Getting Botox.....for my butt!!

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descrapster
Regular Member


Date Joined Jun 2007
Total Posts : 155
   Posted 9/25/2007 6:22 AM (GMT -7)   
I should write a book about the saga that is my life at 25!  Well I was supposed to start remicade today but my wonderful insurance company won't pre-authorize my treatment and they are going to send it to medical review if they do get any bills so I decided not to risk it.  My tummy is doing great with Pentasa my fissures however are not!  I sent my Dr. an e-mail yesterday and told her that I can't deal with this pain everyday and that I wanted to try Cipro since Flagyl gave me nerve issues.  She told me that Cipro has not been proven to help with the anal issues but we could try and see.  I see a lot of people on this board with Cipro so something has to be going good, right?  Well anyway,  she said that surgery is absolutely not an option so we are going to try Botox!  I have heard about it before and it has shown some success.  At this point I am willing to try anything.  It has to be done under sedation and since my last sedation did not work and I woke up in the middle of them slicing my abcess open, I have decided that I will never take any sedation so they are going to have to give me general anesthesia!  The doctor said that she has to insert the injection inside my rectum to get to where the specific muscle is.  It's supposed to paralyze the muscle so it does not spasm and it allows the fissure to heal.  There is no guarantee but I am willing to try anything.  If this does not work I will either have to deal with the pain or have a temporary ostomy so that I don't use my butt and the fissure heals.  I actually have 2 fissures but one of them is the killer.  The doctor examined me under Anesthesia in June when I was diagnosed and she said the fissure went all the way down into the muscle.  I just want to be pain free and not wake up everyday thinking how much is this going to hurt today??? =(  I am crossing my fingers and hoping this will work! 
Descrapster
Diagnosed with CD June 15, 2007
Currently 2 Fissures and 1 Fistula...YAY! Seton Drain currently in.
8 Pentasa/day
Had to stop Flagyl because of numbness in my toes!
 


Stef17
Veteran Member


Date Joined Feb 2003
Total Posts : 1811
   Posted 9/25/2007 11:35 AM (GMT -7)   
Wow - botox for your bum! I didn't even know it was possible. I so truly hope this is the thing that helps you. I can't believe the garbage your insurance company is giving you over the remicade. You know that your GI can tell them it is absolutely medically necessary and can twist their arm, so to speak? If you want to try the remicade it sounds like it will be a huge fight, but you can win it. As for the botox.... I hope it does the trick. I will keep my fingers crossed for you too. Do you have an appointment set up yet? Keep us posted!

descrapster
Regular Member


Date Joined Jun 2007
Total Posts : 155
   Posted 9/25/2007 12:38 PM (GMT -7)   
I can't wait until I get my renewal for my insurance bill...I am going to go up 200% at the rate that I am going! The problem is that I started this insurance on May 1st and 4 weeks later developed my first fissure and then 2 weeks after that developed my second, had my colonoscopy and surgery to remove a skin tag and place a seton drain. Needless to say 2 months into coverage they have paid a billion times more than what I have paid to them in premium. Since before I started with the insurance, I had not seen a doctor in 5 years, I am afraid they are going to try to claim that this is pre-exsisting and not cover it. They will not pre-approve it for nothing in the world. I had the doctors office call yesterday and nothing. I told them to look into it before I got the treatment to approve it and they said that they will not look into it until they have a claim sent to them. Insurance in this country is the most pathetic thing I have ever seen! I want them to go and search for and pre-exsisting conditions but I can't risk them not paying the treatment and the first 4 treatments are $20K! I had read a little about the Botox before, it's not very common but the idea behind it seems to be a good one so anything is worth a try. It's can't physically harm me so away to Botox I go...I wonder if she can fix a few eye wrinkles while she's at it! =P
Descrapster
Diagnosed with CD June 15, 2007
Currently 2 Fissures and 1 Fistula...YAY! Seton Drain currently in.
8 Pentasa/day
Had to stop Flagyl because of numbness in my toes!
 


straydog
Forum Moderator


Date Joined Feb 2003
Total Posts : 13455
   Posted 9/25/2007 5:20 PM (GMT -7)   
Is it in writing that Remicade is an exclusion on your policy? Are they trying to say its experimental? Do you have a handbook that sets out what coverages are available and what they exclude?

My first phone call would be to State Board of Insurance in your state. Explain to them what is going on. They may send you a packet to file a complaint. By all means, fill out the paperwork and send it in. Keep a copy for your records.

Here in Tx my gi never had to call for approval. My infusions were done at the hospital as an OP and the hospital called for authorization.

Then I would make a couple of phone calls to some personal injury lawyers and ask them if the ins company can legally put you in the limbo they have. My thinking is they must either approve or deny, not sit in the middle of the fence twirling on their thumbs. Good luck, Susie


descrapster
Regular Member


Date Joined Jun 2007
Total Posts : 155
   Posted 9/26/2007 6:30 AM (GMT -7)   
Remicade is not specific in my policy. I technically am covered for any treatment and an outpatient facility with my $200/co-pay. The problem started when the OP Hospital called to get authorization and they said that yes I am covered but I have a 2 year pre-existing clause. When I called them to see what the heck they were talking about (because of course I did not know about this clause), they said that most policies come with a pre-exsisting rider and that this treatment is most likely a treatment that will be flagged down for review. You have to remember that I started this policy on May 1. A month and a half after that I was diagnosed and went for surgery. They are paying out of the wazoo for me right now and adding a treatment that costs $5,000 a session is not something that they are going to want to pay. They will not review it and authorize it before I get the treatment so I have to risk getting the treatment and them not covering it. They are not going to find anything that shows that I had this pre-existing but they are going to try anything not to pay. I had not seen a doctor in the last 5 years so that is going to be there number one excuse. That I have seen a doctor and am just not telling them about it. After all..it is a really big coincidence that one month after I get the policy I get diagnosed and have surgery to fix some problems. My Husband is actually a personal injury attorney and we deal with this stuff all the time. I would have to wait until they actually deny the claim (which could take months in the review process and in the meantime my treatment bills are stacking up) I would then have to start to battle with their departments, and the state and possibly even court. I am doing fine with my intestines, what I am not doing fine with is the fissures and the fistula. Do I really want to start this battle when I am not in grave condition???
Descrapster
Diagnosed with CD June 15, 2007
Currently 2 Fissures and 1 Fistula...YAY! Seton Drain currently in.
8 Pentasa/day
Had to stop Flagyl because of numbness in my toes!
 


MishBall2
Regular Member


Date Joined Apr 2007
Total Posts : 345
   Posted 9/26/2007 1:31 PM (GMT -7)   
Des,

I know how you feel: I changed to a PPO plan at work a few years ago and then developed Crohn's 3 months later. I had to go through 9 months of paying out my butt (so to speak)!

Do you know what other uses related to Crohn's that Botox is used for?


32 years old. Diagnosed in 2002ish. 
Taking Asacol, Lomotil TID, and on Remicade since 2004. 
Lower Bowel area only, except for the short stint (about 2 weeks) that I had mouth sores.  Also have external/anal fistula and anal/vaginal fistula. 
 


FitzyK23
Veteran Member


Date Joined May 2005
Total Posts : 4219
   Posted 9/26/2007 3:34 PM (GMT -7)   
Let us know how the botox goes. It would be great if it was a quick fix for us. I often wonder about collagen injections too. This is what they use to plump up lips. It would be like fake skin to fill the hole. Also, they have a new super glue like substance they use in place of stitches. Why cant they fill a fissure with that and stick it back together lol?
25 Year old married female.  Diagnosed w/ CD 2 years ago, IBS for over 10 years before that, which was probably the CD.
 
I started getting a ton of junkmail after putting my myspace profile link on here.  Im taking it off but if you want to contact me just email me and Ill give you a link to my myspace.  Sorry!


descrapster
Regular Member


Date Joined Jun 2007
Total Posts : 155
   Posted 9/26/2007 6:52 PM (GMT -7)   
Mish- As far as I know, Botox is only for intances like this with the fissures. Surgery would remove a piece of the muscle to stop it from having spasms. Since we Crohnies can't afford to lose any muscle, the next best thing is to paralyze it for a while.

Fitzy- LOL! I needed that laugh! Well the collagen plugs that they use is pretty much that same idea. The plug is placed inside to help the fistula close in on itself. As it closes the collagen is absorbed into your body. That of course would be the ideal but it only works in about 30% of the cases. My doctor told me I would probably need a few. She was hoping the remicade and the plug would do the trick together but since Remicade is a no go we will have to wait and see... I started taking Cipro now since the Flagyl was horrible for me and I have very watery D now so the fissures aren't hurting as much when I go. I am hoping that maybe this will give the fissure a chance to relax and maybe not get the Botox but I don't know. Keeping my fingers crossed!
Descrapster
Diagnosed with CD June 15, 2007
Currently 2 Fissures and 1 Fistula...YAY! Seton Drain currently in.
8 Pentasa/day
Had to stop Flagyl because of numbness in my toes!
 

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