Monday, March 30, 2015

I Understand Your Frustration

What I picture when I call my health insurance provider...
Well, it has been almost two weeks and absolutely nothing has happened. No approvals. No new appointments. No treatment. I called my insurance company to find out what I could do to help in the process and was told, "Nothing". All information and documentation has to come from a medical provider. I can't send them records so that they can see that I have tried physical therapy and medication.

I mean, the insurance company is paying for the physical therapy and medication but they give me the reason that I haven't tried those things for denying the MRI. I am SO utterly confused and frustrated.

The insurance company has 30 days to respond to the appeal. They string these processes out so long that they end up not paying for as much treatment. I firmly believe that this strategy is used on purpose by the health insurance companies as a way to get out of paying for treatment/medication and it is SO WRONG. I have children, a grandchild, and a partner that need me. My life is on hold and it isn't even my choice. I fell. It was an accident and now I feel like I'm being discarded. There is no need to get me healthy and functioning when we have enough people out there that the government doesn't need to pay out benefits for, right?

All I want is to get better. I know I probably won't be pain free but I at least want a chance at feeling less pain and being more active. I'm not asking for a lot and I've been patient. Please just let my doctors treat me.

Wednesday, March 18, 2015

What is the Point of Insurance?

X-ray picture of an injection being performed on my right SI joint. 
Just to keep up on my SI joint treatment/lack of treatment... Insurance still hasn't approved the MRI my specialist wanted to have done.

I really don't know what I could be doing differently. I get treated like I'm the one saying no to treatment. I've wanted injections and nerve ablation for a year and a half. Insurance keeps saying no to everything except pain medication. Now the doctors are warning me, "This is only a temporary solution. You need to try injections and RFA to attempt to get off of pain meds completely or reduce your need." NO SHIT!!!! Tell my insurance that!!

I haven't been eating cause I'm so stressed out. I've lost probably 10 pounds and am back to being underweight. I'm losing more muscle and then that makes my pain worse. My joints need to be stabilized with increased muscle but how am I supposed to work out when I don't eat and have massive pain?

This is when I want to give up. Instead I throw in the towel for a few days and cry a lot. Then it's back to jumping through the hoops, begging for pain medicine and fighting with my insurance.

Monday, March 16, 2015


This little guy keeps me going!

I got some good news Friday! The pain management doctor I saw is on the exact same page as me and my orthopedic specialist. Imaging, injections and then nerve ablation (burning the nerves). He had my records from three other providers including a spine physiatrist and another pain management doctor that had done nerve blocks on me before.

We talked about why I stopped pain management before and he understood. He did a real exam on me and found the same symptoms that other doctors have - I can't walk on my heel with my right leg, my pelvis is lower on the right, positive for FABER (Flexion, Abduction and External Rotation), etc. Something is seriously wrong with my right SI joint and I'm sick and tired of being told I'm too young to have the type of pain I have.

The goal is to get me to a point where I either do not need long term narcotic pain medication or reduce the amount needed. I know that I don't want to get on a high dosage long term because my body will start to need more. I need to be functional though. I've gone from being able to walk 2-3 miles or hike with a pack to only being able to walk a few blocks. The next doctor that tells me I shouldn't have as much pain as I do is going to get an earful. I'm done feeling like a victim of the system and being treated like a drug addict. 

Tuesday, March 10, 2015

Pain Management

I've decided to document my struggle with insurance and medical providers. I think it will be good to have a journal of what I'm going through... 

The initial injury - On May 15, 2011 I fell (on the right buttock) while roller skating at my older son's birthday party. I fell so hard I knocked the wind out of myself. I heard a pop and have been in pain ever since.

Since I fell I have had x-rays, fluoroscopic diagnostic injections, two rounds of cortisone injections, physical therapy, chiropractic care, MRI, prolotherapy, sacroiliac support belt, and multiple shots of Toradol in urgent care and with my primary.

In February of 2012 I got pregnant. In March 2012 I had a miscarriage. I know the pain medication wasn't the reason for the miscarriage but I still felt guilty and decided to stop any treatment until I had a healthy baby & had my tubes tied. In August 2012 I was pregnant again and gave birth to a healthy baby boy in April 2013.

Later that year (August 2013) I started seeing the doctor that is now my primary care physician. My pain had come back and was worse than before the pregnancy. My primary referred me to a specialist. They tried prolotherapy and attempted to get my insurance to pay for physical therapy again so that I could then have cortisone injections. Well, I was also having muscle spasms internally from the pregnancy so I had been to physical therapy for that. Insurance refused to pay for any more visits even though it was a different issue.

The only option I had was to maintain as best I could with pain medicine. Unfortunately there are laws telling my primary care physician how long they can prescribe pain medication and at the end of last year I had reached that limit. I had to be sent to a pain management clinic.

The pain management doctor said he didn't get enough in the referral to prescribe for me though. I've spent years in pain, getting treatment and there isn't enough on record that he can see?! He didn't even seem to be slightly concerned about my state of mind or my quality of life. I was crying and dazed. So many years of dead ends and pain...

In the few weeks since my "pain management" appointment I have gone to an orthopedic specialist, physical therapist and counselor. I've called all my old providers and had every record I can locate faxed & mailed to them. It really shouldn't be this difficult though. I feel like I'm being punished because of a few bad doctors and a prescription drug epidemic that I had nothing to do with!! I didn't choose to get injured. It just happened. Chronic pain sufferers shouldn't be treated like they are drug addicts. It is already hard enough to deal with day to day. 

Wednesday, March 4, 2015


I'm fighting with my body again. I've been in so much pain since falling years ago and now I can't get the pain medication I had been getting because a doctor thinks I'm too young. He coldly said something about DEA requirements...blah blah blah... What about me as a patient? What about my quality of life?! He stares at me blankly. Left the office dazed, crying and confused. My primary doctor told me they would be able to give me MORE options. Not just tell me that I will no longer get the medication I need to function.

My life means nothing to them. Insurance is terrible now. They delayed my treatment by a year and now I'm so much worse. And now I can't even move around to get better...

I feel so damned hopeless right now. I have these ambitions and dreams and my body keeps stopping me. I get sick to my stomach EVERY morning. EVERY morning. Maybe once a year I will have a morning when I don't feel like I'm going to die. Every day I feel dizzy and have stomach pain. No matter what or how much I eat. I've been to specialists, had a diagnosis, gall bladder removed and a bunch of shoulders shrugging at me. Sure, I don't go to the hospital once a month with uncontrollable vomiting anymore but I'm not doing good. Not by a long shot.

Being negative does no good so I soldier on and focus on the positive but when I'm not even sure I can complete the course I'm on and take care of my own basic necessities for the rest of my life I want to give up. I don't have anyone to take care of me. I have four kids to take care of. I have a partner that is depending on me to pull my own weight. There is no way in hell I can get approved for disability so why even try?

Tomorrow I see an orthopedic specialist and I'm hoping against hope he can send something to the pain specialist giving him a good enough reason on paper to please the DEA. Excuse my language but government needs to stay the FUCK out of healthcare. 

Monday, March 2, 2015

An Old Mantra

Music really influences me and helps me a lot. I just heard a song that drove me around 5 years ago to make some pretty significant changes in my life (leaving my husband, new job, etc). Finally, the years of sacrifice and work is showing its results. Thank you Michael Pastore for telling me how it is and forever changing my life. My life is the result of choices I have made, good and bad. It is up to only me to make my life what I want it to be.

by Killswitch Engage

Forever falling, Into oblivion
The darkness crawls forward
It engulfs, my will to live
Fear is failure
And this is my motivation

Take back what was stolen
Reclaim all that's lost
With virtue, I will rise up from the ruins

Through adversity, there is redemption
With passion, fighting
I am unbroken
Through adversity, there is redemption
With passion, fighting
I am, unbroken!!

Take back what was stolen
Embrace the cycle
Refuse to turn back now and be led astray
Fear is failure
And this is my affirmation

Through adversity, there is redemption
With passion, fighting
I am unbroken
Through adversity, there is redemption
With passion, fighting

The absence of fear, is the renewal of ourself
The absence of doubt, breeds desire
If there is truth to face
I will design it
I will not be denied!