Jump to content

So Much For My Great Doctor!


GingerA
 Share

Recommended Posts

I recently had a post about a great doctor's appointment that I had where that doc to me seriously and how great it was. I got some sample of cymbalta at the appointment and have been taking them for about two weeks. I have got to tell you that I have felt the best in the last two weeks than I have in two years. I did not realize that I had so much pain in my body until it went away.

However, during the two weeks I also had a nerve study and an MRI that of course turned out negative so now the doc won't fill the prescription for the Cymbalta. The pharmacy says the the med is not covered under my insurance but that the doc could write and override and it would pay for it. The doc says he can't because he has to follow some sort of protocol. I understand that sometimes you have to try other things to see if a cheaper med can be tolerated but I have tried all sorts of things that don't work! I don't know if he now doesn't believe that I really have pain or if it is really just red tape! This is just crazy!!

Link to comment
Share on other sites

Unfortunately, you have to follow the system of insurance. You can do the other trials and WHEN they don't work - he'll write that letter and it will be proven to the insurance that you've tried the others and the only one that works is this one. Then wal-la you've got your meds paid for. Do it, if it helps that much. It's just how the system works.

It won't take long to go through what you have to try.

Link to comment
Share on other sites

Confused - he tried a medication on you - it worked and now he's saying, oh sorry too bad? What did he give you the sample for... something he assumed would show up on nerve or MRI studies, but didn't? What kind of pain are you having? If it's nerve pain, it can be small fiber neuropathy which wouldn't show up on an EMG or MRI.

Link to comment
Share on other sites

Naomi,

I guess that is what he thought. He told me the day that he gave me the samples that I had fibromyalgia as well as POTS and scheduled the tests. I know little or nothing about fibromyalgia so I don't know if the test was suppose to back up the diagnosis or what.

I severe pain in my neck and shoulders with muscle knots at least twice a week. Pain in my hips and knees like my joints are coming out of place. The skin on my upper arm and thighs are always sore to the touch like the are bruised. But my whole body just aches all the time.

Maybe i am just crazy!

Link to comment
Share on other sites

No Ginger, you're not crazy and the cybalta kinda confirmed his suspicions of FMS. That is one of the best treatments for FMS. Some do really well with it. It's a miracle that he hit on it right away and that you responded so well. Count it as a blessing. Your symptoms do sound like FMS. I have it also and I also have EDS.

It's just in the USA - insurance RULES. And, he does have to go through the steps to get you approved for it. It's just how it works.

Link to comment
Share on other sites

Ohhh.. fibromyalgia - your symptoms sure sound like the descriptions I've read. And so sorry for your pain. I still don't get the logic - if he needs evidence and there aren't any diagnostic tests to prove fibromyalgia, how would you ever get the medicine. So what is he going to give you?

Link to comment
Share on other sites

My insurance plan covers Cymbalta for fibromyalgia, however it really just made me too sleepy to function. DH took it for his pain and depression until our insurance prescription planned changed this year, making the Cymbalta really inaccessible to him (considering co-pays on all the 'must have' Rxs). Some doctors are willing to try and others take the low (easy) road. My insurance wouldn't allow a sleep agent until I had failed results or intolerance to its lower level one first (Temazapam). I'd started out after sleep study on Ambien which is in the same 'level' as the new sleep agent the doc was going to try for me. I had to call her back, remind her that I'd taken Ambien (had sleep walking, talking, eating, the whole 9 yards and that was before doctors were 'alerted' to these possible side effects. After that I went to the gentler Temazepam (Halcion) that they use in elderly in hospitals/nursing homes, but there are times when it just does not get me in to sleep. Then I'm still drowsy all the next day. I have a pretty good pharmacist and kind of 'lax' doc who won't even fax Rx's to Express Scripts. So I usually play dumb now and rather than call, drop in the doctors office with the form filled out, show them where doc needs to sign/put ID no. and where to fax.

DH came off Cymbalta cold turkey when deductible and co-pay went so high--despite pharmacist's/my warnings you can't do that. He's been on it for at least 2 years. He had terrible withdrawal for a week before he had to go back to his doctor (another co-pay) and get a new Rx for something generic. It seems to be helping him in some ways but he kept punching me in the back in his sleep last night (he has hyperspasticity in his arms and legs) so in some way I don't think it is relaxing him as good as the Cymbalta did.

I wish you well.

Link to comment
Share on other sites

Join the conversation

You can post now and register later. If you have an account, sign in now to post with your account.

Guest
Reply to this topic...

×   Pasted as rich text.   Paste as plain text instead

  Only 75 emoji are allowed.

×   Your link has been automatically embedded.   Display as a link instead

×   Your previous content has been restored.   Clear editor

×   You cannot paste images directly. Upload or insert images from URL.

 Share

×
×
  • Create New...