Well, after feeling like there was absolutely no hope and no where to turn, there seems to be a plan. At least something in the meantime.
Dr. B suggest I return to Dr. R (spine physiatrist and pain consultant) and see what he felt my options were moving forward to at least help with the pain. After the typical month-long wait, I met w/ him Nov. 18. I met at length with his assistant first in order to go over all the stuff that's gone on since I had seen them last in August... and her jaw dropped when I told her that my insurance denied surgery. Shocked! After her part was done, Dr. R came in. He was reading the notes that J and I had just done and I mentioned to him the insurance denial and he stopped mid sentence, WHAT?!?! He said, and I quote, "I will get them. I take this very serious." He said he would treat me in the meantime, while working to get the surgery approved. He was going to research the issue and get them. I went back to work and faxed him over all the insurance denial information and the insurance guidelines for a fusion surgery.
Plan: another round of epidural spinal steroid injections
When: Nov 22, Dec 6, Dec 20
When I went to the first injection, he said that he had done some research and found that Anthem was pushing back hard on back surgeries because they feel they are done entirely too much nowadays and that there were already National Boards involved...so his research was quick and the boards, I believe, are taking over from there. He said, "Enjoy your Thanksgiving and don't worry about the insurance at all." So, that's what I've done :)
The injections can take 3-10 days to work. . .and from what I can tell thru today, so far I haven't felt any changes. Maybe after the next one, I'll feel more relief. Until then, I just keep managing it the best I can and seeing where things go!
Oh, the appeal that I was going to write will not be finished. I started writing the letter (because the website STILL will not allow it to be done online) didn't get very far because I needed specifics...so I requested my medical records from Neurological Assoc. Once I got those, I still didn't have anything I could use to meet the insurance's guidelines so I don't feel there is any point.....and it was the same day I met w/ Dr. R and since he is fighting for me, I am ok in letting him do the appeal work, rather than my meaningless attempt.
Fingers crossed something gets done to get me whatever needs done to help this pain!