Health & Wealth Series: Pinched Nerve Timeline

I have now been down for the count for about two months. After writing the article about how health affects wealth, I decided to start a timeline of my pinched nerve debacle as maybe it may help someone else in this same predicament.

Kim’s Pinched Nerve Timeline

My left arm started feeling restless at the beginning of 2024. My index finger and middle finger on my left hand went numb. When I mentioned the restlessness to my psychiatrist, she suggested that one of my anxiety medications causes involuntary movements. But my arm wasn’t moving involuntarily. I just couldn’t get it in a comfortable position, especially when sleeping. 

When the throbbing pain started  in my left forearm,. I was worried that it was a blood clot as I’m a Factor IV Leiden carrier, and both of my brother and my daughter have had blood clots in the past few years. Instead of waiting for insurance to do a pre-auth, my primary doctor (aka GP; general practitioner) told me to the ED (emergency department) where she knew they would do Doppler ultrasound without having to wait for insurance to approve. 

The ultrasound was clear. No blood clots. The ED doctor suggested I have a pinched nerve in my neck and to go back to primary care if it got worse.

The pain got worse and started extending up into my upper arm. My primary doctor gave me a cortisone shot into my elbow. She said it would be painful, but I was already in so much pain that it didn’t hurt at all. 

The pain continued to come and go. My GP suggested I may have to see a hand specialist for carpal tunnel surgery. Carpal tunnel wouldn’t have surprised me as I have spent most of my career at the keyboard. But I wasn’t convinced that was my problem.

My employees had given me spa gift certificates for my birthday and Christmas, so I figured it was about time that I had redeemed them. I booked an hour-long massage.

Wednesday, June 18th, 2024 – Massage

My massage therapist was a male, and when he had asked me if he was applying pressure too hard, I said yes. I felt him work on several knots by my neck, which I’ve been told is also symptoms from sitting on the computer for long periods of time.

I’ve had professional massages before and always feel a tad sore afterwards, and this massage was no different. Until it was.

Thursday, June 19th, 2024

The next day, my life came to a halt. That burning, throbbing, stabbing, dull pain in my left arm had now traveled to my shoulder all the way to my spine. And the pain was the worst pain I’ve ever encountered, worse than childbirth! I barely moved from the recliner as that was the best position for the pain – feet up, knees bent to the right, and my shoulder blade back. I tried ice. I tried heat. I tried ibuprofen. 

Friday, June 20th, 2024  – Chiropractor

I called my chiropractor who was able to get me in right away. He said I had a lot of inflammation, and that I should contact my GP for an anti-inflammatory. I am lucky to be able to have a GP that I can text and who responds in a timely manner. She called in some Celebrex before the weekend. The called in dose was for 200 mg, but I had googled that one could take up to 400 mg per day so that’s what I took. I was a desperate rebel in pain.

We had a liquidation sale scheduled for that weekend, and I maxed out my daily Tylenol dose before it began so I would be able to function. I paid for that dearly and spent the next few days (which would turn into weeks) just sitting in the recliner. The pain was too severe to even think about, muchless turn on my laptop. 

Monday, June 24th, 2024 – ER

I couldn’t take the pain any longer, and my GP is out of the office on Mondays. So I asked my husband to take me to the ER hoping they could run some tests, see what was wrong and fix me. Or at least give me some painkillers. Nope and nope. The PA (physician’s assistant) told me it’s definitely a pinched nerve. She gave me another shot of cortisone and some prednisone pills, told me to see my GP, and that I’ll be fine. I wanted to believe her. 

Thursday, June 27th, 2024 – GP

My GP is in high demand, so I couldn’t get in to see her until Thursday. Trust me, I called everyday asking if there were any cancellations to get in sooner. I had to have my daughter drive me.

She ordered XRays which showed “Low-grade C5-6 and C6-7 degenerative cervical spondylosis”. She gave me another shot of cortisone directly into my shoulder and ordered an MRI. She also gave me a prescription for Tramadol, and since it’s a narcotic, I had to sign a pain contract as well as submit to a drug test (which was clean by the way). 

But they couldn’t even schedule the MRI until the pre-authorization was done which the nurse said could take weeks to approve! I called Blue Cross Blue Shield myself asking them if they could fast-track the MRI as it was urgent. I hadn’t been able to do anything functional! They actually approved it within hours, but getting the nurse to actually believe me and get the MRI scheduled took longer. And then the MRI was scheduled out for weeks! I called around to different MRI providers, but the waiting lists were all about the same time length. 

Monday, July 8th, 2024 – MRI

We had to be at the hospital at 5:15 am for my MRI. I’m definitely not a morning person, but I was desperate for pain relief. The order said with and without contrast, but when I asked when they were going to put in an IV (for the contrast part), the technician said it wasn’t needed. So they didn’t do that part. 

Physicians’ clinics that use OneChart are mainly a blessing, but also a curse as it gives you results instantaneously, but then you have to wait for your doctor to read those results and get back to you. The MRI results showed…

Degenerative disc osteophyte complex formation at C5-6 and C6-7 with uncinate arthrosis and diffuse disc bulging. Severe bilateral neural foraminal narrowing at C6-7, correlate for C7 radiculopathy. Severe right neural foraminal narrowing at C5-6, correlate for right C6 radiculopathy.

My GP then referred me to a neurosurgeon specializing in spine disorders, but again I can’t get in to see him for several weeks, and I again ask to be put on a waiting list for any cancellations. 

In the meantime, I text to ask my GP if physical therapy would be an option ice, heat, home remedies I googled, and even painkillers were not cutting the pain. 

Monday, July 15th, 2024 – Physical Therapy

I was having one of the worst pain days (and not a good mental health day) on the day that I was to see the physical therapist. In fact, I was feeling so bad that I almost canceled, but I knew that it may be beneficial. The physical therapist took lots of measurements of my strength (the left arm was definitely weaker than the right) and of my neck in various positions. He showed me new exercises to try to “floss” the nerve. He also did needling with stimulation. My neck move ability actually showed significant improvement afterwards. 

Tuesday, July 16th, 2024

Later afternoon, I got a text message that there was a cancellation with the neurosurgeon for the next day at 8:30 am. I had ten minutes to reply before they offered it to the next person on the list. I replied immediately that I wanted it! I called and canceled my physical therapy for the following day excited that I may actually get some answers and relief on Wednesday. 

Wednesday, July 17th, 2024 – Neurosurgeon

We again got up early to make the three hour drive to Omaha for my neurosurgeon appointment only to get there and find out the the rescheduled appointment was at a different location, another three hours away! I had replied to the text message so fast that I didn’t even realize that it was in another city (as I didn’t know they went to other cities). They apologized as it’s apparently happened before (the text message was clearly not clear). They offered to get me in the next day so I didn’t have to wait another two weeks. 

I was devastated, but we decided it was still early in the day that we could get home for my husband to still work most of the day and be able to drive back down the following day. And then the phone rang as we were leaving. Usually I don’t answer unknown numbers, but I was glad I did as it was the clinic offering to have me see someone else if I didn’t mind. Of course, I didn’t mind!

I was impressed with the physician assistant and then the neurosurgeon that did I see. They blamed arthritis for my bulging discs and ordered an epidural steroid injection. And if that doesn’t work, they can do surgery. They also said the best pain reliever for nerve pain is Gabapentin, but I saw they had “pain contracts” too, but I figured I would ask my GP for it so as not to get into trouble. They also wrote out a new prescription for physical therapy. 

I was praying they could do that injection right there right then. Nope. 

The epidural steroid injection involves seeing another doctor, an anesthesiologist, first for a consultation, then they have to do pre-authorization, and then schedule the injection. And so once again, I wait. And when the receptionist can’t find your order because the other office forgot to send it, there’s even more waiting. Looking back, I don’t think the other office forgot; I think the receptionist didn’t look hard enough. 

On our drive home, I got a call from another doctor’s office to confirm my appointment with a physiatrist – say what? I’d never even heard of such of a doctor, and since I just left the neurosurgeon thinking I had a plan, I cancelled the appointment. I immediately regretted this when I found out I couldn’t see the anesthesiologist for my consult for a couple of weeks yet. 

Monday, July 22, 2024

I had ordered a TENS unit on Amazon because the physical therapist had recommended one, and then the new physical therapy order actually had that check marked as part of therapy. 

I also called the physiatrist back and set up a new appointment (for a few weeks away now) as after doing some research, physiatrists try to find alternative treatments to surgeries.

My husband is a huge Joe Rogan fan, and devotedly listens to this podcasts. Apparently Joe Rogan had similar bulging disc issues, did not believe surgery was the best option, and cured his ailments with Regenokine, a type of PRP (platelet-rich plasma) injection. Although insurance does not pay for stem cell therapy of any kind as it’s not approved by the FDA, it might be worth looking into. 

Tuesday, July 23rd, 2024 – PT

I went to physical therapy again today. Since the last session of needling didn’t improve anything, this time, the physical therapy did traction. It felt like he was pulling my head off, but it helped relieve some of the pressure on my pinched nerve! 

Monday, July 29th, 2024 – Anesthesiologist 

I finally see the anesthesiologist at the Pain Management Clinic. He agrees I need an epidural steroid injection and would start the paperwork for the insurance pre-authorization. And so I wait again. 

Tuesday, August 6th, 2024 – PT

I had another physical therapy appointment only this time I say a physical therapy assistant instead of the physical therapist. She did some traction again since I said that helped, but she wasn’t quite as gentle as he was. She did recommend that I use a home traction unit and they had one that I could use. 

Thursday, August 8th, 2024 – Physiatrist

The physiatrist agreed with all others findings that I indeed have a pinched nerve. He ordered a nerve study which he said should solidify the need for an epidural steroid injection, but again I have to wait three weeks to get in for that. He said I am not a candidate for PRP injections as it is more for trauma and joint injuries, not arthritis causing pinched nerves. 

Monday, August 12th, 2024 – Pre-Auth Denied

I’ve been logging into the BCBS website everyday looking for a pre-authorization update. There was one today, but not the one I was hoping for:

Denied?!? I was not a happy camper. Apparently my provider didn’t include my chiropractor and physical therapy notes with the pre-auth as it was denied saying I need to try that first. Ugh. 

Tuesday, August 13th, 2024 – PT

I continue with physical therapy. 

Thursday, August 15th, 2024 – PT

Physical therapy again.

Tuesday, August 13th, 2024 – Nerve Study

The physiatrist had a cancellation, so I was able to get in this day for my nerve study. The first test was some electric shocks on my arm. The doctor said his farmer patients say it feels like touching an electric fence.

The second part of the test is having tiny needles inserted on various spots on my arm. He said I do not have carpel tunnel, which I wasn’t worried about, but wouldn’t be surprised if I did since I’ve been typing away at my computer for over two decades. He did say though I definitely have nerve damage in C7. He said my insurance should definitely approve an epidural steroid injection with this test. But first, I needed to see the anesthesiologist again. 

Thursday, August 22nd, 2024 – Pain Clinic

This appointment went much like I expected it: 5 minutes with the doctor for him to tell me they will either submit a new pre-auth case or appeal the denial with the new nerve study. I think this could’ve been done over the phone, but then they couldn’t bill me as much. Such is life. 

September 2024

I spent the whole month waiting for my insurance to approve my procedure only to find out after contacting BCBS that the doctor’s office never filed a new pre-auth or appeal! I left multiple messages at the doctor’s office, but they never call back (and apparently never answer the phone). I’m so frustrated that I’m thinking of asking my GP for a referral to a new pain specialist where the office will actually do their job. 

October 18th, 2024 – New Pain Clinic

Since the first pain management clinic never filed a new pre-auth or appeal and refused to answer their phone for me, and even Blue Cross Blue Shield, and I’m sure loads of other potential patients (and never returned any phone calls), I went to see a new pain management doctor. 

I went through the hospital’s physicians service because 1) I know they answer the phone, and 2) I know they do pre-authorizations in a timely manner. When I told them my story thus far, they reassured me that they do appeals, too if needed. I wish I would’ve went here in the first place as it was much more reassuring.  

I will continue to add updates as they occur. Until then, you’ll most likely find me in my recliner.

Featured Image Credit: Deposit Photos