i hate my insurance

Adenomyosis can only be 100% diagnosed after a pathology following a hysterectomy. That is one reason doctors try to rule out any and all other conditons and try alternative treatment options. If adeno is suspected, that is just it, it is suspected and you could have a hysterectomy and find out that nope, you didn't have adeno after all! And if the problem turns out to be cysts on the ovaries, then you are still going to have issues post hysterectomy.

I really encourage you to keep a list of your symptoms and seek a second opinion. A new set of eyes on the situation could offer some additional help and solutions. Possibly this has all happened to give you some more time to plan, think, research, and find out exactly what might be going on and what treatment option might be best for you.

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Originally Posted by Weiser Adenomyosis can only be 100% diagnosed after a pathology following a hysterectomy. That is one reason doctors try to rule out any and all other conditons and try alternative treatment options. If adeno is suspected, that is just it, it is suspected and you could have a hysterectomy and find out that nope, you didn't have adeno after all! And if the problem turns out to be cysts on the ovaries, then you are still going to have issues post hysterectomy. I really encourage you to keep a list of your symptoms and seek a second opinion. A new set of eyes on the situation could offer some additional help and solutions. Possibly this has all happened to give you some more time to plan, think, research, and find out exactly what might be going on and what treatment option might be best for you.

well i do know my right ovary is damaged the gyn did say that.oh don't know if u saw where i wrote in here that my pcp refused to give my my 2nd opinion which i do know is against the law.i called my insurance company and they advised me to wait and see if my current gyn can get the appeal thru so i can get hyster done.i am so misserable right now it hurts to walk.i have to change my pcp when all is done.the scheduling nurse at my gyn's office told me not to do anything right now to change my pcp because it might hurt the appeal process.man i tell ya i hate this.i just wasn't sure, i know i read the only real way was a hyster to find out for sure about adeno but oh well. i guess i will ask my gyn about it.thank you "weiser".

well no appeal papers or denial papers in the mail yet at the gyn's office yet and my pain is worse and worse.i went out for a drive today just to get out and it hurt to drive.when i called my gyn's office the girl at the office said the scheduling nurse that is handling everything that i normally talk to will call me first thing monday morning after the mail comes,she wasn't there for me to talk to today(vacation).they canceled my pre-op for monday morning and said we can schedule it at anytime if we can get the appeal pushed.i really doubt we can get it done in a week.when i am suppose to have it my surgery on the 28th.i also called the clinic where my pcp is to make a complaint to whom ever i need to about her denying my 2nd opinion referral.i talked to the main dr's nurse about the whole ordeal.now i have to wait all weekend and i hate the worrying.i am sorry about the venting and complaining i just hate that i am starting to hurt worse and i probably can't get this hyster in a week.

My dr. warned that the ins would likely deny my hyst the first time. And another gyn in the practice had recommended a novasure! That year my regular gyn was out of town when I went in. Needless to say, this year I went in in the midst of a mad bad period! I was balled in knots, was given vicodin. but he did an ultrasound that day and that was in march. By May we had the darn thing approved!!!! He couldn't believe the other dr had suggested the Novasure for a retroverse ut and posterior cervix. and pills are not an option for me. He realized I was perfectly happy with the hyst path and made it happen. Lots of notes, he knew exactly how to word it to get it done!

Daiseyjean: That's what we are here for. Vent away!

Ok I got it in the mail today myself this is what it says,this is bull.

The tvh-bso is not medically necessary in a patient who has had pain for 5-6 weeks without any clincial findings or etiology of her pain
per millman care guidelines. The patent has not had any diagnostic studies for a non-gynecologic etiology(I.e. Bowel disease),comprehensive evaluation ( a mental health evaluation would be appropriate in this patient with anxiety and Dr's impression of a possible psycholgic component to this patient's pain) and the pain has not persisted for longer than 6 months. Finally, the patient has just recently stopped her ocps and does not have significant adnormal uterine bleeding history except for a single meses that lasteed 10 days which is not uncommon after discontinuing ocps. Therfore , the patient does not meet criteria for the tvh-bso per milliman guidelines. The tvh-bso is not medically necessary.

this is so wrong I don't need to go to a mental health person I am only on anxiety meds because of my husband going back and forth to Iraq and he just got home in dec and his grandfather is terminally ill with lung cancer. I am not making this pain up.I hate this insurance so much.what can I do?? I do have my period for more than 10 days a month too,i have big clots I have nothing wrong with my bowels either,this is just bull they don't want to pay for it. I have had nothing but problems with this insurance anyways.I guess I am totally screwed anyways.I guess I have to suffer.The bad thing is they sent it to the PCP doctor to that denied me my second opinion.we have new insurance with my husbands work that takes effect Sept 1 but I am hurting really bad.it says in the paper it can take up to 30 days for a a decision on in if we appeal it.i guess i just give up on it and just go on.this doctor doesn't seem to put everything down we talk about when i tell him about my period and things, and thats not right.

I think you need to seek another opinion. Do you have any other Gyn's in the area you could call for an appointment?

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Originally Posted by nicoler76 I think you need to seek another opinion. Do you have any other Gyn's in the area you could call for an appointment?

thats what i wanted to do and my pcp denied me that.she told me that pelvic pain isn't gonna be resolved thru a hysterectomy(whatever). i was telling her it is hurting to have intercourse.i am trying to change my pcp but the nurse at this gyn's office said don't do anything right now that would hurt the appeal's process.so i don't know what to do.but if i change my pcp it doesn't change till 1 sept.i get new insurance on 1 sept anyways.i am so screwed right now. we only have this insurance till 22 sept.i will be happy to get rid of it.the problem is the new insurance has 100 a day hospital stays which stinks.

I am sorry things have not gone as planned. I know that has to be frustrating. I hope you can speak to your doctor on Monday about what to do next and what to do while you wait.

My periods were always 10-15 days with clots so I know that is not fun. The birth control pills did help lessen them to 7-10 days and decreased the clots though I still had them. But you might want to consider trying some type of bcp right now to buy you some time.

And unfortunately for us women, stress and trauma can manifest itself via pelvic pain. I have had to discuss that with all of my doctors as well to be sure the pain was not actually stress related rather than a GYN issue. I have also gone the whole GI route to figure out how much, if any, of the problem was gastro. And some of it was gastro issues.

I know that a hysterectomy looks like a cure all for you right now but possibly there are some other options to consider. And if there are additional issues besides GYN, you will need to have those taken care of as the hysterectomy won't help.

Having your husband deployed does affect you in many, many ways and maybe having him home will help. I know my friend's health was terrible the whole time her DH was in Iraq. After he came home, slowly her body settled down and we were amazed how much of her health, including GYN issues, improved!

Please in there. Talk to your GYN about a second opinion. He may be able to refer you and help you in that area. Keep notes regarding everything you are experiencing. Talk to your PCP again. See what kinds of tests you can go through to help comply with the insurance guidelines.

And again, take some time to weigh your pros and cons again to see if this is what you really need to do right now. I wish you all the best! s

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Originally Posted by Weiser :comfort: I am sorry things have not gone as planned. I know that has to be frustrating. I hope you can speak to your doctor on Monday about what to do next and what to do while you wait. My periods were always 10-15 days with clots so I know that is not fun. The birth control pills did help lessen them to 7-10 days and decreased the clots though I still had them. But you might want to consider trying some type of bcp right now to buy you some time. And unfortunately for us women, stress and trauma can manifest itself via pelvic pain. I have had to discuss that with all of my doctors as well to be sure the pain was not actually stress related rather than a GYN issue. I have also gone the whole GI route to figure out how much, if any, of the problem was gastro. And some of it was gastro issues. I know that a hysterectomy looks like a cure all for you right now but possibly there are some other options to consider. And if there are additional issues besides GYN, you will need to have those taken care of as the hysterectomy won't help. Having your husband deployed does affect you in many, many ways and maybe having him home will help. I know my friend's health was terrible the whole time her DH was in Iraq. After he came home, slowly her body settled down and we were amazed how much of her health, including GYN issues, improved! Please in there. Talk to your GYN about a second opinion. He may be able to refer you and help you in that area. Keep notes regarding everything you are experiencing. Talk to your PCP again. See what kinds of tests you can go through to help comply with the insurance guidelines. And again, take some time to weigh your pros and cons again to see if this is what you really need to do right now. I wish you all the best! :hug:s

hi ,gyn, said absolutly no bcp's because of my migraines with aura'smy problems didn't start till after i had my tubal ligation.my husband has been home since dec 16. he has been out of the army since march,thank God.i have put in a complaint to the head dr at the clinic where the pcp is because of what she did.i will not go back to her.my gyn wanted me to get a 2nd opinion even.everything has to be thru my pcp though thru the insurance i have.i actually have no problems with my gastro area,no heartburn,my bowel problems.i take fiber and everything.