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Background

In 2014, I noticed a sensation of pins and needles in my feet and went to consult with my Podiatrist. He believed I had some old nerve damage resulting from a large disc herniation I had experienced in 1994. At that time, I had an L4-L5 laminectomy which took care of all my low back and leg pain symptoms. 

My Podiatrist referred me to a Neurologist for additional testing who performed a nerve conduction study and sent me for an MRI. He concluded that I did have some residual nerve issues and some evidence of stenosis on my MRI and referred me to a Neurosurgeon for a consultation. After reviewing the MRI, the Neurosurgeon prescribed physical therapy, and said there was nothing else he could do for me. 

I was very disappointed, but did attend physical therapy and used over-the-counter NSAID medication for pain management. I subsequently developed right buttock pain and started to have trouble going up and down the stairs. At this point I was still working full time as a departmental supervisor at a large home improvement store. My husband is an RN at a local hospital and I asked him to recommend a surgeon who might be able to help me determine the cause of my ongoing pain.

I had new x-rays taken prior to my appointment with the Orthopedic surgeon. He reviewed my x-rays and asked about my childbirth history. After I told him I had two children born breach, he pointed out my SI joints on the x-ray and explained why he thought my SI joints could be the cause of my pain and difficulty walking. We decided to try muscle relaxants, narcotic pain medication and physical therapy. None of these treatments provided any relief so he suggested a diagnostic SI joint injection to confirm that my pain was coming from my right SI joint. If the injection relieved the pain (“positive”), I could be a candidate for an SI joint fusion. After the injection, my pain was completely gone for a short time and I thought “Oh my gosh; we have finally found the problem!”

My surgery was scheduled for March 2016, but three days before the procedure my insurance company called saying they would not pay for the surgery because they felt it was experimental. I was devastated. My surgeon scheduled a therapeutic SI joint injection to help with my pain and suggested I contact SI-BONE for insurance support. In June 2016, I had to resign my position as a departmental supervisor. I reduced my hours at work and took a desk job. I had to use an electric cart to get from my office to the break room. Walking had become too difficult and painful.

I was determined to fight the denial from my insurance company and wrote several emails about my “quality of life” to the CEO of my insurance carrier. I emailed my own human resources department, and when they couldn’t help, I emailed the CEO of my employer. Finally, the Senior Manager of benefits contacted me and with the assistance of SI-BONE’s Reimbursement Department, we took my appeal all the way to the external review process.

Update

I won my appeal and in January of 2017, I had a right SI joint fusion utilizing the iFuse implant System®. I had surgical pain when I woke up from my procedure, but it was nothing like my previous right buttock pain. I used a walker at home for 6 weeks and set up my own physical therapy suite in a bedroom with bands, balls and weights to regain my strength and mobility. 

I went back to work full time three months following my procedure. I now work in the appliance department and I track 5 miles a day on my Fitbit. I have taken up practicing yoga, and enjoy swimming and kayaking on the river. Customers who knew me before my surgery comment on my “new smile” and my ability to walk across the entire store.