My Healthcare nightmare...(and it's not Obamacare!)

[ghostsinthemachine]

I signed up for Obamacare via the Covered CA plan in 2014. Went to my new doctors at a clinic in Grass Valley. Immediately I got stuff happening and taken care of. (Cancerous growth, diabetes and started on the path to treating the CT) then took a test, an EMG (?) (the single most uncomfortable thing ever), to determine the extent of the CT....Then went to a specialist to determine my injuries. Both hands and elbows and shoulders all suffered serious injury via carpal T.

That doctor did not advise to the surgery but instead proscribed physical therapy. BUT, the only place to do that was 40 miles and an hour on a winding road away, so I went once, because driving, (and typing), aggravate it so (I am using a voice on my tablet right now).

So I moved back to the Sacramento area to be closer to PT, and that is where my nightmare began.

In November, on the 15th I started to change my insurance to a Sac doctor under the same HMO (Anthem) that I had before. (via MediCal) Anthem did not do this timely, at all. Then they got confused totally and dropped me all together. Then, after reinstatement, they did not transfer me to a Sac doctor of my choosing but kept my doctor as the one in Grass Valley, who I was no longer an official patient of.

then came the re enrollment period and Anthem again cancelled me and MediCal started for me. For one month. (Which I knew nothing about). I didn't even know I was back on Anthem until I had a medical emergency in May and spent 6 days in the hospital.
Finally I get back on Anthem, and I am still listed with my former Grass Valley doctor, even though via all the forms etc I filled out I tried to make a change.

Hundreds of phone calls, hours of wasted time trying to get all this straight with Anthem. HOURS AND HOURS.

So I finally get to choose a Sac area doctor, but all the ones I want are not available (Because I was late in the sign up game) so I settled with one that was close. On that day that I made my appointment, I also sent a form to my past doctors allowing them to share my info...

And oh my God. Bulletproof glass in the reception area. Big signs warning against scamming for pain meds. Seriously it was like walking into an inner city KFC instead of doctor's office.

The doctor had not received my medical history. So the appointment (Which took a month to get) was wasted at least as far as my CT was concerned (and pain relief too).

Finally I got the record sent over and we had a second appointment, but my CT tests were not there......

That doctor (From Ukraine as were all the staff, many of whom only spoke broken English) referre me to a pain doctor as he called it.

And it was like a cartoon. Torn exam table. mismatched drawers. Dirty.....Staff that took blood that were incredibly horrible at doing that. Like a Tijuana doctors office if you can imagine. Or worse. That doc told me I had to take the test again. (and really not again?) because my records still had not followed me (Phone call after phone call and still nothing) to that doctor.

Well today I got it all straightened out. I went to my former GV Doctor and talked to them. they told me they sent the records, the complete records and that something must have happened to them at the other doctors end (they "lost" them surely)

So here I am 8 months later. BUT, I got the results to him today and the doctor still wants me to take the test again. (Which was so horrible I dread even thinking about it). "Things may have changed in the past year" (as if severe carpal T in left and right wrists, shoulders and elbows is going to get better with time or maybe more severe?). Of course, this doctor will be the one giving the test.....

And wont be until late September. So that is one year, completely wasted, to get to where I was in November of last year, actually not even close really because I won't have diagnosis or a report for another few weeks after that.

So why don't I (meaning everyone in the US) have a flash drive with my medical history on it? I could be well on my way to being pain free if so. Now I won't even get pain meds until late September ("I can't give them out until I make diagnosis&quot ....

This is all about Anthem not giving me service, losing me, cancelling me accidentally etc. And about the doctors seeing a healthy charge at the ready, Losing my medical records in order to bill for the testing etc.

The Obamacare part of this worked perfectly and when I had a doctor that was caring (At the clinic) they were great. When I changed to a doctor who was not a clinic, things changed and it all seemed a scam.

[REP]

1. I'm afraid the news may get worse

I have severe bilateral CTS, tenosynovitis, epicondylitis, etc. I'm also diabetic. While I've had pretty complex surgery on both shoulders, none of my orthos think surgery for the CTS is worth doing because of the diabetes. Why? Even if the CTS was caused by RSI, it's exacerbated by diabetes, which also causes the scarring to be much worse after surgery - meaning the surgery may actually make the condition worse. So be sure to get several opinions before you chance losing what ROM you have left.

I had PRP therapy for my epicondylitis. If it's offered under your plan, it's worth looking into, especially since if it's unsuccessful, there's almost no chance of the condition worsening. I had about 60-70% improvement after my therapy.

[ghostsinthemachine]

6. Well thanks, I think.....

I've lost about a 100 lbs so my diabetes is not as it once was.

i've talked to 100s of people who have ahd the surgery, some with diabetes and others without and except for a few (like three)they all were pretty successful.

All I know is, I cannot take the pain. It is killing me and NORCO's don't even help anymore...

[REP]

7. It's important to talk to surgeons about your case

Everyone is different; that's why it's so important to get opinions based on your anatomy. You may be a good candidate or not, depending upon the degree of scarring that already exists in the tunnel. Too many clinics are willing to perform the surgery whether or not it's appropriate (my health care is not clinic-based, but I still saw three hand surgeons).

I did have a very successful tendon release surgery on my hand.

Good luck!

[SheilaT]

2. People would lose those flash drives.

Although that's actually a good suggestion.

At the risk of making an unwanted and perhaps ignorant suggestion, can you change doctors? What you're describing sounds very sketchy, and while I understand you're frustrated because of all the delays and problems, this office sounds like a complete disaster.

[ghostsinthemachine]

5. No cannot change my doctor

The one I got was too hard to find and that would mean another set back......Another year....

[onethatcares]

3. krykey, my wife just read me a story

about one of her friends that has C-diff, which she said is rampant here in St Petersburg FL.

Imagine how many people have been treated(or non treated) for other problems that were really C-dff.

as far as our medical system seeming to be a scam. Isn't that the American way? Here it seems the doctors and clinics get busted
for Medicare/Medicaid/insurance fraud on a daily basis and the amounts of fraud are not in the range of three aspirins and a hot pad.

We're fucked in no uncertain terms

[No Vested Interest]

4. I thought medical records were supposed to be electronically available to all your

medical people now.
Is it not implemented in your state or area?
If not, why not?
(Perhaps there is an amount of time _ years?- permitted for this to be done - I don't know.)

[ghostsinthemachine]

8. And the nightmare keeps grooving

I finally had the CT test (again in September) by the dirties filthiest doctor I have ver seen. Broken exam tables and tools from the dark ages. I asked him if he ever cleaned his computer screen and he asked me if it was dirty. I took my finger to it and there was 1/4 inch of filth on it and the computer itself was filthy. That doctor confirmed the earlier diagnosis and a couple of weeks later I was referred to a surgeon. He checked me out and scheduled surgery for the 4th of November. One the first of November he cancelled the surgery telling me that the surgery hospitals he dealt with no longer honored my HC insurance (Anthem).

In the meantime, between the tests and the scheduled surgery my pain went from a ten to a fifty. Or a hundred or a million. I cannot tell you how bad it is.....Cannot lift my left arm over my head. Wipe myself, drive nothing. No longer did the norco's work (Vicodin) even three at a time (10mg).

Four Sundays ago The pain got so bad that I went to the ER cuz NOTHING could stop the hurting. Shoulder to the tips of my fingers of my left arm. Excruciating. I went and they gave me a shot of Percocet and that worked for about 4 hours. Then the pain returned. The doctor there(Wrongly and illegally it turns out) did give me a script for 15 Oxycodone (10 Mgs) that I had a hard time filling at three in the morning, but finally did.
BUT, one of them did nothing at all. NOTHING. Took three or four of them at one time to even get it so I did not want to kill myself. And they only lasted about three hours for pain relief.

I had a doctors appt. (pain management) scheduled for the following Friday but changed it to Wednesday. Almost didn't make it. ran out of meds early the night before and by the 11 o'clock appt, my pain was out of control..

I told the doc (Actually a PA pain manager, I have yet to ever seen an actual doctor except for the induction test guy and the cancelled surgeon) about what was going on and he got pissed off because the ER doctor prescribed me meds. Read me the riot act all about doctor shopping etc.


Not sure how I would have gotten through those days without them however and asked him what I should have done and he offered me NO other options.

The PA also tried to re refer me (he did it on our initial visit but I got no response) to PT for some shots but I still haven't heard from them.


I told him how the Oxy's worked for me at that time, that they were half as strong as they should be and only lasted about three hours. He ignored me and prescribed the same 10mg's and only three a day when I was taking two at a time and six times a day. I asked him what I should do when I ran out (I was sure that this was not going to be every day pain but was a serious flare up) as I knew I would. he offered me nothing and told me to make it work out or something to that effect.

For two weeks the pain was incredible. So I doubled the dose and took what I needed to be able to live. I also saw that I was going to have to cut back and when the pain subsided (to a much higher level however than before the flare up) and when it did I did. but I knew I was not going to make it to my next appt on December 7th.

For two days I tried to call to change my appt on the 7th, with no answer and no return call. Finally today they called and can only schedule me for the 1st. BUT I will be out of meds after tonight. (I have two left) and I don't know what to do. I went 12 hours last night to this AM, but the incredible pain returned. So I took another one. Two left now. And a week to go and I know how bad the pain will be when it returns (this morning being an indicator).

How am I going to make it till the 1st? I don't have 20 bucks a pill to buy them off the street, (let's do that math shall we?) or even the lesser NORCO's. Will I ahve to go to and from the ER to get shots? I cannt let them presecribe me more meds, then I will be labeled a doctor shopper and denied any meds. (And to think I had never taken ONE vicodin until 2014) and have been stringent about usage. But the pain will return and i have no idea how to cope with this.

Oh yeah, the doctor has referred me to a surgeon two times since then, both times the same surgeon that cancelled on me (using his various company names to confuse them). They also told me that I HAD TO check to see the surgeon worked with hospitals they did business with, it was not their job.

[Dems to Win]

9. I don't know if Kaiser is a possibility for you, but if it is, take it!

I'm on Obamacare in California, and have a Kaiser card. The runarounds you speak of are non-existent in the Kaiser system. I've had very good experience with them. From routine doctor visits to surgery after my hubby broke his leg, it's all been great. Talk to CoveredCA and see if you can get onto Kaiser.

Good luck to you.