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Thursday, February 18, 2010

Insurance Woes

One of the most common questions I get from readers is regarding insurance and how to get coverage for your stimulator.  Mine was easy enough...my doctor's office did all the pre-approval work.  But it looks like I jinxed myself by bragging about how lucky I have been to have great insurance to cover my stimulator.  Last week I got a letter in the mail from the insurance company saying they were denying over $12,000 worth of claims.  I had no idea what they were talking about so I just set it aside.  On Tuesday I got a letter from the surgeon's office saying they'd tried submitting my claims several times but the insurance company refuses to pay so it is now my responsibility.  Fantastic.

The charges they don't want to pay for are specifically for the stimulator.  They already paid everything else, including all the hospital costs, as well as many of the surgical costs.  I don't understand how you can pay for 90% of a surgery but not the other 10%.  Don't they do hand-in-hand?

I'd like to know why I sat around waiting for pre-approval for 6 weeks when that approval apparently means nothing.  On the positive side, I have all the paperwork to back up what I say.  On the negative side, I'll have to get a lawyer and go to court to fight this.  $12,000 isn't much to an insurance company so I am hoping they will settle out of court but still, it's going to be stressful to deal with.

I guess I should be happy they covered ANY of the surgery, since it seems like so many companies won't.  But still...the whole thing is really pretty annoying.  I haven't even seen or paid any medical bills in months; I thought this was all resolved.  Grr.


Wednesday, February 3, 2010

Chronic Pain: Hitting Rock Bottom

I usually try to limit blog posts to things related very closely to occipital nerve stimulation, but I'm now faced with a situation that I want to discuss. It's not directly related to ONS but I think it's important to talk about.

I was informed on Tuesday that my supervisor killed himself this weekend. He suffered from chronic back pain. He only moved here last January, so I don't know his history, but from discussions with him last summer I know he's been to many doctors and tried many things. He had a metal rod implanted in his back at some point so he has more of a history than I can begin to imagine, I'm sure. His condition deteriorated quickly at the end of last summer. He got to the point where he could no longer sit or stand for more than about 5 minutes at a time, so he was essentially a prisoner of his bed. He was taking a lot of heavy-duty painkillers just to get through each day. He was not married and did not have any family in the area. Someone from work would go over once or twice a week but they wouldn't stay long so I think part of his downward spiral must have come from feeling isolated and alone. I guess he decided it just wasn't worth it anymore.

However, I do think he gave up on himself a long time ago. We had a discussion last summer about a doctor's appointment he'd been to and the doctor has said something along the lines of "you need to get something figured out. If you feel this way now (he was in his 40's), how are you going to feel when you are 75?" And my boss said "I hope to god I don't live to be that old." I know people made suggestions to him of where to go for treatment, and offered him transportation but to my knowledge he didn't accept much help.

The moral of this story to me, and why I wanted to share it, is this: no one can help you if you don't help yourself. I understand chronic pain. I've been there. Last winter I myself was feeling extremely low and got to the point where I couldn't envision a future for myself because every day was just filled with pain. I was not suicidal but I certainly was depressed. But I (luckily) got to the point where I got mad, not to the point of giving up. I refused to "live" this way and realized that I had to go find help for myself, whatever that took. That's why I traveled 1000 miles and spent 4 months away from home. And if it would have taken 4 times that long, I still would have done it. I had been to "experts," and no, they didn't help. You have to keep searching until you find the right doctor for yourself. Just because someone is labeled as a specialist or has been treating "your kind of case" for 30 years doesn't mean they can help you. You don't have to stick with a doctor that isn't helping you. I wasted way too much time doing that. If they don't help you, move on and try the next one. But if you just sit around wallowing in misery and self-pity, you will never feel better. No one will come knocking on your door saying "I think I have a solution for you."

Wow, I guess this turned into a bit of a lecture but it's just something that I feel very adamant about. I'm very sad for my boss. In all honesty, I didn't know him very well at all, but it still makes me sad that he felt death was the only way to end the pain. I hope to inspire people to take a different path than that, to give them hope, because you don't have to just give in. But you do have to be willing to help yourself.