[wendya2J]

Hi!

I got a concussion back on 2/5/13. I fainted in the shower falling onto the right side of my forehead on the edge of the tub. Then as my husband helped me out of the tub I fainted again this time whacking the right side of the back of my head! 2 concussions for the price of 1! So, I have been having terrible migraines that give me head pain and vertigo, double vision, poor visual tracking, nystagmus, tinnitus, fatigue, balance issues and left sided weakness. I had a 4 day hospital stay, and when I was discharged, the dr cleared me to go back to work the next Tuesday.

Well, he we are, 3 months later, and first my family dr said I couldn't go back to work after he saw me. Then, I saw a neurologist who would not clear me and actually is recommending a stay at a rehab center in our area! 2 months ago I asked if I could see a PT for my balance issues. After I saw her, she recommended a speech eval for me because of foggy thinking, word finding issues, attention issues,memory stuff. And then I also was asked to see an OT for my left hand, which is my dominant hand, yet weak and very uncoordinated right now!

So all of this is totally freaking me out! It's so crazy! And people don't seem to understand because you look normal on the outside! My anxiety level is super high!!! I'm so afraid of losing my job too! I was just accepted for long term disability, but hope I don't have to use it very long!

So, I had an eval by a physiatrist at Bryn Mawr Rehab, along with PT and OT and they all recommended an intensive rehab stay so I could get OT, PT, vision, speech and neuropsych. But, the dr also said that insurance may close the door on that idea and make me stay outpatient. I do have a limit on outpatient visits per year.

Has anyone ever been in a similar situation? The dr really wonders how the hospital discharged me without follow up to begin with, and thinks I should have been sent to rehab from the start.

Also, extreme fatigue anyone??

Thanks, wendy

[MiaVita2012]

Welcome to Neurotalk.

What is your underline diagnosis to the fainting may I ask?Do you have a condition?where you dehydrated?If you could share more there is a lot of support that will help you here.

Fatigue is very common with a TBI and this is a time you let your brain rest.Very important to do quiet rest.

[Concussion]

Wendy,

I'm going to try to tackle this alittle bit.

First, which insurance are we talking:
- Homeowner's - since you were injured at home and can/should be able to receive some injury coverage from that; you should explore that avenue for use also - even if just secondary coverage.

- Personal Health, which is what everyone usually goes to as first use, when they have to go to hospital for care anyway.

The issue about Rehab - Acute vs Subacute - or Inpatient vs Outpatient - boils down to many guidelines set forth by the insurance companies in cahoots with guidelines along pathways set out by Medicare/Medicaid, and other sources; Physical therapists and Occupational Therapists could give you a litany of what those guidelines are.

The scheduling can be setup as outpatient with numerous visits, or set times per week - the insurance companies like to put set numbers of visits out there so they don't have to pay out too much - its their way to limit their costs and keep more monies ( I know thats a harsh statement but they are into making money really, not patient care actually).

Now, here's what is needed - YOUR doctor has to become very proactive and aggressive with your needs at the forefront - you have to become (with your husband's help) very proactive; and begin your appeal process . Your therapists have to assist you in building your case, pointing out all your deficits and showing where INPATIENT Rehab will better benefit you - and your Doc will have to write a very pointed letter supporting that viewpoint directing them (the insurer) in that direction.

The other avenue that your therapists, your Doc and you can take is to begin preparing to appeal for more Outpatient visits to Rehab, repeatedly until your Doc , and therapists are satisfied you are clear; appealing over and over.........its a repetitive, aggravating process, sadly - but does happen at times and the insurer does approve at times, so you continue coverage.

Its not over - their reviewer will have to then re-evaluate all that information , and your situation, and probably visit you and see if they agree - prepare for that. It will take time, and patience.

This cannot be the first time your therapists nor Doc have had to face this with Insurance companies - it happens frequently in hospital settings - but like they said, they don't usually see patients not go directly to Inpatient Rehab from hospital when its needed.

I hope this is helpful.

Best Wishes.............

[Mark in Idaho]

wendya2J,

Welcome to NeuroTalk. Your insurance issues are common. It is tough to make a medical diagnosis that supports the time in Neuro Rehab. Insurance Cos try to avoid Neuro Rehab since it can get very expensive.

The intensity of a Neuro Rehab stay may be too much.

Have you had any intensive diagnostics of your upper neck and spine ? Absent a specific brain injury causing your dominant hand weakness, an upper neck injury is very suspect. It is very difficult to diagnose C-1 (atlas) to occiput (base of skull) injuries. It can help to just focus on maintaining good neck posture with routine icing of the upper neck. Inflammation is often a cause of the weakness symptoms.

As much as in-patient rehab may be helpful, please be aware of the need to keep beds full in rehab hospitals. There is a protocol of "use up all of the patient's insurance then discharge the patient."

Obamacare is also throwing a huge monkey wrench into healthcare right now. The stress of dealing with insurance is not conducive to recovery.

Check out the Vitamins sticky at the top. It has a link to the You Tube "You Look Great" series. It can be helpful.

Homeowners would help if you fell in the tub at someone else's house. No coverage if you fell at home.

Please feel free to unload your frustrations. There are plenty of good people here to help.

My best to you.

[wendya2J]

Thanks so much everyone! It's so nice to have others understand what you are going through....

Yes, I was at home when it happened, thank goodness hubby heard the loud crash and came running! I remember waking up, looking up at him from the bottom of the tub as he was calling 911 and screaming at me...I just wondered why my head hurt so bad, and how much time had passed because I didn't want to be late for work! I don't remember the 2 nd fainting or him getting me to the bedroom while he got things together for us to go to the ER.

I have been having GI issues since August, first they said reflux, then in October discovered my gallbladder was defunct and took that out. I lost 80 lbs in that time period. Post gallbladder surgery, I experienced terrible nausea...who wants to eat or drink with that! I was hospitalized a month after surgery for dehydration and vomiting. So they said when I passed out that I was so dehydrated that my blood volume was very low...and they stuck the vaso vagal syncope label on it.

My therapists are wonderful! They will push buttons if they have to for sure, and my new neurologist is so awesome. I have had a 2 nd MRI which was very detailed..I had to spend 3 hours in the tube, but at least got it all done at once. I also have had CT scan, echocardiogram, EEG, somatosensory evoked potential of the leg nerves, and am scheduled to have the arms done this week. The only thing that they found slightly abnormal, was on the MRI, I think it's c6 there is a narrowing of the hole in the vertebra that the spinal cord goes through. He doesn't think that is causing a problem, but since I had brushing on the side of my neck, he just wants to make sure and that's why he ordered the evoked potential tests.

I am very frustrated with the fatigue!!! I never felt anything like this before! My arms especially feel so heavy that I can hardly lift them! Just feel crummy. I thought I had it figured out that it was my premigraine thing, but I don't have a migraine this week. Never had migraines before the concussion, which they are also calling TBI...anyway, I have had 2 nerve blocks done to break up the migraines, and it works for me!!

I was approved for my long term disability benefit, but I really don't want to lose my job! I've been there for 22 years! My only job since I graduated college, and I love it. In an OT at a children's hospital. If I'm not back by June 5, I don't know what will happen,,,,but I don't even think I'm at 50%yet unfortunately....has anyone else gone through therapies? I think my balance and vision are my worst enemies!!

I think I forgot to say that I am doing OT, PT and speech 2x/week.

[wendya2J]

Just got word that insurance denied...so disappointed., we have appealed, but they said it can take up to 60 days!!! Ugh, feeling lost and confused...just want my old life, brain, balance, routine, vision, back...but I guess no matter what, we are never the same again are we......

[MiaVita2012]

I'm so sorry to hear about insurance....I was stuck in a similar situation dealing with insurance and had to apply for disability to get medicaid.I don't have any advice but I want to let you know you are not alone.I was curious how long did you get approved for SSDI? Im still waiting and I need so bad right now.

Why did the insurance denie you? Could seeking counsel (attorney) help your situation with the insurance? Keep your head up and hope you can get some solutions sooner than later.