Lyrica can be very effective in treating nerve pain. It can take some time for the pain relief to be felt, as you have to build up to the dose needed to achieve pain relief.

The disc tears may or may not be the cause of some or all of your problems.

You need to appeal the appeal that you got from your HMO. Follow the procedures for the appeal and keep doing it and fighting them. They usually deny requests and when they find that the patient is not going to quit with the appeals, they usually give in to the request.

You may need to hire an attorney as well to help you out with the accident and possibly assist you with fighting your HMO

Was another car involved that caused you accident? If so than you can go after the other driver for ins. coverage.

Good luck

Fran

Thanks Fran,

I'm 3 days into the Lyrica, which isn't much, but my paresthesia has increased in that time. I will continue to take it, to build the level.

I do have an attorney, but the other guy only had 15k of coverage, so my insurance will be picking up the rest, to 100k. It is a case law workers comp case, but we are still fighting for them to pick it up.

I will continue to appeal with the HMO as well. I will most likely just pay out-of-pocket to see the outside specialist, and submit the bill to my attorney. I just really need to get some direction from someone who knows.

It's good that you have an attorney and if you can afford to get a second opinion, that would be a good thing to do.

Be sure to bring all of your test results with you, MRI, x-rays, CT etc. Don't just bring the written report, bring the actual films with you or the pics that are on the CD. Also get the written radiology report, but keep that with you and DO NOT GIVE IT TO THE DOCTOR, until after you have heard what the doctor has to say about the pics.

Please do remember that not all orthopedic spine surgeons or neurosurgeons that specialize in spines can read an MRI or CT.

I know that is really unbelievable, but it is true. You want a spine specialist that CAN read an MRI pics or CT pics and doesn't rely on someone else's opinion to tell him/her what is wrong with your spine.

I suggest, if you go for another opinion, you bring someone else with you to hear what is said and to bring a notebook or plenty of paper and a pen to write everything that is said down.

Have the spine surgeon point out to you what he is talking about on your pics and explain everything to you.

IF you are told different information than what you have been told by your HMO doctors, ( I meant to tell you also to not tell the second opinion doctor what the first doctor has said was or wasn't wrong) THEN ask how and or why the first doctor you saw has a different opinion and disagrees.

If you do get a different opinion, MOST IMPORTANT HERE AS WELL, GET ALL OF THAT IN WRITING FORMALLY FROM THE SECOND OPINION DOCTOR. GET IT ON PAPER WITH THE DOCTORS OFFICE INFO ETC ON IT.

BE sure to give it to your attorney, any and all information that you get from the second opinion, especially if it differs from the HMO doctors.

Make copies of the information and appeal to the HMO with this new information.

It does sound like you have nerve compression coming from the annular tears and maybe from the minimal bulges as well.

Keep after the HMO and be sure that your attorney is working for you and helping you fight the HMO.

It's a pain in the you know what and they know that. When you are in pain it is even worse to fight to get what you need and these insurance companies know that.

It can really wear you down to the point you want to give up and many people do. that is why they keep fighting you and saying NO. It is the ones that won't take NO for an answer and keep fighting their system for the medical coverage that they need and deserve that win the battle and get the coverage.

Take it from one who knows. Several years ago I had to fight the health insurance company for the coverage I needed.
They denied it on the first round, I appealed and they denied it a second time. So I appealed a second time and they denied that one.
I was then told I could appeal one more time and then if that was denied, I could "sue my husband's employer. to possibly get the coverage."

I thought, they had to be nuts. My husband is employed with a company and paying plenty for the insurance coverage. Now the insurance company is denying the need based coverage and if I don't win the appeal they tell me to sue the employer that my husband works for. and while I am suing the employer and trying to get the coverage, my husband will no longer have a job, and I won't have the insurance.

I was sick, in pain and really having a problem functioning with my arms and hands and putting up with this stupidity for 3 months and getting worse not better.

So I put a call into the women's name on the letter of denial and politely but bluntly told her what I thought about her stupid idea of suing the company and i would appeal and appeal.

I appealed again and lost that round and it was month 5. They gave me another chance to appeal and I did, and in the appeal I added the following statement.

"Just in case you don't realize it yet, I will appeal and appeal and appeal and fight you as long as I am alive and the earth hasn't self destructed."

The following week I received a phone call from the ins. company that they where "reversing the denial".

Then I was stunned to hear that the reason that they where reversing the denial is that they knew I would appeal "till hell froze over and just about everyone gives up and they don't have to pay. In my case, they knew I would not give up and they would give in and cover the medical care that I needed." She went on to tell me that fortunately most people give up and they don't have to pay.

The sad part about all of this stupidity, is this. I was going through occupational therapy for a botched surgery on my arm that left me with some serious injury to my arm, wrist, hand and fingers and since I wasn't making the progress they wanted at the speed they said I should, according to their little book they use, the stopped the coverage for the occupational therapy.

This stupidity of theirs cost me to lose ground in what I had gained and instead of covering the extra 5 weeks needed to wean down to a home program, the ended up having to pay for an extra 5 months.

And they wonder why the cost of insurance and medical care has increase do much.

and to top all that off it was 2 years before the lumbar spine problems decided to rear it's ugly head.

So fight them all the way and I'm betting that in the end you will win and not only win but maybe even get the coverage for an outside the network doctor too.

Good luck

Fran

If you'd like a non-drug treatment for relief of Sciatica, google VAX-D. It's non-surgical, therapeutic, and the results have been fantastic. Hope this helps!

Thanks again Fran for the time you took for your response. I am seeking the outside opinion, and will take all my MRIs, etc with me.

The spine surgeon that I saw, did mention that it looked like I had "cauda equina syndrome" as a close rear-ward bunching of my spinal nerves can clearly be seen on the MRI. However, he did not elaborate on this, nor did he officially diagnose me with this. This was one of the reasons he tried me on the Medrol, to reduce swelling of those nerves.

I have since researched the condition more thoroughly, and find that my symptoms do match those commonly found with that syndrome.

Again, my frustration with the HMO doctors so far, is I cannot understand why they are not actively looking for an explanation of my symptoms, or expanding upon the possible ones they think of!

Vanessa, I have researched the Vax-D, and similar DRX9000, and have found plenty of info that questions the validity of the company claims, treatment effectiveness, and overall benefit vs less expensive conservative treatments. Personally, I will avoid those.

I tried regular traction, and for my injury, it made me worse. It felt good while traction was applied, but as soon as the traction was released, it felt like my back had just been snapped in two. My pain shot through the roof, my paresthesia intensified greatly, and I could not stand for 10 mins afterward, and had trouble walking for a couple hours afterward. The increased pain lasted several days. Will not do that again either!