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I am under enough stress right now, but to have my husband call and tell me how to handle things, and who can come play with the boys, and who I should call to come over to play with the boys is really getting on my nerves!
I am an adult, I can make these determinations on my own.
I know he is stressed as well because the insurance company won't pay for my surgery, but geez! Don't poke and prod to try to start an argument.
He will be home for 10 days starting tomorrow, and I am not looking forward to it! He will be on me constantly, do this, do that. Me me me. He wants sex, "oh it hurts you, oh poor me, let me run down the list of things you are doing wrong, if you don't satisfy my need" Me me me.
Do you love me, do you want to be with me, do you like me. Me me me.
You don't show me enough attention or affection. Me me me. I know you do a lot of things for me, but.... Me me me. I want you to show me love and affection like you do our boys. Me me me.
WHAT ABOUT ME? WHAT ABOUT YOUR WIFE? DOES IT MEAN ANYTHING THAT SHE IS IN AN EXTREME AMOUNT OF PAIN? DOES IT MEAN ANYTHING THAT YOU ARE CAUSING HER MORE EMOTIONAL PAIN THAN SHE CAN BARE?
Grow up, look around you, there are other people in the world besides you, these other people have needs too.
Here is the letter I wrote for G to send to the committee in hopes they will help us to get the decision of the insurance overturned...
Dear Values Committee:
My name is ......... I am writing to you hoping for any assistance regarding the denial of benefits from United Health Care. The procedure is for my wife R..., who is suffering with two herniated discs in her neck. The surgeon recommends a total disc replacement for one of the discs to take the pressure off the other surrounding discs in hopes of preventing more disc herniations, thus preventing further surgeries.
A few years ago R... suffered a herniated disc in her neck, the surgeon at the time recommended fusion of the vertebrae. Which was successful at the time. Unfortunately the fusion of the vertebrae put additional stress on the surrounding discs, which caused them to herniated as well a few years later.
This time we have the advantage of having artificial discs that can be put in place of the damaged disc and still keep range of motion, and thereby keeping stress off the surrounding discs. Preventing further disc herniations. Thus, preventing further surgeries. This is what the surgeon strongly recommends for R...., and says is really her only option to prevent further surgeries.
The problem seems to be that the disc replacements they are now using for the cervical spine are fairly new, but have been used pretty regularly by this surgeon for the last 2 ½ years for the very condition he is trying to treat R.... for. He has had great success with this disc replacement. There is an artificial disc for the lower spine that has been very successful for the last 20 years, and now thankfully there is one for the cervical spine as well. It is FDA approved, and an accepted, and approved procedure by many other insurance companies. Yet United Health Care refuses to recognize it as an accepted procedure. It costs the same as a fusion surgery, and has a better outcome for the patient, and virtually negates any need for further surgeries, which would most certainly be needed with a fusion surgery. Yet United Health Care refuses to recognize it as an accepted procedure, and does not consider it a covered benefit.
We are currently appealing this decision, but we are running out of time. This process between the surgeon and the insurance company has taken months, just to find out it was denied. We are still waiting on the decision of the appeal. In the mean time R.... is experiencing debilitating pain, and loss of mobility. She is a stay at home Mother of two young boys and is finding daily activities extremely hard to accomplish.
Due to the severity of my wife’s condition and the hope to avoid a reoccurrence we have been forced to schedule the disc replacement for October 28th because we simply can not wait any longer. The pain, and limited mobility is too great for my wife to endure much longer.
I was told by United Health Care that since (Airline) is self insured and United Health Care only administers the policy, (Airline) has the ability to make an exception to their denial.
Today I spoke with S.... C... from (Airline) Benefits about this situation, and she said United Health Care is mistaken. She said (Airline) does not have the ability to overturn a denial.
S..... was very helpful by offering to try to expedite our appeal with the insurance company, and offered her assistance with an other questions we might have.
Again, due to the severity of my wife’s condition and the hope to avoid a reoccurrence, we have been forced to schedule the disc replacement surgery for October 28th because we simply can not wait any longer. The severe pain my wife is experiencing can not be tolerated indefinitely.
Any assistance you could provide us would be greatly appreciated. Thank you for your time in this matter.
Sincerely,
G.................
Comments
Surgery is scheduled for October 38th!!!
We talked with the surgeon Friday about the fact that my insurance won't pay for total disc replacement. He said he could do another fusion, but that he would have to fuse both places that I have a herniated disc, and if he does that, it is a guarantee that I will be back in a year or so for another herniated disc, not to mention the loss of range of motion. So really the only real solution is to replace the disc below the fusion site, and leave the disc above for an indefinite period of time. Since most of my symptoms are from the disc below, he wants to operate on that one and says there is still some life in the disc above.
The surgeon talked about the cost of the fusion verses the disc replacement. He says they are exactly the same cost, and he does not understand why insurance companies don't cover it just as they do fusions. He says the disc replacement has been FDA approved, and it was approved for cases just like mine.
The surgeon said that he would wave his fees for the surgery, there will still be minimal charges for his services, but it won't be the $25,000 that he would bill the insurance. He also let us know that though he would charge the insurance company, he never gets paid the amount that he charges, in reality he gets maybe 1/3rd of what he charges. So he will wave all but the charges he legally has to charge, and that he can write off some of that. Then we have the hospital bill which could be as high as $50,000 or as low a $30,000. So I am trying to get in contact with a woman that works in the billing department to find out what our cost might be, and what kind of payment plans they have etc.
Originally they had me scheduled for surgery December 3rd, but someone called and postponed their surgery, so since I was on the cancellation list, they called me yesterday afternoon at 4:30 to see if I would be interested in moving my surgery up to October 28th. This was great news, but is leaving us little time to fight with the insurance company to try to get them to pay for this surgery.
G called his company and talked to them about this, and got a big fat NO. He continued to talk to them and explained that this is not something we can lay about and think about for any period of time, he said that this is debilitating for his wife and we don't have the luxury of having time to squabble about this, we need to get this resolved right away. He got no where.
G told me, not to worry about this, we will figure it out, one way or another, it would be ok. He is being very kind about this, very understanding.
Well, he should be very nice to me, especially since the night before we were up till 1am 'discussing' things. The day started out with me telling him not to sit and look over my shoulder while I paid bills. I never like anyone looking over my shoulder while I do anything. (especially not him!) So he goes on about why don't I want him in the room? What am I trying to hide. NOTHING!! I just don't like him sitting there questioning everything I am doing!! I told him I would be glad to explain and show him what I did, and how I did it when I am done. I told him I don't want to try to show you while I am doing it because I don't want to make a mistake. He didn't get it but eventually left for a few minutes. He came back though and watched me as I was finishing up. I showed him how to do a couple of things to pay the bills on-line, and then I showed him the Quicken program and what I did there. Well on the left side of the page there is a column for our checking, savings, yearly savings, and credit card, and under that there is a negative 2,000 something. Well he asked me "what, do you have another credit card?" I told him no in an insulted tone. He said then what is that number under the credit card balance? I said I am not sure, I think it is the difference between what we have and what we owe on the credit card. He made a couple of other comments that made me think that he does not believe me. Then he goes on to criticize other things in the program and point out a couple of errors I made. And then basically say that he can't trust me to do the bills and keep track of our money because I don't have everything right. He says you can't make mistakes with the money, you have to pay closer attention to what you are doing, mistakes with the money are not acceptable. Ok the mistakes he is talking about are accounts that I set up to keep track of how much we have paid on the lease of the car, another one is of what we owe on the loan to his dad. These accounts have no bearing on anything, the sole purpose of these are to just see how much we still owe, it has no affect on anything, and in all reality if the balance is not right, it will not cause any problems. Anyway, I made a mistake and didn't put what we paid in interest a few times on his dad's loan(money his Dad loaned us so we could buy the land our how was built on) so I didn't have the correct balance. Anyway, those mistakes in no way affected how much money we have in our accounts, nor did it cost us a penny. But I am not allowed to make mistakes.
So I was not in the best of moods, so later when he asked me an insulting question, I snapped at him. Then later when he saw that my parents had bought the boys pez dispensers along with the Halloween costumes, he asked in a accusatory way, " so WHAT ELSE did your parents buy?" I said nothing, just that and the costumes, in a very irritated tone of voice. Then later he said something else accusatory and insulting and I answered in a snotty, irritated tone. So he went downstairs to make the fire for the night, and I went with him, he asked me why I have been so snappy to him. I tried as best I could to explain it, and he of course blamed everything on me, and poor innocent him is just sitting there wondering why, what did he do. I said you know, I was irritated this morning by our conversation about the bills, and also I was upset about him having a beer at his Dad's earlier in the day. I said you promised me you were not going to drink anymore! He said he sees no problem with having a beer after getting some things done for his Dad. I said you promised you would not drink anymore and you have been doing so. He said he didn't see any problem with it, especially since it was just one, and I was there with him. I said that doesn't make it ok, you promised you would not drink. So then he goes on to point out that I have not kept some of the promises that I have made to him. I said we are not talking about me, and this is an easy on to keep! I said you have been drinking while you were at work too haven't you. He said yes, but like today it is just one, once in a while. He said this is something we need to come to a compromise on. I said no, I will not compromise on this one, it is caused this family too much damage to compromise on this. I said you may start out with just one beer, but then it will be two, then three, I said I have been down this road with you before. I said I will not go through that again. He asked me why it was so important to me, I said because I worry that it will damage your health, it has hurt me, hurt the boys, and we all deserve better than that. I said it has caused a lot of damage to our marriage and we don't need that again. We have enough problems without adding alcohol to it. Earlier in the day he sent me to the store for some snacks. He was in a crappy mood before I left, when I got back he was happy as can be. I smelled alcohol I know we don't have beer, but we do have the rum he brought back from Puerto Rico. So I had already marked the bottle at the level the liquid was before he came home because I have suspected he has been sneaking drinks from that bottle. So when he wasn't looking I checked the bottle. Yes in deed he had drank probably two shots worth out of the bottle since he got home. I didn't say anything at that point, but I did ask him when we were down stairs if he has had anything to drink today, yesterday, last week, etc. To which he lied to me and said no to all! I did not call him on that, which was my mistake, but I got up the next morning, and was going to confront him about it, but he had already dumped the bottle out, and showed me the empty in the garbage, like aren't you so proud of me. So there went that. But I know that he lied to me, and I know he has been drinking at work. (Not while he is flying, but after he is done for the day)
Anyway, he went on to try to argue with me about drinking and he should be able to have one every once in a while. I said no, no drinking at all. He said or what are ya going to do. I said I don't know, but I won't have alcohol in the house. I said, I am not going to drink either. I said you promised in counseling that you would not drink, you broke that promise. He started to bring things up about me that he doesn't like, trying to deflect the attention off himself. Trying to point out all my failures. Oh and did you know, he does laundry??? NO HE DOESN'T!!! I know, because I DO IT!! Yeah, he threw in a load a week ago, and I finished it, but he hasn't folded laundry, and he rarely puts a load in the washer or the dryer, and when he does he shrinks everything!! Anyway, I didn't say that to him, but I did say, that he does not do laundry except to through a load in once in a while. Then he tries another thing that I am not keeping up on, the toys laying around, he says there is no reason that we should have to take half a day to clean up the house before company comes. Now first of all that is not true, it does not take me half a day to get ready for company. It is true that the boys need to pick up their toys, buy that is just what happens when you have children, there tends to be toys laying around. I wanted to point out that he leaves things laying around and I am constantly picking up after him, but that would not help the situation so I didn't mention it. He would just tell me how lazy I am again.
So I got him back on track and said, it is an easy solution to one problem to simply not drink. It is not hard. He says it is embarrassing to be with people that you used to drink with and not have a beer. I said, they should understand. They order a beer, you can order a soda. Not a big deal, and I bet if you told them that you quit drinking alcohol for health reasons, they would totally understand. I said you don't have to tell them the real reason you quit drinking. Besides, beer causes your stomach to hurt anyway, with the GERD. You shouldn't drink for that reason alone, I would think. I said I don't want to take a hard line about this, but I will if I have to. He said "Don't you demand that I do something! You can't tell me what to do or not do! If you take a hard line about this there is going to be trouble." I said, well we will see about that. I went on to remind him what he said in counseling about not drinking, and what I should do about it if he did. He said you better watch what you say and how you say it or I am going to get mad. I just went on, and said you told me how to handle this if this ever came up. I said I am just doing what you said for me to do. In fact, I am being very lenient about this. No more, I said I will not sit back and say nothing if you drink. I said I will not live with alcohol in our lives. I will not stand for it. I said I can't go through that again, I won't put the boys through that again, and I would think you wouldn't want to go through that again. I said I am asking you to stop drinking, period. I will not go through the violence again. He eventually said ok I won't drink again. He asked me why I chose this particular thing to take a stand on when there are plenty of other problems in our marriage that need more attention and discussion than this one. I said because this one is very easy to solve, you just don't drink, at all. It is easy, there are no emotional issues to get in the way, you just don't drink. He tried to go on to say there are other easy solutions to other problems like my parents, we should not see them so much when he is not here, etc. I stopped him dead in his tracks. I said I will not isolate myself from them.
Anyway, it came to an end finally at 1am when I pointed out what time it was, we were in a lull in the conversation, and as far as he was concerned ending on a positive note, with me agreeing to show him how to pay the bills, and how to work the Quicken program on the computer so he can do that while I am healing from surgery. He just feels the need for more control. I have no doubt that he is fishing for more control and the story about the credit card shut off may just be a cover, a way to make sure I have no money to pay for a lawyer. He does not realize that my parents are ready to pay for the lawyer again. If he wants to take over paying the bills, that is just fine with me! Less hassles for me! And I know how to do all the programs so I can keep an eye on things, and I will know what is going on. Anyway, he may think he has something over me, but he has no idea that my parents are right there, ready to help me in any way I need.
He said again, "If I didn't know any better, I would think you were having an affair." I laughed at him. He said, "Well I said, 'if I didn't know any better.' I wasn't accusing you." Ok another red flag that he might be cheating on me ...again ...still. Not sure what to make of that, but I do know it is a classic sign of a cheating spouse to accuse the partner of cheating. Kinda fishy if you ask me.
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First, it's horrible the insurance company won't pay for the surgery. Makes me wonder why people have insunce in the first place. It sounds as if G will never change. I hope that once you heal from your surgery you'll leave his sorry ass. He doesn't deserve a good person like you, and you don't deserve to be with an abusive control freak like him. I'm so happy your parents remain in your cornor lending you all the support you need. How generous of them to offer to pay for the lawyer. I wish you a quick recovery. Please take care of yourself.
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Becky Becky Becky!!!!!!
I agree that it is terrible that your insurance company are giving you such a hard time. Now correct me if I am wrong, but isn't it the doctor who should be the one to say which surgery is the best, and which one is needed for this problem at this time??? GRRRR, The who insurance thing makes me so mad!!! Anyhow, you are very lucky to have such a kind and understanding doc! I hope the surgery goes well, and that you have a speedy recovery, and when all is said and done, No more pain!!!!!
OK, moving on the the other pain.... Your G sure seems to have a control issue!! I can understand fully why you might make a mistake with him hovering over you. Like you tried to explain, the mistakes had no bearing whatsoever on the outcome of your monry situation, so he should have no problem with it. But if he thinks he can do a better job, let him... This very thing happened at my house about two years ago. At first I was very hurt that he wanted to take the bills over then I said, WHAT??? go for it! I hated doing them anyway. He still grumbles when doing the bills, but I just go about my business, laughing to myself!!!
The whole drinking debacle kills me. Here, he has made promises to you, and to your family as a whole, that he would stop drinking. He should be able to handle that. You know it seems funny that this guy wants all the control, yet isn't willing to take control and responsibility for his own actions!!! As usual, he is badgering you. Good for you for not backing down! GO BECKY!!!
As for him telling you that if you made a big deal out of his drinking, and kept on bugging him about it, there would be trouble... that is a threat. That can be reported to the police department. He broke a rule that was settled upon in couples counseling, and you are just trying to keep him healthy, honest, and keep his promise... who does he think he is??? GRRRR I wanna come yell at him!!! LOL!
Well, Becky, I still say that you will one day be inducted into sainthood for putting up with this man, yet at the same time, being a terrific wife and a wonderful mom!! Boy, if you do decide to give him the boot one day, he will be lost. Then see how fast he will try to crawl back... But bottom line, I just want you and your two sweet boys to be ok! It is wonderful that you have parents who are willing to help! You keep your chin up my dear! Surgery will come soon enough, and you will be on the road to recovery! I am so hoping that you will feel much better once this all over with!
You take care Becky. Talk to you soon, k???
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Becky, I wish I were healthy enough to learn how to do the bills with the computer software. My hubby has complete CONTROL over this issue in our so-called marriage! I do worry about things constantly here at home because of what he's told everyone else in our lives! You are so very fortunate to have the support of your parents. I do hope your surgery goes well for you. I will keep in contact as much as is possible with you, Do you hsve an e-mail? If you could message it to me, I'd love to keep in contact with you that way as well, if you don't mind?
I'll definitely try to do my best to keep in touch, tho my health keeps me limited to do as much as I can.
Huge hugs N God Bless You
Kim xoxoxoxo
I started today in a good mood. Yay for me!!!
I took the boys to school, dashed over to Bible Study, had a wonderful time with the ladies. Dashed back to pick Clay up from school, had lunch and read some books, talked about what he learned from the firefighter that was in his class today. And did you know his fire truck is "HUNORMOUS!!!" Not huge, 'hunormous'. lol He told me all about the fire truck and what is on it, and what all the stuff does, and said if fire is on your cloths you should "drip, drop, and roll". lol I said do you mean 'stop, drop, and roll'? Oh yes that is what he meant. lol (like duh mom) Clay was sure that we needed to go to McDonald's for lunch, and as I tell him most days after school when he asks me that question, I told him I don't have any money to get Chicken-n-Fries. Clay looked at me and in his most earnest, serious tone he says "Momma, I have dollars, you can use my dollars! We are a team, and we can share our money, you can use my dollars!" He looked at me with those pleading eyes. Ugh, but if I give in this time he will expect to get McDonald's every lunch after school. So I said "ya know bud, we need to save going to McDonald's for a special day." He said to me with those angel eyes, "today is a special day." But I continued to drive home and we started talking about other things, and soon he forgot about eating out. Oh what a charmer he will be when he gets older. lol Watch out ladies!!! lol When Cole got home from school, Clay told him that we didn't go to McDonald's because Momma didn't have any dollars, Cole MR. Smarty Pants that he is said, "Momma why didn't you just go to the bank and get more money, they have money for you there." lol AAAAAhhhhhh
The boys are just too cute!!
Cole got another 100% on his pretest spelling test!!!
I am just too proud for words!! 3rd week in a row!!!
This evening I am feeling a little green around the collar. I don't know why I feel yucky. My tummy just does not feel good. Came on suddenly this afternoon. This may be because my husband is coming home a day earlier than I had thought. It may be because of the growing tension and stress. It may be because I have an appointment with the surgeon on Friday to figure out what to do about my neck. What it boils down to is my anxiety is rearing it's ugly head again. I have lost 4 pounds in a week. Which right now is good because I gained 30 pounds from a medication I was taking a while ago, but still, once I loose some weight, I want to stop, not keep loosing as I had before the medication. Anyway, I will not be on tomorrow (Oct. 7-10) trough Friday. He leaves again on Saturday, so I will talk with you all Saturday.
Oh well, I am going to try not to let this ruin my evening!
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Aw Becky...Those stories of your boys captured my heart... so cute! What a speller you have on your hands. In a few years he will be on my TV screen competing in the Scripps National Spelling Bee!!! You have every reason to feel proud!
I am sorry that you are not feeling well this evening.. I would bet that the anxiety of G coming home could do that to you. I think you should pack up those cute boys, and come live at my house! What fun we would have, and I would promise to never torment you!!! It's fun to daydream! I will miss you the next few days. Please let us know how you make out with the surgeon... I will have my fingers crossed for good luck! Feel better, and see you Saturday!!! xxxx
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hey hun, sounds like you doing a bit better...hope everything goes ok once your husband gets home....i will be thinking of you....let us know what the doctor says ok.....??? lots of love..jann
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What a couple of sweeties you have. ;)
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Kids can always make us feel better. Thanks for sharing the story with us and good luck on feeling better with everything.
I think that you need to discuss this with a lawyer; he may be able to "bully" them into doing the right thing here, Becky. This is something that they should not be able to say not to, as you have plenty of documentation that you HAVE to have this.
As for G, well, he is never going to grow up, I fear. My heart goes out to you.
LynneC