ANA Discussion Forum
General Category => Hearing Issues => Topic started by: Soundy on February 27, 2008, 09:12:18 pm
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I have been stewing since my appointment last week...
I have more hearing loss in my hearing ear but the doctor says it is still not enough
to worry about as it is serviceable hearing ... it would be serviceable if I had a second
ear to help it out... >:( ...
sit me in a sound proof booth with a plug right in my ear with a clay like clump blocking out
all sound I may make moving in said booth and yes , I can understand words spoken by
tech...( 85% ) ... but that is not the real world...
He sent me next door to see audiologist about TV ears and BAHA... TV ears would solve
watching TV without making my family nuts and can get super model and hook up phone ...
but that would not solve day to day stuff
Like not knowing where my name is being called from and having to do a full spin to
locate who is talking ... or the headaches and confusion from having to concentrate just
to know what is going on around me at school and out in public...
They say BAHA is my next best option... insurance will pay for surgery but not hardware
and they want the thing ordered by hospital... $8995 ....I was told by another patient
that was there to have theirs adjusted or something , that their insurance allowed them to order it
and have it sent directly to their doctor when they had theirs done in Florida in the fall and it
cost them only $4200... so if I do it which at that cost I won't the hospital would make
almost $5000 just to have it delivered to them and hold it til surgery... that just sucks...and
definitely puts it out of my reach...
my insurance would pay for it if I was under 18... so I guess as we get older we are no longer
entitled to hear... :-[ they have a rider I can purchase ($69 per month) that will pick up 60% of
the unit after a 12 month waiting period because the hearing loss would then be a pre-existing
problem...but by that time my co-pays and out of pocket will roll back to zero and the surgery
itself which I was told would run $10000-$15000 would not be covered 100% and it ...that would
run me about $5000 .. . where til June 30th it would only cost me $200 doctor co-pay for surgery and
unit cost...
The doctors told me we could revisit this at my May 19 appointment but I want to jump on it now
and work on getting it paid for or find a way not to have to pay the huge markup on it ... or just forget
about it all together...
I wore the simulator and it sounded different but so much better than silence ...and the doctor said that the
actual BAHA would be much clearer since sound would be going thru bone and not the skin first...
something also told by insurance is that there is a possibility that they would pay if I could prove that
the loss of hearing was causing me significant mental anguish and problems ... me and friends were talking
about insurance and problems we have had with insurance companies... we came up with a plan
this is part of an email
If Cochlear company will sell me the appliance and a screw me and my partner
in crime at day camp figure we can sterilize her garage,put my head in a vice ,
clean it good with betadine and shoot site full of lidocaine (I have some for
veterinary use that would work) then she can drill a pilot hole and take a screw
driver and twist the thing in ...Bo and her husband can stand by as nurses
if I get wiggly and they can hold me still... and need to get a bottle of
Jack Daniels for pain management and relaxing after the procedure ...
I think all of will need a swig
y'all think that would prove mental anguish and instability ???? ;)
don't really think we will do home grown surgery but just frustrated that there is something that
could help and it is out of reach...
they told me Trans ear was not a good option due to size and shape of my ear canals...and
insuracne wouldn't pay for it either...
any insight and ideas to help find a way would be appreciated... some say fight it on age discrimantion
or pull the nut case card...I may be nutty but haven't really lost it yet
just whining and crying in Tennessee... tomorrow will be a better day :) ..start it right with Total
Good Night
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Soundy, I'm in TN also - I'll bring some extra Jack Daniels and swing by Home Depot for some spare screws, just in case. I also have a big box of Snoopy band-aids you can use as a pressure bandage, and a big bottle of Bactine. Sounds like we may be able to go in business here.
Seriously, though. This has got to be frustrating. I think the actual cost of my BAHA was about $4200, and I was fortunate to have my insurance company cover it. What audiologist do you go to? Mine told me that usually, the insurance companies deny the request the first time around, but they've ( the doctors) never lost on an appeal. Now, instead of waiting for the initial denial, they have the ENT or whatever surgeon write a letter of necessity and the audiologist does the same and they send EVERYTHING all at one time so they have no reason to say no. I go to Dr. d***inson at Vanderbilt and he's been wonderful.
I guess if all else fails - go ahead with the nut card. ;)
Hope today is a better day! At least it's not snowing!
Lori
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I see doctors at Nashville ENT at St Thomas...
the whole thing is just frustrating to no end ...
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Soundy, Did the TransEar people say you couldn't use their product or did the ENT/audiologist say this?
TransEar works if you have good hearing in the low and mid ranges.
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audiologist... said small canal and the shape meaning crooked it would be hard to
fit and get good contact... but I will investigate it further ...haven't even talked to anyone
today about any of it today... had to take a break from it ...so went and put in time at school...
and came home and napped
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I go to Dr. d***inson at Vanderbilt and he's been wonderful.
Oh my... I've been censored.... :o
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I tried to decode that with my book of doctor lists but couldn't come up with a match :D
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I think you have to send away for the secret decoder ring for that one. Just send in 1 box top from the eye gel package and the receipt from a case of hearing aid batteries. :D
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You guys need to buy El Marko black felt tip pens to decorate the hearing booths inside and MRI tubes! Medical Graffiti its the in thing and its nice to read others comments
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I will keep that in mind about the markers...
I got a second consult with audiologist to discuss BAHA and Transear...not til the last of March ,
so back to waiting...I am taking suggestions that I have gleaned from here with me
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Soundy...make sure you ask your insurance company if they will pay for the hospitalization and subsequent surgeries if your garage procedure has complications, especially infection or post traumatic stress. Make sure you talk to a representative who is recording your call, and be sure to sound very serious when you make the inquiry. This may help to convince them to pay...or at least that you are mentally unstable ;D
Sitting in a soundproof booth vs. the real world are not even comparable. Too bad we all can't live in a soundproof booth. Good luck in your quest.
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I think the biggest thing that bums me about having one ear that works is my wife still cant figure out not to talk to me when Im on the phone as the phone is covering my good ear? I think I need to wear a traffic cone over my left ear while on the phone?
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oHIo... that would be an interesting call to make :) ... I have a feeling that I could land in the
mental hospital with little trying ... but they will pay for any member of the family to receive up to
45 days inpatient treatment per year... I guess I could make it a vacation away from the worries of
taking care of the kids ,husband and house and trying to deal with insurance people :o
Don... my husband and kids talk to me when I am on the phone and it drives me nutz... what
part of deaf do they not understand??? ... I just watch their lips move and nod at them ... most
of the time they wonder off ...
so far I have not nodded permission for anything that has gone overly wrong... unless you count the
kids eating Oreo cookies and ice-cream before dinner and then not wanting to eat because they were
full and it was all my fault
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Its amazing isnt it do you also sleep on the side with your deaf ear off the pillow? Just be glad they think we are still normal my wife is so happy she doesnt have to tube feed me and help me into wheel chair anymore she thinks Im cured! This always causes problems so you have to be patient we look the same pretty much but are oh so different, this is the nature of brain injury for example you wouldnt buy a man with no legs a pair of shoes it takes patience and understanding, my favorite line when dealing with fools is I may be brain damaged but Im not stupid..............
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I think the biggest thing that bums me about having one ear that works is my wife still cant figure out not to talk to me when Im on the phone as the phone is covering my good ear? I think I need to wear a traffic cone over my left ear while on the phone?
After almost 11 months my husband still doesn't get this either. He also doesn't get the fact that I can't hear him talking when he's in another room. I used to run my hind end off to ask what he was saying; now, I figure if it's that important he can find me and tell me so I can hear.
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I have to train people who know me not to come up to my left side and to try to whisper comments in that ear at activities like I said I think you can buy miniture traffic cones and If I can find one I think I will wear it over my left ear? Its even more depressing when your eye is gooned on the same side as you are gun shy on that side? It erodes my levels of confidence, I used to participate in all sorts of radical activities and it sure crimped my style. For example my off road racing days are over. The desire is still there in fact I can still feel weightless when cresting a rise and want so much to do it on a motorcycle again, but I gotta deal with the Osteoporosis first will be starting a regime of once a day injections to the stomach on Tuesday for a year this new med is suposed to build bone mass, we shall see so if you here about a guy competing on bikes in his 60's that will be me if it works, I know I will be faster than before as after all I have been through not much scares me?
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RIDE 'EM COWBOY - YOU GO 'JOHN COREY' !!!!( Nelson DeMille's hero character)
BABY BOOMERS RULE !!!!
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Don ...I'll be watching for you on your bike
As for sleeping with good ear down ...I don't... I sleep on wedges almost sitting up because
if I sleep flat I get bad headaches ... I don't bend at the waist sideways enough to sleep on
my side
People around me alot like family have harder time remembering I can't hear on right side than people
I am around less often... I think you hit the nail on the head... I don't look different unless I am
wobbling off somewhere ...people I am not around as much make an effort to make sure they are on my
left side and will ask me if they are talking loud enough... family just sees me as mom /wife and not as
having a problem...
I got choked the other day and a coughing fit brought on a head ache that while not boo hooing tears
were streaming down my face... my husband asked what was wrong and I just said it hurts... he said it
has been 8 months should I be over it yet... he and a few others don't understand that there are things
that I may never be over... headaches are one ... and we know there will never be hearing in right ear again...
I had no answer that the kids could hear so I locked myself in the bathroom (presently only one :) ) with a good
book and told them all that if they needed to go we had 126 acres and they could find a friendly bush...I
may never finish redoing the second one... ;D
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Sleeping with wedges? Tell me about it I now have to have a couple of pillows at my feet to keep em elevated as I now have some mystery condition that causes em to swell?They look like toes glued on a loaf of bread if I dont? wonder what will go wrong next? I have found that the best thing for people like us to sleep in is a LayZBoy! I would love to motorize mine and ride around in my flannel Beaver Cleaver bathrobe all day!
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I have my wedges and then a roll type pillow under knees because if I don't my lower back hurts
from sleeping upright... we got new furniture about a month ago ...the girls and I picked everything
out ...husband didn't even go look before delivery...included is an oversized recliner for my
husband ;) wink wink ;) but I had other plans for it when we picked it ...and have used it on
bad nights...we just let him think it was purchased for him 'cause he is such a great guy :)
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I learned today... well yesterday since it is now tomorrow ... or thirty eight minutes into today ... ???
Heck... on the 4th of March I learned that our insurance has a Wellness program that offers discounts on
things not normally paid for by their policy... not insurance more like using your insurance card as a coupon
at participating places...have 6 providers of hearing care givers with in 100 miles (the limit they will accept my card)
and none do implants of BAHA screw... they have traditional hearing aids... but they say they could order it
and send to a surgeon... it takes 25% off cost of device but guess what????
they charge from $800 -$1000 to order it for you .... bahahahahahahahahahahhahaha
a friend said she would organize a fundraiser for me at school... I am not to the point of that yet... last
year our Girl Scouts raised over $6000 at a spaghetti supper for one of our girls that had cancer... sadly
she passed away ... they say turn about is fair and I have earned it ... I don't volunteer for me or to earn
something... I do Scouts (cubs and girls) because there is a need for something for the younger kids to do
around here that runs year round... I honestly don't want them to do it ... the thought is enough...
insurance and the ropes I am jumping thru are making me mad enough to find a way to get this done
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About the time I hit post I thought to myself that I shouldn't use my bahahahahahahahaha laugh
when talking about BAHA...
I am toooooooo tired... and alarm sounds in about 4 hour ... ain't insomnia grand???
Good Night
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Soundy -
personally, I kind of like the bahahahahahaha laugh ;D I was amused ;D
I just had BAHA surgery yesterday and all I can say is push your insurance company. Most people, medical people and insurance companies included, don't know what a BAHA is. Yesterday preop both the doc and I had to explain to the others involved in my surgery what a BAHA is, how the operation is performed, why I needed it, etc. Find out if your insurance company cover Cochlears (if they do, they should cover BAHAs) and also point out to them that BAHAs are covered by Medicare (or Medicaid ? I forget). My doc's office first requested coverage for me in October and it took until February to get an answer from my insurance company. I got the "royal runaround" but was persistent and it finally paid off. Don't give up.
And, if you have to go the route of a fundraiser, let us know. I can't speak for others, but I'd be happy to contribute.
Jan
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I doubt it will come to a fundraiser... just a royal pain to be put through the hoops ... I did tell
my husband that I am picking out 10 of the calves in the field and naming them all BAHA... I figure
10 would cover devise and Co-pay... he called a couple Down Payment when he was looking
at trucks
Waiting to hear back from insurance after giving them the code that was posted
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Soundy,
Will your insurance cover Vanderbilt or Baptist Hospital in Nashville - because I know they do BAHA's there? Your doctors should be able to write a very convincing letter to the insurance company stating why this is a medical necessity. My audiologist told me he has to do it all the time because most insurance companies deny the initial request, but he said he's never had an insurance company deny the second request when they appeal.
Where there's a will - there's a BAHA. Keep fighting - it's not only for your hearing - it's for the poor cows!
Lori
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My FIL told the girls when they were little bitty that every calf born on this farm had
the same name... MONEY..
:)
Insurance will cover both Vanderbilt and Babtist... They cover St Thomas where I had surgery
too but only cover what they want...
I did learn yesterday that there is a BAHA clinic in Columbia which is alot closer to me ... waiting to
hear from them and see if they can work with my doctor and see if insurance will pay for it
through them...
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Soundy -
am keeping my fingers crossed about the clinic in Columbia.
Good luck,
Jan