Dear Jade,
I was sickened to hear that your insurance company won't pay for tests that your cancer doctor wants you to have. It isn't bad enough? What kind of ____ is that? I can't believe they would do that to you after all your have been through. The more I hear about these insurance issues, the more I think it has to do with just money, rather than the quality of life for the patient, or for that matter what is in the best interests of the patient. I do think your doctor could write a letter to your ins. company, and state his definate reasons for wanting the tests done. I hope you fight your insurance company, and get what you need to have done. The doctors who want these tests for you are not doing it for no reason. Your continued pain is a good reason. so sorry that our medical system has put you through more heartache, when it is hard enough to face the surgery you already have had. I hope all the best for you, and good recovery. ginnie

Hi Sandy,

Does your prescription say to take "as needed" or around the clock, like "every 8 hours", "3 times a day", etc.?

If it says to take it "as needed" that's fine. However, if it says to take it continuously, you should be doing that - take it however your doctor has prescribed it.

Some pain medications need to build up in your system, and then be maintained at a certain level, in order to work most effectively. It may seem the right thing to do to "tough it out" as long as possible, but then you wind up either with too low a level to control the pain, or on a kind of pain rollercoaster, with pain levels rising & falling. When the med levels get too low, it requires more medication to get back up to where it needs to be to control the pain than if you just take it as directed - even if it feels like you don't need it all the time.

So... whatever the doctor prescribes is the correct way to take it. Do not fear addiction. Pain patients who take their meds as directed rarely have addiction issues, and even then, only if they have a pre-existing substance abuse or psychological issue.

Doc

Thank you Ginnie!
Right now this is all in the appeal process. My primary care dr and breast surgeon are both fighting for me to get this bone scan done. I went to my plastic surgeon today and am having surgery Jan 17th to do the finishing touches on these breasts. At least that will give me some closure. Going to call this spine surgeon tomorrow again, cuz i'm not going to be able to lay on my tummy for 2-3 weeks when i have surgery, so i won't be able to even get an epidural shot then. This is all such a nightmare, but i am blessed to have had phenomenal care with this breast cancer issue. I'm just hoping for the same with my back. I got spoiled with professional, proficient and caring drs! I'm getting better with all this. Just have to find a new normal and accept it! It's like life throwing you lemons, without the tequila! lol sorry, just trying to laugh and lighten things up a bit. It's the only way to survive! It is a bunch of S**T what insurance companies are pulling these days. People complained about Jack Kevorkian, but the truth is.....ins. co's kill people every day br refusing tests and treatments. Somebody needs to start holding them accountable. I pretty much told them in an appeal letter that they were being iiresponsible and negligent with my care and that I did in fact send a copy of every denial letter to my attorney. Thanks for all your support! I really appreciate it!!
Sandy

Dr. Smith,
It does say take every 4-6 hrs as needed, so I wait till I absolutely can't take the pain anymore to take it, only cuz it upsets my stomach. Believe me, after a bi lateral mastectomy, I have a very high tolerance for pain! Just kinda goes with the program, but that part of me is getting better. Final stage of reconstruction scheduled for jan 17th and i can't wait to close that chapter!! Now i have to somehow try to get in to see spine surgeon before then so if he decides a shot is needed, i will be able to lay on my tummy. After surgery, i can't lay on tummy and have to be idle for like 2-3 weeks. The problem is I'm a very active person, so sitting around is VERY HARD for me and it makes my legs go numb!! Thanks for all your advice sweet friend!!
Sandy
Just when the caterpillar was about to give up.....she turned into a butterfly <3

I am glad to hear you are fighting the insurance company for your right to have that bone scan done. It is good to hear your psysicians are sticking up for you and are in your corner. That makes all the difference in the world. Sorry to hear you also have back problems. me too. That was my primary reason for finding neruo talk. Breast cancer is in my close family so I have ties to that issue as well.
I have a real beef anyway with insurance period. I was denied insurance my whole life because of pre-existing conditions. Even my folks couldn't pay the priemum for me to get coverage. Well I didn't hold up, and wound up having 8 surgeries total now, and it wiped me out financially. All because I could not get insurance. I am now on Medicare/medicaid. I am grateful for that, but I don't receive alot and it is a hard existance. I expected better after 30 years of work. This country needs so solve the insurance issues on all levels. I too have had to fight medicare, for different proceedures, or medicines that my doctor wants me on. The whole system we have stinks. Keep the good fight up. You deserve to have the proper care.
Are you going to have to address your spinal issues in a surigical way? Sure hope not. I was fused C3-7 after a failed C6-7. It isn't any fun eithor.
I hope your coming medical proceedure work out good, and that you are comfortable while you heal. Have a peaceful and healing Holiday Season. ginnie

Ok, that still sounds like it may be some of the rollercoaster effect. If you need it every 4 hrs, take it that often* - that's why it's stated the way it is. As you heal, and the pain subsides, the need will decrease and you can back off the dosage. Most pain meds aren't affected by "taking with food", and that can help. If the upset stomach is intolerable, then I would still call the doctor and tell him/her and ask if there's something different you can take, or something you can take for the upset stomach.

Doc

*If it contains acetaminophen/tylenol/apap, do not exceed 1000 mg. of that within a 6 hr. window or 4000 mg. within any 24 hr. window. If taking it longer than 1 week, the 24 hr. limit should be no more than 3000 mg.

ginnie,
I'm not sure what will be happening with my back. I can't even get in to see the spine surgeon until jan 11th, and i called there today to explain that i'm having breast surgery on jan 17th and will be unable to lay on my tummy for like 3 weeks. My primary care dr doesn't feel my body can handle another major surgey yet, so she wants me to get epidurals to hold me over, but this spine surgeon has someone else do the shots, so if they can't move me up, I will be suffering for over 2 months. It's so important to me to get this final breast reconstruction done, physically and emotionally. I need closure on this so bad, it's not even describable. It's been a long rough year for me and I don't seem to be getting anywhere with ins or this spine dr. I would've thought the secretary would have been a little more sympathetic when i called there today, but she was like we don't call you if somebody cancels, you have to call every day. I'm thinking maybe i should call my primary care dr and ask for another spine dr to go to. It's all so upsetting to me, but I'm grateful to have had the best breast cancer team a girl could ask for! they have been my heroes and saviors! I thanked them for saving my life and told them i loved them, their response was it's a good thing you love us, cuz you are going to be here for the rest of your life. They are fighting my ins co tooth and nail for me....so I'm blessed to have them on my side. I try to find humor in this cuz it's the only way to survive, so I baked them booby cookies for Christmas. They turned out so cute, they were like little bikini tops! My plastic surgeons motto at his spa is "Fabulous at any age" and he had a shirt made for me that says "Fabulous at 50", since i just turned 50 on Saturday. They have been so sweet to me. Yesterday, I gave up the earlier surgery day to a woman who was just diagnosed, so she doesnt have to wait an extra week to get the cancer out. I recognized her sadness and fear all too well. I vowed to always give back, whenever I am able and I pray for you daily now also! I have never heard of any successful back surgery, so I'm very leary of all of this. I was in physical therapy before and it didn;t help. The week that ended was when i was dx'd with breast cancer, so the roller coaster is just continuing, and i want OFF this ride! I'm just kind of at a loss as to what to do now, cuz i do need the breast surgery as a matter of sanity at this point. The weird part is I'm an active 50, am 5 ft 4 and weigh about 118, so I'm not overweight or inactive. At least I wasn't till all of this! Kinda sad how your life can just change in an instant. But I'm blessed to still be here...pain and all!! Hope you are having a good day and remember I'm always praying for you sweetie xoxo
Sandy

You can only handle one trauma at a time. Get the first overwith. I do have some advise on your back also. If you are not getting the kind of responce from your neuro surgeon that you need, please look for another. While you are going through re-construction, you need to have some help with your pain, to get you through to the time you can investigate your back. You need several evaluations, lots of homework. You need the same kind of help you received with your breast cancer, the same good kind of team. Having surgery really is a last resort. As far as good back surgery results, you are talking to one right now. I did have a fist failed attempt fusion at C6-7. My second corrected all the things that were still wrong and I have a wonderful result. It was worth all the pain I went through to get to this point. There is good results that can happen with back surgery. Researching all your options and getting the right diaganosis is critical before any surgery is done. You also need to be healthy to go through it. You will need recovery time for that too. There are many here that can help with diagnostic tests, and being able to understand what they say. Try to take it one thing at a time. Deal with your current surgery and heal from that. Ask for help with your back pain as it will be awhile until you can address that issue. Don't settle for anything less than the good care you already received from those people who helped you through cancer. My neuro surgeon second time was the best in this area. It took me time to find him, and do all the research I didn't do the first time around. There is help there just as soon as you recover. I will pray that you find the right kind of physician so you will feel less anxious about your back condition. Take care Jade, I am sorry you have had so much to deal with in your life. tap back at me anytime and I will try to help you. ginnie

Consider a pain specialist, not just anybody for epidurals or infusions. I have had several uncomplicated, non painful katamine infusions. some people report bad side effects, I was one who got good pain relief that lasted about two months. I had no side effects at all, not even at injection site. My pain specialist is top notch. ginnie

I'd hate to judge a surgeon by his staff; it depends on the setup (private vs. hospital/clinic, who makes that policy, etc.) but I hope you've had at least a couple of opinions on this surgery anyway. If you're thinking of finding another, maybe the cancer team would be willing to suggest some others (e.g. who would they trust/go to?)

There are surgical success stories, and I don't want to take anything away from them (I am thankful for their success/victory ) - there should be more, but all the statistics/studies I've read seem to go the other way; surgery should only be considered as THE last resort, and even then only after multiple opinions, asking about each surgeon's success rate with your exact procedure, patient referrals... You can use the net, your ins. carrier, anybody you can think of (your cancer team?) to check them out. Most surgical mistakes cannot be undone.

Like doctors, not all physical therapists are created equal, and I've run the gamut with them as well. If you've only done one course, consider trying another one with a different therapist - one more experienced/specialized with your particulars. You can ask/call around and find out - it's worth it.

There are still many other options to investigate before surgery, and Ginnie is right about a pain specialist getting you through things while you try other options. Unlike the cancer, you've got some time on this one. Heal... rehab... get things together.

Doc