I wanted to be clear-headed to write this post. I wanted it to be perfect because it is, I think, the most important post I've ever written.
Instead, I'm a little foggy brained because my pain level is through the roof right now and I couldn't handle the pain without pain meds.
I ask you, upfront, to forgive the imperfections in my writing today and to read with your heart. I ask you, please, to forgive the grammatical and punctuation errors I might make and feel my words instead.
My words have never come from my heart more than they do right now.
Four and a half years ago a man ran a stop sign and t-boned my car. My life was forever altered in a matter of seconds. Since that time, I've gone through seven surgeries. I've logged thousands of hours of physical therapy, and I've cried buckets of tears.
My most severe injury as a result of the car accident was the loss of the use of my right, dominant, arm. Now, four and a half years – and seven surgeries later, I have around 20-25% use of my arm.
The loss of the function of my dominant arm has proved to be a challenging obstacle.
The pain I now live in – every minute of every day – is beyond most people's ability to understand.
It was with cautious optimism, I recently went through my seventh surgery for the "trial" of a neurostimulator. A neurostimulator is a device which has successfully helped thousands of people with chronic pain.
Insurance companies will not authorize the implant of a neurostimulator without first having a patient go through a trial period to make sure it works for that particular individual.
My medical insurance is with Anthem Blue Cross.
Anthem Blue Cross requires candidates for neurostimulators to also go through psychological screening to make sure they can handle, psychologically, having an implant in their body.
Anthem Blue Cross approved the cost of a pain psychologist consultation for me as one of the necessary steps towards getting a neurostimulator. The pain psychologist proceeded to "clear" me as a good candidate.
Next, Anthem Blue Cross approved the actual cost of the surgery.
Last, Anthem Blue Cross approved the cost of the neurostimulator device to be used during the trial period.
Yes, it took separate insurance approval of all three steps for me to undergo a trial of the device.
I underwent Surgery #7 two weeks ago today, with the hope for a better life.
The trial was deemed an unquestionable success.
I can't even put into words the joy (!), the hope (!), and the renewed sense of possibilities I experienced. This "device" is so much more than a device. It's a chance for me to live a more normal life.
During the one week trial period, my use of narcotic pain meds went down substantially. The function of my arm increased. I slept through the night two nights in a row. Does that sound minor to you? Prior to the trial period, I hadn't slept through the night once in four and a half years.
Try imagining for a minute, you are living in so much pain you are unable to get even one full night's sleep for four and a half years.
Was life changing.
No, the neurostimulator will not give me back full function of my arm.
No, it will not make me pain-free.
What the device did during the trial period, is improve the quality of my life remarkably.
It also gave me hope.
I wrote a letter to a friend after the trial, telling him all the things I planned to do once I got the permanent neurostimulator implanted. I listed things I haven't been able to do since the accident four and a half years ago.
I closed the letter like this: "2011 is going to be my year of great strides … I just know it!"
I believed, truly believed for the first time in years, I was finally going to get a portion of my old life back again.
Yesterday afternoon, I came home to a devastating message from my doctor.
Anthem Blue Cross has denied me benefits for the implant of a permanent neurostimulator.
My doctor was angry – and floored.
A "review" doctor from Blue Cross talked to him. My doctor asked why they would approve the cost of psychological screening, the cost of the initial surgery, and the cost of the trial device and then turn me down for the permanent implant when the trial was a resounding success.
The doctor for Blue Cross?
"Well …," he answered, "I don't know."
If Blue Cross doesn't know why they would make such an asinine decision, who would?
To say I'm devastated, that my hopes have been crushed, that my spirit has sunk to its lowest low … does not begin to describe how I feel.
Why would Blue Cross put me through the trial surgery if they have no intention of allowing me to get permanent help through the use of this device?
I went through a seventh surgery for no reason?
Help me to understand that.
Why, why, why?
My doctor wrote a letter of protest to Blue Cross and informed them he would be sending a copy to the California State Insurance Commission also. I will do whatever I can on my end to attempt to appeal the decision also.
I've never asked anything like this before …
But Internet – I really need your help.
What Anthem Blue Cross is doing is wrong on so many levels.
I need to find people who can tell me what to do, where to start, and how I can be helped.
I need to draw attention and publicity to my situation.
How else can one, lone, person fight an unfair decision by a huge, greedy, medical insurance company?
Internet, tell me …
How can I possibly –
Get my hope back?
** Follow-up to this post can be found by clicking here. **
© Twenty Four At Heart