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Should I go to ER - doc's office not coming through with MRI request

I have chronic pain from failed back surgery syndrome for lumbar central canal stenosis / current bilateral foraminal stenosis / DDD / L5 S1 - L4-L5. I had 3 surgeries in 2016. Pain never went away, the intensity came down, but always in pain.  My last CT Scan and MRI were 2 years ago -- showed the foraminal stenosis and "modic type 1" issues,  but no fractures in vertebrae (?) and stability was okay. I see a pain management doctor who prescribes about 300 MME's. I still have breakthrough pain with this amount but the pain has been "stable" with the meds for about 1.5 years.  Within the past few months, I have been experiencing increased levels of pain without any change in my routine. Today and yesterday were days that I end up in tears from the pain through my legs, feet, back. I would rather not walk or stand because of the pain. I quite frankly am nervous something has gotten worse -- whether the stability of my spine or fractures have occurred or whatever. I have tried to get one of my many doctors to order an MRI. The surgeon from 2 years ago agreed to do it over the phone 3 days ago. The order still hasn't come through. Maybe there is some kind of pre-auth needed, but of course his admin don't have any of the details -- they just say it hasnt been ordered. My PM is away on leave, his office didn't call me back from Monday. My primary doc's admin staff were not exactly helpful when I called last week. I think I'm answering my own question, but its nice to vent on here and get other peoples input -- should I just go to the ER and insist on an MRI? 

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Comments

  • Hello Aunt-Reese

    I'm sorry u are going through this pain. It has been my experience ER primarily will only do xray on your back which we both know wont show anything. I would reach out again to doc who said they would order MRI. And push his staff. Even after its ordered it will depend on insurance to respond and pre authorize. 

    It may depend where you live on how emergency room responds. Wishing speedy response and answers follow by some relief ahead.

    Jenn


  • In my experience the ER won’t do an MRI unless it’s an emergency life and death situation. ER’s prefer CT scans and x-rays. Both are much faster than an MRI.

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  • Thanks for the input! I agree —- ER probably won’t do it. Talked to doctors admin directly finally today, she clearly was trying to push me off through a variety of excuses “didn’t you see a different surgeon last time? You haven’t been here in 2 years. The PA told me something different than the doctor” then finally agreed to getting me in for a same day MRI / consult after she “confirms” with the doctor.  Great. I thought  she was going to call back with appointment time and then never did. I’m so seriously annoyed by all this. I kind of knew they were going to push me to come in for a consult before the MRI was ordered, but then just give me an appointment time!!!? Like why is it taking four days and I still haven’t gotten a time for an MRI or an appointment with the doctor? 

  • So sorry it's taking so long to get what you need. I'm still waiting on insurance approval for MRI.  Dealing with all the bs can drive us crazy. Hang in there.

    Jenn

  • My dr. requested mri for lumbar and cervical spine June 2019. I have been denied by insurance 4 times. They said try physical therapy and I went for 6 weeks. My dr wants me to get evaluation from pain management specialist and have him request mris. I have daily neck pain and chronic back pain. I have had these issues for  10 years. I had one mri 10 years ago when I first started having sciatica. Since then,things have gotten worse.  I moved shortly after my mri and had to get new insurance. I live in Ca. and had to purchase the state insurance. My life seems centered around pain and depression and anxiety. Maybe it doesn’t matter whether it’s disc degeneration or stenosis or arthritis. It’s my body and I would like to know what’s going on. 

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  • Sorry for rambling. I received another denial yesterday and have been really depressed.

  • @nancyann Very sorry to hear. Did you attend all your PT sessions? Sometimes if we miss any of the PT sessions the insurance company will use our cancellations or “no shows” to deny an MRI. That’s why I learned it’s very important to not miss any appointments.

    Your doctor should know the right verbiage to use to get the MRI approved. I’m not sure why they keep denying you. If it was me I’d be calling the insurance company Monday morning to ask why. No point in having health insurance if you can’t use it when you need it.

    Good luck and please keep us updated.

  • Isn't is ironic how all of life comes down to how much money you have or your ability to afford great insurance in order to receive the health care we need????

    Insurance companies are going to fight big ticket items like MRI's and CT scans because they do not want to pay for them.  There is a process we must follow such as first a primary dr appointment followed by xrays.  Then if this shows nothing (which it always seems to) we then have to try physical therapy.  That is also a fight to have coverage for.  Then if pain persists then an ortho or neuro appointment is made.  It is all a long process then it starts over again as the specialist requests imaging which is then also denied.   

    My trash can is filled with all the rejection letters I get each month for denial of coverage. 

    Trust only in the One who can save the soul.  Man will forever worship the dollar.  In the meantime people will suffer. 

    Nancyann my prayers are with you this day. 

    dale

  • Thank you both for your kind words. I went to every pt appt. so not sure about last denial. I was referred to specialist for evaluation and he will request mris. Unfortunately he has no appts. until mid March. I am having cataract surgery in a few weeks so I will have to wait to see dr.  Thank you for your prayers Dale, I pray for you and others who are suffering so much, for so long. Today was a better day.                                                                                                        

  • Nancyanne, sorry you are struggling. Depression seems to follow pain and battles with insurance, doctors, etc. Please hang in there. We are in this together and I believe all the prayers we share for each other will help.  Keep us posted. 

  • memerainboltmemerainbolt IndianaPosts: 4,165

    nancyann

    How are you today? Keep us posted on your cataract surgery. If it's not one thing it's another. You are in my prayers, along with everyone here.

    Sandra


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