HOT NUMBER 3 DR. REFUSAL

Went to see Dr. Digby today, he doesn't feel comfortable doing my surgery. I have to be smoke free, redo all the tests again, and see him in 2 months, and he said he will still feel the same. he only does opens and I have a lot of scar tissue. So right now my sinus's are hurting from holding back the tears of frustration. I don't know what else to do at this point. Blue Care isn't going to keep paying for me to see a different psych because a different Dr. want's me to see theirs. That shouldn't be a necessary factor, find one, have the eval and have the paperwork faxed to the Dr. I'm in a wheelchair from a fractured hip and pelvic. Ihave an under active thyroid that puts the weight on. My joints hurt so much with weight baring, and swelled with so much fluids. He wants me to be able to walk 2 blocks with out any type of aid, not even using a walker or cane. And to be able to breath, excuse me, but with the weight problem, my lungs can't expand, I get breathless, and they are shrinking because of the weight. No surgery and I won't be alive within the next 2 years, with surgery I would be able to live longer. Because I have so much scar tissue, he is afraid to do the open, which is all he does, and I can't have the laporscopic done. I want to cry, to scream at the unfairness of it all. Everything I have read from y'all has been insurance denials, what about having 3 Dr.'s turn you down. It's not fair. I am I need I don't want to give up, but it's like God is closing the doors for me. Kathy

Hey woman Do you have a case manager???? I can't stress how awesome they are or atleast mine was. If you don't get one you tell them your medical history and they will find a surgeon that is willing to operate on you. My problem when I first started this process was my BMI was too high for any local surgeon to touch me. So I got a case manager and in less than a month she had found a surgeon that would take me. If you need anymore info just let me know. Also I don't know about the psych evaluations. My surgeon didn't require us to go to a certain one. All I had to do was have one done and I took it to her. *huggles*

damn damn damn............i am so sorry Kathy..........I have to agree with dixie; call Tn Care and get a case manager...................Kelly

NOOOOO don't call TNcare look in your provider book there should be a number to the Case Management Division. If not email me and ill give it to ya. If you call TNcare or Bluecare direct they will just give ya the run around. You gotta call case management directly.

Ya'll... Hmmm... I don't think its TennCare giving her the problems. It's the doctors telling her personally, they don't feel comfortable doing the surgery on her as a patient because of her medical promblems. So... What will a case manager do for her? Hmm nothing. A case manager can't change a doctor's mind. I'm not trying to be negative here but from what I read in her posts, that is what my understanding is. Anyways, Kathy - Have you seen Dr. Hruska in Clarksville? I know its a pretty far drive from you but maybe she'll be able to help? I can't promise you it but it's worth a try and she takes TennCare! She won't require you to go to a different shrink either, just as long as she can have a report from it... However, hon - I can understand the reasoning they want you to be able to walk because walking is SO important after surgery. You gotta get those legs moving, in order not to get a blood clot, which I'm sure you understand. Good luck hon! And don't give up, you know were here for you! -Katie

TnCare wasn't giving me problems either when I got a case manager. I was having problems finding a surgeon that would take me. My case manager did the footwork for me. She called up surgeons in the network told them my medical history and found one that would take me knowing that. Case managers are not only for if you have issues with TNcare or your MCO they are there if you are having problems getting the medical care you need no matter what end of the spectrum you are having a problem with.

yes Dixie, I would love a number to call. I am going to die fighting the unfairness of it all. Thanks, Kathy

Thanks y'all for everything. My emotions are so out of whack from the frustration and the unfairness of it all. I apprecate the help, and advice. I just can't think anymore tonight, the pent up emotions are really wanting to vent, I think I can find a few things that I could throw to break. love y'all so much, Kathy

Kathy, i wish there was something I could do for you, even some advice I could pass along that would make the difference, but alas, I don't have any. What I do have is compassion in my heart for what you're going through. Please know that someone out here in cyberspace is rooting for you, and please keep us posted. Hugs Carol

Kathy, sweetie, I'm soooo sorry to hear you've been turned down again. Before we moved I worked for a 5 physician family practice and was in charge of all referrals. I had several Tenncare patients that I was unable to find specialists willing to accept them. Tenncare has whats called a outbound or SAMS unit. Their job is to locate specialists for patients when noone will accept them. When you call they will ask you what surgeons you have attempted to see. Give them the names, etc that they need, and they will help you find someone that will accept you as a patient. If I have to hold yard sales and bake sales and stand outside Walmart with a bucket, this will happen for you! Keep your chin up babe! We're here for you! Love ya! Melanie