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As if there are not enough challenges already

My gosh the challenges just keep on rolling in.

Hi my name is Shawn and I was scheduled for a four level plif tomorrow. I receive a call from my neuro's office telling me that insurance has not approved it. That it was declined. And that we would have to reschedule. So I stop her there and tell her to pump her brakes and give me chance to sort it out. Mind you that here in Oklahoma offices close at five. And most offices won't accept calls after 4:30. Anyway so I have my companies insurance rep start calling while i call the ortho surgeons office to tell them to hold my spot. I get a return call from my ins rep stating that my surgery wasn't denied. That they had just received my paperwork at noon today is the only reason it has not been approved yet. So sorting this out I find out that the blame is falling back to the admitting doctors office for not filing the paperwork sooner. Hence the Neuro admin office. So I call the ins people begging and pleading to mark my file as urgent so that I can still go through with my surgery tomorrow. So now I'm in a holding pattern waiting to see if I can meet the timeframe of everyone's expectations to go through with it. All the while deciding how best to deal with the lies told to me by my neuro's office early. You see how I grew up and luckily where I work as well , we are a relationship driven company and keep the standards for ourselves. Being lied to in such a manner with someone I really need to trust is nagging at me to no end. I wish I had her lies recorded.

Anyway here I am waiting after waiting so long to try a procedure that might give me a life again. So I am praying and hoping that it will work out. As you all are aware it takes a lot of planning to get one of these done. All the doctors visits. All the co pays. All the tests. All the pre op visits. All the up front long paid to both doctors. And really one of the biggies here is all the missed work to do all of this. And all the work I have planned to take off for after the surgery. And to be held up by someone's incompetence is just beyond me. And why am I doing their job of fixing the mistake. I should be focussing on my surgery at this point not the admin mistakes. Well that is all the venting I have for now.
Shawn
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Comments

  • Thank goodness you were levelheaded enough to make the necessary phone calls and get this fixed. I cannot believe that woman blatantly and outright lied to you! It makes me so furious when someone won't own up to their mistake and accept the consequences. I always tell my kids that their punishment will be way less severe if they confess to whatever it is they did, as I will not tolerate lying.

    For now, just focus on you. Get in, get surgery, get better. You can deal with that mess later. I think a call and a letter to the office manager is definitely in order, but that can be done later. My employer terminated my position 2 days after I had surgery, and it was a workers comp injury! They decided to change the rules on me without any warning - told me one thing in January and something completely different in July. Good thing I have the letter they sent me back in January, huh? So right now, I may or may not have a job, but I'm not worrying about that until I'm even physically able to go back to work. That stress is not going to help me heal, so I've put it in a little box in the back of my brain and I will deal with it when I am strong enough.

    Best of luck with the surgery! I hope everything works out for you. Please update when you are able!
    Michelle
    L5-S1 Fusion, Discectomy on 7/10/12
    Herniated Discs at L3-L4-L5-S1, Spondylosis, Spondylolethesis at L5, DDD, Partial CES, Lumbar Facet Arthropathy
    Chronic back pain since 12/2010 (slip and fall on ice)
  • Hey bigshawn......I'm not surprised at all what happened to you. I think that happens more often than you think. As I get older (44) and have gone through the medical system (Canada) a few times ,I am so disappointed at how we are treated. It's really a joke... I've learned that no one is going to take care of you ......but you! Keep track of everything and ask lots of questions......Good luck!
    Michelle.......I noticed you had a similar surgery ,very close to when I had mine this year. Mine was on the 13th of July (yes...it was a FRIDAY !)
    How are you doing? I'm still in a fair amount of sciatic nerve pain down my leg. I can walk, lift and do almost anything but will suffer later with more pain. I've gone through 9 visits of physio with little help, in my mind , but I hope I continue to heal! The surgeon wants to see me and be off work till December 17th.....
    Kevin

    Different degrees of back pain since 1994
    Chiro-Physio-Ostheopath-Homeopathy-Acupunture
    Cortisone shots Jan/09
    Discectomy and lamenectomy April/09
    L5 - S1 spinal fusion July.13th/12
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  • its a nightmare. i had my surgery denied, but it came from the isurance company. they claimed it wasn't medically necessary, but they'd pay for a laminectomy. gave my doc the run around. told him who to speak to for a peer to peer review, and then the guy wouldn't even get on the phone with him. he spoke to several other docs who wouldn't make the decision in place of the one listed on the paperwork.

    needless to say, 1 week before my surgery, the office called to cancel my pre-surgical testing figuring it was a waste of time and money for everyone.

    we complained to corporate offices. written letters to 7 top execs. and it was a huge complaint, since they already paid for 2 laminectomies which obviously didn't work since i was trying for the fusion. plus denials of other stuff like PT and what not for 2 years prior to requesting this surgery. well, less than 24 hours later my insurance company called me to say they were approving my surgery. then they called my doc's office.

    and 5 days before my scheduled surgery date, doc's office managed to reinstate my testing for the next morning and surgery was back on for monday. thank heavens they never gave away the OR spot.

    but it kills me that insurance claims it wasn't medically necessary when 3 docs i saw all said it was. plus my doc showed an image from my most recent CT scan to 200 docs at a lecture he gave, and every single one of them agreed based on the images shown, i needed a fusion and a laminectomy would be a waste of time.

    nothing is every easy. i hope you get it cleared away with the insurance company so you can go through with the surgery. if nothing else, you can't worry about the actual surgery if you're worrying about the insurance approval. (I got so sidetracked with the insurance approval, never had time to think about the actual surgery... might have been a blessing in disguise.)
    Microdisectomy / hemi-laminectomy 6/2010 and revision 10/2010
    Cervical fusion C4-5 and C5-6 9/2011
    Lumbar Fusion L5-S1 6/2012
  • And may you have a successful and relatively pain free outcome.

    Let us know how you go.
  • I can't believe you had surgery on Friday the 13th! I don't think I would have! I'm not a really superstitious person, but that would have been pushing it.

    I'm still miserable. I think that my "caregivers" (meaning the workers comp nurse case manager) made some bad decisions regarding my post op care, such as starting pt 2 weeks after surgery. Workers Comp....ha. Don't even get me started on them! Took me 2 hearings with the WC Commission, 3 surgical consults (including their own surgeon) and 8 months to get my surgery approved. I am walking with a cane most days, but a walker on really bad days. Still can't stand long enough to shower, so I'm still using my shower seat, and it takes me FOREVER to do my makeup and blow dry my hair because I have to stop several times to lay down. I'm in constant pain - low back, with nerve pain in my hips and legs. I had a Caudal injection on Monday which has sent my nerves into overdrive, so I keep getting what feels like electrical pulses down my legs. Needless to say, the past few days I've been completely useless. I have no idea when I'll be going back to work, since my job was terminated 2 days after I had surgery. I'm telling you, you gotta love workers comp.

    Sounds like you're doing pretty darn good, though! Keep it up, and don't push it too hard! Slow and steady, right?
    Michelle
    L5-S1 Fusion, Discectomy on 7/10/12
    Herniated Discs at L3-L4-L5-S1, Spondylosis, Spondylolethesis at L5, DDD, Partial CES, Lumbar Facet Arthropathy
    Chronic back pain since 12/2010 (slip and fall on ice)
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  • Davey16DDavey16 Posts: 31
    edited 10/04/2012 - 6:46 AM
    Hi

    Can relate to most on here, Had L4/L/5S1 fusion, with decompression @ L4 L5. surgery was slated for 6 hrs ended up being 7.5 hrs, My 6.5 inch incision got infected shortly after my doc took out the stitches, he stated I had left it too long to have them out, I am in Ontario Canada, I find that post op there is little follow up, as to what you should be doing except the BLT as some one mentioned, I have an appointment to see the Surgeon on the 19th Oct 2012,

    It is one step forward and 2 back some days, My incision is super sensitive and I still have nerve pain down the right thigh, from groin to knee, this is so intense sometimes it is a burning/electrical shock sensation, I have to lay down and take the weight off my feet,

    Last night I could not bear the weight of bed sheets on my stomach/thigh area as it gave so much nerve pain, also the incision felt like a knife in my back, finally took 2 x T3's and placed 2 pillows under my legs and finally got some sleep, this morning the pain is only 25 % of what it was thank god,

    Only persons that have back problems really understand, fed up of people saying your getting around well and look okay,I do believe that once the swelling around the incision (which is noticeable) and the nerves settle down I think the nerve pain will gradually improve, (heres hoping ) I am going to bath bed and beyond to get me one of those cushions, still not able to drive yet as get spasms in back and right leg.

    Regards to all

    Davey
  • Wow Davey..... I feel bad for ya.... Being in this type of pain shouldn't be allowed in this day and age! You would think after thousands of back surgeries, that a fairly pain free outcome would be somewhat normal, it doesn't seem like that. Granted , mostly everyone here has "not" had as good an outcome as they would have liked, but there are lots who are much better off for having this surgery.
    After reading your story here , it seems to me that your incision (or internals) was definitley infected and that sucks. That's what the docs don't want to happen. My wife applied "polysporin" to my wound every day which helped a lot, i recommend you start doing that just to help with any further infection and or swelling. It's great stuff !
    I can't believe the doc said the stitches were in too long! Aren't "they" supposed to tell you when to take them out?? My surgeon from St. John (Dr Abraham) put in self disolving stitches which seemed to wotk out great. My 6" cut looks and feels good.... :) Why wouldn't the docs in Ontario go with this type of stitch?? You would think information would be spread from hospital to hospital , but not the case I guess...
    You're spot on when people say, "Oh you're moving around OK , you must be fine" I'd like to smash their little faces in sometimes! :) If pain were a "color" , they would see our pain but they can't. I've often wished that I could touch someone on the arm and transfer my pain to them (like the movie Powder)...... and then see them drop to the ground screaming in pain. Then maybe they would understand! Sorry for the drama here ,but it feels good! lol
    lol @ Michelle.....I hear that all the time about the Friday the 13th..... I am superstitious too but I figured , a lot of bad hapens on that day, but also a lot of good. That's what I told myself anyways! :) So far so good , by hearing others, I think I'm above average with my recovery though it's hard to believe.
    One more thing.... You said it takes you forever to do your make-up..... I can see your profile picture and I would say it wouldn't take you long at all, couple of minutes maybe? Wink! I hope I made you smile! :)
    Keep up the postive thoughts and I'm wishing everyone a speedy recovery!!
    Kevin

    Different degrees of back pain since 1994
    Chiro-Physio-Ostheopath-Homeopathy-Acupunture
    Cortisone shots Jan/09
    Discectomy and lamenectomy April/09
    L5 - S1 spinal fusion July.13th/12
  • Davey16DDavey16 Posts: 31
    edited 10/04/2012 - 7:52 AM
    Hi

    Kev the Stitches was 1 long continual thread, much like a bacon stitch, I knelt up on a chair while the Dr pulled out each loop, he did not cut the thread but pulled it through each hole,it was agony, he had to dig in several places where the skin had started to grow over, My wife watched him do the whole thing and swear this caused the infection, (I am changing Drs after this ) 3 days after stitches out it was oozing green stuff and I could not lay down on my back had to go to a walk in clinic and get anti biotics, My 4 day stay in hospital was something else, I am currently awaiting the outcome of an investigation as to my concerns


    Davey
  • Whenever people say "oh, you look like you're getting around great!" or "you look all better!" it annoys me, even though I know they mean well. They don't realize that we're just putting on a brave smile for the world, while inside we are screaming in pain, or that we know that we are going to suffer the next 3 days because we try to walk normally in front of other people. It's so embarrassing to walk around with this stupid cane. People are always staring at me and it makes me feel so self conscious. And I can't believe the dr let your stitches get that bad - as if you can see them to know what's going on, or that you have anything to compare it to to know what's "normal" or not. I can't believe they stitched you up like that! And I can't believe they didn't use staples. I had 28 staples - my back looked like a zipper. It went right through my tattoo (yeah, I have a tramp stamp lol).

    Kevin, thank you! You made me blush! ;)

    Michelle
    L5-S1 Fusion, Discectomy on 7/10/12
    Herniated Discs at L3-L4-L5-S1, Spondylosis, Spondylolethesis at L5, DDD, Partial CES, Lumbar Facet Arthropathy
    Chronic back pain since 12/2010 (slip and fall on ice)
  • I also had some spots where skin had grown over the staples. Omg it stung so bad! Have you ever had staples removed or seen it done? It fascinated me. They have this thing, like a crimper, and it pinches the center of the staple so that it bends upwards and the two ends pop up and out. Then they grab it with pliers or whatever and pull it straight out. I felt every. Single. Staple. Thank God my dr was counting them down for me! Then the slathered it up with a bunch of neosporin and slapped a bunch of steri strips on it (which I picked off the next day because I wanted to see what it looked like lol). I have pictures of it with and without the staples. Wish I knew how to post them here. They were definitely cringe inducing to my friends. ;)
    Michelle
    L5-S1 Fusion, Discectomy on 7/10/12
    Herniated Discs at L3-L4-L5-S1, Spondylosis, Spondylolethesis at L5, DDD, Partial CES, Lumbar Facet Arthropathy
    Chronic back pain since 12/2010 (slip and fall on ice)
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