Question:

Too Old??? medicare pays for alternate therapy for chronic health problems. If Medicare does not approve of a procedure the HMO does not either. shirley

Response:

Probably that they don’t care much about my deviated septum because they are pretty sure it’s not related to my primary problem, which is neck and shoulder pain. This week i went to the doctor and my goal was to ask for the required paper to see a physician. He did not want to and gave me a prescription instead. I tried to explain him that i want to fix the problem, not mask it with pain killers. It’s frustrating. He did not realize that i’ve been suffering for many years, that my condition is serious to the point of quitting my quality job. But don’t get me wrong i’m not complaining about doctors, i appreciate their services. They must see so many people every day that they can’t feel every patient distress correctly. It’s normal. Back to my problem, i went to see another doctor today. He gave me a paper to see an ENT about the deviated septum, good news. About the neck and shoulder pain i was told to make exercices and watch my posture at computer. Looks like the solution to a complicated problem might be simple. Thanks for reading! Matt

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My husband has a deviated septum. He is a Senior and Medicare would not pay for it. They pay for nasal meds with steroids in  it.  Its been 10 years now. shirley

Response:

On Sun, 17 Jul 2005 10:03:07 -0400, thebagladyshirley…@webtv.net (Shirley Thebaglady) wrote: >My husband has a deviated septum. He is a Senior and Medicare would not >pay for it.

*If* he needs and wants the surgery (after a couple of opinions at least), he should appeal. You will probably find that the policy is along the following lines: "Aetna considers septoplasty medically necessary when any of the following clinical criteria is met:    1. Septal deviation causing continuous nasal airway obstruction resulting in nasal breathing difficulty not responding to appropriate medical therapy; or    2. Documented recurrent sinusitis felt to be due to a deviated septum not relieved by appropriate medical and antibiotic therapy; or …….." – Hide quoted text — Show quoted text ->They pay for nasal meds with steroids in > it.  Its been 10 years now.

Response:

My Hubbys nose seems to close up at night and  he cannot breath through his nose. He elevates his head at night now  and uses Rhinacort so he does not get nasal infections` anymore. His doctor that did the fungal surgery appealed to Medicare but they still said no. shirley

Response:

On Mon, 18 Jul 2005 06:56:24 -0400, thebagladyshirley…@webtv.net (Shirley Thebaglady) wrote: >My Hubbys nose seems to close up at night and  he cannot breath through >his nose. >He elevates his head at night now  and uses Rhinacort so he does not get >nasal infections` anymore. >His doctor that did the fungal surgery appealed to Medicare but they >still said no.

On what grounds?

Response:

"Matt" <matio…@hotmail.com> wrote in message

news:[email protected]… >I had constant shoulder, neck, jaw and eye pain for more than 10 years, > mostly on right side. Also my right nostril is often congested for no > reason (no nasal discharge) and i get frequent nosebleeds on the left > side during winter. I was told by two doctors that i have deviated > septum, and this is the cause of my congestion/nosebleeds. Also had > scans for my sinuses, they are clear. They don’t seem to care much > about it. > However, could a deviated septum cause severe muscle pain down to the > shoulder? The facial pain and pain behind the eyes is realistic, but > what about neck and shoulder? I don’t think this is realistic, but i > wish it is! I would not hesitate to have a surgery done then. > Hoping to find answers to run away from hell. Thank you.

Unfortunately, as a doctor I can’t give advice on the Internet regarding your medical problem, but I would advise you to see a different doctor. Several things come to mind which haven’t been pursued by the doctors you’ve seen so far.  You could either start with a primary care physician (FP or IM), or go straight to a neurologist. This problem of doctors not seeming to care is pervasive.  It results from declining reimbursement rates of insurance companies (which take their lead from Medicare) for primary care physicians, and the consequent need to see lots of patients every day (15 minutes per patient seems to be the best you can do nowadays and still stay in business).  However, ultimately the problem is with the individual physicians, who need to find a way to practice within the constraints of the system and still give their patients good care.  My approach is to ask patients to come back frequently.  The down sides to this approach are (1) the patient has to be lots of co-pays for lots of visits, and (2) you can’t get everything done right now that you’d like to get done.  But I see no better solution.  There’s really no excuse for a doctor not seeming to care, in my opinion.

Response:

On 13 Jul 2005 16:44:06 -0700, "Matt" <matio…@hotmail.com> wrote: >I had constant shoulder, neck, jaw and eye pain for more than 10 years, >mostly on right side. Also my right nostril is often congested for no >reason (no nasal discharge) and i get frequent nosebleeds on the left >side during winter. I was told by two doctors that i have deviated >septum, and this is the cause of my congestion/nosebleeds. Also had >scans for my sinuses, they are clear

That part is good news but have you had the CT scan  looked at personally by a sinus surgery specailist who also examined you?    Sometimes things are subtle. >However, could a deviated septum cause severe muscle pain down to the >shoulder? The facial pain and pain behind the eyes is realistic, but >what about neck and shoulder? I don’t think this is realistic, but i >wish it is! I would not hesitate to have a surgery done then.

I do not know about that part – I have my doubts – but I suspect Dr. Grossan or others may have a comment..  Some of it may not be sinus-nasal in origin. Even if you are just looking at a possible minor septal correction I would sugest only considering having a very experienced sinus surgeon (e.g at a major medcial center) do it or give an opinion on it..

Response:

I had constant shoulder, neck, jaw and eye pain for more than 10 years, mostly on right side. Also my right nostril is often congested for no reason (no nasal discharge) and i get frequent nosebleeds on the left side during winter. I was told by two doctors that i have deviated septum, and this is the cause of my congestion/nosebleeds. Also had scans for my sinuses, they are clear. They don’t seem to care much about it. However, could a deviated septum cause severe muscle pain down to the shoulder? The facial pain and pain behind the eyes is realistic, but what about neck and shoulder? I don’t think this is realistic, but i wish it is! I would not hesitate to have a surgery done then. Hoping to find answers to run away from hell. Thank you. Matt

Response:

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