Writing

Battling Insurance: My Fight for Essential Female Health Care

I should be prepping for surgery. My kids should be dropped off at different grandparents’ houses, and my bags should be packed for an overnight stay. Instead, my “provider” and I have been fighting with my insurance company. God I hate that word, provider. They are doctors and should be addressed as such, no matter what. Maybe by renaming them “provider” it is easier for the insurance companies to deny the approval requests.

For the last two years, and longer, I have been jumping through every step needed to get a partial hysterectomy. But even with the evidence provided by the doctors, UNITED HEALTH CARE has decided there wasn’t enough proof and deemed it elective and therefore not covered. 

Strange. 

I am unaware that removing precancerous cells is elective. I thought that was called preventative. Maybe the language changed while I was being put under for leep procedures and in-depth biopsies. The removal of MY uterus wasn’t only because I needed a more invasive way to remove the precancerous cell. 

—side note: my doctors warned me that once they removed my uterus that there was a 90% chance they would find stage one cancer. 

My cycle is so heavy that my doctors have said it is the equivalent to hemorrhaging. Last year I had to have iron infusions because my levels were so low. If I had been male, I would have been sent to the hospital four times over, but because I was female, I was told it was okay because being anemic was normal. My cycle lasts anywhere from 7- 9 days. For me to function like a normal human who isn’t bleeding out, I have to take a pill called Tranexamic Acid. This medication the blood clots hold longer in the womb, significantly reducing blood flow. But this medication is only a band-aid for the actual issue. The fibroids that line my uterus. 

Another reason at 39 I am trying to remove my uterus. Let’s not get started on the cysts that make me throw up from pain whenever they swell.

My doctors told me that anyone under 40 usually gets rejected. Something about women changing their minds and wanting more kids. But my husband is fixed and we already have three kids. So because of this nonsense it’s why it has taken me two years of having my body scraped, burned, and prodded repeatedly before we even tried to submit UNITED HEALTH CARE. But it still wasn’t enough. 

I had no idea that my procedure was rejected until Monday evening when the mail arrived. At that point, it was too late to call my doctor and find out what happened. Tuesday morning I called and spoke to the woman who submits all the information to the insurance companies. She said their office received the information Friday after their office had closed for the weekend and they did not know about the information until Monday morning. She was already in the works to send almost six years of medical records to UNITED (un)HEALTH CARE.  When I called back this morning, she said she was on the phone with them for 3.5 hours trying to FAX — because it’s the 90s still in the medical world — the information over because UNITED HEALTH CARE’S fax was not working. She had to fight with them because the fax number they provided was not working, and they claimed it was the doctor’s office’s fault. It wasn’t until she tried three different machines before UNITED HEALTH CARE provided another number and it worked.

I called UNITED HEALTH CARE myself after finding out that it wouldn’t be another 72 hours before they decided my six years of preventative care would be deemed worthy by their standards. When I got a hold of a human they told me that they were unable to explain why there was not enough evidence. She also told me only providers can discuss this information. Not the fact that I know what’s going on with my body, or the fact that I have actively jumped through every hoop they have asked for… 

No…

As a normal non medical person I am unable to hear why I was rejected or even be able to defend myself. If I were to try it would stop anything that provider had submitted.

So the only thing that would be able to hurry the process along would be for my doctor to stop doing her job, seeing other patients, and have a peer to peer call explaining away the miscommunication. 

I find it absurd that anyone working at an insurance company would think themselves to be on the same medical level as a doctor who works for patients. Those who are insurance company’s medical directors are no longer working for humans. To me these people have sold their soul for  the almighty dollar because that could be the only reason why so many people are rejecting those who need medical care.

I don’t know when I will be able to reschedule my partial hysterectomy. I had it set up this way so I would have my entire summer to heal. I know my body, it is stupid. It likes to reject anything to make it better. I need 8-10 weeks to heal and that is what the summers off give me. I didn’t want to have to schedule a sub to cover my classes for two months. If I was going to do that, I would have taken care of this in January allowing myself the ability to enjoy my summer. Now I am going to be playing the waiting game, wondering when I will have organs removed so my body has less of a chance of turning angry cells into cancer. 

Lent

Day 8: Therapy 101

Today I took the first step in actively working on my mental health. I had an hour-long session with a therapist. This isn’t my first time with therapy. The last time I sought help was to deal with my postpartum depression and anger. However, that ended quickly after the therapist said to me, “have you ever been to therapy before? Bec” Because this isn’t how it works.” The woman said, after I bared my soul… That may have been word vomit of emotions and feelings, but she wasn’t correcting me, just being rude.

Even though I had an awful experience with therapy, I have always suggested it to family, friends, and my students. My husband is alive because I pushed him to speak to those are the VA who were trained in his combat related PTSD. I have guided more than a handful of students into either talking with a guidance counselor or a mental health specialist. Even my own little clone is in therapy, learning how to handle her massive emotions. So when my husband told me I needed to get help, I didn’t fight him. I didn’t want to do it, but I did it. I would hate myself forever if I always suggested those to seek help while I became lost within myself.

Somehow I got lucky. My new therapist seems wonderful. She has a kind voice, and she genuinely seemed engaged when I spoke about the things I’ve lived through. I can’t explain why I went with the first therapist I contacted, but a tiny voice inside me said, “this one.” When she asked me to fill out the pre paperwork, she asked if I had any trauma. In that millisecond, I finally stopped running and decided I didn’t need to be strong. I said “yes.”

While I have documented my sexual assault by my boss on here before, I have lived through a lot of other extremely dark things. Situations that I don’t feel comfortable putting out in the world, I will say this: I’m essentially a statistic for many things that can go horribly wrong to a female.

One thing she was gauging me on was to see if I may suffer from PTSD because my scores were pushing me there. However, that I don’t avoid situations that have caused me trauma means I don’t qualify. Part of me didn’t like that response because, for most of my trauma, there’s no way to avoid it. As I keep finding out, Jupiter/Gardens is a small ass town and the only way to avoid being triggered would be to move.

But fuck that. I’m not leaving my hometown. This is the place I’ve always wanted to raise my kids. It’s a wonderful community offering more in one location than any other community I’ve lived in. Another reason I throw my middle finger in the air at the idea of avoiding things is that I won’t be the victim. I am stronger than that. Those people who have bruised my soul will not now or ever win.

After an hour of jumping around and explaining pieces of myself to this woman with a trusting voice, I felt drained. However, even though we didn’t dive that much into the crap burdening my soul, I felt a small sense of relief. One that I can only hope will grow.

Lent

Day 40: 40 days and 40 nights of not interacting with social media

After 40 days and 40 nights of not interacting with social media, I don’t think I’ll be adding it back to my life. I woke up and checked my notifications. There was nothing that I truly missed. There was nothing on any of the apps that required my attention. I added the apps after Easter dinner and deleted them before midnight.

I finished reading book two of the new series I started last week and picked up my phone. Instead of checking to see if I turned my alarms back on. I opened Instagram and Facebook. I didn’t even really interact with the app. I just cleared my notifications. It all just felt like an empty habit. I got no enjoyment from what I was reading, and as I scrolled through my timeline and saw people’s pictures pop up, I felt sick. Everything about it felt voyeuristic and empty.

I discovered a friend of mine had a baby while I was on my detox. I also learned another friend had been pregnant and delivered the daughter she so desperately wanted this Easter morning. Out of the two women, I only knew one was pregnant. I thought it was strange how I felt nothing while looking at their tiny cute babies.

However, I’m not a cold-hearted ice queen. One of my longest friends gave birth to twins a week ago. I knew they were due on a Monday; however, I couldn’t remember what Monday. Time slipped by, and I texted her about the babies on Thursday morning, asking when they were arriving. Instantly bombarded with pictures of two adorable faces and a phone call. My friend apologized for forgetting I gave up social for lent and not letting me know the twins arrived. It baffled me. If anyone should have been apologizing, it was me. She just brought two tiny humans into the world. The least of her concern should have been the weird person breaking away from social norms.

We talked. We caught up. She sounded amazing. It felt real and meaningful. Nothing like I felt when I reconnected with the thing marketed as the best way to communicate.

My time away has been healing. I don’t feel the need to always have my phone on me. I am less anxious when I see my notification light go off. One of the biggest things is I feel my interactions are more human. What I know about my friends is what they want to share with me, not what I stalkers learned about them while silently watching their lives through a screen.

I’m not deactivating my accounts, but apps aren’t going on my phone. I will randomly check things on a web browser, but nothing like I used to. For the short time I had the apps on my phone; they were trying to occupy my time. I turned off notifications. However, whenever I opened an app, it asked if I wanted to turn on notifications. I don’t need that kind of bullying in my life. I already told it no multiple times. It was forcing itself on me.


So here’s to newfound freedom. I hope we all can break away from this false reality someday.

Lent

Day 24: A painful journey from the V.A to the Cleveland Clinic

I am not going to lie; there are times that I forget that my husband is broken. Maybe that’s not the best way to word it. Should I say permanently injured? I don’t know. Tyler joined the Army at eighteen in the best shape of his life, and now about six months from his 40th birthday, we are spending our fifth day in the hospital, hoping to get some relief for the pain in his back. Only this time, we’re at the Cleveland Clinic instead of the V. A. 

You’d think after almost eight years, I’d be used to his limitations. But I am not. I 110% blame him. Tyler is amazing and pushes through the pain more than he should. To give you an idea of how bad things are, he was medically retired from the Army for how destroyed his discs were in his lower back. Before thirty, he had one of the destroyed discs replaced, his back fused, and has two rods and four screws. However, if you looked at Tyler, you’d never know he lives in constant pain. 

Probably one of the worst things about his injuries; unless he takes his shirt off, there are no visible scars. I know they are there, but it’s easy to forget. Tyler still goes about his life, mind you, sometimes slower than others our age but still more active than most. 

He coaches our son’s 10U rec baseball team, and he isn’t just sitting on the side. I can not count how often I watched Tyler and wondered if his brain had fallen out because he was catching for Mark as he warmed up to pitch. I’m certain that I pray every time he squats down that he’ll be able to stand back up because I’m far too tiny to help. Luckily there are some big dads, and his assistant coaches can help if that is ever the case. 

In December, on his way home from work, Tyler hurt his back after changing the tire on the truck. When he got home, he was very stiff and was having trouble getting off the couch. I suggested that we go to the V. A., and he shot down the idea. He told me he just needed rest. So Saturday rolled around, and I did my best not to bug him, which felt impossible since he had promised to put up the Christmas lights. However, the rest did not help, and when he woke up Sunday, he told me, “we’ll go. Something is wrong.” 

The V. A. doesn’t give painkillers anymore; however, they did give him something to help manage the pain. The Er gave him two shots, one was a steroid, and the other was a muscle relaxer. A few days later, we were surprised to find out that the Er doctor could get him in for an MRI. It had nearly been two years from his last one, and no matter how many times he told his primary care doctor, they never sent him to get a new one. 

Tyler got the results of his MRI back through the patient portal with no call from a physician at the hospital. So we were left to try and decode what was going wrong with him. As he waited to hear back from pain management or anyone from the hospital, his back went out again. 

At the end of January, and the beginning of 2023 baseball season, Tyler was in pain. It was so bad that he called me and said we needed to go to the Er. I called my parents and asked if they could watch the kids as we went to the Er. Of course, they said yes. 

After checking in, a nurse came in with a wheelchair. Tyler tried to refuse it, but she was very convincing, and thankfully he took the ride because it would have been a very long and slow walk. 

We had been to the V. A. hospital nearly once a month for the last three months and it had been a pure shit show. Just trust me when I say you never want the government involved with your healthcare. It has been a nightmare of a fight trying to get Tyler taken care of. It took putting the V. A. on blast on social media, before we finally started to get somewhere regarding his health care. Only it was far too little too late. His health was declining, and the injections scheduled at the end of February were looking to be too long down the road. 

The Er doctor gave Tyler the steroid shot again to alleviate the pain. That way, we could make it to the February appointment. The nurse came out with a cane, and he outright refused it. But I took the cane and threatened to beat him with it if he didn’t use it. The nurse laughed and asked how long we were together. She also asked him to blink twice if he needed help. Tyler, of course, blinked rapidly. 

Since he likes to pretend nothing is wrong when he’s on the field, I’m a bit hypervigilant watching him during practice. And at the beginning of the season, one of the mom’s noticed that I looked stressed. Anita was Adelyn’s cheerleading coach in the fall, and that was probably why I unleashed everything when she asked if I was okay. I didn’t mean to word vomit everything we’ve been dealing with with the V. A., but I did. Anita sat and listened to all the crap we’ve dealt with the V. A., and her ex-husband listened too. I knew she was a nurse, and I assumed he was a doctor because he always wore scrubs. I didn’t know he was a neurosurgeon specializing in spines and degenerative disc diseases. 

After I explained all the shit we’ve been going through over the last seven years, Dr. Miller asked if we had a copy of Tyler’s mri, which, oddly enough, I had the write-up in my email. I showed it to him, and Dr. Miller said, “that was the worst thing he’s ever read.” I wasn’t surprised because the medical care, or lack thereof, we were used to getting at the V. A. had to trickle down and into the imaging department. So I told him we’d bring the cd to the next practice. 

So by the rec baseball season opening day, we had to visit the V. A. twice for how severe his back pain had gotten. Even though Tyler is in chronic pain and probably shouldn’t be coaching baseball, he has never allowed the pain to get in the way of doing what he loves. Because if he does let the pain stop him, then what does he have left?

I know I joked at the beginning of this blog about Tyler falling down and not getting back up, but it’s not really a joke. His bulging discs have been pressing on the nerves in his back, affecting his legs. Tyler’s right leg has lost feeling, and when he steps, he doesn’t entirely feel what his leg is doing. 

A few days after Tyler gave Dr. Miller the cd of his MRI, Tyler told me that the pain was terrible. He didn’t actually need to tell me. I could see it. He had trouble standing from a sitting position, and his legs had trouble supporting him. I suggested we go back to the V. A. He complained that there was no point since they wouldn’t give him anything for the pain, and he had an epidural scheduled for a few weeks. But I reminded him that the Er gave him a steroid shot, and it did help a little with the pain. Instead of going to the ER, as I suggested, he waited. But he did promise that if it got worse, he’d go. 

The following day was the opening day of baseball. Tyler coached, but this time he actually sat. His thigh started to pulsate, making it even more challenging to stand. I was worried and told him we should go to the hospital, but he said no because Mark had a travel game. He promised if he felt worse after the game, we’d go. I teased him a little about waiting, but I was glad to know he was toying with the idea. 

I didn’t join him for the second set of games. I went home with our five-year-old and three-month-old and started making dinner. As I cooked, I had a strange feeling that something terrible had happened. For the last hour, I had not received a text or phone call, and usually, he would text me randomly throughout the games, like stupid memes or updates on how Mark was playing. However, it had been radio silence. 

Then the game ended, and shortly after Tyler would usually call to tell me about the game, I received a call. 

“I’m only telling you this because I know how pissed off you’d be if you heard it from someone else.” 

I don’t know what ran through my mind other than it couldn’t be that bad because he was driving. 

“My leg gave out,” he said before I could ask. 

I tried not to laugh, but I did. “Excuse me, what?” 

“A foul ball came over the fence, and I stepped to catch it, and my leg gave out.” he was laughing while explaining what happened. 

“Did you at least catch the ball?” I asked. 

“No! That’s the worst part.” 

I waited until he got home to hear the whole story. Again I called my parents and asked them if they could watch the kids as we went to the hospital. I think it was becoming routine at this point. I finished cooking, inhaled my food, and packed up things for the littles in case they had to stay the night. 

I heard the door open and nearly pounced on him. I asked him if he was okay, and he said not really. His thigh was still pulsating. It looked extremely uncomfortable and weird. He grabbed a bowl of dinner and ate, explaining what had happened. 

A ball went over the fence, and he barely stepped back. I asked if he was on the sidewalk or stairs, and he said no, it was level ground. One minute he was fine, and the next, he was on the ground laughing. A few other dads laughed with him, but I think they did it because they were equally uncomfortable with what happened. 

One dad, Larry, a physician assistant who used to work for a nero, walked over and asked if Tyler was okay. He said yes. Then Larry asked if Tyler was going to just lay there or wanted help. Tyler chose to lie on the ground for a while. 

A few moms checked on him, and one yelled at the other laughing dads and then yelled at Tyler for not using his cane. That just made Tyler laugh more. His motto is if you can’t laugh at it, then what’s the point? 

He said that after getting off the ground, Dr. Miller called to discuss his MRI, and Tyler told him about his leg going out. Dr. Miller said his nurse would call in a steroid pack for him and try to get a hold of him on Monday. She would be starting the process with the V. A. To get his case transferred to Dr. Miller because what the V. A. had planned wouldn’t help fix what had made Tyler’s leg go out. 

As he told me about the incident, Tyler rubbed his leg. It had been pulsing for eight hours, and it was fatigued. The muscle hurt, and Tyler couldn’t fully support himself. We dropped the kids off and headed to the V. A. 

They gave him steroid injections and sent us on our way. 

About a week or so after that Er visit, we were at the V. A. again, only this time for a scheduled visit. Tyler’s pain management doctor had him set up to get his nerves burned, and the procedure that he was supposed to go through was to see if he was a candidate or not. Everything seemed to go reasonably smoothly. He went in relatively close to his appointment time and was out in the approximate amount of time.  I was ready for him to tell me something had gone wrong. Nothing ever goes smoothly with the V. A. 

So when I asked him how everything went, I shouldn’t have been surprised when he said they changed everything once he went back with the doctor. 

“Well, what did they do to you?” I asked as we were walking to schedule his next appointment. 

“I got an epidural,” he told me. “the doctor said he looked at my MRI and said what the pain management doctor wanted to do wouldn’t help without doing the epidural first. And since I was already there, they just had to get a different pack.” 

I guess that’s the only bonus of being at the V. A. If they change their mind about what they want to do, everything is at their disposal. It seemed the epidural helped some with the pain. He could walk without a cane if he used a knee brace to give him enough support. The epidural worked well enough to avoid returning to the Er as we waited for Dr. Miller’s office to be approved by the V. A. 

About two weeks later, we got a call from Dr. Miller’s office. They were ready to schedule Tyler’s procedure. The nurse apologized to Tyler for it taking so long. She said there was a miscommunication between the offices. Without her even saying what the issue was, Tyler asked, “did you receive information for an R. Jenkins?” and the nurses said, “yes! I couldn’t figure out why they kept sending me the wrong person’s information, and finally, I saw that Tyler was the middle name.” 

I don’t know how many times this has happened. Tyler always forgets to tell people that he goes by his middle name. And I don’t think he thought about mentioning anything to Dr. Miller’s office since he’s so used to doing everything at the V. A. with his last name and social. 

Tyler received the call Monday, and by the end of the week, I was waiting in the lobby of the Cleveland Clinic to take him home. 

After the procedure, Dr. Miller came out to talk to me. He explained that Tyler would be a little sore and that in the next 48 hours, things may hurt slightly, but it should be better by the end of the week. He reminded me that Tyler should take it easy and not overdo anything, and I said that would not be a problem. Usually, I’m the problem asking him to do things for me because I’m too tiny. Dr. Miller also recommended lots of fluids. 

“Does beer count?” I asked. 

He laughed. “No.”

 “Well, you might want to tell Tyler.” 

When Dr. Miller left, two women sitting in the lobby looked at me like I had grown two heads. 

“Was that Dr. Miller?” one asked. 

I nodded. 

“He must really like your husband. He never does that.” 

On the way home, Tyler and I talked about his procedure. The nurses kept asking if he had wanted to be satiated, and he said no. He was used to receiving the injections with localized anesthetic when he went to the V.A., but with how many times they asked, he was wondering if he should be sedated. When Dr. Miller started the procedure, Tyler and he were joking around. The first injection didn’t hurt, but the second one did. Miller said the second injection was on the nerve causing the most pain. The third injection hurt the worst. Dr. Miller had poked him once, but Tyler’s mental rod was in the way, and he had to dig around a bit. Dr. Miller apologized for the pain, and Tyler said, “don’t worry, I’ll just make your son run, so he hurts as much as me.” 

I don’t think the nurses were ready for the banter between the two men. 

We’re four days out from the nerve injections, and Tyler says he can tell that the feeling is finally coming back in his leg. Today as he was going down the stairs, he knew his leg was still a little weak, but it wouldn’t be long before he wouldn’t need the knee brace anymore. 

I just hope we’ll be able to avoid hospitals for a while.