Having private health insurance means waiting five months for an MRI.

I’ve been in a neck brace since early April of this year. I didn’t sustain the injury in a car accident, and I didn’t try to fight a bear. All I did was exactly what I’m doing right this moment: I sat down at my keyboard to write. That was apparently too much physical exertion for my cervical spine, and it decided to stage a coup.

I went to the doctor right away, and was met with shrugs and drugs, which were just as effective as that sounds. Then another doctor took an x-ray of my neck and noticed the disc bulging out from between my vertebrae in a very unfriendly fashion and said, “I’m not a spine guy, but I’m going to order an MRI so you can go see a spine guy.”

If I had still been on MediCal, that would have been the beginning of a very efficient process, and I would have likely already have had several months to recover from the resulting surgery by now. But last year, I got married, and I am now covered by private insurance from my husband’s work. So for every person who thinks that private insurance is the answer, let me give you a little wake up call.

The doctor’s request for an MRI was rejected. Even though I had the X-ray, had pain, numbness, reduced motion, muscle weakness, and can hear my bones crunching like dry cereal whenever I try to move my head. The insurance company said that they wouldn’t approve it unless I first tried six weeks of physical therapy to fix it.

Fix it? If I could fix my own spinal degradation by rolling my shoulders and nodding for thirty minutes a day, why would I have gone to a doctor?

Regardless, the doctor’s office told us that I had to go through the insurance company’s hoops in order for them to resubmit a request for an MRI, and that without the MRI, the spine specialist wouldn’t see me at all. So I booked time at a physical therapy center, and tried to suck it up.

On the first day I was there, the therapist asked, “Why didn’t they give you an MRI before sending you here?” Not surprisingly, it’s difficult to treat neck trauma safely with physical therapy if there’s no clear idea of the extent of the damage. I only made it to the second week before I was told that they didn’t want to do anything else without the MRI, because I was in too much pain for them to help.

Then we got to go back and forth with the doctor’s office, the physical therapy center, and the insurance company, none of whom could seem to communicate with each other, to try to re-request the MRI. We were told, at the 4 month mark, that we needed to come back to see the doctor, so he could verify that I hadn’t magically, miraculously, “fixed it” on my own.

During that time, I’ve lost feeling down both of my arms, across my back and chest, and part way up my neck. My arms both spasm and twitch, and if I extend my right arm, like when I yawn and stretch, it doesn’t come back unassisted. I literally have to use my left hand to manually bend my elbow. I have so little grip strength I can’t reliably hold a debit card in my hand without dropping it on the floor. I can’t look right, left, or up, and my upper arm muscles are beginning to atrophy from the lack of innervation input.

Did you know that your nervous system sends messages to your muscle cells once per second to let them know they’re still alive and should keep their tone? I’m not talking about the message to contract, this is literally like pinging a network to keep the connection live. My nerves aren’t reliably getting that ping, and my muscles are basically, timing out. (When people get Botox injections, they’re actually blocking this signal on purpose, giving a “smooth” appearance to the paralyzed cells.)

I went back down to see the doctor, and of course, he’s looking at me with confusion, because he already knows I wouldn’t have improved, and he fills out the paperwork again to resubmit the MRI request.

It was denied again. The insurance company claimed, this time, that there was “insufficient data” to justify an MRI. They now have the initial X-ray, two sets of evaluations from the doctor, and one from the PT center.

At this point, I’m beginning to wonder if Cigna ever approves these requests, or if they just hope they can ride it out until the patient has so much permanent nerve damage that they’ll be physically unable to sue them. I’m thinking about how I spent my son’s entire summer vacation inside, because I can’t ride if a car, ride my bike, or even go for a walk without pain. I can’t even sit down to play a video game with him because my hands aren’t working well, and the tension in my neck is worse when I’m trying to fight mobs.

Finally, yesterday, the doctor’s office called. After four failed attempts, they’d finally received approval for the MRI, which we scheduled locally and got the same day. That’s funny… once the money is there, all the doors open. It’s like magic or something.

I’ll be going to the spine specialist tomorrow, with my scan on a CD. Anyone want to place bets on how long it will take for surgery to be approved? -K

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