Just a little rant, OK?
Let me start by saying to the Insurance Overlords, State of New York: Thank you for my coverage. Thank you for my leg. Thank you for my socket that fits.
But... Why must you deny me a knee brace that costs a fraction of an above-knee prosthesis and less than half of a socket? I know--it's on the edge of being experimental. The Bionicare Knee Brace has a stimulation system that zaps the joint into thinking it's normal, or at least this is my understanding. Studies show it to be effective in staving off knee replacement surgery. Which my doctor says I'm too young for, at fifty (going on seventy). Though I have a feeling the Overlords, in their twisted universe, would pay for surgery first. Spite surgery.
The last letter I got was signed by a PT named (appropriately enough) Pike. Think of a spear with a severed head on it. She said my request (which included med & injection records, a letter from my doctor, a statement from me and a plea from my orthotist) could not be processed because information was...inadequate...incorrect. Or not present.
It appears that a trial to confirm the efficacy of this device for Ms. Heywood's pain and dysfunction is warranted. Provide details of Ms. Heywood's trial...Provide initial evaluation...Provide documentation...Provide studies that compare Bionicare to other treatments such as (but not limited to) exercise or medications or to different forms of electrical stimulation...
Ah. They want a flipping term paper. And they want me to use the brace on trial to see if it works. Except they won't approve the brace for me to use without knowing how the trial went. See the beauty of their world? It has the logic of a moebius strip. I bet they all believe six impossible things before breakfast. Well, hey: I used to believe nothing I experienced was real except as defined by Christian Science. Did I spend fifteen years in therapy so Nurse Ratched can play mind games while my "good" leg gives out?
But. I've got a friend on the inside, sort of. A fabulous trooper of a paperwork magician at Hanger prosthetics. Her name is Sarah. We have regrouped. I just signed a release to send the Overlords my nastiest bone-on-bone knee x-ray. I will be calling Madam Overlord tomorrow. I don't want to believe (though I know this often is true) that she is paid to deny middle-aged single-mom above-knee-amputees a band aid that might postpone surgery. I really don't.
But for her sake, I hope Nurse Ratched gets a good night's sleep. She's about to meet One-leg Liz. ;-)