Archive for March 2012

Getting screwed again by my HMO   3 comments

I’ve been in excruciating lower back pain, off and on since last September. I’ve had injections, chiropractic, Physical Therapy, Traction, and Acupuncture. Yesterday, I had to use the electric cart at my grocery story and was in unrelenting pain; fortunately one of the employees went around the store with me to get my groceries and help me checkout. On a scale of 1-10, this pain is a 12 and literally stops me in my tracks, and it has been nagging/gnawing at me for a good while, and only recently got even worse.

I have an HMO for health insurance and that means going through a primary care physician to get authorized/referred to a specialist. I have a pain management specialist who treated me for this last May-July. Since then I have been trying for relief through other modalities. I am not one to take narcotics for pain; I do have a tens unit and an ice pack. A week ago I made an appointment for tomorrow with the pain management specialist and have been awaiting the referral authorization since then. It should have been done within 48 hours. It is now a week later and guess what? I’ve just been called and informed that I have been authorized for a ‘visit’/consultation and must do that before I can get any treatment. That is what my appointment tomorrow is going to be even though I was very specific in requesting authorization for a treatment that I had had before from the same doctor.

The doctor has decided that she needs to see me first and then submit a request for treatment. The referral coordinator ignored my request and after a week submitted the request for an office visit. The result is that tomorrow, instead of getting the pain management treatment that I so desperately need, I’ll have 1 minute consultation that the doctor will bill more than $500 for to the insurance company (no wonder the costs are skyrocketing), and then tell me what the treatment will be and that an authorization request will be needed for another appointment.

Under the best of circumstances these referral authorizations take 48-72 hours to be approved. Factor in the time for the doctor to  compose her notes, send them to the transcriptionist so that her clinical notes can be sent to the primary care physician, fax that request to the primary physician. I’m looking at another 3-4 day minimum, before the authorization request will be made. That’s assuming that the referral coordinator does not forget to check the fax machines (and she has gone on vacation before, leaving one of these unattended), and submits the request. Then, if the request is made for STAT (ASA approval, expediting the authorization, it will be 48-72 hours for it to happen. Then I’ll have to make an appointment with the pain management doctor, who does huge business, and it could be at least a week, or even more, for another appointment.

Under the best of circumstances, I’ll be getting the treatment a week from tomorrow. Under the usual circumstance, I don’t really know how long it will be.

To make matters worse, I received a message just now from the referral coordinator telling me that she can no longer handle this matter because I have been transferred to another primary care physician (that does not go into effect until April 1, and I may have to wait until then, after a visit to that doctor on April 2, before the referral request can be made.

I may suffer excruciating pain between now and the second week in April, unless a miracle happens. This is worse than catch 22; it’s a good example of the flaws in the medical care system, particularly in the HMO, less expensive type, health insurance system.

I have a fairly high pain threshold; but this pain stops me in my tracks…I don’t know what I’m going to do until I get that pain injection.

My Childhood Horror   4 comments

When I was 8 years old, my dad used me as a pay off for his gambling debts. I lost my beautiful purity to a fat disgusting drunk gambler (sorry if these words offend anyone) when I was only 8!!!! This continued until I ran away at 15. I ended up being raped several times between that and the time I found the one who I thought would be my forever. We had kids and I ended it because he was mentally abusive like so many of the men my father “loaned” me to.

I have spent time dealing with all these issues and realized that it actually helped me discover some of my sexual limits and inhibitions as well. Of course, I am tested regularly because of all the rapes and attacks in my life (one of which created my extreme fear of choking to death and not enjoying anything that requires something tied around my throat).

I have tried to start a conversation with my father to see if there can be resolution to and reconciliation for everything that happened when I was a child. He refused and even blew me off by saying, “I need to go back to work so I can support my family.” He has recently remarried to a woman with two children, one of whom is an 8 year old girl. I am scared for her, although his new wife says he is not gambling anymore.  (I hope she is right). I guess with his last statement, he no longer considers me family so I have since let it go to the best of my ability and moved on. I do have four beautiful children who are my world. I will never let anything like this happen (if I can prevent it) to any one of them. My kids know that No means No and never let anyone push them around or force anything they do not want.

So, to sum it up, Dad was a sorry jerk, as were his buddies. There are always gonna be jerks out there who will rape for fun the illegal way. I am scared of being choked because of it. I do not think I can ever forgive 100%, but I can remember that it brought me to where and who I am today and that is all that matters.

Posted March 19, 2012 by kinkididi in Uncategorized