Thursday, November 13, 2008

still having bad back day ...

I'm still having a bad back day going into a bad back week ... and the first available appointment with my surgeon isn't until December. Oh well. Nothing new really, he told me the block might be good for only a year.


My back injury is covered by Workers' Comp, and one could argue I was "lucky" I was hurt when I was. I was hurt under one of the old laws that is a bit more injured-worker friendly than what we have now in California. Not that I wasn't for reform, because during the 18 months I worked as a nurse case manager for various workers' comp carriers, I saw my share of bullshit claims and people milking the system. Perhaps I was lucky because my injury was witnessed and I was a state employee at the time.

Like everything in health care, nothing happens quickly. I'll see my doctor on December 4 and he will refer me to the affiliate group that does diagnostic blocks and the eventual procedure I'll have, a rhizotomy. Sounds scary, all it will do is zap some nerves feeding into the painful facet joints and I'll be relatively pain-free until they repair themselves. 

I hinted that I'd been dealing with back problems for some time before I got the state job. I worked at a small rural hospital that was grossly understaffed and I hurt myself several times doing janitorial work (cleaning up after deliveries once the custodian went off duty at 10 p.m.) and also assisting postpartum women to the bathroom after their deliveries. Not meaning to sound bigoted, but each injury was because of a Hispanic woman, each of whom had birthed several times before, willing themselves to faint dead away in front of their husbands to garner some sympathy. Rather than letting them fall, I tried to slow down their progress to the floor. Dumb dumb dumb. At least I documented every injury and that hospital now pays 40% of the bills associated with my back. The primary carrier I am sure is grateful.

When I was working in the case management field, I had three difficult clients who were champion malingerers. Two ended up being under surveillance for a short time and found to be frauds; the third was vocational rehabbed out of her deli job. They took a lot of time away from my legit clients, those who needed a health care advocate to explain things to them, to keep doctor visits and physical therapy on track, those who wanted to go back to work. 

There was an article in the SF paper about a firefighter who has received more than $100K in back pay who claims to be unable to work as a firefighter but who is able to compete in triathlons. Why wasn't she reassigned to a teaching position if she is that unable to work? She claims a shoulder and thumb injury apparently ... and people like her are the reason cities are going broke (people taking "medical disability" retirements) and legitimately hurt at work people get hassled all over the place. Not to mention our veterans being given substandard care when they can get it at all ... 

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