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My surgeon ordered epidurals with steroids

almost 2 years ago my Spine Surgeon - difficult 360 fusion, only last 2 levels were not included in fusion - diagnosed me with spinal stenosis

He asked me if I had a wheelchair and said that at some point with my Scoliosis even after the fusion, I would experience weakness but not paralysis and now the stenosis 

I was shocked to hear that , my back was so weak and hurt so much, even with medication

He ordered epidurals and I have been getting them every 3 months - when they wear off, I just begin to painfully walk and he ordered a walker which I do use when the shots wear off

There is sometimes a gap of a few weeks without the epidural when they wear off due to scheduling 


The epidurals have been so successful and the anesthesiologist  is excellent, he uses the X-ray scope to find just the right place, I had one in late January and it helps so much

I was shocked to receive a notice from Medicare on Saturday  that the..local Medicare review board, I am in Ks - will no longer pay for them as they are not effective for stenosis  and that I would

Not be billed for the last one as it had not been decided yet - it mentioned appeal...but I don’t know what to do except call the anethesiologist office who has been doing the epidurals


He has been very pleased with how well they work.... my Scoliosis is so bad, maybe that is what is being helped not the stenosis...I don’t know what to think but I know


I probably cannot get it reversed - the decision, has this happened to anyone else, my back is not very strong, I am so concerned and in 

December my Spine Surgeon Of 10 years retired and all of his patients and records have been turned over to his replacement, I was told not to come in until I had a reason,


I had assumed I would go in and meet him but that isn’t how it works, I am still being prescribed oxycodone , if that is cut and I don’t have the epidural I can’t imagine getting around

The medication is prescribed by the same Dr I have always had

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Comments

  • Susie - I believe what the doctor needs to do is re-evaluate his diagnosis.  If the injections are working, then perhaps this issue is more than just stenosis.  Medicare and Medicaid look for any possible way not to pay.  If the doctor adds a condition that does respond to epidurals, they will most likely cover it.  BUT, many docs will stick to their original diagnosis.  He/she would have to explain what's changed that caused the new diagnosis code. 

    Unfortunately, you are getting caught up in the same mess that everyone else is as well.  It's going to become even more difficult to get care/medication.  Something has got to change.

    Keith

  • Hi Susie
    Keith is right on about everything he said and how sad that you have found something that works to have it stopped for those reasons. 
    One thing I was wondering is it possible for you to get another opinion another doctor may give you the diagnose you need just a thought.
    Hoping you get some help
    Sherri

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  • Yes Sherri, my Surgeon retired and I inherited a new Surgeon taking his place in his Group.


    I will have to make an appointment , hope I like him and he feels good about me. The anesthesiologist remarked about 6 months ago that he thought my Scoliosis was beginning to cause trouble in my neck, I get large hard knots on middle to either sides of

    My neck which dissolve almost with an anti inflammatory shot , he suggested I would probably need an MRI for my neck

    Will need a neck Dr for that! 


    Thanks for your kind and thoughtful input   

  • Hi Susie

    Make an appointment as soon as you can to discuss all the things you have shared with us.  Your condition is clearly increasing and your neck issues will need to be investigate as that will already be on your note hopefully.

    Good luck with finding something positive out of all that is worrying you.  Meeting with your new doctor will at least answer some questions .

    Take care

    AJ

  • Susie - I get those knots from time to time as well.  I recently (within the year) started going to a massage therapist.  He has been able to work out the knots without me having to get additional medication.  It's not a fru fru massage...he has to work the heck out of the knot which does hurt while he is doing it, but by the end of an hour, he generally has the knot worked out.

    In the future, you might want to consider seeing a massage therapist.  I was hesitant to see one until a chiropractor darn near effed up my fusion area where I told him not to go.  After that debacle, I was willing to try just about anything for relief.  Hope you all start feeling better soon!

    Keith 

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  • I am sorry you are having these difficulties as well as coping with your condition.  Here in England it's a national pastime to criticse our National Health Service but I have to say that if the doctor  says a certain treatment or procedure is necessary it's done.  It might take a little while in the queue but it does happen and no-one  can gainsay it except in very exeptional circumstances.

    I realise this post doesn't help you but my best wishes come with it.

    John

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