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  #11  
Old 06-09-2007, 02:07 PM
marilyn marilyn is offline
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Harrison,
I was unfortunate enough to have been hurt at work. I had, therefore, to deal with Worker's Compensation Insurance. I have a tape that they took of me that has been cut and spliced. I have the bill for an entire wrecked engine for the day I tried to bring it in front of the judge so they could get punished for falsifying legal documents.
I also had long term disability through work. Thanks to ERISA laws I havn't seen a cent in years.
We spineys should work with Michael Moore. No one besides the mentally ill gets treated worse by the insurance companies.
Marilyn
Been through the insurance mill big time
three level ADR Stenum July '07
Quote:
Originally posted by Harrison:
Thanks for the interesting discussion and ideas. I thought about sharing some of the interesting op-ed pieces I read on Michael Moore, but I couldn’t find the time to carefully articulate my views about this latest movie, and how our community might use it as a springboard for furthering our cause. That is to say, promoting awareness of the absurd insurance issues as well as medical tourism issues (there are many).

I’ll think carefully about what you’ve thoughtfully shared here, and send in my comments via the Oprah web site. If anyone here has contacts/phone #s for the producers, pls email or PM them to me so I can follow-up on my feedback.
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  #12  
Old 06-09-2007, 07:29 PM
marilyn marilyn is offline
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Hi Harrison,
I hope this gets to you. Not feeling so well.
I regret our conversation, but it may be useful. I would like to take a three pronged approach and be solution oriented. Especially if we have Michael Moore and Oprah listening.


1) Insurance companies know from the get go that they are trying to get rid of us. We cost too much. I can prove that if you read a book by Ray Bouhrris.It is called "Insult to Injury" Read it. Spineys don't get a fair shake because the problem is difficult, lengthy and often unresolveable.Insurance companies hate us. They deny healthcare as well as disability pay. They thought up ways to get rid of us looooooooong ago! We are too sick to fight back (until now)!
2) Probably related, drug regimens like "Lyrica" are delegated to;egally protected drugs that make pharmeceutacals a load of money. They are still under protection from the laws that keep other pharmeceutacal companies from stealing their inventions.No generics yet. Why not profit from this enigma? They often charge a fortune for this stuff. Or re-delegate the use, such as was seen for antidepressants for PMS? Any way to gouge us/insurance co's, /anyone else!
3)We often can be helped. Somehow it got lumped in to the "just say no" to addictive drugs, and we are criminals thinking...
We are sick, not criminals, and often what will help one person will make another useless. The Neurontins and the Lyricas are quite toxic, if you care to look it up. The simple opioids are well known to work well, give the patient a sense of well being, and be less toxic. Hey, if the Neurontins work, great! What if they make you choke (like me)and make it hard to think? The docs don't want to give you the opoids that will work. The DEA will actually put them in jail if they do. They're understandably scared. This is very real. After I almost choked on a piece of bread from the "Lyrica",(and everything else going down my throat, it's a side effect) I'm scared.I also feel like hell when I take the Lyrica type stuff. We need to push for safe drugs. Even if it's an opiate. We have the technology!

and........by the way, why do we accept the fact that if you got hurt at work that you won't get good medical care? That's true, but wrong! We are treated like criminals. I worked full time since I was nineteen and put myself through college and then some. We are injured workers, not the same as criminals. I was followed,filmed, recorded, harrassed, tapes altered, car ruined, reputation and self esteeem ruined, what else?
Stenum. Oye Vey!
Read "Insult to Injury" by Ray Bouhrris. All the documentation you need on insurance companies is RIGHT THERE!!! I beleive this and want to talk to Michael Moore! We all deserve timely, state of the art medical care!

Sorry you got in the way, bad day!
Much love to all spineys,
Marilyn



Quote:
Originally posted by LBP:
I also edited my previous post...what about the stenum folks. That might be enough of a shock factor to get the rest of our discussion reviewed.

The part I saw on TV had to do with a women who was denied a test to determine whether kemotherapy would be successful (denied because the test itself was considered investigational and experimental)

Another women was denied treatement for a brain tumor. She was out of the country and dx with a brain tumor and her US insurer denied she had a brain tumor.

There were 5 women in focus...a variety of Blue Cross people and a Cigna. A chunk of the show was interrupted due to a local plane crash into Lake Michigan, so I didn't see the whole segment.
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  #13  
Old 06-10-2007, 08:32 AM
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Harrison Harrison is offline
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For people that wish to be involved, I would like to fax/email the producers at the Oprah Winfrey show. We MUST get their attention; so here’s how you can help:

- I’ll consolidate your concerns/complaints about health care (un)coverage for ADR (and other) procedures. Please spell out your concerns succinctly; I recommend 3-5 paragraphs, which is app. 500 words or less. Please use a spell & grammar check too.
- Time is of the essence, so send me your thoughts ASAP, no later than June 14th, this Thursday. Please email me this (prefer in MS Word) to info (at) adrsupport.org
- Whether I receive five or 500 responses from you, all will be included as long as your writing is coherent.
- After editing, I’ll post the final document that I’ll send Oprah/Moore in the Big Bucket.

Folks, I could argue that we spine folks are the largest, yet most unrepresented population of patients in the United States – as LBP points out in this topic! And things are only getting worse – see D. Coley’s post from today!

Come on everyone – spouses too – let’s pull out ALL the stops on this one! This may be our chance to work together and make some changes for all of us!
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"Harrison" - info (at) adrsupport.org
Fell on my ***winter 2003, Canceled fusion April 6 2004
Reborn June 25th, 2004, L5-S1 ADR Charite in Boston
Founder & moderator of ADRSupport - 2004
Founder Arthroplasty Patient Foundation a 501(c)(3) - 2006
Creator & producer, Why Am I Still Sick? - 2012
Donate www.arthropatient.org/about/donate
  #14  
Old 06-10-2007, 09:06 AM
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Harrison Harrison is offline
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Folks, I submitted my comments to Oprah, and communicated that I'll be sending YOUR stories in within 5 days. So send me your thoughts...see above post!
___________________________________________

Thank you for your e-mail! Your message is important to us. Unfortunately, due to the volume of e-mail messages we receive every day, we cannot guarantee that you'll receive a personal response. Feel free to check out our Frequently Asked Questions for additional help.
http://www.oprah.com/tows/program/tows_prog_main.jhtml

Thanks again for writing to us!

Sincerely,
The Oprah.com Staff
www.oprah.com
__________________
"Harrison" - info (at) adrsupport.org
Fell on my ***winter 2003, Canceled fusion April 6 2004
Reborn June 25th, 2004, L5-S1 ADR Charite in Boston
Founder & moderator of ADRSupport - 2004
Founder Arthroplasty Patient Foundation a 501(c)(3) - 2006
Creator & producer, Why Am I Still Sick? - 2012
Donate www.arthropatient.org/about/donate
  #15  
Old 06-10-2007, 04:37 PM
spotty14 spotty14 is offline
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LBP,
I got your message and I don't know how to respond back to it except here. Please tell me now. Thanks
__________________
7/05 EMG/Nerve Conduction Tests
8/04 Disqualified from ADR clinical trial due to severe osteoporosis -- getting treatment
3/04 updated MRI
11/2000 IDET L 3/4, L4/5
1/2000 Discogram
numerous epidural injections
physical therapy
  #16  
Old 06-10-2007, 08:35 PM
LBP LBP is offline
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Just read harrison's post above about what to do! Thanks
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Injured 9/01
Annular tears L4/5 & L5/S1
denied adr by insurance for 2 level charite as well as hybrid fusion at L5/S1 with Charite at L4/5.

New ins paid for 2 level lumbar prodisc surgery on 4/7/08 (at age 39) with Dr. Westerlund, at Core Orthop
  #17  
Old 06-10-2007, 10:24 PM
Abbe Abbe is offline
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Here is what I have sent Harrison hope this can help all of us somehow!

My Back Story
Abbe

For me my back problems started when I had a water skiing accident in 1986. The tip of my ski caught the water and before I knew it I was *** over teakettle. I did not release the ski rope from my hands and knew right away that something had gone pop in my back. I was very athletic and figured I would heal in a week or two with rest. That was far from the case. I finally went to an orthopedic doctor and had X-rays taken and there were abnormalities. At that time MRI’s were a new technology and were not being covered by insurance companies. They were considered “experimental and investigational”. I would have to shell out the money to have one of these studies done. But the claim was that they could see the soft tissue and be able to determine my ailment more accurately than any other technology at the time. So, I opted to have the test done. Sure enough the MRI showed a ruptured disc at L4 L5. I was young and scared of having back surgery. At least two doctors wanted to do spinal fusion, I was only 26 years old and knew I did not want my back fused. I put off surgery for six years until I could wait no longer and was on the floor in excruciating pain and tired of living on narcotic painkillers. I found a neurosurgeon who said he would try removing part of the disk orthoscopicly to see if that would make the disc bulge retreat. He told me up front that this was not a promising surgery but it was the least invasive. I gave it a go yet I did not have the relief I had hoped for. My second option was to have a hemilaminectomy along with more of the disc being removed and no fusion. He said this would leave my options open later down the line. I had a great success with this surgery and was happy not to have had the fusion surgery that the other two doctors had recommended.

Almost twenty years after those first surgeries I have also been diagnosed with the vertebra above and below with degenerative disc disease and ruptures and tears in the discs along with the original disc that I had problems with being all but gone and now I am bone on bone there. In 2004 I was considered a good candidate for the Prodisc trials but I would still have to pay for the artificial discs and they would run $10,000 each. I have had my ups and downs and have even went through steroid type of injections into my spine to alleviate the swelling and discomfort due to enflamed areas pressing on my spinal canal. I have also been put on a medication called neurontin, which helps the nerve pain but does not make it go away. In addition I also take an anti spasm medication to keep my back from going into spasms. Blue Cross of California has denied me three times this year for artificial disc replacement stating that it is “Investigational”. They dropped the term “Experimental” after the second denial when I wrote to them and I included the FDA approval of Prodisc which was approved last year. Blue Cross of California said they would approve a three level fusion surgery which is a major surgery and would take a year or so to heal from not to mention the loss of any lower back flexibility.

I have done quite a bit of research on fusion and disc replacement and have read many research papers and articles. I now have nerve damage affecting my legs and the last three doctors I have been to have all suggested I have disc replacement over fusion yet I am at the mercy of the insurance company.
Although I am not a doctor I am in charge of my body and not the insurance companies. If I were a person of unlimited means there would not be a problem with getting this surgery done. But since I am a middle class American I cannot get this procedure done without jeopardizing the financial well being of my family. If I were a federal employee Blue Cross would have to cover this procedure since it is FDA approved.
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Water ski accident 86'
Chiropractic& PT Pain meds
Discectomy Laminectomy
L5 S1 Partially sacralized
97' epidural injections
L3 L4 ruptured and torn
L4 L5 Almost no disk height left along with osteophytes
Left leg pain and tingling going down back of leg into heel & foot
3 appeals with BCBS no success Lost insurance.
Kaiser Permanente
L3-L4, L4-L5 Prodisc 9/18/09
C5-6 & C6-7 ruptured and looking at hybrid surgery fusion & Prestige ADR
  #18  
Old 06-11-2007, 06:59 AM
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Harrison Harrison is offline
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Thanks all. I now have 3 stories -- but looking for many more.

Please note:

- I’ll consolidate your concerns/complaints about health care (un)coverage for ADR (and other) procedures. Please spell out your concerns succinctly; I recommend 3-5 paragraphs, which is app. 500 words or less.

- Time is of the essence, so send me your thoughts ASAP, no later than June 14th, this Thursday. Please email me this (prefer in MS Word) to info (at) adrsupport.org

-----------------------------------------

Thanks Nanci, Amy, Abbe for your stories...
__________________
"Harrison" - info (at) adrsupport.org
Fell on my ***winter 2003, Canceled fusion April 6 2004
Reborn June 25th, 2004, L5-S1 ADR Charite in Boston
Founder & moderator of ADRSupport - 2004
Founder Arthroplasty Patient Foundation a 501(c)(3) - 2006
Creator & producer, Why Am I Still Sick? - 2012
Donate www.arthropatient.org/about/donate
  #19  
Old 06-11-2007, 11:12 AM
marilyn michalak marilyn michalak is offline
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We are all targets for insurance/disability monkey business as Spineys. Now's the time to come out of the closet. Spine injuries/treatments are expensive and don't work well if at all. We are often too sick to fight back to get the treatments and compensations we deserve/need. Often, we get injured at work. Workman's compensation is a realnightmare among nightmares. Working Americans are denied WC care, and cannot use other companies'services since it is a work comp. claim. I hope it is finally time for justice.
Marilyn
Quote:
Originally posted by LBP:
Okay everyone, this may be the time to email Oprah about our coverage issues. Oprah has a link asking for people to email her about our health insurance woes. See http://www.oprah.com/tows/pastshows/...070605_b.jhtml

She recently had Micheal Moore on her show to discuss his latest documentary "SICKO" where he takes the health insurance indus head on. I just saw part of the Oprah show and he had a few woman who were denied test and/or treatment because it was experimental etc....

So it made me think..if she gets enough of our stories...maybe ADR can get a little air time.
  #20  
Old 06-11-2007, 11:13 AM
LBP LBP is offline
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Okay people....

even if you don't agree with Moore's documentaries in the past...we haven't seen his new one yet. Even Oprah says it's much less political.

Regardless, we all have stories to tell, why you went to Germany, you're denials and fights to get US ins coverage etc... not to mention good and bad stories of medical tourism etc.

No matter what your politics are, can't we all agree that the US Insurance Industry Dictatorship rule of our health is not a good thing???!!!!
__________________
Injured 9/01
Annular tears L4/5 & L5/S1
denied adr by insurance for 2 level charite as well as hybrid fusion at L5/S1 with Charite at L4/5.

New ins paid for 2 level lumbar prodisc surgery on 4/7/08 (at age 39) with Dr. Westerlund, at Core Orthop
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