and the website. So I search online to learn how to write an appeal, since I was counting on the website to give me guidance, as I've never had an issue w/ my ins. co. before. Talk about overwhelming...didn't leave me with any hope, and I didn't have much to begin with anyway. But I did learn that I needed the denial letter to write the appeal so I could include specifics. So I waited....well, just so happens it came today. DATED LAST FRIDAY!!!!!!!! Just pour more salt in my already deep wound. Knowing what I learned online, and reading the letter...there's little hope, or if I'm being completely honest, none at all that anything i write is going to change the mind of my insurance co who denied it before and AFTER speaking to my surgeon.
My head spins. . . .to think that I've spent the last 5 months waiting for this very day. Today, October 15th, I was to have my best shot at relief from the daily pain I've been living with for the last 18 months. I went to my doctor appts, MRI, waited for results, was subjected to the MOST EXCRUCIATING PAIN EVER with the discogram and waited weeks for results and then longer to find out the plan...then waited another month for today to come.... for what?????????? Absolutely NOTHING! Instead, not only do I have more pain than I did in May...but I have no forseeable options for relief. The surgeon has her hands tied and cannot provide me the option she feels is best for my recovery. She's done w/ my treatment completely. I now wait for Dr. R to get my message next week to see if there is anything that he can do to attempt to alleviate the pain. (Dr. R is the pain physiatrist who did the discogram who specializes in non-surgical pain treatments) Dr. B recommended I call him to see what he might come up with but wasn't sure he would be much help, as he is the one that sent me back to her after the positive discogram, recommending the fusion surgery. At this point, Dr. R seems to be the only hope that I have for relief. The thought of temporary treatments for pain is not ideal to me, when the underlying problem cannot be fixed.
Maybe something will happen and I won't suffer from this forever. Maybe there is a good reason for this denial and cancellation of the relief I was hoping for. But right now, I don't see anything positive. Living everyday with chronic pain that limits me from doing things I enjoy is unacceptable....and it more than angers me to think that the insurance company can overrule the recommendations of two neurosurgeons and a pain physiatrist. Living on pain pills and muscle relaxers to function is not the quality of life I deserve...but thanks to Anthem, that's what I'm left with now.
Back to square 1. . . .completely lost!
Friday, October 15, 2010
Saturday, October 9, 2010
the Final Countdown...
Well, just 5 more days until surgery!! Pre-op appt is done and cleared for surgery. Brace fitting is done and the two-colored blue brace is just waiting (and I didn't pick the color, despite what everyone thinks LOL, it just worked out perfectly). Meet n greet w/ Dr. D (surgeon and hardware expert who will be assisting Dr. B this time around) is done. I am more at ease with the upcoming surgery, now that I know the details of what's to come.
Here's what Dr. D shared w/ me. . . .
Dr. B will be removing 3 bones in my spine that will allow for decompression and relieve the pain in my legs (which was tremendous news as that gets to be the worst by the end of the day). The side bones that stick out (don't know their names) will be shaved a bit in order to signal to my body to generate new bones. Dr. D will put rods in that will line my spine, attached to the bones with 8 BLUE titanium screws in order to stabalize the 3 level area, so that it no longer has the ability to move. Because there will be tremendous pressure in the area(just by normal living), they have to fuse the area w/ bone in order to prevent the rods/screws from breaking over time. This is done by grinding up the 3 bones that were removed and adding it to the good parts (minerals, etc) of cadaver bones until a 'putty' is formed. This will be placed in between the bones and allow for the fusion to take place.
The surgery has 3 purposes...decompression, fixation, and fusion in 3 levels (L3/L4, L4/L5, and L5/S1). Because of the invasiveness of this surgery, I will be in the hospital for 2-3 days to manage the pain and such. I will be walking before leaving the hospital. My brace is for times where I'm up and moving about. I don't have to wear it when I'm sleeping or even necessarily when I'm sitting and watching tv, per se. I need to wear it a bit more this week to get used to it...don't need to be healing from this surgery and getting used to the brace at the same time. I'm a pro at getting it on and off so that helps. I could be wearing it for 8wks, 12 wks...it all really depends on how quickly I heal. After I do heal, then i will start PT again, to recondition my body for movement. It's not used for pain management post-op this time, as it was after my first surgery. So I won't be starting that for a couple months.
I have been ok'd (by the nurse LOL) to work from home beginning 11/1 so I don't have to go too long on disability income. However, I won't be returning to the office for approximately 6 months it sounds like. I'm not gonna know anyone when I get back! That's such a long time but they want to be sure that I'm healed and ready to return to sitting for long periods of time.
After this week of appointments, I feel I'm ready for surgery (as well as I can be). Just ready for the relief that I'm praying this brings to me!
let the countdown begin.... 5....4....3....2....1......
Here's what Dr. D shared w/ me. . . .
Dr. B will be removing 3 bones in my spine that will allow for decompression and relieve the pain in my legs (which was tremendous news as that gets to be the worst by the end of the day). The side bones that stick out (don't know their names) will be shaved a bit in order to signal to my body to generate new bones. Dr. D will put rods in that will line my spine, attached to the bones with 8 BLUE titanium screws in order to stabalize the 3 level area, so that it no longer has the ability to move. Because there will be tremendous pressure in the area(just by normal living), they have to fuse the area w/ bone in order to prevent the rods/screws from breaking over time. This is done by grinding up the 3 bones that were removed and adding it to the good parts (minerals, etc) of cadaver bones until a 'putty' is formed. This will be placed in between the bones and allow for the fusion to take place.
The surgery has 3 purposes...decompression, fixation, and fusion in 3 levels (L3/L4, L4/L5, and L5/S1). Because of the invasiveness of this surgery, I will be in the hospital for 2-3 days to manage the pain and such. I will be walking before leaving the hospital. My brace is for times where I'm up and moving about. I don't have to wear it when I'm sleeping or even necessarily when I'm sitting and watching tv, per se. I need to wear it a bit more this week to get used to it...don't need to be healing from this surgery and getting used to the brace at the same time. I'm a pro at getting it on and off so that helps. I could be wearing it for 8wks, 12 wks...it all really depends on how quickly I heal. After I do heal, then i will start PT again, to recondition my body for movement. It's not used for pain management post-op this time, as it was after my first surgery. So I won't be starting that for a couple months.
I have been ok'd (by the nurse LOL) to work from home beginning 11/1 so I don't have to go too long on disability income. However, I won't be returning to the office for approximately 6 months it sounds like. I'm not gonna know anyone when I get back! That's such a long time but they want to be sure that I'm healed and ready to return to sitting for long periods of time.
After this week of appointments, I feel I'm ready for surgery (as well as I can be). Just ready for the relief that I'm praying this brings to me!
let the countdown begin.... 5....4....3....2....1......
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