The Never-Ending Period

[VivaLasViejas, ASN, RN]

OK, here's a question for you GYN experts: How long should I put up with periods that last for weeks?

Here's the deal: I've been having irregular, extremely heavy periods since I was 39 years old. I mean, they required 2 super-plus size tampons, plus an overnight maxi pad, PLUS a Depends to control the flow......and sometimes I went through all of this in 30 minutes. I was anemic, tired, and cranky, but at least these periods would stop after 7-8 days.

About a year ago I had an endometrial ablation, after my health insurance company denied me the hysterectomy I was all set to have because they figured I hadn't tried everything yet (I'd been through the hormones, taken iron to combat the anemia, etc.) or just hadn't suffered enough. So for the first 6 months, the ablation was a success..........periods were still very irregular, but lighter than they'd been in many years, and there were a couple of months when I had NO period and thought hmmm, I'm partway through the "change" as it is, maybe this is the end of it.

NO such luck. The next month I had the heaviest period I'd had since the ablation.....passed a couple of large clots, needed the extra "padding" etc., but it didn't last more than a few days. Then, a few days after I stopped bleeding, I started again........and have been bleeding, more or less all the time, ever since. It's never gone back to being as heavy as it used to be, but it just never stops for more than a week or ten days.

Needless to say, this makes having a sex life next to impossible, and forget being able to PLAN anything.......not even my annual pelvic exam! I don't leave the house without a pad on for fear I'll start without warning. I never know when it's coming, when or if it will stop, or how bad it will be. The hell of it is, other than bleeding pretty much all the time, I'm not technically suffering......my H&H are perfect, I feel fine, I don't have cramping or pain like I used to, and the flow has never been as heavy as it was prior to the ablation.

Now what? Obviously another ablation isn't going to be the answer, but I'm afraid of being disappointed again if my health insurance denies my surgery a second time because the bleeding is merely annoying. (I don't think they care that I'm living like a nun.) If I couldn't get the hyst when the bleeding was so severe that I almost needed a transfusion at one time, what makes me think they'll let me have it now?

On the other hand, how freakin' long does a woman have to bleed and bleed and bleed before the paper pushers at the insurance company (probably all MEN) say OK, she's been through enough?

This does not take into consideration that even if I were to be approved for the hyst tomorrow, I could afford to take off the 6-8 weeks needed to complete the recovery process.......how does one deal with THAT, I wonder? I've got less than 2 weeks' worth of vacation time saved up.......I can't just NOT work for 4-6 more weeks and expect to have a roof over my head at the end of it.

I'm seeing my GYN on the 9th of next month.....I know she'll say I need the hysterectomy, and I know she'll fight the insurance people again, but if they say no again I don't know what I'll do. I probably will have enough vacation saved up by summertime, and if I just knew there would someday be an end to all of this SHYTE I could deal with a few months' more of it.

What do you all think? Should I just put up with what is mainly an inconvenience until menopause finally arrives? Or should I fight the insurance people until I get what I want? And just in case I do get to have the surgery, how is my family supposed to survive my being off work for two months? (My husband makes $9 an hour, and in his industry he's lucky to get that, so please don't tell me he needs to change jobs---it's not gonna happen.)

Thanks!

[suzanne4, RN]

First of all, do you have a documented second opinion? Second, I would submit a letter in writing to the head claims review and the doctor that oversees the denials for ob/gyn.

What else did the insurance company suggest that you do, if they thing that you did not try everything?

Was this refused only once and by a clerk? Ask to have it reviewed by the director of claims. Also, I would be very persistent. You can also write a letter to the insurance commission for your state. They back up alot of patients.

Good luck and keep us posted.

[CseMgr1, ASN, RN]

Originally posted by suzanne4

First of all, do you have a documented second opinion? Second, I would submit a letter in writing to the head claims review and the doctor that oversees the denials for ob/gyn.

What else did the insurance company suggest that you do, if they thing that you did not try everything?

Was this refused only once and by a clerk? Ask to have it reviewed by the director of claims. Also, I would be very persistent. You can also write a letter to the insurance commission for your state. They back up alot of patients.

Exactly. Your HMO should also have an appeals process, which gives you and your physician the right to have a denied request for services reviewed internally by its chief medical officer. If they uphold the denial, and you still don't agree with their decision, then you can request that your case be sent for external review by an independent third party. Don't give up!:)

[renerian, BSN, RN]

I went through that four years ago, everything you have plus birth control pills bid and nothing worked. Took a full year to get the insurance company to pay for a total hyst. Feel much better now. I got a second opinion which the insurance company looked at, agreed with and paid for.

renerian

[passing thru]

Maybe a new gyn doc who's office takes a more aggressive approach with the insurance people? Who won't take no for an answer?

[live4today, RN]

((((((((((mjlrn97)))))))))) :kiss

:balloons: I see by your "bio" that you have a birthday coming up on Monday!

I went through what you are going through when I was only in my late twenties. I eventually had the hysterectomy. Cured! At least I still have my ovaries today, so thank God I didn't have to suffer through surgical menopause at such a young age.

I'm 52 now, and think I've experienced some "peri-men-o-changes"...crying at the drop of a hat, one minute hot...next minute cold, heat up...heat down.

I know that you will feel soooooooo much better by having that hysterectomy, but keep your ovaries (if only one) if at all possible.

I wouldn't give up either. Keep bugging the insurance people. Get a second and third opinion if you must. Heck......I had FIVE different doctors vouching for the fact that I needed a hysterectomy, so give 'em what for until you see some results.

[VivaLasViejas, ASN, RN]

Thanks, Renee, and to all of you who've posted. I'll see what happens when I go to the doctor on the 9th.......I figure I have to wait until after my oldest daughter's wedding and my younger daughter's graduation and induction into the Army, anyway, so that should give both me and the doc enough time to fight with the insurance company. Actually, I think I'll have a better chance this time because I have my hospital's insurance as well as my husband's, and maybe if one doesn't have to pay for it all, I'll be able to get pre-authorization. Plus, there's the matter of that failed ablation...........is that stupid, or what? Now they've got to pay for TWO procedures, when if they'd just let me have the hyst in the first place they'd only have had to pay for one. Talk about a waste of healthcare resources!!