Coccyx sucker

[DianaCox]

PSA for anyone else who has tailbone pain - I have some possible helpful information - everyone else can just stop here.

I’ve had a specific pain in my ass (besides the usual human ones) for several years now. I assumed it was because I lost a lot of weight, and my once ample booty is flat, with excess skin as well, resulting in direct pressure on my coccyx. I did not have a fall or any reason to suspect an injury.

I have just lived with it, trying multiple types of butt pillows with tailbone cutouts, and/or sitting cocked up on one hip, but nothing worked very well or for long periods of sitting. Recently, it got much worse, and started hurting even after I stood up. I finally decided to ask for help.

After first getting X-rays to make sure there wasn’t anything wrong with the bones, I was told I could get a referral to either pain management or physical therapy. Since I didn’t want to take drugs, I opted for PT.

After only ONE appointment, things were already better. I’m astonished.

Apparently, although the pain feels like it’s in the bone itself, it’s a muscle issue. I’m doing exercises to strengthen and stretch weak tight smaller muscles that have attachments to the coccyx under the larger surface butt muscles, plus getting deep tissue massage in those muscles, and electrical muscle stimulation (TENS). PT three times a week and home exercises.

I wish I had known this was possible 2-3 years ago.

 

[JackieOnLine]

at least you are getting it now, very good.

 

[Spiky Bugger]

Cute title.

 

[Riverswept]

Have a awful time with pain do believe it is not bone but muscle. I will speak to dr about PT because this is serious pain in the tush

 

[DianaCox]

Update on my PITA.

Keep in mind, I do health insurance appeals for people as my pro bono work. This is how someone who knows pretty well how to work the system handles it - and it was aggravating, time-consuming and frustrating!

After 4 weeks of PT, I was told that I was doing well building strength and stretching the muscles and ligaments around my tailbone, but that there was underlying inflammation that needed an injection of an anti-inflammatory. <shudder>

But even with a PPO, it was not simple in this insurance/opioid world. I needed a referral to pain management from my PCP, because the PT guy is not a doctor. That took 2 days, despite multiple phone calls - and by then it was the weekend. In the meantime, I called around to various pain management practices (which, by the way, are not listed that way on the BCBS website - I had to call BCBS to find them - they’re listed under anesthesiology! who knew?), and made an appointment with the group that could see me soonest - because we’re setting off on a 3 week RV trip next week, which means a lot of sitting, and even driving the RV.

But one appointment does not get you a shot - newp, it is a consult, during which they decide whether what you want is what they are willing to do, and THEN if they agree, they have to get preauthorization for the shot.

My appointment today (that I was lucky to get) was with an NP, whom I fortunately convinced to drag the doc into the consult to expedite the process. Otherwise, it could have taken even longer.

(Note: I arrived 20 min early for the appointment. There were approximately 25 pages of forms to fill out, including legal disclaimers and agreements to be drug tested. One woman stomped out in anger at that. I wasn’t ushered into an exam room until a full hour after my appointment time. And it turns out that the confirmed referral from my PCP, which happily was to the same practice, didn’t arrive, so they didn’t have my medical records, including the X-ray of my coccyx - fortunately, it had been done in the same building.)

But do I get the shot? NO! The preauthorization can take days! And the shot has to be done at a surgicenter ($350 deductible, in addition to the deductibles for anesthesiologist and the guy who does the shot), under fluoroscopy and light sedation.

The whole procedure itself takes 5 min. But it will be a whole day thing. Assuming they get expedited preauthorization from BCBS (which I will have to check on multiple times tomorrow, I’m sure), I have to be at the surgicenter at 1:30 on Wednesday, FASTED for 8 hours. It will be 2:30 before they do the shot. I will be gnawing my own arm off by then. And probably pooping myself - fasting tears up my guts.

But I am hoping for relief from this PITA, at least for a while (the doc warned it might require nerve ablation as a next step, but in order to get that approved, they have to try this first anyway). At least it should be better for this upcoming RV trip. And I am getting it done 6 days after it was recommended, and before the trip, which is considerably less time than I was told to expect.

How do people who don’t know how to fight the system - or even know they can - manage??

 

[hilary1617]

I hope your pre-auth comes through swiftly and you can get your shot very soon. Also, even more so, I hope it provides the relief you seek. Feel better!

Insurance struggles are real for laypeople, for sure. I'm about to pay out of pocket for a needed drug for my son $675 (a month for 4 months) because I don't have the energy to deal with the insurance, pharmacy, and doctor to file an appeal to make the right thing happen. The insurance process has already cost a month delay.

 

[DianaCox]

"I'm about to pay out of pocket for a needed drug for my son $675 (a month for 4 months) because I don't have the energy to deal with the insurance, pharmacy, and doctor to file an appeal to make the right thing happen. The insurance process has already cost a month delay."

A CHILD is not getting his medicine after tumor surgery unless you pay out-of-pocket? That is outrageous!

You should be able to apply for reimbursement. Let me know if you need help with that.

 

[Spiky Bugger]

I hope your pre-auth comes through swiftly and you can get your shot very soon. Also, even more so, I hope it provides the relief you seek. Feel better!

Insurance struggles are real for laypeople, for sure. I'm about to pay out of pocket for a needed drug for my son $675 (a month for 4 months) because I don't have the energy to deal with the insurance, pharmacy, and doctor to file an appeal to make the right thing happen. The insurance process has already cost a month delay.

Get a denial. Appeal after the fact. ??

 

[Spiky Bugger]

Update on my PITA.

Keep in mind, I do health insurance appeals for people as my pro bono work. This is how someone who knows pretty well how to work the system handles it - and it was aggravating, time-consuming and frustrating!

After 4 weeks of PT, I was told that I was doing well building strength and stretching the muscles and ligaments around my tailbone, but that there was underlying inflammation that needed an injection of an anti-inflammatory. <shudder>

But even with a PPO, it was not simple in this insurance/opioid world. I needed a referral to pain management from my PCP, because the PT guy is not a doctor. That took 2 days, despite multiple phone calls - and by then it was the weekend. In the meantime, I called around to various pain management practices (which, by the way, are not listed that way on the BCBS website - I had to call BCBS to find them - they’re listed under anesthesiology! who knew?), and made an appointment with the group that could see me soonest - because we’re setting off on a 3 week RV trip next week, which means a lot of sitting, and even driving the RV.

But one appointment does not get you a shot - newp, it is a consult, during which they decide whether what you want is what they are willing to do, and THEN if they agree, they have to get preauthorization for the shot.

My appointment today (that I was lucky to get) was with an NP, whom I fortunately convinced to drag the doc into the consult to expedite the process. Otherwise, it could have taken even longer.

(Note: I arrived 20 min early for the appointment. There were approximately 25 pages of forms to fill out, including legal disclaimers and agreements to be drug tested. One woman stomped out in anger at that. I wasn’t ushered into an exam room until a full hour after my appointment time. And it turns out that the confirmed referral from my PCP, which happily was to the same practice, didn’t arrive, so they didn’t have my medical records, including the X-ray of my coccyx - fortunately, it had been done in the same building.)

But do I get the shot? NO! The preauthorization can take days! And the shot has to be done at a surgicenter ($350 deductible, in addition to the deductibles for anesthesiologist and the guy who does the shot), under fluoroscopy and light sedation.

The whole procedure itself takes 5 min. But it will be a whole day thing. Assuming they get expedited preauthorization from BCBS (which I will have to check on multiple times tomorrow, I’m sure), I have to be at the surgicenter at 1:30 on Wednesday, FASTED for 8 hours. It will be 2:30 before they do the shot. I will be gnawing my own arm off by then. And probably pooping myself - fasting tears up my guts.

But I am hoping for relief from this PITA, at least for a while (the doc warned it might require nerve ablation as a next step, but in order to get that approved, they have to try this first anyway). At least it should be better for this upcoming RV trip. And I am getting it done 6 days after it was recommended, and before the trip, which is considerably less time than I was told to expect.

How do people who don’t know how to fight the system - or even know they can - manage??

Get old.

Medicare doesn’t do pre-authorizations.

At this point, I call my SI joint injecting guy, an anesthesiologist, and make an appointment. He gives me a shot, Medicare pays him almost nothing.

~~~~~~~
From my post here August of this year:

My weirdness...so in the procedure room (an OR set up for this) I thanked the physician for doing the procedure at all, given how little Medicare and ins pay for it.

Dr: I guess I still do this because I always have.
Me: But how do you pay the rent? Are these guys [there were three others in the room in addition to the three or four people who helped before and after] all on minimum wage now?
Dave [guy in corner]: I'm a volunteer!
Dr: Yes, once in a while patients look at their EOBs and tell me I should set up a tip jar...but that's against the rules.

(Thinking back...it cost a lot more to get saline added to/subtracted from the stupid lap band port...which is why many of us went to Mexico for that.)

 

[JackieOnLine]

sorry you are having to go through all this, what a stupid "system"

How do people who don’t know how to fight the system - or even know they can - manage??

frankly? we give up and expect bad/no care - wish I were kidding.

 

[hilary1617]

"I'm about to pay out of pocket for a needed drug for my son $675 (a month for 4 months) because I don't have the energy to deal with the insurance, pharmacy, and doctor to file an appeal to make the right thing happen. The insurance process has already cost a month delay."

A CHILD is not getting his medicine after tumor surgery unless you pay out-of-pocket? That is outrageous!

You should be able to apply for reimbursement. Let me know if you need help with that.

Get a denial. Appeal after the fact. ??

@DianaCox Thanks for the offer to help. You are so kind! Any shot news?
@Spiky Bugger Denial is in hand.

Just venting and empathizing with the insurance challenges of many. Nobody has time to deal with this kind of back and forth run around on the insurance front!

Good news is it's not life-saving. It's for testosterone - his body is producing almost zero - all measurements so far are in the single digit range with levels literally those expected for a two-year-old. So, at age 14.5, he hasn't even started entering puberty. Due to tumor and subsequent surgery, his pituitary isn't functioning properly and he just isn't producing a number of hormones, including testosterone.

Situation is complicated by doctor being full time researcher and part time clinician so has appointments and office staff only one day per week. He charges $450 / hour and doesn't take insurance. He's in Los Angeles, we are in IL - visits are by phone or email. That said, he's the best diagnostician and physician I've ever met, but difficult (and costly) to reach for non-emergency or unplanned situations. Working through an appeal on this would probably not be the best use of his time. We have so many other things for which we need his expertise. It took a heroic effort dealing with the state and school paperwork to permit the school nurse to administer life-saving rescue shots for his current main issue of adrenal insufficiency.

Doctor has been asked by pharmacy to write a new prescription for a different % as they think that will resolve the issue. Purportedly, insurance allows 2.0% but denies 1.67%. Doctor claims he faxed new script to pharmacy. Pharmacy denies receipt of fax. Still no medicine. Still would like for my son to be able to transition from boy to man.

 

[DianaCox]

ARGGHH!!

I understand your being understanding of your preferred clinician's skills, but not being able to count on him for follow up and paperwork, including insurance issues, is not good. Can you get him connected with a local doctor who is willing to work with the expert and stand in his place for the stuff where you need to be able to have follow through?

 

[Spiky Bugger]

@DianaCox Thanks for the offer to help. You are so kind! Any shot news?
@Spiky Bugger Denial is in hand.

Just venting and empathizing with the insurance challenges of many. Nobody has time to deal with this kind of back and forth run around on the insurance front!

Good news is it's not life-saving. It's for testosterone - his body is producing almost zero - all measurements so far are in the single digit range with levels literally those expected for a two-year-old). So, at age 14.5, he hasn't even started entering puberty. Due to tumor and subsequent surgery, his pituitary isn't functioning properly and he just isn't producing a number of hormones, including testosterone.

Situation is complicated by doctor being full time researcher and part time clinician so has appointments and office staff only one day per week. He charges $450 / hour and doesn't take insurance. He's in Los Angeles, we are in IL - visits are by phone or email. That said, he's the best diagnostician and physician I've ever met, but difficult (and costly) to reach for non-emergency or unplanned situations. Working through and appeal on this would probably not be the best use of his time. We have so many other things for which we need his expertise. It took a heroic effort dealing with the state and school paperwork to permit the school nurse to administer life-saving rescue shots for his current main issue of adrenal insufficiency.

Doctor has been asked by pharmacy to write a new prescription for a different % as they think that will resolve the issue. Purportedly, insurance allows 2.0% but denies 1.67%. Doctor claims he faxed new script to pharmacy. Pharmacy denies receipt of fax. Still no medicine. Still would like for my son to be able to transition from boy to man.

Damn, I need a few thousand bucks worth of sewer line run out to that "storage room" behind the garage. You could camp poolside, for free even. But right now, it's just too rustic...especially for most DSers. It's about 300 sq ft, right now holding a Cal King bed, lots of Ikea Billy bookcases and books, chrome shelving, a loveseat. There's room for a pretend "kitchenette," with cooking stuff and a microwave out there and even a little college dorm refrigerator. Many of my neighbors rent out bootleg apartments or Air bnb rooms in far worse shape. But I'm rather anal about being law-abiding, and it is not okayed for occupancy because it needs plumbing and, apparently, wall insulation. Bummer.



[And, totally unrelated, but a random comment I made almost a year ago on a board having to do with Mid Century Modern stuff may have just sold the STUPID stove that came with this house. I wrote, "If $300 is a fair price, I'm in." And somebody is coming to see it later this month. I said it was unrelated. Well, it's more of my hoarded leftover furniture such as in the storage room...but ALMOST unrelated.]

 

[hilary1617]

ARGGHH!!

I understand your being understanding of your preferred clinician's skills, but not being able to count on him for follow up and paperwork, including insurance issues, is not good. Can you get him connected with a local doctor who is willing to work with the expert and stand in his place for the stuff where you need to be able to have follow through?

It's possible, but the appointments necessary to make that happen probably also will dig into my wallet (and more importantly, my time). We'll see what happens. I'm a bit overwhelmed with what's already on my plate these days to be honest. Good news is that I have some iron in my veins now, so have a bit more energy to deal with it all. But I'm struggling to keep my head above water and it's tempting to just write a check to resolve the issue.

 

[hilary1617]

Damn, I need a few thousand bucks worth of sewer line run out to that "storage room" behind the garage. You could camp poolside, for free even. But right now, it's just too rustic...especially for most DSers. It's about 300 sq ft, right now holding a Cal King bed, lots of Ikea Billy bookcases and books, chrome shelving, a loveseat. There's room for a pretend "kitchenette," with cooking stuff and a microwave out there and even a little college dorm refrigerator. Many of my neighbors rent out bootleg apartments or Air bnb rooms in far worse shape. But I'm rather anal about being law-abiding, and it is not okayed for occupancy because it needs plumbing and, apparently, wall insulation. Bummer.



[And, totally unrelated, but a random comment I made almost a year ago on a board having to do with Mid Century Modern stuff may have just sold the STUPID stove that came with this house. I wrote, "If $300 is a fair price, I'm in." And somebody is coming to see it later this month. I said it was unrelated. Well, it's more of my hoarded leftover furniture such as in the storage room...but ALMOST unrelated.]

Would love to visit Camp Sue. It would be the best Air BNB ever!

I wasn't aware (or have I just forgotten?) that you were an MCM aficionado. My home is a Usonian. I bet your furniture hoard would make me swoon.