Cigna won't allow my friend to go into hospital with swine flu.

[monmouth]

This is her 30th day, every imaginable drug, including a steroid prescrip has been given. She's had a 102 temp since the beginning and is dehydrated. She went again to the doctor. He says she doesn't meet the criteria (according to Cigna) to be admitted. I'm shocked. She's very upset, aged 48, single, no one to help her and I can't stay with her, if I get it I'm up the creek. We discussed trying the back door of the emergency room but don't know how that will play out as she is in the middle of foreclosure, etc.

Any suggestions I can pass on to her? This is a person who has never missed a premium payment on her insurance... This is making me ill.
Life is short, live like it's your last day....

[blm]

1. Call the local newspaper and local television newsroom.

.

[ChickMagic]

3. Good Idea!

The "we're on your side" consumer reporter would be the one to call.

[ChickMagic]

2. You could try the ER

You and she could mask and glove up if you could go to her home and make sure she has
loads of water and food she can heat in the microwave.

At least in the ER they will give her IV fluids.

[monmouth]

8. I think we will try the ER, just say we don't know what it is and play it

out that way. Seems a shame in this country and in this day and age we have to resort to some sort of trickery to get treatment with a solution. Thanks for your help.

[ChickMagic]

11. Anytime, monmouth

:hug: And it's not trickery.

[dflprincess]

35. Unless she takes a turn for the worse, Cigna may not pay for it

if they have the records that she's been to her doctor and he hasn't admitted her they'll claim it what not an emergency that would drive a "reasonable person" to the ER.

If you do decide to go, call Cigna first - exaggerate the symptoms if you have to be but get the okay from them to go to the ER. Get the person's name and record the call (if it's legal where you are) or tell them the call "might be recorded for quality".

[Spider Jerusalem]

4. If your friend has been ill for 30 days it probably isn't swine flu.

The majority of cases run their course within a week. An illness that's continued to be symptomatic and has produced consistent fever for a month is very likely to be something else.

[monmouth]

7. I am also thinking this is a mis-diagnosis. With so many symptoms

the same it's perhaps easier to give that diagnosis. I think tomorrow, depending on how she's feeling, we're going to go to the ER and play the "I don't know what's wrong with me" card and hope something can be done. Thanks all for your help.

[Lydia Leftcoast]

13. If she's dehydrated, try giving her little sips of water every 10 minutes

Dehydration is nothing to kid around with.

[The Backlash Cometh]

21. Mine lasted two weeks and a day.

I'll tell you firsthand that it plays with your respiratory tract. You think you're getting better, but it starts hitting another part of your breathing areas.

Five to seven days -Tamiflu puts the virus in check. That's just the fever, stomach upset and diahrea, confusion, muscle aches. Meanwhile, your lungs are getting congested and your sinuses are infected. Second week, run to the doctor for anti-biotics for your lungs to keep them clear. Also in the second week, you suddenly come down with a cold. It's your sinuses. Nose rinse in the morning, Steam inhalataion three times before going to bed. Vicks on the chest, cough medicine to calm a cough that begins the second week, mild decongestion before going to bed so you can sleep.

Oh, and one day I took twelve steaming baths to help me keep my air passages open.

I don't work. All I did for two weeks was take care of myself. Lots of chicken soup. No appetite for anything else. I really don't know how working people are getting over this.

[Mojorabbit]

24. Almost a month and I am still not at 100 %

Mine went about like yours but I didn't take tamiflu. My vocal cords still haven't recovered after all the coughing and I have a raspy voice.

[The Backlash Cometh]

28. I'm so sorry.

hydrocodone-homatropine syrmor is the cough medicine I was prescribed.

Boil some water, put it in a bowl (like the kind you mix batter.) Stick you head in the bowl and inhale the steamy fumes. Be careful not to burn yourself. As the water cools enough to touch it, get a face towel and soak it and apply the hot towel to your sinus areas if you have sinus problems. Do this three times.

Good luck.

[CherokeeDem]

5. This is appalling...

I would start by calling the local press and tell them her story; call the local health department who is in charge of infection control for the community and your elected officials. Maybe a call to the State insurance commissioner might help. Do you know what she is not qualifying for?

If she is in fact, dehydrated she most likely needs fluids...I am not a doctor but it sounds like she really needs a doctor who will fight for her or she needs to get to the emergency room.

Our thoughts are with her...good luck.

[ChickMagic]

19. Definitely go to the ER

You can say you thought it was swine flu, but the fever has gone on for x number
of days. (Swine flu fever that high only lasts 4-5 days). If it's been close to a month, that's something else entirely. Start from scratch - don't give them a diagnosis. Let them figure it out.

[dysfunctional press]

31. have someone from your congressman's office and the media meet you at the ER.

nt

[still_one]

6. What does her Doctor think? If her Doctor believes she should be in the hospital

but the insurance won't allow it, then she should find another Doctor, because he isn't fighting for her

If it has been a month, and things aren't better, just on those grounds alone, at the minimum she should get a second opinion

good luck

[timeforpeace]

23. I was hoping someone would see the flaw in this OP.

[rucky]

30. Seeking advice = revealing a flaw.

I guess that's one way to look at it.

[dflprincess]

36. Cigna doesn't give a damn what the doctor thinks

and nothing s/he says will persuade the low level clerk that an authorization for an admit should be given if it doesn't fit the guidelines the clerk is reading.

[Capn Sunshine]

9. I swear to god

I'm not sure how much longer the American public is going to see this kind of behavior from the Health Insurance companies (multiply this incident times 10,000 by the way) and not take to the streets.

It's mind boggling how they continue day after day to get away with this, and if you're against this type of behavior, you're a commie leftist dirtbag.

[Lydia Leftcoast]

10. A 102 fever for a month is NOT normal

and dehydration is considered an emergency.

[Ms. Toad]

12. You need to find out if her doctor would recommend

hospitalization, independent of Cigna's guidelines.

(If he wouldn't, then it isn't an insurance issue...) If he would, then you need to enlist him to challenge Cigna.

Appeals are generally pretty easy to win, mostly because no one challenges them. Get a denial, appeal it - with the support of her doctor recommending why she needs to go to the hospital. I have yet to lose any of the many appeals I have chosen to pursue. The last win (to a specialist outside of the network) was two months ago.

If he refuses to support her appeal, even though he believes she belongs in the hospital, that should tell her all she needs to know about his commitment to her care - and send her hunting for another primary care physician (and count her blessings that she found out his tendency to subvert his medical judgment to that of the insurance company on a matter so relatively insignificant).

We jettisoned our last PCP for precisely that reason. Daughter broke a bone in her foot - at the time her growth wasn't yet finished, and they didn't know whether a growth plate was involved (lots of swelling, couldn't get a clear x-ray in the ER).

She referred us to an adult orthopedic surgeon. We asked her to do one of two things: Justify her referral to an adult orthopedic surgeon, given that a growth plate was potentially involved (if he had a sub-specialty in peds, for example), OR support our appeal our insurance company's refusal to approve an out of plan visit to the only orthopedic surgeon within 60 miles. She said she knew absolutely nothing about the specialists' training/sub-specialties other than that he was "willing" to see kids, and offered to assist us at her normal hourly rate if that wasn't good enough for us. Needless to say, she was not our physician for much longer.

[monmouth]

15. Thank you so much for all of your help. A second opinion is definitely

in the works. Hopefully she'll be in a hospital by tomorrow.....

[Ms. Toad]

17. Best of luck

I am just over the H1N1 virus, myself. It wasn't much fun - but fortunately the fever portion only lasted 5-6 days (103-104 that I couldn't chase lower than 102 away with a double dose of ibuprofen - and I was guzzling anything liquid I could find to keep from getting dehydrated). Now all that's left is tired and a nagging bit of bronchitis.

[aquart]

14. Who's her goddamn congressman?

Who are her state representatives. ALL OF THEM SHOULD BE TOLD. lET THEM KNOW THAT LIFE AND DEATH IS IN THEIR HANDS.

Amazing how helpful a call from an elected person can be.

[Lint Head]

16. This 28 year old mother of a 9 month old died.

Insist that she be treated. CIGNA is fighting a major negative PR battle. Call the media right now.
Get the news out to anyone that will listen. I had my H1N1 flu shot today.
http://www.tennessean.com/article/20091030/NEWS07/910300375/Young-mom%5C-s-death-exposes-H1N1-dangers



:dem:

[The Backlash Cometh]

18. Ice bath.

Find an old nurse to explain it. It's a sort of shock treatment, but it knocks the fever out.

30 days. Damn.

[Ms. Toad]

25. That, and enemas.

. . . I recall both well from my days of 106 before they removed my tonsils.

[TicketyBoo]

29. An ice bath is overkill.

A lukewarm bath will cut down a fever due to the evaporation of water off the skin, which cools you down.

Alcohol rubs are good, too, if she has someone who can do them for her.

[The Backlash Cometh]

32. The friend (who may have infected me with swine flu) told me

she had a fever of 103 for five days. The ice bath worked for her. I think it went like this:

Throw in three or four bags of ice (without opening) into a bath. Get in and take it to just when you start to shiver. She said for her it was 8 minutes. Then get up and get under the covers to warm yourself. Then when your temperature starts spiking again, do it again; and a third time. She said it worked for her.

[Warpy]

20. She needs to drink even if she thinks she'll throw it up

because she'll absorb some of it and reverse any dehydration. It's vitally important that she does this much.

The criterion for going to an ER is difficulty breathing. If she starts to feel short of breath, she needs to go in immediately. She can call Cigna from the waiting room. Her life is more important. However, if she's breathing OK, she's stable enough to stay home, no matter how rotten she feels otherwise.

Being sick alone is ten times as bad as being sick with someone else around, even if that someone else is a useless husband bitching about not having any clean socks.

[lynne]

22. What is the criteria that is prohibiting her from being admitted? -

- She should be talking to Cigna directly with regard to this matter, not through the physician's office. It's possible that whomever talked to Cigna at the Dr's office didn't have their facts straight or that there is some other type of confusion.

[nadinbrzezinski]

26. Pedyalite in small doses

that will help with the electrolytes... and easier to do than the rehydration formula.

And contact the local media and embarrass Cigna. That is what seems to work these days.

[TicketyBoo]

27. Yes.

Pedialyte. Comes fruit-flavored or unflavored. It replaces electrolytes.

[dflprincess]

37. I think Pedialyte also makes popsicles

an easy way to get the liquid in slowly.

For that matter, plain old popsicles work well when your stomach is so upset you can hardly take water, but they won't replace the electolytes.

[MiniMe]

38. Pedialyte pops are even better

Taking fluids down in frozen form goes down slower and tends to stay down better.

[DU GrovelBot]

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[TexasObserver]

34. How did the hospital catch swine flu?

Sorry about your friend.

As long as we need permission from insurers to get hospital treatment, we're in trouble.