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Old 01-08-2005, 11:31 PM   #1
Member
(female)
 
Join Date: Dec 2004
Posts: 61
CocoandChase HB User
Terrible Update!!

Hello All,

I went to my PM doctor on Jan. 4 and was expecting he would schedule the discogram like he told me he would in Dec and I hoped I would be having the 3 level fusion on L3/4-L5/S1 sometime in Feb/March as he has been discussing with me for months now.

Well much to my surprise he told me that I am totally and permanently disabled, wrote a letter to my attorney who is trying to get me SSDI and told me NO DISCOGRAM AND NO SURGERY because NO HEALTH INSURANCE!

He said my discount health plan Care Entree (not insurance) is not good enough and people want their money, nothing's cheap in this world, he said. I had a breakdown, after all these months of seeing him, getting my pain meds increased every month and all the surgery talk, he is now writing me off, NO HELP! Because I have no insurance. He is just going to keep me pumped up on oxycontin, oxycodone, neurontin and elavil. THIS IS NO WAY TO LIVE!!!!! I HATE LIVING LIKE THIS!!!

He wrote that even multiple surgeries would not help me and that my prognosis is guarded. I asked him to complete forms for me to get patient assistance with my pain meds because they cost me $650.00 per month and he said NO! That's too much paperwork for me, you get disability, and you'll get Medicare.

It will be another 1 to 2 years before I am approved for SSDI and then another 2 years before I get Medicare. I cannot wait that long for surgery and in the mean time become addicted to all this pain medicine.

I am in terrible pain and do not know what to do. I had a laminectomy at L4-5 in 2000 and now this 3 herniated discs and terrible leg pain! What do I do now???

I make too much money to qualify for Medicaid and not enough money to pay $650.00 per month for medicine. I was self employed and have not been able to work since March 2004. I cannot get health insurance due to my back condition, medications and insulin dependency, no company will touch me. If I could work I would get a job somewhere, get the group health insurance and have the surgery, but I can't work.

I don't know what to do!!!! I am thinking of having my family doctor take over on the disability, and refer me to another PM doctor who will get me the meds for free and another neurosurgeon who may take a look at fixing me surgically without insurance, good luck huh!

Anyone have any good advise for me? I sure do need some spirit uplifting right now, thanks!

Best Wishes To Everyone!

Kelly

Laminectomy L4-5 October 2000
MRI 2003
Herniated Nucleus Pulposis T11-12
Epidural Fibrosis L4-5
Chronic Radiculopathy
Disc space narrowing L3/4-L5/S1
Osteophytes
Disc bulge L3-4
Degenerative Disc Disease L3/4-L5/S1
Herniated Disc L5-S1
Physical Therapy 2004
ESI's 2004
Nothng working!

Last edited by CocoandChase; 01-09-2005 at 12:37 AM.

 
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Old 01-09-2005, 12:38 AM   #2
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Join Date: Nov 2004
Location: Melbourne
Posts: 358
Losy HB User
Re: Terrible Update!!

Wow - Thats a not the news one hopes to get when under the impression that surgery was scheduled and all was in hand. I wish there was something we could do to help you.

Living in Aust is a real blessing. Tests like MRI, discograms and CT scans can be scheled within hours, days or in ammaximum of weeks and are predominantly covered my the medicare system of the federal govt.

My dr requested I have a CT scan 2 weeks before christmas - He gave me the referral and contact details and within an hour I had beenn scanned and was able to wait a further 30 mins to take my results to my dr. My out of poscket expenses were $9.


Surgery without health cover is the norm in Australia. If you are uninsured you go via the public health ssystem and while you may have to wait weeks or months you have nil out of pocket expenses. Having private health cover gives you choice and enablke yo to access both the public and private hospital system if you so choose.

On the medication front, these to are subsidised in australia via medicae and when you reach a certain limit ($800 in a calender year) you are entitled to a firther discount.

As for your current situation its very tuff. I think your decision to explore having your GP play a more active role and the idea of exploring an alternate specialis is your best option. Threre are drs out there that out the welfare of patients ahead of the all mighty dollar

Are yoiu perservering with therapy. What sorts of things were you doing and is it worth giving it another go. I have found hydrothe***y to be beneficial (bulge at l3/4 & l2/l3 (previous fusion at l4/l5 & l5/s1). Gentle movements ie walking in water and exercises focusing on the sabilisation of the back (stomach and back muscles) have eased my level of pain and strengthened this muscle group. It certainly hasnt been easy and I have had some setbacks along the way but i continue hang in there and do my best


I understand your concern in relation to medication and addiction, but if you need the medication then I question wheteher you will become addicted . The medication is serving a purpose and your body is using it for that.

All i can do and say is hang in there pray and hope that you and your gp together can find a way to get you into hospital and into a surgical suite

all the very best

Losy

Last edited by Losy; 01-09-2005 at 05:52 AM.

 
Old 01-09-2005, 05:44 AM   #3
Junior Member
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Join Date: Jan 2005
Location: Ohio
Posts: 12
jcshan HB User
Re: Terrible Update!!

coccoandchase
I don't mean to sound rude but I think I would be looking for another Dr. Most of the Drs I have been involved with will take the time to help me get the care I need. As for meds I often get samples from doc, not alot but every little bit helps.
jcshan

 
Old 01-09-2005, 09:50 PM   #4
Senior Veteran
(female)
 
Join Date: Jul 2004
Location: usa
Posts: 2,943
mel1977 HB User
Re: Terrible Update!!

def get a new dr, if you can afford it. I am so sorry. Discograms aren't cheap, got a bill for mine and the procedure alone was three grand. My ins only paid 40 percent bc we didn't realize my dr was out of network. We are hoping he'll write off the rest. He might.... I don't know much about life w/o insurance. I will be thinking about you though, my heart goes to you and I hope you get what you need soon!

 
Old 01-10-2005, 01:03 AM   #5
Senior Veteran
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Join Date: Jul 2004
Location: US
Posts: 941
sandollar HB User
Re: Terrible Update!!

I'm sorry, but I have to chime in here. First your Surgeon was going to do the surgery and was planning it, them BAM, nothing but drugs??
Sounds like he's afraid he won't get paid.
I am on SSD and it only took 6 months to get on it, a Doc put me on it (Severe Panic Disorder, I couldn't leave my house for 5 years), that helped, so SS didn't fight it. But one word of advice, [U][B]EVERYONE[/B][/U] is refused the first time, just to see how much you really need it, so just send in those appeal papers they send you and it will be approved, from what your doctor wrote, you won't have a problem with SS. I also got my Medicare on the 1 yr anniversary of when I was approved.
I think he is waiting for you to get your insurance, so he will get paid. Maybe he should cut down on his vacations
Def, Find another doctor, but keep the SS letter and go for it, from the looks of your post, you'll need the money AND the insurance in the future as well.
God Bless,
Stardust

 
Old 01-10-2005, 04:58 PM   #6
Senior Veteran
(female)
 
Join Date: Nov 2003
Location: Missouri
Posts: 2,128
carol632 HB User
Re: Terrible Update!!

Call the companies who make your meds....sometimes they will help you get on a patients assistance program and give you your meds free.

I also think you should find a new doctor. I understand that the man wants paid and that the hospital does, too as well as everyone else involved. However, the crude, crass way he went about this speaks volumes about the kind of person he is. You might be able to find good help at a teaching hospital where they can also help with the meds.

Carol
__________________
2 lami's, 3 fusions
bone spur removal
cerv. fusion, 1 level
morphine pump

Last edited by carol632; 01-10-2005 at 05:00 PM.

 
Old 01-12-2005, 06:51 PM   #7
Member
(female)
 
Join Date: Dec 2004
Posts: 61
CocoandChase HB User
Re: Terrible Update!!

Thank You All So Much For The Kind Word Os Encouragement! It Helped Alot! I Am Riding The Ssd Out, My Second Appeal Was Denied, I Think Its Because Of My Age, 36 Years Old. I Think The Next Step Is A Hearing With A Judge?? Is That Right? Anyway, My Atty Knows All About What Has Happened, And You're All Right, My Dr Thinks He Wont Get Paid. I Would Spend The Rest Of My Life And His Making Sure He Got Paid If I Could Just Get Out Of Pain And Resume Some Sort Of Half Normal Life Again! I Know Its Expensive Surgery. I Am Having Hard Time Adjusting To Being Disabled, No One Wants To Be Disabled. I Know No Dr Is Going To Operate On Me W/o Insurance So I Must Wait For Medicare To Kick In! Thanks To You All! Lets All Hang In There!! Be Strong And Stay Positive!

Kelly

 
Old 01-12-2005, 10:02 PM   #8
Senior Veteran
(female)
 
Join Date: Jul 2004
Location: US
Posts: 941
sandollar HB User
Re: Terrible Update!!

Hey Kelly Girl
I don't know about any attorney, I never had one. The letter from the Doc was enough. All you have to do is just keep sending in the appeals forms. No, I have never heard of anyone going to court. The only one I ever knew that had a problem was my ex-husband and he got a lawyer who took 2 years to get everything approved and then took over half his money and the SS dept only ask my ex to go see one of THIER docs is all.
Me, I just kept sending in the appeals and had no problem.
It is not your age. I was 30 when I was put on SSD.
I hope this helps. You CAN deal with SS without an attorney though, just keep sending in the appeals and THEY have to do all the work, not to mention, nobody gets most of your money either.
Good Luck,
Stardust

 
Old 01-12-2005, 10:28 PM   #9
Newbie
(female)
 
Join Date: Jan 2005
Posts: 7
breninpain66 HB User
Re: Terrible Update!!

I had to let my attorney handle my ss case after two denials. And now it is going in front of the judge. We will see what happens now.

 
Old 01-12-2005, 10:36 PM   #10
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Join Date: Nov 2004
Location: Melbourne
Posts: 358
Losy HB User
Re: Terrible Update!!

Good luck

Losy

 
Old 01-12-2005, 11:06 PM   #11
Senior Veteran
(female)
 
Join Date: Jul 2004
Location: US
Posts: 941
sandollar HB User
Re: Terrible Update!!

OK, MY BAD!!
Now I have heard from one person who has to go to court.
I wish you the best and will be praying for a great outcome.
Stardust

 
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