A Straight Line
Supposedly the shortest distance between two points is a straight line. Unfortunately, the shortest distance between me and the surgery I need seems to be a more zig-zagged trajectory, involving several different versions of what is to be done to me for the benefit of the insurance company, along with a liberal sprinkling of our cash.
After all the waiting to see Dr. Balderston, after all the anxious days and weeks wondering what was happening to my body, fretting over the insurance company delays and frustrated with not hearing back from anyone in his office, when he walked in and started off with his usual, “talk to me,” I could barely formulate a sentence. I was too terrified of what the answers would be to ask the questions I had. I’d been sick, literally sick to my stomach, for a few nights in a row, worried about the visit, and the outcome.
We looked at the xrays from September, and he showed me where the vertebrae had slid to the side (see picture below, click to see it larger), something that happened just in the last six months or so.
I also saw how the other disc had collapsed completely, leaving the vertebrae to grind together, bone on bone. Just below that was the disc that collapsed unevenly, causing me to pitch forward.
Click to see larger:
When I asked what the possible timeline was, he grimaced, saying he didn’t have a crystal ball, but then started to say something about how they had had “some luck” with some insurance companies by just submitting for the fusion (he had planned to fuse one of my vertebrae, the L3-4 along with putting in the two ProDiscs at L5-S1 and possibly L4-5 if he can pry it apart sufficiently) and then submitting that they were also doing an ADR and would the insurance company pay for the additional operating room time, hospitalization, anesthetic, etc., if the patient paid out of pocket for the surgeon’s fee for the installation of the disc and the cost of the device itself. I realize that he can't come straight out and say these things, but the hints went right over my head. Thank goodness Tyler was there and picked up on it. Once he told Dr. B that we would be willing to do that, Dr. B said they would start working on it right away, adding that it would still be another “few weeks at least.” He also said the insurance company personnel were “evil,” that clerks with little or no medical training were making medical decisions and trying to dictate what kind of surgery I and other patients in my situation would have, but that he would make sure that I got the configuration that I need, even if we have to pay for it (Somehow that sounds wrong, but oh well …).
So now they will resubmit to the insurance company for the fusion and one disc we will pay for the rest. It’s very scary and only partly because of the money we’ll be spending that the insurance company should shelling out. What also concerns me is that he doesn’t think we should wait for the insurance company to fool around, but rather that we should just go ahead and do something now, before it’s too late to do anything. This of course only adds to the anxiety that I already have about every step that I take putting me closer and closer to inoperability and never standing up straight again. He’s penciled me in again for December 6th and hopefully this time the line will go straight from here to there.
After all the waiting to see Dr. Balderston, after all the anxious days and weeks wondering what was happening to my body, fretting over the insurance company delays and frustrated with not hearing back from anyone in his office, when he walked in and started off with his usual, “talk to me,” I could barely formulate a sentence. I was too terrified of what the answers would be to ask the questions I had. I’d been sick, literally sick to my stomach, for a few nights in a row, worried about the visit, and the outcome.
We looked at the xrays from September, and he showed me where the vertebrae had slid to the side (see picture below, click to see it larger), something that happened just in the last six months or so.
I also saw how the other disc had collapsed completely, leaving the vertebrae to grind together, bone on bone. Just below that was the disc that collapsed unevenly, causing me to pitch forward.
Click to see larger:
When I asked what the possible timeline was, he grimaced, saying he didn’t have a crystal ball, but then started to say something about how they had had “some luck” with some insurance companies by just submitting for the fusion (he had planned to fuse one of my vertebrae, the L3-4 along with putting in the two ProDiscs at L5-S1 and possibly L4-5 if he can pry it apart sufficiently) and then submitting that they were also doing an ADR and would the insurance company pay for the additional operating room time, hospitalization, anesthetic, etc., if the patient paid out of pocket for the surgeon’s fee for the installation of the disc and the cost of the device itself. I realize that he can't come straight out and say these things, but the hints went right over my head. Thank goodness Tyler was there and picked up on it. Once he told Dr. B that we would be willing to do that, Dr. B said they would start working on it right away, adding that it would still be another “few weeks at least.” He also said the insurance company personnel were “evil,” that clerks with little or no medical training were making medical decisions and trying to dictate what kind of surgery I and other patients in my situation would have, but that he would make sure that I got the configuration that I need, even if we have to pay for it (Somehow that sounds wrong, but oh well …).
So now they will resubmit to the insurance company for the fusion and one disc we will pay for the rest. It’s very scary and only partly because of the money we’ll be spending that the insurance company should shelling out. What also concerns me is that he doesn’t think we should wait for the insurance company to fool around, but rather that we should just go ahead and do something now, before it’s too late to do anything. This of course only adds to the anxiety that I already have about every step that I take putting me closer and closer to inoperability and never standing up straight again. He’s penciled me in again for December 6th and hopefully this time the line will go straight from here to there.
Labels: Dr. Balderston, money, surgery
posted by Backblog at 8:43 AM
3 Comments:
just now i saw that you had this big and painful problem my mother has back problems to she had two surgery, and she continues feeling pain. I really hope you find the solution!! get well wishes
my thoughts and best wishes are with you.
-MMMMichelle on flickr
man, oh man. it pains me to read the last few entries, knowing how damn tedious bureaucracy can be at the best of times and then magnifying it to minute-by-minute urgency. commercial bureaucracy is bad, and medical/commercial must be the most frustrating of them all. makes me angry (angrier) that health care is such a luxury, and that governments around the world (including mine) try to wash their hands of it while promoting expensive and unnecessary wars. ugh. synapse block, it's the only way.
it's a drop in the ocean and may seem trivial, but my patronising-outsider's prescription for today: the muppet show. it seems to be doing what the drugs won't, for my suddenly-toothless flatmate, after her wisdoms were wrenched from her head yesterday.
hey, i'm clutching at straws here. i know i can't mention acupuncture, for example ;-)
wish i were a global dictator - you'd be mountain-climbing and playing squash by now, and maureen would be doing your laundry afterwards.
big (gentle) hug. keep your chin up, babe.
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