So I had this bright idea that when I moved to a new city, settled into a new house and got a new job, that I would somehow magically transform into a diligent dilator (as in one who dilates, not the object used for said dilating… English is weird), overcome my issues and blossom into a sexual goddess within a few months.
Ha. Ha. Ha. And also, HA.
The sarcasm and pessimism are nearly brimming over, I know. It’s hard not to right now. Lemme explain.
So, when Husband and I moved, we had to change our health insurance to a new provider, because our previous one was local to the city we moved from. This plan was fantastic; they approved the lidocaine and Botox injections with no fuss, and covered 100% of the procedures. All I ever had to pay were copays for my pre- and post-ops. Give them a gold star… No, a THOUSAND. Amazing plan.
I was quite sad about having to move off this insurance, but my husband did some very thorough research into our new options and found a new plan. Not as good, but they had an option for continuing care coverage for three months, and they agreed to cover 80% of approved procedures. Okay, so that’ll be a couple hundred for my last Botox shot, then. Sucks, but we’ve got the savings. We can penny-pinch for a little while.
So I get my pre-op and my appointment for the next (third, if you’re counting) Botox shot. If all goes well, this should be the last. Specialist Doctor knows exactly which areas still have a spasm (between 4:00 and 7:00, if you’re curious) and is going to concentrate there. Awesomesauce! My next Botox shot is scheduled for October 23rd. I’m psyched, I request the day off work, all is well.
… Then, a couple days later, I get a call from Specialist Doctor’s office. I’m driving to work, so I don’t answer, but I listen to the voicemail a few minutes later…
“I’m sorry, but your insurance company has denied to authorize the procedure. Please call us to discuss your options.”
… FUCK. FUCK. FUCK.
Since then, my husband (saint that he is) has made several calls back and forth, first between the insurance liaison at Specialist Doctor’s office, then between several layers of help desk representatives with our new insurance company. And from this we have learned that,
A. They lied in their coverage brochure. The brochure claims that continuing care will be provided for new members who need to see a specialist out-of-network to close their care. The help desk representative claimed that continuing care only applies to current members when their doctor moves out of networks. LIARS. FUCKING LIARS.
B. They refuse to cover Botox as a vaginismus treatment at all. And because it isn’t an FDA-approved procedure, there’s basically no recourse.
The next step, and thank the universe for him, is for Specialist Doctor himself to get involved. If the person who made the decision to deny us isn’t convinced by our appeal, SD will call that person and explain the medical reasons and necessity for it, in an effort to change their mind.
… But that’s basically the only option left. If that fails, if I want to get my last shot, it will cost over a thousand dollars. I don’t know about you, but I don’t have thousands of dollars lying around for casual use… We have student loans, car loans, bills, a mortgage. Where is this money going to come from?
And WHY THE HELL are we paying hundreds upon hundreds of dollars a year for a health plan that LIES and refuses to cover me?
I don’t know where we’re going to go from here. But from this vantage point, hope is a bit of a scarce resource right now. I have an appointment with Specialist Doctor next Friday, a pre-op. But since he’s now out of network, even going in for a pre-op costs sixty bucks, and the gas to get there and back is another twenty… Why should I go if I might not even be able to get my next shot? Can I even keep seeing him at this rate at all? I moved to a comparatively small city, and there are no equivalent specialists here… I’m beginning to wonder if maybe my road of treatment has finally been blocked off, and I’m now stuck with nowhere to go, no sense of direction, no idea what my next step should even be.
Should I dilate more? I dilated for months, YEARS and still can’t bridge #7 (and by the way, my husband is larger than #8, which I don’t even have). Should I abuse the EMLA? Specialist Doctor told me that it should be a short-term solution, because long-term use can cause heart problems. (And besides, the perpetual stinging for hours afterward isn’t something I can deal with after every romp in the hay anyway.) What about the vulvodynia then? Just keep using lidocaine until it runs out? Then how do I renew my prescription? I’ll need to see a new doctor… Does this mean I need to restart the finding-a-sympathetic-gyno process all over again? I’ve already sat through years of “You’ll just have to get over it” and “Well, just relax and have a glass of wine” and “There’s nothing physically wrong with you” . . .
I’ve been trying to be a voice of reason and hope to my readers, but honestly, I think this time I may need that from you. If any of you have some success stories to share, no matter how small, now would be an excellent time to contribute… You’ll have at least one member in your captive audience.
The Defective Woman 