Friday, April 9, 2010

The worker’s comp game

Not my spine, but I did have instrumentation like it in there for about 18 months, along with bone grafts at the front of the spine.

Let me tell you something up front—this is a game you never want to have to start playing. It is a merry-go-round from hell if you receive an on-the-job injury that will require ongoing care.

My odyssey began in late April 1989. I’d hurt my back at the previous hospital I’d worked at, but nothing to the point of daily back pain. Actually my knees gave me more trouble back then. I left that job thinking the job at the prison would have been easier. And it was, physically that is.

Like all acute back injuries, a little bit of time, a little bit of physical therapy and you are right back at it. This one was different. The next day the pain radiated down both legs, and I felt like I’d been driven over by a truck. I went to my internal medicine doctor who prescribed me muscle relaxants and a referral to a neurologist. I seriously should not have seen that neurologist. What an arrogant quack!

Unfortunately for me, he’d examined my sister years before he’d examined me. But with her drug-seeking behaviors, he assumed I was just like her, faking or acting out an injury looking for drugs. So he ordered an MRI scan which he claimed showed no reason for my out-of-control back pain. Yes, there might have been a tiny herniation or two, but that wasn’t the problem. This doctor eventually released me back to work because he did not believe I was as crippled as I was.

I then went to the prison’s comp doctor who referred me to the Spinecare Group in Daly City. Up to that time I didn’t even have a diagnosis, a full eight months after the injury.

So for 21 years now, I have been a patient of Dr. James Reynolds. I don’t doctor-shop, I don’t poly-pharmacy, and I don’t supplement my meager pain medication with street drugs, marijuana or heroin. I take only what this ONE doctor prescribes for pain. And I have not been on pain medication continuously for 21 years!

To read one of the worker’s comp reports, you’d think I am a drug abusing faking malingerer who should be out of their hair by now. So, State Fund denied treatment my doctor ordered back in November, and they sent the denial notice so late that the doctor’s office could not file a timely appeal.

Yesterday I got a letter in the mail saying the procedure was denied, and that they would no longer approve the refills of pain pills. The reason for denial was that my doctor did not specifically define what makes me "bad" and what I can do when I am "good" after a rhizotomy. His stating "she is more active and improved after she receives the injections" and "she does not walk very far and has more pain when she needs the injections" is not specific enough for some quack who has never seen me and doesn't have half the surgical skills as Dr. Reynolds.

Mind you, this is a case that was settled back in 1995. You’d think the rules that applied then apply now.

Nope. They write ‘em up as they go. The scheduler at the doctor’s office assured me that this is the usual game of a worker’s comp carrier after the worker’s comp reforms were voted in. Delay delay delay; deny deny deny. Eventually the patient will give up and deal with it in whatever way possible.

I voted for those reforms, because there is much waste and malingering and misuse. But you’d think that three prior spinal surgeries indicates that there was indeed something wrong, and despite “fixing it,” something of that magnitude needs follow-up care.

Back when the case was settled, State Fund offered me $65K to walk away from medical benefits. I did not.

I’m guessing State Fund has to be such a bunch of assholes to a legitimate claim to save face for being so screwed over by Octomom.

At any rate, the doctor’s office was going to call the comp carrier and complain that they did not receive paperwork in a timely manner, and I told the clerk that she could tell the insurance adjuster that I am no longer driving, that I can’t sit at my desk for any length of time because my formerly perfect special chair doesn’t work anymore, and that in the morning the pain is so excruciating I cannot stand straight and walk with a shuffle for about an hour. It takes about 3 hours for my back to loosen up enough to move around like a semi-normal person.

I don’t sleep well; the pain breaks through the medication. And I am not taking anything particularly nasty—Double-strength Vicodin, which does not impair me in any way. It takes the edge off and I accept I will never be pain free.

So the timetable is another doctor’s appointment on May 11, then another THREE months before the comp carrier has to make a decision. UNLESS of course my doctor gets pissed off and calls someone while I am on the premises.

All I need are four little needles stuck into the facet joints on either side of L3-4 and L2-3, and zap the little buggers. I won’t be pain-free, but the nature of the pain will change and I’ll be able to walk the three blocks from the light rail to work, when I am required to work onsite. I’ll be able to take my cats for strolls around the neighborhood. And I might be able to sleep more than an hour or two at a time.

I am beginning to see how desperate people with back pain can become though. I am seriously considering packing it in, giving up trying to get jobs in the Bay Area, and return to crappy rural King City where there will be no jobs for me. I guess the advantage would be is I’d have lots of time to work on novels that may never be sold.

And it really scares me thinking I may be denied pain medication—will I turn to alcohol? Try pot? Or do what killed my sister and sister-in-law—go get stuff off the street? It makes me sick thinking about it, but I am beginning to understand the desperation.

Friday, April 2, 2010

Single Mom Breaks Stereotype

I’ve been sitting on this one for a couple of weeks, but after a conversation with a friend who works in higher education, I guess it’s time for me to purge and share some thoughts again. As usual, things are a bit of a stretch for me, so be patient.

There is this stereotype, all too often proven correct, that a child born to a single mom is destined for … nothing. Right now in college (especially community college, which certainly can be nothing more than a place for people to hide and avoid adulthood!) there are so many kids, especially males, who give their professors grief through disrespectful behavior and the attitude “You owe me, my life’s been rough thus far.” Plenty of these kids are from single-parent households.

The “you owe me” attitude is something people learn at home. My opinion, it’s all about the entitlement attitude that the United States has created through its welfare system. Start with one female, most likely with no education herself and coming from a family with the “you owe me” attitude herself. A baby equals a nice government check.

An attitude like this creates communities like Oakland, chock full of gangs and aimless young men who disrespect women. And they perpetuate the cycle, and their sisters, who may not be in gangs, perpetuate the cycle.

So when you come across someone who breaks—or rather, shatters—the stereotype, you can’t help but wonder why more families can’t get it right.

The mom in question was 15 or 16 when she became pregnant. My own daughter was a preschooler at the time. This young woman (let’s call her B) decided to keep the baby and finish high school. Her family rallied around her. Sure, they would have preferred she not do things that way, but her pregnancy and the eventual baby were never viewed as a tragedy or a source of a government check.

The baby, a boy, J, had plenty of good strong male role models who were not his father. He has a loving grandpa, uncles, cousins, and an uncle who was right there. His mom did eventually get married and when J was around junior high age, B had another son.

Fast forward 23 years. B is again a single mom, finishing prerequisite classes to apply for an RN program. She’s raising her second son, a great kid. J attended college and today is a talented journalist and gifted writer. Talented journalist and gifted writer are terms I do not toss about lightly.

Did I mention B inherited her grandmother’s cooking abilities and if she chose to do so, could probably support herself as a baker of fancy cakes?

Never has B looked at her boys at a source of cash. Her family circled the wagons and offered support and guidance to the young woman. Nothing but success was ever expected of her and her boys. B’s family is firmly middle-class, by no means wealthy, but they sacrificed to make sure B was able to care for J. J grew up knowing nothing but love, and his family expected nothing but good things for and about him. No excuses.

Why do B and J have to be the exception? Anecdotally, how many single moms do you know who did NOT end up on welfare for years, who did NOT continue to have babies (and plenty of deadbeat baby daddies), and whose babies used every excuse in the book to explain their eventual failures?

B will make an excellent RN within the next couple of years; I have no doubt J will someday end up winning a Pulitzer Prize, he’s that gifted. Son #2 will do whatever he wants and will no doubt be as successful as both J and his mom.

This family needs to write an instruction manual on how to successfully raise a kid! High expectations + no excuses + no sense of entitlement = successful young adult/human being who will make a difference in this world.

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