Greetings to all. I am in need of your thoughts regarding a denial from my HMO for a second opinion with a NS. My 1st NS maintains that he is mystified as to what is causing my left arm pain,weakness,muscle atrophy and absent tricep reflexes.My MRI and Ct reports reveal a central herniated disc with spinal cord compression,multiple osteophytes impinging on the foramin and EMG show severe c7 active denervation. Because of the NS inability to see a problem, I requested a 2nd opinion with a NS but was denied!!!!! They want me to see their ortho Dr.,yet I hesitate because upon investigation I have heard this Dr does not have favorable outcomes. It seem he takes on cases that my NS won't touch!
I paid for an independent opinion outside this medical group at a leading University hospital This ortho spine Dr was not mystified and was very concerned at the level of arm weakness I had and felt surgery was indicated ASAP. So actually I wanted a 3rd opinion and was denied!!! The 1st and 2nd are so different and that what leads to my hesitation to commit to surgery.
So my question is do I appeal this decision with the medical group and insurance company? Should I see this ortho DR they want me to see? My husband wants to again PAY out of our pockets for the 3rd opinion.The good news is that effective Dec 1st we will be out of the HMO and with a PPO and i can go where ever I want!!!! I am really afraid to wait because the symptoms are worsening and the Ortho Dr said the longer I wait ,the less chance of neurological recovery I have.At the rate these Drs are taking, it will be 2009 anyway. I am so tired of all of this run around. I cried so hard on Friday because I can't see an end to this. Your thoughts or ideas to clear my mind would be helpful. Thanks, Bethy