I am a 41-year-old female of two children, ages 6 and 8. My husband provides health insurance for our family through a PPO. We have a $3,000 deductible for the family, and a $3,500 out of pocket individual expense. Meaning, insurance coverage does not begin until my family pays $3,500. On July 8, 2016, I woke up with a terrible headache, excruciating shoulder pain, and numbness and tingling down my left arm and hand. These symptoms lead to an anterior cervical decompression and fusion of C5-6 and C6-7. I easily met our $3,500 out of pocket deductible.
As I was recovering from spinal surgery, my chronic lower back pain and right knee pain from my 2008 ACL repair became difficult to ignore. I had been trying to ignore this pain for years, taking Ibuprofen 600 mg around the clock. I was instructed not to medicate with the anti-inflammatory anymore because it would affect the spinal fusion. I quickly found myself comfortable with the acute surgical pain, but now treating my chronic pain with narcotics. I did not want to be one more American addicted to narcotics.
I referred myself to the local pain clinic for help. The MD spent a lot of time with me. Together we made a plan to conquer my twenty-plus years of lower back pain as well as the residual ACL pain. First, we scheduled a steroid injection to my right knee. The next week we scheduled an injection for my lower back. The clinic RN mentioned that I would need two separate procedures of steroid injections into the subchondral joints to prove to the insurance company that the MD was in the “right spot” before we could move along to long term relief via an ablation.
“Wait.” I said. My first spinal injection wasn’t scheduled until the day before Thanksgiving. “Is there some way to get the long-term therapy, and avoid the two-injection rule prior to the ablation?” I spoke with the clinic’s insurance guru, and the answer was no. I plead my case, “I have a $3,500 out of pocket expense that replenishes on January 1st. Our family budget can’t afford continuing care past the New Year. You see, I’m the mom and it’s just my back.” I couldn’t believe the words as they spilled from my mouth, but they were very true. I will need to continue to ignore my pain until I wake up someday and can’t ignore it anymore. How many other moms avoid caring for themselves due to the costs of care? There has to be a better way.
Jennifer Brown was a contestant in the 2016 Costs of Care Story Contest.