I was looking forward to having a morphine pump until my insurance changed. Now what do I do?

[azmomof2]

I have been seeing my PM doctor for almost 10 years.and end of last year I agreed to his thought of reducing the oral meds by going on a combination of nerve stimulator and morphine pump.The idea sounded fantastic.  Get the nerve stimulator first then withdraw from all of the pain meds I'm currantly on, stay off for six weeks, get the morphine pump and then whatever pain not handled by the two combined, then handle that with oral meds.  From what my Doctor said the need for oral meds after that is minimal to none at all. To say that to someone who has been taking 8 mg of dilaudid like candy and ms contin 60 to 90 three times a day for starters,  I was completely up for the idea!!!

Last year I had the nerve stimulator put in mid May.  By October my doctor said "well we can get started on the wds for all the other meds and have you on the morphine pump in January or we can wait until after the holidays and look more at March or April to put the morphine pump in"  My husband and I opted for the later and decided to have the holidays in peace.  Bad move.

Another company took over the company my husband was working for.  First thing on the list of all companies who do this.....cut costs.  The health insurance was the first to go.  We went from BC/BS to Cigna.  We found out that my doctor of ten years was "out of network" next, our plans of getting a morphine pump would have to be reevaluated by another Doctor and chances were slim and none that they would ever approve it.  Apparently CIGNA does not approve therapies that are purely experimental.  

I desperately want to get that morphine pump and unfortunately am now a victim of insurance companies policies.

HELP??????  anyone have any experience in this?? What can I do????  I've been in constant tears and frustration. speaking to the Cigna reps only makes the matter worse.

[azmomof2]

Flowers are dropping from the sky and happiness overwhelms our little world of Mesa,  AZ  We went to the appointment with the new PM this week.  Despite the fact that I trusted my PM of ten years only I gave him a try as my doctor was the one who had referred him.    He looked at my files, looked at my meds and also my constant running to the little girls room to toss my cookies (too many meds)
After speaking for a very short time, perusing my file and seeing the freight in his eyes as he looked at me.   HE AGREEED!!!!!!!!     AFTER THE WAITING AND HOPING AND PRAYING HE AGREED !!!!!     After all that had happened he said it.  “after clearing your system of all the opiads we must wait 7 to 8 weeks s before the morphine pump trials. I heard a  hoir of angels singing and bells chiming My life, my family’s life has a chance.!!  I’M GETTING MY MORPHINE PUMP!!!!


NICK: This Doctor added a couple things for the old depression and then added a couple of other meds and last but not least….AMBIEN.   I sleep at night now   * M A G I C  *


AUDREA: Sometimes we can not have the exact person to perform a procedure but there must be someone who can help or something you can do.  Heng in there sweetie I will help you figure somethig out. Where there is a will there is a way!! Thank you too, for thinking of me. Your thoughts and prayers were heard.  It's nice to know that works sometimes. *big hugs*

SANDEE, THANK YOU FOR BEEING THERE AND GIVING ME THE COURAG3 AND STRENGTH TO KEEP FIGHTING. Thank you so very much

[nick30]

while you are sorting out the insurance issues perhaps you could change your meds for better relief in the interim. i'm sure you probably have anyway but if not might be worth trying fentanyl patch over the morphine(and keep taking BT meds too of course)

[azmomof2]

Yes it is the the combo that is still being looked at. I already have the nerve stim in. My trial for that was great  It was pulling the tube out after the fact that was a nightmere.  The nurse pulled it out and it felt uncomfortable and all of a sudden I was sreaming bloody murder!!!   I sat down, stood up spun in circles then leaned over the exam table again.  she pulled off the guaze and I spurted all over her and the room.  My husband told me afterward that the room looked like the mess hall in Alien after the famous spaghetti scene! Joy.  
'
Anyway, I was sooo looking forward to completing this thing and getting the morphine pump.  I have an insulin pump and based on what I read it is pretty much the same thing.  It will be lovely going into the airport next time, "okay here is my card for my insulin pump,  the card for the nerve stimulator...uhhhh oh the card for the rod in my wrist. ahhh, the card for the morphine pump!!"  They had to remove the rods in my left leg because I started to get an infection.  That was another 3week hospital stay I am trying to forget!  ''

I lived in Germany for 7 years, almost 8.  My first son was born there.  I  LOVED IT!!!  Money NEVER left my hands to pay for a doctor or a hospital stay.  When I got my meds they were ALWAYS BRAND.  Prescriptions were almost nothing to pay for insulin and all my supplies for my pump were considered "lifes need" items I can not live without.  Those were free.  It was terrific!! The greatest deal.....no such animal as "in network" or "out of network" .   Insurance companies...now there is something I would like to take to the range for target practice. :o)  Just kidding!!!!  ha ha ha.  I have been in so much pain lately that I have not even been to the range.  Heavy sigh...

Insurance Companies Suck!!! The individuals who play god (note: little 'g') I don't know how they sleep at night.  I just keep telling myself that there is a very special place in hell just for them. **big smile**

[nurseaudrea]

The same thing happened to me two years ago. I went in for the pain pump trial and it worked great then I went in to get my pump put in. A week later I was scheduled for surgery to have it put in but when I got to the surgery center that morning they told me my doctor was no longer in network. I already had everything approved and my mom had to take off work to take me and everything went up in smoke. I was so disappointed. I was told I had to find a doctor in my network and start the process all over again. The pump is not considered experimental. I have never heard of a stimulator and a pump put in together so maybe that is where the experimental lingo is coming from. If they will not do both then maybe you could choose the pain pump if that is what you want and then they can't say it's experimental. I do know you will have to get it approved all over again, but if they deny it you can always appeal that decision and make sure you have all your medical paperwork sent in to prove why you need it.

Good luck with everything. I know it is a huge hassle to go through all this again. I opted not to do it again and to try to fix my spine one last time due to a non-union. Hopefully they will get it right this time. If it does not work then my only last choice is the pain pump. I also have a high tolerance for pain meds.

[sandee1818]

Have you seen one of the doctors in their network and had him speak with your doctor of 10 years as to the plans you and he had for the pump? After doing that then stay on top of the insurance company and if they deny it file an appeal and have your other doctor help you do this as far as what this procedure will accomplish.
I have not had this issue personally but I am sure someone here has and they will post. I believe Tuckamore may know about the precedures you need to follow and she will be back soon:)