Tuesday, June 05, 2007

How to Handle Your Health Insurance Company

A number of people have asked, how was I able to get the health insurance company to cover my surgery. A surgery which they had previously deemed to be non-essential - that if I wanted them to even think about covering necessitated an additional 15 day approval process.

I'd like to say that the insurance company stepped up and did the right thing, except that of course they didn't. So here's what happened.


When my surgery was initially cancelled, my doctor's office dutifully submitted the additional paperwork detailing the necessity of the surgery. I called four days before my re-scheduled surgery, and the end of the 15 day period, only to be told by the insurance company "I'm sorry, we don't have the information from your doctor's office" and said some other b.s. how it's better to fax rather than mail (even though their form says either is just fine).

In a panic I called my doctor and they re-faxed the information. The next day I called the insurance company again, and I began to ask about the surgery being covered.

"I'm not sure if your paper work has been processed."
I sat in silence for a full ten seconds, and then said "OK, well the paper work was sent in well over 15 days ago, and let me just tell you this: I have nasal polyps and I'm in my last semester of law school. Now, if I don't get treatment, this can turn into meningitis or cancer -among other things- and can ultimately give me brain damage. I can assure you that if something happens to my brain that now contains over $100 grand in education, my loan companies will be more than happy to hold your insurance company liable. And my law school education is far more expensive than my measly day surgery."
There was a brief pause on the other end and then "Ok then, please hold while I check on that."

When the man came back 15 minutes later, magically, I was approved. "Someone was supposed to call your yesterday to let you know it was all approved," he said.

Sure. Especially since the day before they claimed they didn't even have my paperwork. And people say lawyers are bastards.


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Tuesday, May 29, 2007

Of Snakes and Surgery

A number of people have inquired how the surgery went, and I must say in the end it went smashingly. I feel like a brand spankin' new person - one who can smell, taste, and go for a walk without getting winded. Who knew what a difference one nostril would make? Sadly though, now that I have my tastebuds back in full working order I can no longer eat my food "thai hot" and I sometimes seemed to have super smelling abilities forcing me to cry out "My god, what IS that stench?" to which everyone else looks at me blankly.

Though the end results were good, the surgery itself was not the least fun. It started out well enough with them slipping an IV in my arm and me being out two seconds later. I had forgotten that it's the waking up that sucks. The first thing I remember post surgery is that I was being wheeled into a room (known as the recovery room) and that the left side of my head felt lighter, hollow almost. And also that my right foot was ice cold because, somehow, I had lost one of the little surgical socks during the surgery. It is a special gift I have that I can lose things even while unconscious.

The next two sensations to wash over me simultaneously were 1) pain and 2) nausea. The recovery room should really be called "the room where people writhe in pain and then vomit." The pain was not in my nose or head as expected, but in my throat. It felt like someone had run a rotor rooter down my lovely esophagus.

A fuzzy nurse then drifted into view - fuzzy because I was not allowed to wear my glasses or contacts. "On a scale of one to ten what's the pain like?" she asked me. I considered this question rather philosophically in my blearly, groggy state: I did not have a limb amputated, I thought, and they didn't crack my chest or anything. Therefore I would be a total wuss if I said ten, though I'm going to put it at the top of my personal top five painful experiences.

"Seven" I finally croaked. Fuzzy nurse then pumped morphine into my IV. "We're going to give you something for the nausea" she said, and put something else into my IV. Anti-nausea medication never works for me - all it does is make me more groggy.

(OK, warning it gets a bit gross from this point forward)

When nurse came back I informed her that I had to vomit. "That's good" she said. "You've got a lot of blood in your stomach and it's better if you get it out." Her statement grossed me out and I promptly vomited into a small kidney shaped dish she provided.

And then I filled up the kidney shaped dish.

Another nurse, who was in fact the largest scariest looking african-american man I have ever seen in person (albeit without my visual aids) appeared with reinforcements of another kidney shaped dish. Though he looked like a scary bouncer, he held me gently and then even more delicately cleaned me up with a damp towel after I had proceeded to get blood everywhere. As my sister put it, he was like the guy from The Green Mile. He is my favorite nurse ever.

The female nurse asked me again what my pain level was, and since it hadn't decreased in the least I said "Seven" again and then she gave me more morphine and more anti-nausea drugs. She then brought me some crackers and water to eat so I could take some vicodin. I should have warned her that this was a bad plan, but I dutifully ate the crackers, took the vicodin, and then promptly threw it all up about 15 minutes later.

A bit later I was moved to a chair where more anti-nausea medication was pumped into my IV. My mother appeared and a different nurse began giving us the post surgery instructions. The anti-nausea meds made me so groggy I can remember swaying back and forth in my chair unable to process any instruction. A few moment later I remember shouting at the nurse "Have to vomit" and she helped me to the restroom because I couldn't really stand up. I was so groggy I thought I might pass out.

I think after I returned that the nurse taped a gauze mustache to my face to catch all the "drainage." I was then discharged from the surgical center and wheeled to my parent's van and we began the 45 minute trek home. I passed out in the van only to awaken at the Walgreen's drive-through. My mom was saying we should wait for the scrips to get filled and I shouted "No, home now!" because I could feel the nausea rising.

My Mom drove away reluctantly and when we finally got to the house, she lingered at the driveway sorting the mail and fiddling with our gate and what not. "Hurry" I shouted because I wanted to vomit in our own gleaming porcelain goddess. My mother did not understand the urgency so I was finally forced to get out of the car and leave the rest of the crackers on our driveway.

The next several days were spent in a semi-conscious state punctuated by the taking of medication and the changing of the gauze mustache. That pretty much covers the excitement of surgery. However, you may wonder, what of the snake?

Well, 4 days after the surgery it was mother's day and we ventured from the house for brunch nearby in celebration. I generally had the energy for one small activity a day before returning to bed. When we got back to the house, I went up to my room and noticed what looked like a ribbon on the floor of my bathroom.

On closer inspection, it was a very small snake. My mother is afraid of snakes the way I am afraid of cockroaches. We are very much like Indiana Jones and his father in this way. Knowing my mom would completely freak out and ruin her mother's day I called my dad (who was puttering around outside) on his cell phone and informed him of the snake.

"What do you recommend we do?" he asked.
"How about bring a stick and a paper bag up here and I'll wait here and watch it so it doesn't get away."
"Good plan. I'll bring my putter."

When dad arrived he promptly squished the snake and did not heard it into the bag as I had planned. The snake didn't move and we concluded that it was already dead. How and why, was a complete mystery. Dad kept muttering "I don't like the looks of this at all" meaning he thought it was poisonous. We definitely didn't dare tell my mother at that point.

And that was my exciting four days.

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Thursday, April 05, 2007

Breathing Optional

So at 3:00 p.m. my health insurance company informed my surgery center that they don't cover nasal surgery. For any sort of nasal surgery to be covered, I will have to pursue an additional 15 day procedure which will allow the insurance company to determine if my surgery is "medically necessary".


To my Student Health Insurance: This is all shit that could have been brought to my attention more than 12 hours prior to my surgery.


I basically have tumors in my nose that cause a chronic sinus infection, which could ultimately cause me to have a brain infection. I'm not sure what could be more "medically necessary" than this surgery.

There's also the small fact that oh I CANNOT BREATH OUT OF HALF OF MY NOSE. As I'm wheezing and bitching to the health insurance man he says "I can see that you are having some trouble breathing." But it's not clear if that fact will be sufficient to find that the surgery is medically necessary and therefore covered; the insurance company reviews these surgeries on a case by case basis. So if I understand correctly, my health insurance may consider free breathing "optional".

So I've had to cancel my surgery. But hey, if I have to have emergency surgery, *that* will covered. At which point my brain may be worthless.

Fuck you, health insurance.


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Wednesday, April 04, 2007

Adieu, Mon Nose Fetus

As I've mentioned before, I've developed nasal polyps in my nose and sinus. But before I quite knew what was going on, I called the blockage in my nose my "nose fetus." Well, it turns out that I didn't respond very well to the steroids/antibiotics treatment to shrink the polyps, so I'm having endoscopic surgery on Thursday. In short, I am aborting my nose fetus.

But since life is only fun if it's complicated, I'm flying to Dallas (where I'm originally from) to have the surgery because the hospitals are so full down here I couldn't get it scheduled. It's an additional pain in the ass, but probably better because things are still pretty ghetto down here.

The one bright spot is that my doctor in Dallas gave me a comic book about my surgery entitled "ENDOSCOPIC SURGERY: Seeing and Operating Inside Your Sinuses and Nose." This comic book is awesome. I wish I had time to scan some of the choice pages to share.

I'll just describe some of my favorites; I love the pictures of sad people, all clutching their nose/heads/sinuses in various states of dress and agony:

* See the asian ballerina who cannot dance because she must clutch a kleenex to her nose.
* The caucasian female office worker who cannot stare at her laptop because of overwhelming sinus pressure.
* The african-american man in blue pajamas who sits on the side of his bed poking at his sinus. It is unclear how sinus pain has ruined his life - perhaps he is bed-ridden?


Other highlights include:

* Step by step instructions on rinsing the nose and sinuses with salt water
* Illustrations of various infections one can get in the sinuses
* At the end there is a picture of a fat italian man cooking enjoying the smells wafting upfrom his pot of delicious food.

Over drinks last night, my friends and I also had a lot of fun comparing pictures of my cat scan to the cat scan illustrations in the comic book. Like a high level game of pin-the-tail-on-the-donkey we drunkenly tried to spot my deviated septum and blocked sinuses. Fun for all ages!

At any rate, all of this is to say I'm afraid I'll be on a brief hiatus because I'll be recouping at the 'rents and they only have dial up.


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