Tuesday, September 28, 2010

Aetna and FAI

Sent to me by a fellow hip friend:

Aetna’s assessment of FAI is archaic and asinine!

As you all are aware, our cause for UHC’s coverage of FAI was very successful including a NY Times article and many reversed appeals in favor of the patient. UHC along with other major insurers (BCBS, Cigna, Kaiser) now covers the arthroscopic treatment of Femoroacetabular Impingement.

Unfortunately, Aetna still has not caught up with the times. Many of our fellow patients have been successfully treated with hip arthroscopy and have been able to move on to enjoy active lives. People that are insured with Aetna are being discriminated against IF they also have a diagnosis of FAI. Aetna has taken the position that the use of the hip scope is unproven and/or experimental. This is absolutely ridiculous. It is very obvious that the bottom line is that it IS a covered procedure by the other insurers so how is Aetna’s non-coverage of this procedure accurate?

Aetna would rather have a young active patient become so disabled that their medical situation deteriorates to the point of needing a total hip replacement with all the associated medical risks and financial costs. Take the example of your typical patient. Young, active 30 year old Aetna consumer who is denied access to treatment for FAI. Based on Aetna’s opinion, the patient will go untreated for years UNTIL the patient requires a total hip replacement. Of course, doctors won’t typically do a THR on someone under 60 so this patient has to wait 30 years for treatment because of Aetna’s inaccurate and woefully pathetic position on FAI treatment.

Mr. Ron Williams (CEO of Aetna) when is Aetna going to catch up with the peer reviewed literature and your peers? When is Aetna going to reverse the policy so that your clients that need this surgery will have the same rights as patients that have UHC, Cigna, BCBS and Kaiser? When will Aetna decide that they would like the “A” in Aetna to equate to “Amazing” instead of “Awful’?

Friday, September 3, 2010

Hip Issues and Incontinence

If you are thinking this is TMI, then I suggest you stop reading. As usual, I have no problem discussing the things that no one else wants to.
When I initially had hip pain, over 3 years ago, one thing In noticed was that I had to do a pelvic floor muscle (PFM) contraction, or kegel, when I would cough or sneeze. I never actually leaked urine but felt that I was going to. With regular PT, this got better and I forgot about it. Last week I was doing jumping jacks with L when I suddenly leaked so much urine that it was running down my legs. I was shocked. I not only had never actually leaked urine, but this was a huge amount, and completely out of the blue. I have been having a lot of tightness in my hip, and even had to go back to PT yesterday for a "tune up", but I see no other reason for this.

At PT, my PT loosened up the anterior capsule for me and sent me on my way, encouraging me to go back to running to keep the hip stretched. I did, last night I got right back on the treadmill and began running. I started feeling leakage again and couldn't believe it, I was leaking urine again. Now, jumping jacks I don't do on a regular basis, but running...I never ever had a problem with running. I am totally freaked out by this. My only saving grace is that I was home both times. Yes, I ahve had 3 babies, 4 hip surgeries, but urinary incontinence is NEVER normal.

So, what am I doing about it? PFM exercises, and more PFM exercises. Kegels when I remember, plus hip adduction (squeezing a ball in between my knees) and hip ER/abd with a theraband around my knees. I am going to do them aggressively, I won't be running for a while because I will be travelling a lot in the next week and a half, but hopefully when I get back things will be strong again and I wont have this problem anymore.