managed care is a pita!

<p>Took my son to the dr for a bad back last Tues. It had been hurting for several weeks or more, but had gotten worse. The dr "adjusted" him (he's a DO) and it felt better for a day. The next day it was worse than before he saw dr, back to where it was the weekend before. Went back to dr. He adjusted him again and it didn't help. Dr thinks his hip (sacroiliac I think) had been out of place (possibly from football hit while in stride) and it went back in when he adjusted it Tues and was out again Thurs. Anyhow he ordered an MRI to rule out a stress fracture, though he SAYS he doesn't think that's the problem.</p>

<p>Son has back pain ever since. They dr office supposed to get pre-cert for MRI. I hear nothing Friday. I call insurance today and they have nothing in system. Called dr, the lady says they use a separate company for pre-cert. Call that company. Nothing in system. Call dr, she says I should not have called that company and it could make it take longer. I express my concern that my son is the toughest kid out there and if he is in this much pain then there is a problem. Tell her he is in new school with few friends and I don't want him missing classes due to back pain or depression from pain etc. She still claims she put it in the system and we should hear today. She calls me back after a while and WE DON'T NEED THE PRE-CERT! Are you kidding me? He could have had the MRI last Fri or even Sat, but it's not until I pester them that we find out we don't even need it? OMG!</p>

<p>He plays football, and we can't trace anything back to an injury that caused back pain. He had some hits and did fall on his back after a hit, but nothing out of the ordinary. He has been lifting heavier since fball ended. I sure hope it's not sport ending, and I hope he's not on the road to lifelong back issues. A stress fx apparently can heal with no problems, but stopping my boy from working out will be next to impossible.</p>

<p>It has me stressed out and I needed to vent. MRI is tonight, after I figure out if I can get out of working or hubby can get home early. Jr doesn't have a car at school. I want it done asap because nothing happens fast (like reading it, getting report, getting appt w/specialist)</p>

<p>It's aggravating. I take thyroid meds and I just get my blood tested every year. But my dr makes me see him to physically write the script. I wanted to ask if I could just mail in the cost of the visit.</p>

<p>Take this for what it's worth, my sil is a chiropractor and she's given me the song and dance, but I think they can be very dangerous. It just can't be right to force your joints like that. And many times doing nothing is as effective over a few weeks.</p>

<p>It's time to see an ortho sports med specialist. Backs are nothing to fool around with.</p>

<p>and they wonder why so many go to the ER instead of through their primary MD!! If you went to the ER, you would have paid the ER co-pay (usually more than the MD co-pay if not admitted to the hospital), but would have had the testing done right then!</p>

<p>If it's a fx he should have xrays, also. I would guess the DO did that before the adjustments?</p>

<p>The report of the MRI should be online if your hospital is on electronic records, but you should request a copy of the MRI at the time it is given. It will be on a CD and it will just take a few mins. to be available if you ask when you first arrive. If you see somebody who practices at another hospital, he may not have online access.</p>

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and they wonder why so many go to the ER instead of through their primary MD!! If you went to the ER, you would have paid the ER co-pay (usually more than the MD co-pay if not admitted to the hospital), but would have had the testing done right then!

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<p>Wrong. This type of injury would have been referred to a specialist. They would not have done the MRI in the ER.</p>

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If it's a fx he should have xrays, also. I would guess the DO did that before the adjustments?

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<p>Stress fractures don't normally show up on x-ray.</p>

<p>hops- depends on the hospital that he went to. I have seen many MRI's done by hospital ER's for lesser complaints.</p>

<p>"Stress fractures don't normally show up on x-ra"</p>

<p>And you got your M.D. where?</p>

<p>It's still a good idea to have one.</p>

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It's still a good idea to have one.

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<p>Before you start manipulating vertebrae I would agree with you!</p>

<p>And no MD needed to know that stress fractures rarely show up on x-ray. Rather an MRI or a bone scan is often needed to properly diagnose stress fractures. </p>

<p>I am a licensed healthcare provider who has dealt with stress fractures numerous times in both distance runners and gymnasts...</p>

<p>He was moving him this way and that and I thought he was evaluating him, I didn't realize he was "adjusting" him until he was leaning on his leg while on his side.</p>

<p>I am anti-chiro also...so I'm worried he made it worse. Apparently DO's are trained in manipulation and are supposed to consider medical reasons first. He seemed certain his joint was out of whack and that he put it back. Hopefully he is right and it is just still annoyed and will settle down...</p>

<p>I looked it up, and the dr said, that the mri is the best way to rule out stress fx. I think even if the xray showed it an mri would be necessary for the treatment phase, and if it didn't show it then an mri would still be needed to be sure.</p>

<p>I sure did consider the e/r!</p>

<p>He said today it is hurting but it is in different places, like it's moving around. He could barely bend over to tie his shoes. I'm now trying to get an ortho to see him asap...</p>

<p>Anybody have experience w/stress fractures of low back??</p>

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Anybody have experience w/stress fractures of low back??

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<p>Stress fractures of the low back are often referred to as spondylothesis or spondylolysis. But if he has significant pain with bending forward, it may not be a bony injury but rather a disc. Spondy's are often most painful in back extension and disc injuries are often painful in forward flexion. </p>

<p>I would definitely see an orthopedic physician...</p>

<p>You haven't mentioned it, but is he icing his back, 20 minutes at a time? That would help, a lot, you'd be surprised.</p>

<p>Regarding the thread title, I've had managed care for over 25 years, and while there are a few more hoops to jump through, I have had 4 surgeries completely paid for (except for the hospital telephone bill, and now there is a $250 in-patient co-pay), but compared to tens of thousand of surgeons' bills, not bad. I do have to get pre-authorization for my annual MRI but it has never been an issue.</p>

<p>it's not so much jumping through the hoops, it's finding the hoops, or hoping the people holding the hoops know what they're doing...Today I talked to the ins co, the pre-cert co, and the dr office-several times. All to find out we didn't need the pre-cert and could have had the test Friday!</p>

<p>He isn't icing it. He knows everything, after all he is 18, so he must know everything right? I took him a cold/hot pack and a water bottle. Doubt he's used either. I will re-suggest it to him. Hopefully nothing is fx or herniated and the dr will give him advice he will listen to.</p>

<p>As many as 10% of young athletes have spinal stress fractures, including my oldest 2 years ago. These largely go undiagnosed, treated with rest and ice. By the way, the x-ray showed nothing. His was caught on a CT scan (MRI is also hi-res and will be able to see it).</p>

<p>Treatment ranges from a couple of months in a brace to many months, back stimulators, even surgery. Don't let him get adjusted again - if a fracture displaces the prognosis is way worse.</p>

<p>Where's his pain? Mid or lower center or off to the side? I would see an orthoped with an emphasis in sports medicine soon. Also, many orthos like to read the MRIs themselves as general radiologists can miss things. DD12 has had 2 hip surgeries (2010 and 2011) for FAI which both started as lower back pain off to the side. She is a swimmer.</p>