united healthcare denied back surgery christmas eve

[u/lavendersucculents]

Hi, all merry Christmas. I do hope I posted this in the right subReddit and I do deeply apologize if this is not the correct I subreddit for this, but I’m at a loss. I recently received an email last night on Christmas Eve at 10 PM that UHC are denying a very needed back surgery that was scheduled for the 27th. I’ve already been kind of bullying United healthcare in social media trying to get somebody to call me back and explain to me as to why they’re denying it. I’ve also had very bad experience with United healthcare and their customer service before so I’m just very wary. I tried to appeal the first denial for minor back procedure earlier this year, but it didn’t go anywhere so I’m just wondering if anybody has any experience on how to properly file an appeal or has had any experience doing this? For context, I am a 31-year-old female, I have a severe disc herniation. I’ve already done physical therapy rounds twice and I’ve done two rounds of shots with epidural and Cortizone, which did not help. I’ve had three doctors recommend the surgery for me.

[u/PissbabyMcShitass]

ETA: Fixed a ton of typos, i was juggling my 5 year old.

If this is for a spinal fusion. I'm 37 and I've had one spinal fusion that's failed and I need a second one way more than i needed the first. At one point they actually kept me over night in the ED wanting to do it that week before deciding i was stable and my spinal canal was free and clear. It's so bad that the hardware is dislodged, a screw cap is floating, I had Modic type 1 changes which is basically that it is a bunch of micro fractutes from being bone on bone and there's bone swelling and fluid collection in the marrow. I also have hemangiomas now which are benign blood tumors. Worst mistake on the planet was getting that fusion too soon. After you get a fusion you just get more because everything else around it becomes unstable and the load shifts and the discs start to fail and herniate. Physical therapy isn't a temporary thing. You're supposed to be strengthening your core every day as a part of your routine. Yoga is also incredibly helpful for opening up the hips and releasing tension in the back and the core. With how severe it is now for me the only thing that brought back normalcy and relief was buprenorphine. It's got unique pain relieving properties that only works on the spinal pain receptors and it works literally 100x stronger than morphine. When I have my second fusion I will not be taking any other pain medication but an initial nerve block and a small increase in my buprenorphine. It's one of the top 3 most painful surgeries in the world and if you don't bust your ass to get up and get moving through that pain and do all you can to recover the minute you can(like the next day) then you'll be right back where your started if not worse off. But having dealt with a broken spine in multiple places since the age of 13 I have had every kind of pain management imaginable at varying degrees and there's no way I'm taking anything else but my buprenorphine for the surgery. And the great thing about it is after you build your initial tolerance to it it doesn't impair you at all. I now get mine in a long acting monthly injection.

I'm telling you. You really don't fucking want a fusion until you're like... risking paralysis imo. You need to be exercising every day and trying other measures to manage your pain. You're too young. Way too young. There's a reason they're denying you. Doctors want paid. That's why they'll do it. Of course you could benefit from the surgery in the short term, but if you're cool with having more fusions in the future about once every 10-15 years then go for it. I think if you can get on buprenorphine you'll find it can really take away just about all of your back pain. Really, all of it. It takes a week or two to build up after you get to your dosage range. And it's not something that's commonly prescribed for this right now but it's not unheard of. There's tons of studies backing this up.

As long as there's no critical life altering spinal canal or nerve root compression, it's all about finding ways to be comfortable and strength training. Otherwise you're doing yourself a disservice. But of course you could NOT be taking about a fusion. In which case. Never mind. 🙃