I don’t know what to do

So… It’s time for the next installment of “MizunoGirl’s Back injury”  (Cue theme music…)

I’ve actually been overwhelmed with the moving house and adjustment to new job, and multiple other challenges.  But I finally started to feel settled, and for a bit of time the fog that I’ve felt since this injury lifted a bit.

Since the surgery I’ve continued to have radiculopathy and pain.  I’m completely unable to run, or cycle.  I can swim…and Swimming has been something I’m doing a lot of.  I can do some fitness exercises, but they do aggravate the situation. I do them anyway because they bring me a tiny bit of joy in this joyless situation.

My Surgeon would like to do a fusion.  He feels it is the only option for me.  After such a surgery I really would be unable to return to running.  Now…I’m not running now… so…. perhaps I should just go get a fusion. I don’t think he gets it. Honestly if I hear the words “lifestyle modification” one more time… I will modify lifestyle, once I see all options are exhausted.

I did a tiny bit of research and found out that a FEW surgeons across the country are doing a different surgery.  A Direct Repair of the Pars Defect. In carefully selected patients, they have had a 90% success rate.  So after reading that, I went in search of someone who would evaluate me for such a thing.

Click here for the Sad Trombone sound effect  

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Yes, No one really does this.  No one wants to do it.  After some further reading, I discovered that “technique” is involved.  In other words, it is easier to do a successful fusion than it is to perform this procedure.  SO, fusion is offered. LAZY.

So.  Undaunted, I actually contacted the hospitals where the research authors came from.  Amazingly… I got a stellar response from Johns Hopkins and also the University of Miami.  I had sent the U of Miami folks an email, and got a call back saying the Physician wished to see me, he felt he could help.

Imagine my shock and awe when I discovered I had inadvertently selected the HMO plan for my health insurance and I was not covered for this surgeon.

Imagine my continued shock and awe when the University of Miami stated they would not allow me to self pay for the visit. Their reasoning makes perfect sense, this physician is a very in demand specialist and he will only see people with an intent to do surgery on them…thus, unless I could cough up the 60 grand or more that the surgery was going to cost, it isn’t worth it for him to come up with a plan.

I called back my insurance plan and was told, “Just pick a different doctor”

More shock and awe.  I called ALL the neuro surgeons on the plan. (Sounds hard but there are only really 4 groups on the plan.) NONE will see me since I am less than a year out of surgery.  Freaking specialist in Miami will be happy to see me, but not these yahoos.

It turns out if any of these guys feel that it’s important to refer me out, the insurance company would consider it.  As you might imagine… outward referral is a hassle for everyone involved, and since they all feel that Fusion is the answer…. No dice there. Plus there is that sticking point.  None of the neurosurgeons except the original one will see me, and he is being kind of snooty… “We don’t refer out”  My level of frustration is now 10/10.

I have an appointment with my primary care physician to see if HE can refer me out, which is very unlikely.

Other odd options:

Quit my job for 2 weeks and be rehired.  Seriously could do that.  but not so sure my bosses would go along with that mess.

Enroll in “Obamacare” and drop my coverage through work. The kicker is that in Florida the Obamacare plans have pretty steep fees.  They cost about 300 a month and have a large 6-7K deductible to be met.

Wait until annual enrollment to change plans to the one that covers some out of network physicians and is more expensive.  I would be able to use it in January.  I don’t know what that deductible would be….it also seems to be kinda a long wait.

My last option is to cry to my director.  This is seriously affecting my quality of life, and it is certainly taking a load of time.  She may be able to influence people, but unlikely. I talked to HR and while they were actually quite kind, there did not seem to be anything they could do. Honestly, sometimes people are just stuck.

The entire situation is disheartening and I really feel depressed.  Not you know, “blue”  or “sad”  but seriously miserable. I do not want to get out of bed, I don’t want to go to work, I don’t want to train….it is all requiring a herculean effort.

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My coach has helped brighten my situation.  He read out loud- one of the research articles while we were training. This sounds nice, but he did it in funny cartoon voices.  It was truly spectacular.  It was like  a “My coach wins all the prizes moment”  I texted him some of my pain today and while he wasn’t like Holding my hand or singing Kum By Yah… he did remind me that this wasn’t the end, just a bump in the road.

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Holy Moly.

I do not know what to do.  Not one bit.

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One thought on “I don’t know what to do

  1. I think I’d go with your coach’s option, which is to laugh. There are times that are so awful, so messy, you can’t do anything but.

    HMOs are crap, especially when you have a chronic illness that leaves you with few options for treatment, and the most hopeful of them are experimental or require a specialist with exceptional technical skills, who of course is ‘out of network.’ (And I wonder at the surgeon who wouldn’t accept a cash payment from you. I get why, but why not?) Fingers crossed that something changes for the good.

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