Tuesday, March 16, 2010

Spring Thaw

Wow... three months. I can't believe it's been that long.

Well, we're still here -- and it looks like we've made it through yet another Wisconsin winter. The sun is shining, it's 60 degrees, and (Hallelujah!) I can move my arm again -- still limited, but way, way better than when I last posted to the blog.


Look how high I can reach with that arm... Hurray!

This, despite one major setback in early January.

When my insurance company decided that because I wasn't making "significant progress" with each and every visit to physical therapy, these visits now fell under the category of "maintenance" -- and as such, would no longer be covered by our plan.

No. Way.

So this is what went down: I called my case manager, and within two minutes discovered she was clueless about adhesive capsulitis (aka "frozen shoulder"). I'd barely hung up the phone when I was back on with my orthopedic specialist and PT.

Both wrote letters educating her about the condition; explaining that progress is slow and physical therapy, crucial.

And then I waited.

Four weeks.

During which time I experienced much regression (i.e., more pain, less motion).

Until finally, I called my case manager yet again:

"Have you received the letters from my doctor and physical therapist?" I ask her.

"No, I don't believe we've received any letters... but let me take a look."

"Wait a minute-- these were sent over three weeks ago."

The sound of paper shuffling on the other end.

"Oh yes, here they are.... hmmm... we'll have to review these and get back to you."

"Get back to me!? It's been FOUR WEEKS! And this thing is getting worse-- again! I'm back to waking up every night in pain... "

And then I just lose it.

"... I can't reach my back pocket! I can barely dress myself... this is INSANE! I've had this thing since early fall, finally get the right diagnosis, finally start making progress... and now because of some arbitrary decision -- a decision my DOCTOR does NOT agree with -- I'm back to where I was in November." I pause, tears now streaming into the receiver.

Silence. No response.

So I continue.

"What is your FULL name? I want to know exactly who is responsible for this decision."

"I-I... well... um... I will walk your file down for review right now," the case manager says. "I'll write 'priority' on it."

And then she pauses for maybe a second before saying, "I'm so sorry."

The next morning I get a call from my PT.

"Sandra, your insurance company just faxed approval for another 12 visits. We're back in business!"

So there you have it.

Six weeks later, I'm still doing my exercises, still going to PT-- which continues to be ridiculously painful (but I get back a little range of motion with each visit, so it's unbelievably worth it), and according to my doc, I am now in the third and final stage of this thing-- the thawing phase.

Hurray, indeed.


12 comments:

Anonymous said...

That's wonderful news, Sandra! It took me so long to recover from a frozen shoulder and boy did it ever hurt. I can't believe your insurance company would deny coverage for treatment of this!

Anonymous said...

This is a good example of why we need healthcare reform. Doctors should determine treatment, NOT insurers.

Paige said...

Welcome to spring, Sandra. Hope the thaw continues.

Scott K. Johnson said...

So great to hear from you Sandra. I'm sorry the shoulder thing has been such a mess. I hate that we have to deal with stupid insurance stuff (which we pay through the nose for).

Sandra Miller said...

Anon -

Thanks. And yes, I couldn't believe it either.

Anon(2)-

Agreed.

Paige -

Thank you. Spring is my favorite time of year. This past weekend I started cutting back the old flower stalks and faded foliage I just couldn't reach at the end of the growing season last fall -- a task I'd always taken for granted.

Felt so dang good! :-)

Scott -

Great to hear from you too. :-)

Scott said...

Sandra, It's good to hear from you, and I would echo SKJ's thoughts about insurance!!

Anonymous said...

I am so glad you are feeling better and are back to posting again. And good for you for keeping that insurance company in check.

Mel

Allison said...

You tell 'em, sister!

Bernard said...

Sandra, I've been through 2 frozen shoulders so I know how much of a literal pain it is. I'm glad you read the riot act to that person, our current state of medical 'insurance' really makes me mad. I hope the rest of the healing goes by quickly.

Happy St. Patricks.

Minnesota Nice said...

Sandra, last weekend I was doing some spring cleaning and found this pully contraption that was supposed to provide a miracle cure for frozen shoulder - don't know if it did as I never used it. I thought of you and wondered how you were progressing.
Just remember it takes time. I measure my progress by how difficult it is to change the light bulbs on my dining room ceiling. That's abou once every six months, and I keep seeing tiny bits of progress.

Sandra Miller said...

Scott -

Nice to hear from you as well. :-)

Insane that people have to fight with their insurer over necessary treatment.

Thankfully, I wasn't dealing with something more serious.

Mel -

Thanks :-)

Allison -

I sure will.

Bernard -

I wouldn't wish one of these on anyone, let alone two.

Dang...

And yes, I'm glad I let loose on that call, too. Just wish I didn't have to fall apart in order to get needed treatment.

Oh, Kathy -

Your comment reminds me of my (very wise) physical therapist.

At my last appointment I was so excited -- mainly because it dawned on me that I'd gone nearly two weeks without waking up with pain at night. I told my physical therapist, "You know, I really think I've turned a corner... I'll bet I'm back to normal before the kids are out of school."

And then I went on and on about how this was such a good sign and how fast things are gonna move now.

Oh yeah, I was pumped.

The whole time he just stood there, listening -- wearing a knowing smile.

When I finally finished talking, he took a deep breath and said in a very kind voice, "Sandra, you have worked very hard, and you are definitely making progress, but this is going to take longer than you think. You have a long way to go. Be patient. It's all baby steps."

You're both right... I need to be patient.

(Though I'm still pretty darn pumped about the lack of pain at night! :-)

Lyrehca said...

You go!

Now you know exactly what to say if you need more than 12 additional visits.

So glad things are otherwise going well...