Warning---VENTING

[Birdbomb]

As most of you know, I have Rheumatoid arthritis that was misdiagnosed for 30 years. Because of this, and not being under proper treatment, my body is breaking down.

I had a flare in my neck last year and it hasn't been right since. So my rheumy requested an MRI, but because I still had my VNS I could not get it. After months of struggle with Triwest, they shelled out over $31,000 and removed my VNS in Novemeber 07 and approved the MRI at Mike O'Callaghan Federal Hospital.

Well I show up for my MRI in December 07 and they sent me to a mobile unit parked at the back of the hospital. I don't know how many of you have ever seen one of these trailers, but the MRI unit in there is tiny even for a small person. I couldn't even get my shoulders in. I was mad but the technition referred me back to Triwest to go downtown for an open-sided MRI to accomondate a person of my size.

Triwest has REFUSED to approve this MRI. I sit here crying in sheer fustration. I have called my rheumy's office, Triwest and cannot get it setteled because of roadblocds Triwest has put in front of me. Now they want more "clinical information" My rheumey has faxed to them 3 times EVERYTHING in my records. I faxed the actual printout for the attemped MRI and the technitions notes.

Still not enough. I asked Triwest who do I sue, them or my rheumy when I become paralized from the neck down because my neck has become unstable and they would not authorize this MRI to determine how much joint deteriation has been done. Now they are saying, because of the numbness and loss of sensation, I need a NEUROLOGIST to request the MRI. I told then yesterday I had seen 2 different neuros and had had 2 nerve conduction tests done, 2003 after the auto accident when I crushed my left arm and 2004 prior to my bilateral carpel tunnel surgery. Those tests showed a HISTORY of numbness, loss of sensation and extensive nerve damage.

Not good enough.

My Rheumy says I should wear a cervical collar in the car because, people with severe RA like mine have been know to receive internal decapitation in the event of an auto accident. Lovely.

I am so mad. I don't know if this has to do with that big $60,000,000 budget cut or what. This is not a new referral, it's the same one I requested and was approved for last year. I banned out a letter to Triwest and they say they will respond in 4 hours. Now, I will call my primary and see what she can do. This is just getting ridiculous.

[speber]

Insurance crap reaks....it really does.
It sure sounds like you have a case (if the process of THAT wasn't such a PITA itself) against "Triceratops"..."Tri-someone-else"....whatever that insurance company's name was......what jerks.


Oh well, if it'll help....I'll change my Avatar for you for a little while

[epileric]

They were very willing to give you an MRI at the trailer. That shows they'd already decided that an MRI was appropriate for you. Would a Lawyers letter get their butts in gear?

Good luck Birdy.

[RobinN]

Our system is definitely broken. Sorry to hear of your difficulty. Are there no other labs that can do MRIs?

[Birdbomb]

Are there no other labs that can do MRIs

THAT is the battle.
There are several open-sided facilities here in Vegas but Triwe$t doen't want to approve it for off-base even though I can walk into the base facility with an off-base dr request to have it done with no problem. I cannot use the base's machine.

They are being so anal!!!



I am calmed down enough to post this
Triwe$t just called me back and said they have heard nothing from my rheumy since they sent the rejection letter on the 11th .

Bullshit! I spoke to the office manager Monday and Wednesday and she told me she had faxed my files 3 times since that letter.

Triwe$t tells me I need to have my provider contact and speak directly to Authorization. I need a neurologist report. They won't consider anything I have said. Not the previous testing, surgeries or medical history or the fact this is not a NEW referral, I just can't fit the MRI at Nellis.

I'll have to wait until Monday or Tuesday for my primary doc to call back, but I do see my Rheumy on Monday.

Hopefully I'll be able to speak to him without bursting into a sobbing, blubbering mass.

I am sick of this $hit! It has been dragged out for a YEAR!!





*+*+*POOF!*+*+* all gone!

[Bernard]

Don't tell me about their coverage, Bob! Don't tell me about their coverage!

[angel]

----}-}--@

maybe if you do turn into as sobbing, blubbering mass they will get the point and put a move on things for you....
my mom has Rheumatoid arthritis she is in pain a lot says her whole body hurts and aches.....

she sometimes hurts so much shes a moody grump..... i dont think shes had much help eather tonight i was talking to her and she said she was hurting ......

love, & hugs
angel

[brain]

I am confused. I've had MRI's in a
trailer and in a building ... at
HOSPITALS! Several times ...

I do not understand the issue here?

Maybe I'm lost here, or maybe I'm
just so used to all these scans here.

But as for the Insurances ... especially
the HMO's ... I've had my fill! I think
they're the ones who're responsible for
90% of giving people EPILEPSY!



(((((( BIRDY ))))))))

ENOUGH IS ENOUGH!
Time to kick some Hiney here!

[Nancy]

I'm wishing you the best ........ Wow, am I wishing you the best success.

You know we're on TriCare-North, right? I go to non-military hospital for $3,000 + MRI of my brain in April. I wonder if they will approve that. (we've been on regular HMO's for all the stuff I've been through previously)

A couple weeks ago TriCare refused my prescriptions!! Very long story ..... The hospital filed appeal which was refused. Hospital filed second appeal which was finally approved. OMG.

[speber]

...someone's gonna try and sell a toilet to the gov for $30,000!

Sounds like rolls of red tape are mucking up the works and causing idiotic moves by every department you need to talk to Birdy...if I can state the painfully obvious.

Who cuts red tape??????

[Nancy]

What's truly frightening right now (well, maybe not TRULY because it's just something I've "heard") is that TriCare is being reduced AGAIN. ~sigh~

Hang on, Birdy, hang on.

[Birdbomb]

(sulks)

I slept till 12:30, I am exhausted from this. My neck/back/hands/anklesl/hips are screaming. Stress agravates RA. Nice huh? Plus the weather is nasty today.

Nancy, what happened with the prescription thing? I know once in a while Walgreens ( I get mine filled there instead of the base, just more convenient) will have a problem but they get it setteled PDQ.

If I can't get results by Wednesday, I will be contacting the higher ups. I.G. has contacted me in the past, guess that's the next step.

[brain]

<--- should learn to READ

TRI-CARE



Go BIRDY! You never
loose a ....

[RobinN]

I just read this. I have never tried it, but it certainly is worth a try.

Cabbage leaves contain powerful anti-inflammatory compounds. When applied to arthritic joints, these compounds relieve pain and swelling fast.

What to do: Use a rolling pin or knife handle to bruise one or 2 large, outer, dark-green leaves from a head of green cabbage. Then warm the leaves in a microwave, steamer, or oven. Wrap them around the joint, cover with a towel, and leave in place for 15 minutes. You'll be amazed!

[RobinN]

I was researching some information that I have found on restricted caloric intake on seizures and convulsions, and I found this:

Low-energy diets and fasting have suppressive effects on rheumatoid arthritis. It was reported recently that urine levels of pentosidine (i.e., an advanced glycation end product formed by glycosylation) is associated with the activity of rheumatoid arthritis. We conducted a regimen of caloric restriction combined with fasting in patients with rheumatoid arthritis, and then evaluated urinary pentosidine levels. Ten patients with rheumatoid arthritis underwent a 54-day caloric restriction program. Urinary pentosidine levels were measured and the Lansbury Index were determined by examining the clinical features, blood biochemistry and the inflammation activity of rheumatoid arthritis on days 0, 25 and 54. On day 0, the mean urinary pentosidine level of patients with rheumatoid arthritis was significantly higher than that of the control subjects. On day 54, the mean body weight had reduced due to caloric restriction. The mean values of the erythrocyte sedimentation rate and the Lansbury Index of patients both significantly decreased during the study. In addition, although the urinary pentosidine levels showed no significant difference between day 0 and 25, it was significantly decreased at the end of the study (day 54). The study showed that under a low energy diet a reduction of disease activity in rheumatoid arthritis was accompanied with a reduction of the urinary pentosidine.

http://www.anti-aging-guide.com/32rheumatoid.php
http://antiaging-europe.com/lists/31/diseases.html

[Bernard]

Stacy's breastfeeding coach (a certified nurse) told her to use the cabbage trick if she experienced undue swelling because of breastfeeding. It's worth trying.

[BuckeyeFan]

I have no idea how effective it will be for joints, but my sister used it for breast feeding years ago and it worked for her. It sounds like a good enough of an idea to try on my knees.

Birdy, hire someone to kick the insurance company in the a**. Most people would do it real cheap, some may even pay you for the opportunity.

[brain]

Cabbage tastes great with
Corned Beef which is about
a few more weeks away!

[Birdbomb]

Not in the mood for cabbage so I sure as hell don't want to smell like one. But I will keep it in mind.

I spoke with my primary today after playing phone tag with her nurse. Once again, I must recite the entire saga to the nurse so she can tell the doc, whom will call me and I will recite the saga to HER too. (God! I can do this in my sleep)

It seems Triwest IS being anal, not just with me but anyone who is not active duty. She put in for the MRI under a different heading and said to check with them in a week to see if it's approve, if not to call her back and she'll do something else.

If they refuse it again, I will go to top brass and have just the connection to get there. Screw them.

My rheumy changed my lortabs to percocet and increased the chemo. Blah. Cross your fingers this gets this flare to die down.

I'm tired. I'm going to bed.

[brain]

So sorry you're having to go through
all of this!