h2g2 The Hitchhiker's Guide to the Galaxy: Earth Edition

They're dragging their feet because this is the state of health insurance in the US, especially since in Shea's case, workman's comp will be paying for this.

See, if they drag their feet long enough, she won't be able to have the surgery as scheduled, which means workman's comp won't be stuck with the bills (yet). They probably figure if they drag their feet long enough on this, Shea's "little problem" will just go away on it's own, or she'll forget about it and pay for it herself out of desperation, then they can make up some excuse to never pay for it at all, thereby saving themselves $$thousands$$.

It's worse than pulling teeth to have medical needs taken care of in this country when you're dealing with the intricacies of organizations like HMOs (Health *Maintenance* Organizations - what a sick joke!), or Workman's Comp, especially when they've decided at some point along the way that you don't really need something taken care of.



There was an article in the paper this morning about a little girl who died from some kind of cancer last month. Her parents had to sue the HMO to pay for one phase of her treatments ($36,000), which they had earlier refused to pay because it was an "experimental treatment", which the insurance does not cover. Experimental, yes - but her *only* hope of beating this thing at that point. Perhaps if they hadn't dragged their feet so long on approving the treatment(to the point where the parents went ahead and scheduled the treatment without their approval), the little girl might have survived. I honestly think the HMO would *still* be refusing to pay for it, if not for the fact that the story about how they refused to pay for this treatment ended up in the paper a couple months ago. No insurance company wants that kind of bad press.

Yes, Workman's Comp is notoriously slow at dealing with injuries, for that very reason - they don't want to pay.

But it's not just Workman's Comp, some of the regular insurance companies play this game also. I know the employer at my previous job had to get on the phone with our company insurance and raise hell because they weren't taking care of an employee's back problem. Finally they gave the employee an option of traditional back surgery (metal rod up the spine, limited mobility, 6 - 8 months off work) and they would cover it, or the newest surgery (6-8 weeks off work, no metal rod, less invasive & much less cost). Guess which one the insurance company was going for? If you guessed option #1 you were right. They were willing to spend 3 times more money for the "traditional" surgery because the newer surgery (although becoming common place) was still considered "experimental". They wouldn't cover the "experimental" surgery at all.

Well, my boss ended up paying for the newer "experimental" surgery out of his pocket, because he didn't want this employee to end up partially paralized. 3 months later the employee was back to normal, no back pain, full range of motion,etc.

Clive - " *confused* why are they dragging their feet?"

Because they are tangled in all the red tape they've tied around them!

It's not just the regular reason of not wanting to pay that makes them drag their feet, but the fact that the original injury report and Workers Comp case was filed before my company was bought out by another company to make an even bigger company. Change of management meant a change of Workers Comp insurance company. But I still had to deal with the *old* insurance company. Since they're no longer receiving payments from my company, they don't want to have to cover the people they're still responsible under the old plan. I can only imagine the amount of money they took in from my company over the years. We've got thousands of employees, and how many get injured and need to take advantage of the insurance? I'm sure they didn't lost money on the deal.

The good news is that I got approval! So I'm still on for next Thing! Woohoo!

Yay!

Not that surgery is ever *fun*, but at least once it's done, you can begin to recover and hopefully your hand will begin to return to normal again.

Before you go in for this, Shea, make sure you take a big black magic-marker and clearly label all the body parts you don't want them to remove by mistake.

"DO NOT REMOVE!"

*has visions of two nurses chating in the background as Shea is led through in surgical gowns covered head to toe in black marker.*

"Wow. she's worse than we thought...."

"No kidding."



(and good news about getting approval - finally! )

I'll be awake for the whole 10 minute surgery, so I'm sure I can stop them before they lob off anything important! Especially since my surgeon is the same doctor that's grabbed my right arm for the past year and a half every month, raps on the wrist and says, "Still tingling?" He knows the right arm! The right arm!

Only 10 minutes?!

When Lord Scott had his carpel tunnel done, I know it must have taken at least 90 minutes. But then again, the surgeon said he just happened to still have a vein in there that didn't belong (one that normally disappears before birth), so he had a little extra work to do there.

We have disappearing veins? Who knew? I wish those spider veins in my thighs would take the hint...



So now that they're finally proceeding with you case Shea - do we need to change it to "Carpe Tunnel" syndrome?

My very dear Shea,

I can think of a lot of nice things that TJ will enjoy doing apart from your hair!!

Life has been very hectic since the return but the holiday was wonderful. I have decided though that I do not want to go and live in France. Sadly their ideas of what someone in a wheelchair can cope with are really primitive at the moment. Cobbled streets are also very difficult to negotiate. However, the food was out of this world. Marvelllous fish and shellfish which I love. And wonderful new unknown cousins who were quite marvellous to me.

I have not finished reading this new thread, so if you have had your op. I shall be thinking of you - if you have not well good luck for it.

Tomorrow it is ten years since I had my "emergency" double by pass due to an aneurysm in my left coronary artery. I was going to have a "hearty" bridge party, but have decided to have a nice lunch with a special friend!!.

I shall obviously drink to the surgeon and the cardiologist who diagnosed the problem. Without them I would have been pushing up daisies years ago. And just think!. I would have missed meeting all of you!!. I still hope to come and have my walk along the explanade and then my chowder with you both - and your sister if she can come!1.

Very much and affection

Also Ran1

I'm very glad too, AR1!

Surgery tomorrow! At 8:15am! So I'm cutting out of w**k a little early tonight to try to get in a few hours sleep before I have to get up at 6am. TJ's not even going to bed. No point, since he usually comes to bed around 4am. The made a wisecrack about me not needing any anesthesia at that hour. Haha.

Hope you're still there Shea, in time for me and Mrs Gosho and the babies to give you a before go under the juice

s and s Shea - You'll be on the road to recovery soon!

Big s for you Shea!

and a BIG

s Shea.

Don't forget your magic marker!


May your surgery go perfectly and make you perfectly well again.

Um.... too late to say hope you'll get through it OK, so I hope you're recovering well and that the wedding was nice.

I didn't need the magic marker! My came in and put his "mark" on the back of the hand having surgery. His name is Dr. Rho, so he put an "R" there. One of the s joked about him being Zorro ... I said he was Rhoroo ... I think he got a new nickname around there.

Anyway, the surgery went okay. I was put under general anesthesia for it. I thought I was getting a local, so that was a surprise! Luckily, I had told them about having had problems with anesthesia before, and they gave me Dramamine before going under, and I seemed to do better this time. Unfortunately, the Vicodin I was given for the pain made me very sick, and the day after surgery I was throwing up and very dizzy. They changed the medication to Darvocet, which wasn't as good for the pain, but made me feel quite a bit better. Yesterday was the first day I felt well enough to go without the Darvocet, and just took some ibuprofen. I'm doing much better now! I've got my brain back! I even felt "unfuzzy" enough to drive myself to physical therapy today!

I had the wrappings taken off last Sodit, which helped the pain a *lot*. The swelling went down after that, and now I only have some leftover bruising, and pain around the incision area unless I overdo it. Unfortunately, the stitches aren't coming out until Sodit the 13th. It will probably feel much better once they're out and it stops pulling!

I have to say that I'm convinced this was the best thing I could have done. Even the pain I have now is much less than the pain I had before the surgery! I get a lot of pain if I do too much, but if I take it easy, it's okay ... and I know it will only get better!

TJ has been fabulous, and gets a kick out of having to rush to my aid all the time! Thank goodness he w**ks at home! I keep running into situations where I need two hands, and can just call for some help at anytime. It's keeping me from overstraining! I love that man!

Yay! s

I'm glad all is going well and I hope your recovering to full posting capabilities comtinues. Say g'day to TJ for me.

<..... you probably shouldn't drink that whilst under medication.