I'm about to commit a crime against my prescription plan ppl!!!!

a_dmond_n_the_ruff
on 12/28/12 4:28 am
RNY on 09/17/12 with

I've been having sciatic nerve problems for almost 2mths.  I finally went to my GP to be diagnosed and get some relief.  We ALL know you can NOT take oral NSAIDS..and so does he.  So, presribes me a patch.  My plan denies it saying it needs prior authorization.  Ok...so they do that and they STILL deny it based on their opinion that I should be able to take an oral pill because I'm currently taking meds orally.  Uh yeah, and NONE of them are NSAIDS.  It has nothing to do with me physically being able to swallow a pill!!!  So, the doc calls out a gel and same scenario.  I call and talk to the idiots yesterday and explain that I can not take NSAIDS orally because of my surgery.  They say that was not listed as a reason when the doc sent it in.  So I call the doc office and let them know.  They specifically tell them about my bypass and that's why I can't have it orally.  I just got a call and have been denied AGAIN!!!!  W T F!!!!  I'm so freaking mad!!!  If I could take a pill, I would've done it already you f**king *******s!  In the meantime, I'm not getting any better.  I don't know what to do now!  Who the hell is on these "panels" that can determine what can be covered or not?  Is there a doctor?  I doubt it!!  So, I've put in a call to my surgeon's office to see what he can do.  I'm SOOOO close to calling the insurance and losing it. 

Shannon
HW: 260 SW: 254 DOS:227 CW: 175   27lbs lost before surgery
    

Citizen Kim
on 12/28/12 4:33 am, edited 12/28/12 4:35 am - Castle Rock, CO

You do know that you can't take NSAIDS in ANY form, don't you?   I may have misread your post but I got the feeling the "patch" is an NSAID just another form ...    It is the systemic action of an NSAID that is the problem to us, not the way it's delivered and I'd guess it's why you are being repeatedly denied!!!!

If you are going to take an NSAID you might as well swallow it - it'll have the same effect either way!

 

Proud Feminist, Atheist, LGBT friend, and Democratic Socialist

Cicerogirl, The PhD
Version

on 12/28/12 4:35 am - OH

FWIW, that's the way I read it, too.

Lora

10 years out; 190 pounds lost, 165 pound loss maintained

You don't drown by falling in the water. You drown by staying there.

a_dmond_n_the_ruff
on 12/28/12 12:27 pm
RNY on 09/17/12 with

You know, I didn't know that.  The way I understood it was that I just couldn't take it orally.  My mistake.  I'm sure my surgeon told me that, but I must've misunderstood.  I contacted his office and now have some options on meds I can take.  Thanks for pointing this out. 

Shannon
HW: 260 SW: 254 DOS:227 CW: 175   27lbs lost before surgery
    

scarlettbegonias
on 12/28/12 4:33 am - Australia
RNY on 10/19/12

Oh Shannon, you poor thing I've had sciatic problems before, feeling for you big time!!!

hope they get their **** together and get some kind of pain relief sorted for you soon.

 

Band placed April '08 four years of hell-Band removed may '12~Non VSG July 26 '12. All went to hell~RNY on the 19th october '12~Leak & infection 26th october '12 ~infection 24th November '12, 2 weeks hospital~infection 25th dec '12 4 days ~30/5/13 hernia repair 4 days~hw120/sw/115/gw/58kg

    

Cicerogirl, The PhD
Version

on 12/28/12 4:36 am - OH

Is the patch he is trying to prescribe an NSAID?  The person on the other end may be denying it because they know that NSAIDs in any form are not recommended after RNY, not just orally.

Lora

10 years out; 190 pounds lost, 165 pound loss maintained

You don't drown by falling in the water. You drown by staying there.

Carol S.
on 12/28/12 5:04 am - Milwaukee, WI

I had a doctor tell me he never heard that people with RNY couldn't have NSAIDS.  He got the slow blink.  I switched doctors.

Carol

SW/276 CW 150 GW 185

9 Years out.
            
Dee.spunk
on 12/28/12 5:24 am - Sacramento, CA
No NSAIDs in any shape or form. No matter which way you take it, it all has the same effect. It can cause an ulcer in your "blind stomach" and that can require surgery. It goes thru the blood.

Height:5'1.5 RNY:11/30/11 HW:307 SW:234 CW:136 GW:140 (LOST 73 Lbs. PRE-OP)

 


 

JUSTJUNQUIES
on 12/28/12 5:27 am - Citrus Heights, CA
RNY on 04/04/12

If the patch is an NSAID it's still a no go , the insurance may want you to try Vicodin pills before a narcotic patch , or if it is a lidocain patch it prob won't work .

Hope you can work it all out , believe me I know how frustrating it can be...keep pushing until you get what you need!!! unfortunately it is a weekend and a holiday :(

Donna Q. --5'8" -60 years old
Band 2005
hw320 sw276 lw with band 195 gw 160-180? 
Bypass 4/4/2012
pre sw 258 lw RNY 162 cw 203

Mal
on 12/28/12 5:34 am

I feel your pain, literally I do.  I too suffer from a chronic back/hip condition and have been in treatment for it since May of this year.  I have done two rounds of spinal steroid injections, with no relief.  I am currently on medication (Tramadol) that does not much more than dull the pain slightly.  It sucks, I know it really does.  Sometimes, when my pain from the sciatica gets really bad, I will ask my pcp to call in a muscle relaxer and that sometimes helps.  I am currently in physical therapy twice a week and it does help but its a slow process.  I'm seeing a chiropractor on Monday for some adjustments and have hope that the combo of pt/chiro will work.  I've already stopped taking the Gabapentin and Lyrica (nerve stabalizers) because neither did anything.  Good luck with your fight!  I'm currently fighting with my local pharmacy that's a joke (I'm switching to another one really soon) because the Omeraprazole that my GI doctor perscribes me is now a 'prior authorization' and they can't get their **** together with the computer generated authorization at the pharmacy.  They told me today that it'll take 3-5 business days.  I know its super frustrating but hang in there!  Hopefully you can get some much needed relief really soon!

 

M'Lane

                
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