PAIN DR TOMORROW--Question

[designgyrl]

I am very happy to be getting my epidural in my neck. I had a fusion at c4-c5 and now my old MRI that I got two years ago stated that I have degenerative disc disease and a herniated disc at c5-c-6.  

My question to everyone is. I've been faithfully getting epidural injections for about a year, have gone through physical therapy and have United Healthcare as my insurance carrier. I went and saw my pmp in April and I asked if I could get another MRI since I haven't had one in awhile just to make sure that my neck and back aren't worse.  I've been having a hard time turning my neck, and having radiating pain going down both arms.  He agreed, but then United Healthcare, which I have a PPO, balked at my request and had to physically speak to my doctor about why I needed the MRI.  Has anyone else have this happen to you?

My other thought is:  the pain management doctor feels that surgery may be in order to fix another one of the discs, but the neurosurgeon is still undecided.  My thought was since I haven't had a MRI it would be worth finding out if anything is worse since my symptoms are getting worse and still there.  United Healthcare would rather have my pmp give me epidural, vicodin, tramadol, and flexeril then give me a MRI that could possibly show a way of fixing this situation to possibly get off the medication?   It seems to me that the insurance company wants me to keep taking all these medications.  They did approve the MRI and I had it done today. I'm not sure when I'll get the results, but I have an epidural scheduled for tomorrow. It's really sad that I'm excited to see my pmp for an epidural because they do help.  Anyone else ever get excited to see their pmp?  I've never had to sign a contract, I'm not sure if it's because I only take vicodin, but I know the state of Kansas does have them because my best friend who was on dilaudid had to sign one in the state of Kansas.  

[mellie4]

I also look forward to my procedures at the pain management clinic.  Some have worked for me and some haven't.  Luckily nothing has made me worse!  Next Thursday I'm going for another stellate ganglion block.  I think I've had 5.  Only one didn't work.  With the others I got varying degrees of relief for various amounts of time.  I don't know what I would do without the pain clinic.  The nurse practitioner I deal with gives me so much time and is open to talking about all sorts of things.  One thing we're working on is finding a pain psychologist to help with alternative treatments since I haven't had tons of luck with traditional ones.

I'm on worker's comp and at times that can delay getting approval for certain things, though, overall I feel lucky with my adjuster as he's been good about approval.  If he doesn't approve something and I call him, he'll ask me some questions, and apparently I answer in a way that's acceptable, because I'll then get approval.

I posted on contracts a few days ago.  My pain clinic does not have contracts, which I think (after learning more from here) is a good thing for the patient.  My clinic is quite reasonable with the medications.  If they tell me to take something every 4 hours, and I feel it isn't working, I'll send off an email letting them know I've changed either the timing (maybe going to every 3 hours) or the dosage (taking 1.5 instead of 1.)  They give the patient a lot of leeway, I think, as they know we're the ones that are dealing with the pain.

(My surgeon, on the other hand, is fairly useless when I talk to him about the pain.  He's not very empathetic.)

[designgyrl]

Sara and Sherry and Storm Cloud,

Thanks for your input.  I'm glad that you gave me that information.  The place I go to is an orthopedic hospital and it has probably 50 different doctors in there ranging from orthopedics, to pain management doctors.  So, that may be the reason why he doesn't do it.  I trust my pmp and will just about do anything he tells me to.  I feel he has been a great help with the epidurals.  I didn't think about the reason they didn't want to do it was for a possible surgery, but that does make sense.  

[StormCloudf_Fire]

Yhis is point i get  very  angry With US  insurance Companieis they are there to Cover the cost not PLAY DOCTOR  IVe heard of  hunddereds of   insurance  Cpos  Balking at   MRIS and Of course  the PROdisk I have is   Almost  Ipossible to get covered by any ins Co because its a few hundered  bucks   MIFFED ANGRY and So sorry to hear of your  plight .

[Sarajmt]

I agree with Sherry.  Not funny at all.  When my neck is hurting, usually my shoulder and arms go with it.  I can't wait to get it.  I agreed to one without sedation a few months back because it was hurting so badly.  Now my kids think it's weird that mom likes shots.  Understandable from their point of view.

I have UHC as well.  They've been good about approving procedures and tests for me and my family.  However when I got my fusion in my neck, I was told that originally I needed 3 levels done.  I ended up getting only C5 6 done.  Insurance issues.  I was still left with pain but did have function back in my hand.

I hope everything goes great and tomorrow arrives before you know it.

Sara

[namnam46]

Hi Sunshine,

I don't think it's funny that you are excited about seeing your PM to get an Epidural. I could hardly wait ot get to my PM for my RFA. I just KNEW that it was going to work on me (I've ALWAYS been VERY optimistic my whole life) and I was ready for that part of my pain to go away ...AND IT DID!!!

I have Medicare with United Health as my secondary. Medicare ist EXCELLENT about letting me get the MRI's that I need. United can't say anything as it it only secondary and since the Primary is Medicare they don't have to pay nearly what they would if I had regular insurance as the primary.  I'm sure that they didn't want to pay for the MRI and probably were thinking ahead as to what might lie ahead,  such as surgery, and they probably weren't to enthusiastic about the thought of having to cover that..:) You know Insurance Companies. That said thou, you are lucky to have United as they are one of the very best. You may need to get everything approved (everybody does that now) but in the long run I think that you'll find that they approve just about anything.

I'm so glad that Epidural is tomorrow. I hope that you will be able to get the needed relief finally!! As fasr as that Pain Contract goes, it's up to each individual Dr., I think, to decide if they want to use one. It's just that MOST want that protection. Is your PM Clinic rather small or do they have hundreds of patients and numerous Dr.'s in it? That could be a determining factor in their decision about the contract.

I hope that tomorrow comes QUICKLY for you so you will be feeling better SOON!!!

I'll be thinking about all day so please post as quickly as you can so we will know how it went.....Take Care.....Sherry