....january 26th is the date!
Insurance will render its decision on my appeal and notify my by that date!
I think when the envelope comes, I'm going to be afraid to open it!
Wednesday, January 5, 2011
Monday, January 3, 2011
Follow up...Let down...
Went to see Dr. R for my followup after the latest round of injections. Well, not much to report, let alone anything good. His assistant came in and got all the latest info and did the typical tests (reflexes, push/pull, bend forward/backward) and talked about the spreadsheet I created of pain/symptoms since Nov 10. Clearly everything is getting worse and the injections didn't do anything...which my first round didn't either last year so I didnt have the most hope!
By the time she was done, I already knew I wasn't liking how things were going. Basically, the plan for the next month is manage pain w/ narcotics....as being in pain constantly isnt' good for the body...and come back in a month. UGH!
Dr. R came in and, as always, said there are many people fighting for me, and all the others in my situation. Also suggested I needed to send letters to the senator and govenor and all those kinda people...get the word out about how insurance companies are denying these surgeries that need done. Also confirmed to take the medicine and come back in a month.
What will happen on Feb 2nd when I go back? I have no idea! I don't know if there are any other options. . .if there are, they have never been mentioned. Maybe after that, he will be done w/ me as well. I just dont know. No matter what happens, I was left with nothing today. An option that I despise, as I've been taking them since September 2009!!!! I HATE taking them. Which, now that I've started school, it makes it hard to study and learn new material while experiencing the affects of a narcotic. So, I will continue on as I have been for months and months....because really, what other choice do I have?
By the time she was done, I already knew I wasn't liking how things were going. Basically, the plan for the next month is manage pain w/ narcotics....as being in pain constantly isnt' good for the body...and come back in a month. UGH!
Dr. R came in and, as always, said there are many people fighting for me, and all the others in my situation. Also suggested I needed to send letters to the senator and govenor and all those kinda people...get the word out about how insurance companies are denying these surgeries that need done. Also confirmed to take the medicine and come back in a month.
What will happen on Feb 2nd when I go back? I have no idea! I don't know if there are any other options. . .if there are, they have never been mentioned. Maybe after that, he will be done w/ me as well. I just dont know. No matter what happens, I was left with nothing today. An option that I despise, as I've been taking them since September 2009!!!! I HATE taking them. Which, now that I've started school, it makes it hard to study and learn new material while experiencing the affects of a narcotic. So, I will continue on as I have been for months and months....because really, what other choice do I have?
Monday, December 20, 2010
Quick Update
Injection #3 is complete. Still no relief but I really didn't expect any. It did hurt quite a bit after it was over - each has progressively gotten worse.
I asked if I needed to continue w/ the 2bananas/1gram of calcium a day because it hasn't helped in the first 11 days...and he said yes, I needed to finish the final 4 days. However, I did find out what he was ruling out......he was ruling out the leg fatigue/weakness being from the injections. Which because there has been no relief, that was indeed ruled out. What does this mean? It means the cause of the leg issue is from the original reason I needed surgery to begin with...not good news. Confirmation that surgery is needed....frustrating because I can't have it.
Made a claim to the Office of the Inspector General against the insurance company. Not sure that it will do anything but I did it at the request of my dr. Guess now I'm supposed to write the insurance company. Again, not sure it's going to do anything but at least it's something.
Jan 3 is the next appt to follow up on the injections and see where to go from here.
...and again, the waiting begins.
I asked if I needed to continue w/ the 2bananas/1gram of calcium a day because it hasn't helped in the first 11 days...and he said yes, I needed to finish the final 4 days. However, I did find out what he was ruling out......he was ruling out the leg fatigue/weakness being from the injections. Which because there has been no relief, that was indeed ruled out. What does this mean? It means the cause of the leg issue is from the original reason I needed surgery to begin with...not good news. Confirmation that surgery is needed....frustrating because I can't have it.
Made a claim to the Office of the Inspector General against the insurance company. Not sure that it will do anything but I did it at the request of my dr. Guess now I'm supposed to write the insurance company. Again, not sure it's going to do anything but at least it's something.
Jan 3 is the next appt to follow up on the injections and see where to go from here.
...and again, the waiting begins.
Saturday, December 11, 2010
another path..
After going on three weeks of my legs being constantly weak/fatigued feeling, as if I had completed 6 marathons a day....I called the dr. Dr. R (who is doing my injections) made two suggestions that I'm to try.
1 gram of Calcium a day x 15 days (aka FIVE HORSE PILLS)
2 large bananas a day x 15 days
Not sure what he thinks it is but I'm following the suggestions.
Final injection Dec 20 then the follow up Jan 3.
We'll see what happens in the next 15 days!
Fingers crossed!
1 gram of Calcium a day x 15 days (aka FIVE HORSE PILLS)
2 large bananas a day x 15 days
Not sure what he thinks it is but I'm following the suggestions.
Final injection Dec 20 then the follow up Jan 3.
We'll see what happens in the next 15 days!
Fingers crossed!
Tuesday, December 7, 2010
Injection #2
the injection itself didn't hurt but as soon as I was in the chair resting, as I am required to do after each one, it started to hurt... thankfully, the xanax knocked me out shortly after I got home which I think is a savior nowadays.
today was the day after the injection....by far the worst day of pain i have had in a long time. not welcomed. very frustrating! from shooting pains down my legs to pain with every step i took to aching in my legs to tingling in the majority of my body........tears of pain and frustration.....
i just want it all to stop!
today was the day after the injection....by far the worst day of pain i have had in a long time. not welcomed. very frustrating! from shooting pains down my legs to pain with every step i took to aching in my legs to tingling in the majority of my body........tears of pain and frustration.....
i just want it all to stop!
Sunday, November 28, 2010
Back to square...let's say 2.
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!
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!
Friday, October 15, 2010
Remaining broken...
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!
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!
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