….insurance…..

Just put lots of impolite words where those dots are please!

So I’ve talked before about the fact that I have arthritis in both hands and wrists.  I was diagnosed before I turned 30.  At that point my right hand was so bad I couldn’t turn a door-knob with my right hand, my left was better, but I could already see the progression.

When I originally went in to see my doctor for it the xrays of my right wrist made her think that I might have damaged the ligaments there (at that point my left hand wasn’t hurting yet).  She referred me to an orthopedic surgeon.  Who couldn’t fit me in for another 4 months and who’s office was quite rude about it.  I puttered along for another month, during which time my right hand got ALOT worse and my left started hurting, at which point I went back into my doctor and asked for a different referral.  She was horrified at the wait time to see the orthopedic, and I was referred to a plastic surgeon’s office.

Yes, a plastic surgeon, or more correctly termed a “reconstructive surgeon”.  What wasn’t obvious till I got there the first time is that although they do all the normal “plastic surgeon” type surgeries, they specialize in hand and nerve reconstruction.  Cool!

He quickly determined that the problem wasn’t the ligaments (ThankYouGod), that it was arthritis (to which I responded I was too young to have and he laughed at me), but that it wasn’t anywhere near needing surgery and they’d just put me on a maintenance regimen and keep an eye on it.  Depending on a variety of factors that weren’t predictable it was possible that in the worse case prediction that it would continue to get worse and I’d need surgery in 10yrs or so, but it was also possible that it would just maintain or even fade away till I was in my 50’s or so at which point I might need additional help with it.

I could live with that.  Especially since with the right regimen the pain almost completely disappeared except for some weather related flairups, with the only lingering issue being a weakness of the fingers and thumb when it comes to thinks like opening cans /jars etc.  I now have a lovely collection of “jar opener” type things.

Its been a couple years since I was last in to see him.  Nothing major has happened, but some of the weather related pain has gotten worse, and I think that my finger strength has decreased again as well, so I decided it was time to see him again, just to be safe.  Unfortunately I’ve changed insurances since then.  And that meant getting a new referral.

My doctor had no problem with it.  Her office gave me hell (no, I am not going to explain to the referral clerk why I need a referral to a plastic surgeon for arthritis, ask the doctor), but I finally got the new referral sent in.

My new insurance company just informed us all that there was no way they were going to approve a referral to a plastic surgeon for arthritis…..

*beats head into wall*

So, I’m debating between agreeing to see a new doctor.  Which I don’t want to do, I really like this guy, among other things his “no need to open you up to take a look” attitude was a relief.  Or just going to see him and paying the office fees myself.  Which I can afford, the downside being that if something DOES require additional scans (xrays, MRIs, what have you), much less surgery, likely the insurance won’t cover that either…..

2 Comments

  1. Ping from bogie:

    I’m surprised the doctor doesn’t have a second “practice” set up for just such occasions. Of course I know less than nothing about how one would go about it, or if it is possible, but it seems to me there should be a way. Maybe he can set up a detailed plan for treatment to be sent to the insurance company for their “approval”?

    Bah, shouldn’t have to go thru that since you got a referral from your doctor anyway!

    • Ping from Ruth:

      Yah, its one of the things I need to go back in and discuss with my doctor. I haven’t had a chance to set back up an apointment, but obviously I need to since the insurance isn’t going to co-operate!