Saturday, October 23, 2010

Thoracic Outlet Syndrome

So two years ago, I was in a car accident. I was stopped in traffic and I was hit from behind by someone who was going about 45 miles per hour, and was texting, and didn't try to stop.

I was in my old Bronco, and when I was hit, my head went back over the seat and hit the metal brace in the seat.

When I stopped screaming, I wondered what that loud sound had been. I realized that it had been me, and that I should absolutely not move, because I felt like I had broken my neck.

I went to the hospital, and they did some CAT scans and some MRIs on me, diagnosed me with a TBI (traumatic brain injury) and several bulging discs in my neck that were impinging the nerve root.

At first, State Farm was very helpful, and I was able to get the treatments that I needed. In that first six months, we were most concerned about the brain injury, the headaches, and the bulging discs. I developed post trauma Fibromyalgia, which was managed well by acupuncture, massage therapy, soaking in the hot springs and some chiropractic work.

It was recommended to me to get some facet injections into my spine, but because I try not to put any unnecessary medicine into my body, I waited to do the injections.

State Farm refused to pay for treatments up front, and most massage therapists don't do any billing. Over time, as I moved out on my own with my kids, my financial situation changed dramatically, and I was unable to get the treatments that I needed in order to stay in a manageable state of pain.

It has now been a full year since I got any body work, because I simply can't afford to front even $100 to a body worker, let alone the $2200 a month that my injuries are requiring. I did manage to get one set of facet injections, because I hadn't had any body work, the situation in my neck and shoulder got markedly worse, and I was faced with no other option.

The injections helped a LOT, but I'm now sitting on a $10,000 medical bill that State Farm refuses to pay until I get an independent medical evaluation. My lawyer has advised against getting this evaluation, because most of the "approved IMEs" work for State Farm, and its very difficult to get an honest evaluation.

Meanwhile, my orthopedic surgeon has strongly recommended that I get three more sets of injections, which of course I can't do unless State Farm agrees to pay. Over the summer, my left hand started going numb and I began experiencing shooting, stabbing and burning pain through my shoulder, back, neck and down into my hand.

I had to dramatically reduce the amount of massage work I was doing, because I couldn't feel that hand, but I needed to pay my bills. I got the job as the manager at the stables, which is also lots of heavy, hard, physical work, but the team there was amazing, and helped me out quite a bit with the heavy lifting.

In the last three weeks, due to the fact that I can't manage my injuries with massage, yoga, chiro, acupuncture, etc, they have gotten dramatically worse, and now, my left hand is cold, numb and weak most of the time. I can't pick any thing up that weighs more than about ten pounds, and my lower lip, left side of my jaw and ear are going numb.

I am, for the first time, scared.

I called Dr. Raub at Vail Summit Orthopedics and told him, look I can't pay you and I have an existing balance, but I'm very worried about the numbness and the amount of pain I'm in. I was raised not to complain, I believe that the mind has the ability to handle pain if it is properly trained, and so I work anyway, no matter the pain.

The difference is that now, I am physically unable to do the work that I need to. I am exhausted. My stomach is always upset. My body hurts from head to toe, all the time, unless I've been to the hot springs. My left shoulder is weak weak weak, and in pain. There is no position of comfort or rest for the shoulder, and the pain radiates down my arm and into my numb hand.

The question now becomes, how do I pay my bills? How do I make a living, and how in the world do I get the medical help that I need?

Dr. Raub told me to come on in, he wanted to see what is going on. He spoke to the billing department who put me on a payment plan that makes it so my account is current, even though I'm barely paying on it.

Dr. Raub diagnosed me with Thoracic Outlet Syndrome, a direct result of my car accident, and we discussed the fact that it probably would not have progressed to this point if I had been able to do the PT and soft tissue work that my injuries required. Because State Farm wouldn't pay for the treatments my injuries required, I am, two years later, much worse off.

We have scheduled an MRI for my c-spine and my left shoulder, and pending those results, we are going to see a neurologist. I have scheduled another set of facet injections for my low c-spine, so at least the treatments are happening, regardless of the ever mounting medical bills and the fact that I can't do any supportive pain reducing therapies.

They want to put me on Lyrica, which is an anti-seizure medication that calms and sooths the nerves, but the problem with that medication is that the common side effects are confusion, fatigue, and massive weight gain. No thank you, we have five weeks to ski season and this is a tryout year.

I'm already working hard to become more aware and responsible with my schedule, I don't need to add a brain confusing drug that makes you fat and tired. Michael looked up the effects of this drug and told me right off, "Babe, please don't put that toxic poison in your body." and I quite agree. Its a slippery slope to the beginning of the end.

So basically, State Farm would pay for a toxic band aid, but not for massage, which is super effective at reducing the pain without diminishing my ability to do my job and pay my bills and make me sicker.

I'm glad we didn't end up settling the case, as we almost did earlier this year, I was hoping for a settlement that would allow me to finally go get the therapies that I needed, but we decided not to take it, it was such a small amount, it would only cover the outstanding bill and one more set of injections.

It turns out that these conditions, Fibro and TOS, are lifelong issues, both of which can degrade into serious issues later in life. I'm not planning on letting this injury change my lifepath, make me sick, or take me down. And so I'm hanging in there to get the therapies that can get it in check, take the symptoms down, and allow me to do what I love, ski hard and teach skiing, do body work and help people relax and heal.

Michael's gift of Yoga has been an incredible help, and I've been spending my rent money on trips to Glennwood Springs, because every time I put my body in that hot water, I feel immeasurably better, my arm doesn't go numb for hours afterwards.

Its my job to work hard enough to pay my bills and care for my kids. I'm proud of the fact that I get better and better at that, I have some good friends who have given me some excellent advice on saving money over the winter, and I have the opportunity to work a lot at the St. Regis spa. The question is... am I healthy enough to do 8 hours of massage four days a week?

Right now, the answer is no. But the reality is that it's Bodhi's birthday this week, he's turning seven. Its time to put together a birthday, some costumes, and pay my car payment and my rent. And so I go to work.

State Farm says, well, she's working, she can't be that hurt. But what they don't know, or won't believe is that you can work when you are hurt. Yeah, it hurts more. Its hard to use a weak, painful left arm while giving massage, every stroke sends an electric shock down to my numb hand and deep into my ribs and back. But lots of people have to do work when their body hurts. What is the alternative? Not to work? I'm not sure what planet that works on, but here on planet earth, we have bills to pay and groceries to buy.

I'm not upset that I have to work while my body hurts. I don't mind doing what needs doing. What makes me angry is that insurance companies bill themselves as here to help, when really, they are accomplished conspiracy theorists that are fairly certain that because I'm still working, I'm just trying to milk them for money. They think that because I try to do the most minimal invasive medical treatment that I'm not injured, and that if time passes between treatments its because I'm not injured. As opposed to time passing between treatments because I can't afford to do the treatment, or the treatment is so medically invasive that I'm trying to do healthy supportive therapies to reduce the amount of actual big procedures.

So that's the update. The rest of me is strong, excited for ski season, and working hard. I do have to say Than GOODNESS for the Skier's Edge Machine, because I'm keeping my core and legs in shape without doing further damage to my back, neck and shoulder. Yoga helps immensely. Pilates rocks my world and is making my core ready to go hard. MRI on Monday. Game on.


Judy Tannenhaus said...

Kate, You are my hero, so strong and focused. I wish I could take that pain and injury magically away. You are doing all the right things. I am thinking that maybe you may need a more holistic oriented lawyer who can kick that ins. co.'s butt into gear for you. It is rediculous how they treat you and make up rules as they go along. Well, this happens so, then that is true. Not realistic at all. Oh! I am so mad. I have always hated insurance co. of any kind, they are unregulated evil giants and are not our "good neighbors". aaarrh! I want to help you, coming fr. my own OT background, I am thinking you should alternate ice and heat at the core area of injury, maybe teach your boys to do the massage you need. Sleep with a ergonomic supportive pillow. I will keep keep you in my thoughts. Send you good energy. Wishing you the best outcome! Judy

Anonymous said...

Dear Kate,Reading your blog that you are in constant pain from a car accident just broke my heart. There are so few healers that when one is taken down like this, it’s such a huge loss. I just wanted to let you know that I’m thinking about you. Skiing in the Shower has been an inspiration to me. We have much in common, I think. I'm a massage therapist and herbalist too. I'm also older and just rediscovered skiing. Where your love and affinity is for horses, mine is for dogs. My heart just goes out to you. I don't know if it's something you would consider, but there's a tea for inflammation that might help. Email me at and I'll give you the recipe. I hope it helps. Love and light, sister-healer! Sue