Hopefully You Will Never Have To Have Surgery!

I wanted to share this with you all, wondering if anyone else is having the same experiences.
My husband was having pain in his left foot and went to our general doctor, she sent him for an imaging test. The results showed an artery problem so he was then sent to a vascular surgeon for analysis.
He went to this specialist several times and was sent for more tests, at which time he was told that surgery for a blocked artery in his groin would be necessary. However, this surgeon had to have surgery of his own so my husband was transferred to another vascular surgeon. This new surgeon sent him for even more tests to get a closer look at this artery problem. He had the dye injected to check his circulation and many other tests.
I should have kept a list of the numerous testing he had done, it seemed never-ending, and of course there was a co-pay of hundreds of dollars for each test, and a waiting period for an appointment for each test. Then the holidays came along, more waiting.
The surgeon was finally ready to book my husband for surgery, but that had to be put on hold until our local hospital accepted our Insurance Company's policy.
When that acceptance finally went through, the surgeon wanted 'medical clearance' from our general doctor, so back we went to her. She decided not to sign, but to send him to a Pulmonary Specialist (lungs) and a Cardiologist (heart) for clearance from both of them.
The cardiologist was no problem, he performed an EKG (his third) and signed for clearance. The lung specialist decided not to sign, but to send my husband to another hospital for a breathing test.
That was a total nightmare, waiting for a few weeks for an appointment, parking on the sixth floor of their parking garage, having security look at both of our id's and photographing them and us as well, and we had to apply those photos to our clothing, I felt like I was at some government office. He passed the test, no problem.
Days later, the pulmonary doctor had not gotten the test results, I was calling the hospital frantically, as that test was the last before medical clearance for surgery. The hospital kept telling us that the results had been faxed to the doctor, who had now decided to put his phones on answering service for a week, and was not returning calls.
We went in person to the pulmonary doctor's office, who after a long wait finally gave us his signed clearance.
Finally the surgeon booked my husband's surgery for this Friday, it had only taken four months.
But that's not the end of this horror story - my husband got a letter in the mail yesterday from our Insurance Company, denying coverage for this surgery.
I won't bore you with all the stupid details, but it was finally approved.
I am seriously wondering what gives insurance companies (any type of insurance - medical, auto, homeowner's) the power to be able to simply deny coverage - I realize they don't want to pay the huge costs involved, but they are playing with people's lives.
Also very disturbing is the money train - seems that everyone has their hands out to cash in on your medical problems. All the doctors, specialists, imaging companies, hospitals, etc.
As my husband said, they would be quite happy if you just never made it to the operating table.

Why it's simply the Golden Rule.

He who has the gold makes the rules.

Congrats on successfully navigating the system, I do hope your husband and his foot do well with the procedure.

a reply to: tjack
Thank you so much!

a reply to: RonnieJersey

It sounds outrageous! I would have been fuming by the end They are just toying with people's lives and emotional state

a reply to: RonnieJersey

Is this in Canada?

a reply to: RonnieJersey

Sorry to hear that, Ronnie. I sincerely hope your husband is feeling better.

I recall what my mother said. At the time, I thought she was exaggerating:

"The hospital is where people go and don't come back"

Cheers and Best Wishes

originally posted by: Antisocialist
a reply to: RonnieJersey

Is this in Canada?

No. If it were Canada, she would have been pissed because they would have asked her husband if it he would rather just have MAID.

Sort of tracks with what my mom went through. She slipped a fell heading into GP's for general blood draw and checkup. She's being monitored post-cancer because she has lingering issues from chemo not jiving with an antibiotic she's on for a lung infection. It causes low iron. Now both her cancer team which is continuing to monitor her and her GP are aware of this and watching. They want to get her off the long course antibiotic before they start to make any aggressive changes in anything else as they feel it's the clash of drugs causing the problem and she's close to done with the antibiotics and done with chemo.

But I digress ...

The fall causes her to hit her head and split her lip. She ends up in one ER for stitches. *They* x-ray her for possible head trauma since she also hit her head despite a lack of symptoms of head trauma. That shows a possible brain bleed. So despite them not thinking it was anything really, they pack her up on an ambulance and ship her off to a bigger hospital with a neurosurgeon. He proceeds to scoff at the x-ray and wonder what they were thinking but orders her kept in ICU overnight with a closer scan the next morning just in case.

This ends up being what he thought when morning comes. He signs off. The PT signs off saying she's steady on her feet. The plastic surgeon looks her lip and decides it's basically badly abraded and to put stitches in it would make it worse, so the thing she ended up at the hospital for ... they aren't even going to do. It's the fourth doc who looks at bloodwork, notices the low iron, and decides this is national emergency!

He orders a slew of tests and won't answer any questions about their purpose. Even after her medical records have been faxed over from her GP showing this is an ongoing issue that she's being monitored for by both her GP *and* her medical oncologist, he still orders even more tests keeping her in the hospital even longer for a known and monitored issue. He didn't let her go until they had done a bone marrow biopsy.

In the end? It was the issue she was already being monitored for.

The ACA turned human beings into statistics on a spreadsheet. They now equate outcomes of treatment based on current health, age and cost of treatment.

Like Obama said, if Grandma needs a new hip at 70, perhaps a cane would be a better choice.

The only thing worse than the ACA would be socialized medicine, IMO.

a reply to: RonnieJersey

Thoughts and prayers to you and your husband.

Health insurance carriers are the worst, I think customer service gets paid more for the hoops they make you jump through. With my Dad, we would get excited we had a new treatment, procedure, or drug suggested, and then we would have to perform it for approval from the insurance companies.

It's almost as when you are sick you need to get a preliminary reason, then go to your insurance and say I have this health issue what do you approve that I can get done quickly without the hassles.

a reply to: Antisocialist
No, it's the State of NJ, where the border runners are getting free medical services.

Thank you all for your well-wishes, much appreciated!

I lived with a total UPJ obstruction for 20 years. The top of my left ureter where it comes out of my kidney was completely fused shut so that my left kidney was unable to drain. 20 years. I spent years telling people I was sick and in pain and something was very wrong with me. Doctors kept telling me I was fine and that it was probably just "growing pains". One day I had to go to the ER while in terrible pain and violently ill, where they finally realized I actually was sick the whole time when they discovered that my left kidney was swollen and not able to drain. I became so sick at one point I that had to be put in a wheelchair because I couldn't even move.

I've also suffered for my entire life with bouts of disabling tiredness. I fall asleep uncontrollably just about every day at work. I've lost one job, got suspended from another, and "had a talk" with supervisors at my current job. It is nothing short of a disability. I've seen many doctors about it. None have helped. Just recently I went to a sleep specialist to get tested for various sleep disorders. The specialist felt I didn't have a sleep disorder, so I figured my next step would be to get a referral to a neurologist. I went to the doctor and mentioned the debilitating tiredness I've had my entire life and that sleep disorders had been ruled out.
What to know what she told me? "There's not really anything you can do to treat tiredness."
I can't comprehend how a doctor who is in charge of helping people who have medical needs can stand there and exhibit such astounding ignorance of one of the most basic things.

My experience so far in life is that our medical system (US) has been absolutely and thoroughly useless. I have no faith in it whatsoever.

originally posted by: Antisocialist
a reply to: RonnieJersey

Is this in Canada?

too fast and efficient to be Canada. probably would still be waiting to see the first specialist in Canada. and then slowly dealing with the rest. seriously, back in Nov, it was decided that i need a couple MRIs done to see if they can find and deal with the cause for over ten years of severe pain. my MRI appointments are at the end of August, so almost a year. although i have been lucky, in that it only took about three months to get to see a cardiologist, to get my heart checked out due to both medical issues that were happening, as well as a family genetic heart issue that was just found last year that needed to be checked out. that is the medical system in Canada, wait, wait, wait, and perhaps if you wait long enough and don't die while waiting, they might eventually help you.

a reply to: ketsuko
I am so exasperated over all this, my husband must have had every test known to man.
And I have the uncomfortable feeling that all this is due to kick-backs from imaging companies, pharmaceutical companies, etc.
I had faith in our old doctor, but he retired recently, and since then I am dealing with God knows what. When I was on the phone with our insurance company who denied covering the surgery, after a few hours of dealing with them on and off hold, I started screeching about calling our local Senator and then going above him to report this nonsense.
That's when suddenly they 'approved' the surgery.
I have no idea what to make of all this, and hope your Mother will be all right.

a reply to: generik

I would be seriously worried about some things if I were in Canada.

Several of the adults were I train with have had injuries recently with one snapping her ACL. Your recovery and rehab time lengthens depending on how long it takes you to get to surgery, and they have to do the scans and pretests to see what they're dealing with coupled with pre-therapy. I'm not sure how that works out in Canada. Are you just screwed if you destroy your knee?

a reply to: RonnieJersey

Mom is fine, but I hope you get yourself worked out of all this and get your husband taken care of properly.

We have been fortunate. One thing my husband's company HR is good for is fighting with insurance. You have a problem with them, you call HR and they handle it. It's been invaluable to us several times through the years, but as I said, we've been more than fortunate.

a reply to: trollz
Shame on these doctors!

a reply to: generik
Three months to see a Cardiologist??
Some wouldn't last three months, totally unacceptable!

originally posted by: RonnieJersey
a reply to: generik
Three months to see a Cardiologist??
Some wouldn't last three months, totally unacceptable!

Basically, you get what you pay for. It's free, and it may be very good once you get it. The key is getting it.

I'm sure it works well enough to most basic things, but there are just some things you don't want to leave to chance.

I have to say one more thing:
In this area many people go back to their country to have surgeries, dental implants, and any type of expensive medical procedures.
And now I know why - first of all, it's Free. Second of all, they get it done fairly quickly, I don't know how but they do.
That's what they tell us here.