DRs, Medicine and Insurance

[Atkins&Rebel]

Went to my primary because my bad back flared up with acute pain. This round is just localized pain in the mid lumbar region. Previous episodes have involved nerve numbness in my left leg and foot.
I explained my history: Heavy manual laborer and have played football O line since 7th grade. I have Managed pain through PT, Chiropractor, Ibuprofen, Bought a hot tub and a high end hammer massager.
Asked for MRI.
They suggested PT.
After much arguing, finally settled on X Rays which showed an age unknown previous fracture in my thoracic region as well as some severe degeneration throughout my lumbar.
This level of damage led them to authorize a referral to a Spinal Orthopedic Specialist. (finally getting somewhere!)
Called to make an appointment.
Dr so and so won't see me, I only have X-Rays. I need an MRI.
Fine, give me the referral and I'll get that done ASAP
Dr so and so also doesn't order MRI's for patients.
Would I like the number for a pain management specialist who might refer me for more advanced imaging if several rounds of pain shots that I have to pay for don't do the trick?
No I would not. I just want an MRI that will tell me if any kind of surgical procedure is warranted for the severe pain I'm currently in and have been for the last week.

And....Just left a message for my primary asking if they were aware that the referral specialist won't see me without the imaging I started out arguing for in the first place?

I'm just about done.

[wab]

The medical industrial complex is … well. Awful.

[UOK]

I'm questioning if I should just lock this thread now to get ahead of it.

[LacertineForest]

Went to my primary because my bad back flared up with acute pain. This round is just localized pain in the mid lumbar region. Previous episodes have involved nerve numbness in my left leg and foot.
I explained my history: Heavy manual laborer and have played football O line since 7th grade. I have Managed pain through PT, Chiropractor, Ibuprofen, Bought a hot tub and a high end hammer massager.
Asked for MRI.
They suggested PT.
After much arguing, finally settled on X Rays which showed an age unknown previous fracture in my thoracic region as well as some severe degeneration throughout my lumbar.
This level of damage led them to authorize a referral to a Spinal Orthopedic Specialist. (finally getting somewhere!)
Called to make an appointment.
Dr so and so won't see me, I only have X-Rays. I need an MRI.
Fine, give me the referral and I'll get that done ASAP
Dr so and so also doesn't order MRI's for patients.
Would I like the number for a pain management specialist who might refer me for more advanced imaging if several rounds of pain shots that I have to pay for don't do the trick?
No I would not. I just want an MRI that will tell me if any kind of surgical procedure is warranted for the severe pain I'm currently in and have been for the last week.

And....Just left a message for my primary asking if they were aware that the referral specialist won't see me without the imaging I started out arguing for in the first place?

I'm just about done.

Sorry to hear about your troubles. My wife is disabled and she's been through hell and back navigating the medical system. Best of luck to you - I hope you can find something to help with your pain.

[Ditka’s dictaphone]

We’re engaging in self destruction of the NHS at the moment in the UK and seemingly ploughing straight at the US model.
That’s because we’ve got dumbass politicians and even dumber population which is expanding, ageing and getting dumber by the day.

Britain is being dismantled

[mmmc_35]

Yeah the whole system is incredibly frustrating.

I spoke to a doctor about PT referrals. To summarize his statement. Most people are non compliant with post and pre surgery rehab. So they almost always recommend PT to gauge compliance. (This is an extremely dumbed down summary)

Unfortunately I can see that with a lot of clients. That doesn't make it right.

I hope you are able to get proper treatment. I'm sure you will be pulling your hair out trying to navigate the system.

[Rusty Trombagent]

Worst healthcare system in the 1st world, and there's not a close 2nd!

BUT, to be fair, I kind of know what you're going through. I'm a stonemason with a herniated disc (L4/L5, terrible sciatica).

I went through all of this maybe 15 years ago, a few years of PT, and I had to put my foot down and demand an MRI to figure out what was going on. But no one wanted to, because the corrective measures available are generally still pretty barbaric and an absolute last resort. Disc Shaving or spinal fusion are often just replacing one problem with another. So if you're youngish and otherwise healthy, they're going to push every non-surgical alternative available. They generally know what they're going to find when they do the MRI, and they're just putting off the inevitable "we arent doing surgery" discussion.

I think there's a psychological element to wanting to know what's wrong, I know there was for me even if functionally it doesn't really make a difference.

And also I know every injury is unique and me telling you what worked on my back isnt some catch all. BUT! After a few years of different PT's (inversion therapy, different types of core training), ultimately what was the magic bullet was massages. The one thing not covered by health insurance, of course (please see my opening statement). Releasing those muscles that were basically holding everything together in the wrong place was key, and I dont think any kind of personal massager can really replicate that.

Just one guy's experience!

[dplank]

Went to my primary because my bad back flared up with acute pain. This round is just localized pain in the mid lumbar region. Previous episodes have involved nerve numbness in my left leg and foot.
I explained my history: Heavy manual laborer and have played football O line since 7th grade. I have Managed pain through PT, Chiropractor, Ibuprofen, Bought a hot tub and a high end hammer massager.
Asked for MRI.
They suggested PT.
After much arguing, finally settled on X Rays which showed an age unknown previous fracture in my thoracic region as well as some severe degeneration throughout my lumbar.
This level of damage led them to authorize a referral to a Spinal Orthopedic Specialist. (finally getting somewhere!)
Called to make an appointment.
Dr so and so won't see me, I only have X-Rays. I need an MRI.
Fine, give me the referral and I'll get that done ASAP
Dr so and so also doesn't order MRI's for patients.
Would I like the number for a pain management specialist who might refer me for more advanced imaging if several rounds of pain shots that I have to pay for don't do the trick?
No I would not. I just want an MRI that will tell me if any kind of surgical procedure is warranted for the severe pain I'm currently in and have been for the last week.

And....Just left a message for my primary asking if they were aware that the referral specialist won't see me without the imaging I started out arguing for in the first place?

I'm just about done.

Sorry to hear this, I have had a VERY similar experience. Old cracked disc in my neck went undiagnosed, nerve started to snag in the crack as it expanded as I aged. No one would help me, I was borderline suicidal - literally tried sleeping standing up.

Our system is a joke. It’s gross and no one will fix it.

[Rusty Trombagent]

Sorry to hear this, I have had a VERY similar experience. Old cracked disc in my neck went undiagnosed, nerve started to snag in the crack as it expanded as I aged. No one would help me, I was borderline suicidal - literally tried sleeping standing up.

If you've never experienced chronic pain, I think it's really impossible to imagine what that actually does to your brain, being in pain all the time. Saying "I was borderline suicidal" sounds super dramatic, but once you start thinking "is this what the rest of my life is going to be like?" you get all kinds of crazy intrusive thoughts.

And if you're having crazy thoughts, and you're sympathetic, you get a better understanding of why we've got an out of control opioid epidemic in this country.

[LacertineForest]

Sorry to hear this, I have had a VERY similar experience. Old cracked disc in my neck went undiagnosed, nerve started to snag in the crack as it expanded as I aged. No one would help me, I was borderline suicidal - literally tried sleeping standing up.

If you've never experienced chronic pain, I think it's really impossible to imagine what that actually does to your brain, being in pain all the time. Saying "I was borderline suicidal" sounds super dramatic, but once you start thinking "is this what the rest of my life is going to be like?" you get all kinds of crazy intrusive thoughts.

And if you're having crazy thoughts, and you're sympathetic, you get a better understanding of why we've got an out of control opioid epidemic in this country.

Yup. My wife suffers from chronic pain (part of her disability). She has good days and bad, and by-and-large is able to stay positive and try to manage her pain as much as possible, but there are times when she just can't do whatever we had planned to do. She had to give up working years ago, and that was a really hard transition, given the weight society puts on what you do for a living. I know she's been in some really dark places, and I'm just thankful that she was able to manage those situations. My dad also suffered from chronic pain after he suffered a work-related injury when I was a little kid. He was never the same, afterwards, and it ultimately ended with him taking his life (and I don't blame him - he was miserable for years). I can definitely sympathize with you guys, and it gives me a lot of perspective on how lucky I am to be as healthy as I am.

[dplank]

If you've never experienced chronic pain, I think it's really impossible to imagine what that actually does to your brain, being in pain all the time. Saying "I was borderline suicidal" sounds super dramatic, but once you start thinking "is this what the rest of my life is going to be like?" you get all kinds of crazy intrusive thoughts.

And if you're having crazy thoughts, and you're sympathetic, you get a better understanding of why we've got an out of control opioid epidemic in this country.

Yup. My wife suffers from chronic pain (part of her disability). She has good days and bad, and by-and-large is able to stay positive and try to manage her pain as much as possible, but there are times when she just can't do whatever we had planned to do. She had to give up working years ago, and that was a really hard transition, given the weight society puts on what you do for a living. I know she's been in some really dark places, and I'm just thankful that she was able to manage those situations. My dad also suffered from chronic pain after he suffered a work-related injury when I was a little kid. He was never the same, afterwards, and it ultimately ended with him taking his life (and I don't blame him - he was miserable for years). I can definitely sympathize with you guys, and it gives me a lot of perspective on how lucky I am to be as healthy as I am.

Thx I had surgery 5 years ago and I'm good, hope things work out well for you Atkins&rebel

[Burl]

Our medical system is incredibly frustrating. Sorry to hear of your troubles and just being in pain makes everything miserable so I hope you get what you need.

I'll offer the following just as informational, as my wife is a DPT and a good friend of mine is an Ortho surgeon and here's what I've taken from their view on things.

*In general*, patients seem to prefer more invasive, less likely to be successful surgeries than to go with the more likely to result in positive outcomes associated with PT. This hits the insurance companies too since they have to pay for the imaging, the surgery, the followup surgeries etc. So, what you see are both the medical professionals (who care) and the insurance companies trying as hard a possible to steer people away from these things because most times the outcomes are not great and the actions are expensive.

Of course, there are the times when a surgery truly is required and no other good option exists, and it seems like the game is rigged against those folks, but the impetus to steer folks in the opposite direction comes from a reasonable place, IMO.

[Atkins&Rebel]

Just to clarify, I first injured this area in 2008
Did PT and Chiropractor to the point as an athlete, I can do everything they’ve asked me to do and my wife is also a PT

So I’ve had episodes of chronic pain, and stretches of only mild tightness or no pain but it keeps reoccurring. And this one is the worst one I’ve had in awhile. Going into week 3

[Rusty Trombagent]

*In general*, patients seem to prefer more invasive, less likely to be successful surgeries than to go with the more likely to result in positive outcomes associated with PT.

It's kind of like that rumor where dish washers are designed to be a little noisy, because if they're too quiet people doubt that they're working.

[Grizzled]

Just got turned down for infusions to boost my immune system and prevent infections. My oncologist and the insurance company went back and forth until they denied it. Guess they just want to pay any med bills if I get sick.

[Atkins&Rebel]

After several weeks of back and forth, Finally got an MRI middle of last week.
(severe damage to L5-S1 joint and moderate degeneration and damage to 6-7 other disk joints among other fun and exciting things)
 
After several dead ends with doctors who automatically refer to physical therapy or pain management (asked up front what their policy was and told them I won't be stepping foot in their fine office), and 1 Dr who initially agreed to see me but I just found out he's not going to accept new patients due to an opportunity to work on a career dream project in another state. yippee for him I guess.

Today I finally found a Neuro specialist, but have to wait until early May to be seen unless there's a cancellation that I can take advantage of.