scar tissue really!!!

[mwolf2022]

My pain has slowly started to come back.I feel aroud 20 percent better.Friday and Saturday were amazing.

Last night and now today I am starting to feel like I have for the past couple years.
I sent an email to the doctor , waiting for his response.

[jsewell]

So sorry to hear that.
judy

[Maria]

If you get the Botox injex please let us know how that goes. Wishing you less pain (again)!

[mwolf2022]

Originally Posted by Maria

If you get the Botox injex please let us know how that goes. Wishing you less pain (again)!

Maria I will keep everyone posted.I spoke with doctor fishman last night and he was happy i had some relief as a proof positive.

Dr.fishman is starting a new study for piriformis syndrome in a month or two and all the injections will be covered as long as you meet certain criteria.

I am hoping I do as they seem pretty expensive (I have a hmo plan so they are not covered as he is out of network.)

MiKE

[Maria]

Mike,
You might be able to try the angle with the HMO re going out of network that they don't have an in network specialist that provides specific treatment for your diagnosis however this doctor does. Perhaps then he could be treated as an "in network" provider. HMOs are pretty stinky to work with tho it's worth a try unless this is a clinical trial then hopefully you will qualify for it and be able to get into the Clinical trial. Will keep my fingers mentally crossed for you! Good luck there!

[jsewell]

Mike i hope you do qualify for the study and that is starts quickly . i had to work with an HMO and once they told me that they did have a qualified doctor to do a procedure that my out of network doc wanted me to have in Los Angeles. (i was living in Ga at the time) WEll i went to their doc , the test was a mess and came out inconclusive. The doctor performing it was complaining that he had no idea what to do next when something did not work. I then at a later date flew out to Michigan for the test and saw how it was done with a practitioner who knew what he was doing. It took a lot of time but they eventually paid for the trip to Michigan. But it is a frustrating fight.
Good luck and i will keep my virtual fingers crossed as well
judy

[Maria]

If you have one as a provider then you pretty much can figure out what I'm going to say though I'll just keep it to this~ trying to get the specialist you choose or know about to be "qualified out of network specialist" that offers what no one in network can offer is the trick. It takes some doing tho I've seen it done before. My last employer was a Managed Care Company and just sometimes things can work to the patient's advantage. It takes near a miracle tho it actually can happen at least occasionally.

I know it's far easier to blow someone off and say that there is an in network specialist that does the same thing or that the insurance company isn't going to authorize "that" kind of procedure or surgery or whatever however with enough documentation and the right circumstances I'll say it again~ sometimes things do work out.

Judy I certainly hope you let the HMO know how things went for you with that particular situation. Sometimes the only way that these companies can figure out that they're wasting their money is to have people continue to complain and see if the company had perhaps just authorized the first thing requested they could have saved several other consultations, procedures etc.

People/patients do have to report things that don't work out well for them however and many people don't go any further than calling Member Services and complaining vs. writing to the CEO of the company and really filing a grievance or something of that nature. In Managed Care/HMOs sometimes it is that squeaky wheel that gets oiled vs. just ignored!