Recently I saw a young woman in clinic for knee pain. Far too young to have the kind of joint pain she was having though she had radiographic evidence of joint degeneration (arthritis). But recently she had increased pain. She had been getting lubricating gel shots to her knees with relative success and temporizing symptoms for years. All of a sudden she was getting the run-around from her insurance about these bi-annual injections. They changed their drug preferences and no longer covered the kind that had previously been helpful and were even giving her flack about approving ANY kind of similar injection. She was understandably frustrated and frankly a little devastated.
Together, wearing my PA hat, we discussed her pain in great detail. Triggers, patterns, alleviating factors and came up with some possible home remedies. Wearing and advocates hat, I helped her get to the bottom of the insurance issues and found that they were willing to pay for a comparable alternative. I also encouraged her to discuss with her PCP about ordering labs looking for signs of inflammation and/or potential autoimmune involvement. I’m happy to report that I’ll be able to start her next round of injections next week and we will continue our journey together.