Friday, July 23, 2010

If this is what healthcare reform is all about, I'm really not sure

Yesterday, I had a lovely medical procedure on my back. My husband went with me. Usually I have been dropped off by someone and picked up by someone else so am basically on my own for the duration which is not a problem. Most of the time, no one is allowed to go with me. But yesterday's included sedation so I knew I would be waking up for a bit and preferred to have my husband there to hang out with me.

We arrived at the hospital in a timely manner (in other words, with all my procrastination, we weren't late). I was checked in and allowed to change into a 'lovely' gown with coordinated robe and my husband was sent off to the waiting room. Then they stuck an IV in the back of my hand - ow, ow, ow, and it bled all over the place. After a brief wait, I was taken in to the 'minor operating room' and they started the sedation which was meant for me to be pain free but able to hear them.

They started the needles and the doctor remarked that insurance was no longer going to cover the procedure. Hmmm.... I couldn't talk but I definitely wanted to follow up on the remark. I asked the nurse about this as she brought me to recovery and she said as part of health care reform we are going to see more of this, that insurance companies are going to stop covering procedures because, in the case of this procedure, they don't think it works. But why is an insurance company making decisions about what procedures work and don't? Isn't it up to a medical professional to decide what is the appropriate course of treatment? Who went to medical school here and has seen that patient? Not the insurance companies - they are just faceless voices on the phone after long periods of being on hold and told 'you are important to them'.

I am calling my insurance company this morning to be sure I am covered. The hospital admissions department was supposed to get a pre-approval last month when the procedure was ordered but I want to make sure. Actually I was told by one of the nurses that it is a best practice when ever a procedure is ordered to call your insurance company to ensure you are covered and get their name and a confirmation number of the call.

Anyway, so after the procedure yesterday I was in recovery with my husband. My pain level went up to somewhere around 9.5 out of 10. It was awful. They got me some percocet and it barely touched it. I was also shaking uncontrollably. And crying. And squishing my husband's hand. Then they gave me morphine and then some more morphine. Then they gave me Demerol. The pain finally subsided and the shaking eased up. They told me to go home and sleep and wait for the drugs to get out of my system. The theory was the shaking was a result of all the medications in my system.

I woke up 3 hours later feeling shaky but not shaking with my pain somewhat bearable. I figured out by looking in the mirror the pain wasn't where they did the procedure by in my hip instead. I slept so so last night. Today I will unproductively work from home and catch up on my DVR shows. After I call my insurance company that is.

PS I just called my insurance company and was told if a procedure is deemed medically necessary by the doctor, they approve it.


Anonymous said...

Hi. I just wanted to say that I found your blog today and its been a good inspiration for me. I'm just starting out on my cancer journey so its nice not to feel alone.

linda said...

ugh. You don't usually say that, so I will for you. Insurance stress on top of all you're going through. It's just not right!

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