Excellence in Pain Practice Award

dr. kamson

Sol Kamson MD is very proud that the Spine Institute Northwest has earned an Excellence in Pain Practice (EPP) Award from the World Institute of Pain. The achievement of this award provides Dr. Kamson and his colleagues with recognition of their dedication to treating patients with the highest quality of care and for attending continued educational and training programs and seminars in the field of interventional pain management.

The World Institute of Pain began distributing the EPP Award in 2010 to promote the highest models and standards of pain management practice around the globe. This organization was founded over 20 years ago by Phulchand Prithvi Raj, Ricardo Ruiz Lopez, and Gabor B. Racz, in order to help physicians and researchers work together to improve the quality of life of those suffering from chronic and acute pain.

Pain Treatment Center Credentials

Physicians, such as Solomon Kamson, and scientists who are members of the World Institute of Pain are able to share important information concerning research and clinical studies in order to help and learn from one another. Through the Institute, these medical professionals can attend international seminars and training sessions. Data and information is pooled from physicians around the world. This knowledge is then distributed to members, enabling them to learn more about the results of certain procedures, new treatments being developed, and the best practices in pain management techniques.

With the EPP Award, Dr. Sol Kamson and Spine Institute Northwest, have been singled out not only for the treatments they offer, but also for the practice as a whole. The organization reviews the ways in which patients are cared for by every member of the staff during a site visit.

“Gaining the cache of being able to display the World Institute of Pain’s red shield on our web site has inspired even greater confidence in our abilities from our many satisfied patients, while it also helps to reassure new patients that they will be receiving the quality of care they deserve.” Solomon Kamson MD PhD, Director of the Spine Institute Northwest, notes that the EPP Award is an honor to receive, as it points him and his team out to patients as being a top practice in the field of pain management.

Now that you are aware of the EPP Award bestowed upon Dr. Sol Kamson at Spine Institute Northwest, give us a call and schedule an appointment before you make the decision to undergo treatment for your back pain. You may send us your MRI or CT scan for a complimentary consultation with Dr. Kamson.

Stem Cell Therapy: Not Just for Athletes Anymore

golfer-swinging-club-backProfessional athletes were among the first to receive innovative stem cell therapies to treat problems related to sports injuries. Knee injuries, for example, can be hard to treat due to the fact that the body usually doesn’t repair torn cartilage and tissue on its own. With the help of stem cell therapy, physicians like Sol Kamson, MD, can offer a natural fix for damaged tissue. There may even come a day when knee replacement surgery will no longer be necessary.

Athletes and Stem Cell Therapy

When Peyton Manning sustained a serious neck injury in 2006, the former Colts and Broncos quarterback had to travel to Europe to receive treatment with stem cells, as this option was considered to be experimental in the United States. After his therapy with stem cells in Europe, Manning was able to play football for several more years and retired after last year’s big Super Bowl win. It’s now known that stem cell therapy is particularly encouraging for neck injuries because this delicate area can be hard to treat.

Today, stem cell therapy is widely in use when it comes to healing athletic injuries. This type of therapy is considered a medical treatment by the NFL, rather than known as an athletic enhancement. Many sports physicians and orthopedic surgeons, such as Solomon Kamson of Spine Institute Northwest, now recommend stem cell therapy for certain injuries that require regenerative treatment. Famed tennis player, Rafael Nadal, chose this type of therapy in 2014 for a back injury after having opted for stem cell therapy for a previous knee issue. Kobe Bryant of the Los Angeles Lakers went to Germany in 2011 for regenerative treatment on his knee.

Regenerative Medicine

Stem cell therapy uses material from your own body to fix and regenerate injured tissue without undergoing surgery. Sol Kamson MD offers different options for regenerative therapies to heal injuries at the cellular level.

Stem cells have the capacity to change into the kind of cell they are placed next to. This helps the body repair tissue and regenerate new tissue, stimulate bone growth, and lessen the formation of scars. Dr. Sol Kamson uses stem cell therapy to relieve joint and/or back pain at the Spine Institute Northwest. The different types of stem cell therapy used by Dr. Kamson include:

  • BioD Regenerative Therapy
  • MatriStem A-Cell Injection
  • Platelet-Rich Plasma (PRP) Therapy
  • Amniotic Cell Matrix
  • Stem Cell Therapy

If you have severe joint pain, ligament or muscle damage, these types of therapies may be helpful to you when used along with surgery to promote healing. Used for shoulder injuries, acute accident trauma, mildly degenerative discs, and bulging discs, stem cell therapy may be right for you. It takes just half an hour to receive regenerative treatment.

Contact Solomon Kamson MD at Spine Institute Northwest for more information or to schedule a consultation.

Dr. Kamson Patient Testimonials, 2017 Update

Dr. Kamson, president of the Board of Directors For the Society For Advanced Spinal Intervention and founder of Spine Institute Northwest in Seattle, is an advocate of both minimally invasive surgery and regenerative medicine in treating spine conditions of the thoracic, lumbar, and cervical areas.

Minimally invasive surgery spine surgery (or less invasive spine surgery), as opposed to traditional open back surgery requires much smaller incisions since it relies on state-of-the-art imaging technologies and endoscopic tools, resulting in significantly lesser damage to surrounding muscle areas, lesser pain, faster recoveries, and shorter downtime for the patient. Another significant difference is that minimally invasive surgery can often cost a lot less than open surgery.

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Dr. Kamson consultation with a patient

Watch information on Dr. Kamson and the procedures they perform at Spine Institute Northwest in the YouTube video link below:

dr-kamson-youtube channel

Latest Patient Testimonials for Dr. Kamson

Read the success stories of some patients who were suffering from various forms of back pain in their individual testimonials below.

Chronic Pain Survival: Jeremiah Dawson

As a field training officer, Jeremiah relied on his ability to be active – running, performing training exercises, and keeping up with rookies. However, a bout with back pain while training turned out not to be just any ordinary pain. Painkillers did not help with Jeremiah’s pain at all, which led him to seek out alternative treatment. His search led him to Dr. Kamson and the Spine Institute where he had fusion performed on his cervical and lumbar spine. Grateful of the care he received from SINW, Jeremiah says:

“Thanks to Dr. Kamson and SINW, there is light at the end of the tunnel.”

spinal fusion

Cervical Fusion Ends Michelle’s Suffering

michelle-roberts

Arthritic degeneration in Michele Roberts’ spine caused her chronic neck pain that prevented her from doing normal everyday things such as turning her neck and simply brushing her hair. Dr. Kamson operated on her cervical vertebrae and did a fusion to deal with her pain. “I came to see Dr. Kamson and he was so nice and confident. I had trust in him,” Michelle says. After becoming pain-free, she encourages other sufferers like her to have their back pain looked at instead of keeping on suffering.

Kathleen Cowitz-Laski: Lumbar Decompression

Kathleen, an active grandmother who owned her own house cleaning business was in very bad shape before having back surgery.  She needed a walker to move around and gradually her mobility worsened.

“My leg actually felt like concrete. I couldn’t lift it, and to get into the car was bad!”

A lumbar decompression procedure restored her mobility, so she now can tend to her business. What’s more, she can now play with her grandchildren – an activity she could not enjoy before her surgery. “I was surprised how soon I could walk after my surgery.”

Esteban Castaneda’s Chronic Pain Relieved

Desperation led Esteban to seek out an alternative form of treatment for his chronic back pain. No amount of painkillers or medication could address his back pain, which turned out to be caused by a birth defect – a pars defect. Dr. Kamson operated on his lumbar area to address Estaban’s pain.

Cameron Reyes Opted for Minimally Invasive Surgery for His Back Pain

Cameron, a 300-pound 6-foot former football and wrestling enthusiast as a young man, ended up with chronic back pain as an adult. His severe back pain left him depressed. Wanting to find a way to deal with his pain, Cameron researched traditional open back surgical procedures, but decided that the extended healing and downtime was not for him. With the minimally invasive procedure he received (a lumbar decompression), he was able to end a “horrible chapter in his life.”

“When Dr. Kamson told me that he could make me better…I wept like a kid.”

lumbar decompression patient

Cameron can now laugh when he recalls his successful operation.

Randall Huff, was another Spine Institute patient who underwent lumbar decompression for his back pain. After his back pain dispossessed Randall of the ability to do anything – he could not work and found it impossible to sleep – he decided to seek treatment.

Tim Watts: Ruptured Disc Treatment

Tim suffered from two ruptured spinal discs and was also enduring the painful effects of spinal stenosis (a narrowing of the spinal canal) that put pressure on the nerves in the spine and spinal cord. After meeting the staff of Spine Institute Northwest and speaking with Dr. Kamson, Time says, ” I felt comfortable with what he had to say…I felt like this was the place I needed to go.” True enough, after his procedure and much to his surprise, the tension in his legs completely disappeared quickly after.

Dan Schmalzried: “It Almost Feels Like a Miracle.”

Dan faced opposition from from everyone when he decided to get surgical relief for his back pain. No one in his family believed that traditional surgery was the best solution for his pain, since he would still have to deal with more pain and an extended healing period afterwards. Even doctors and physicians he consulted were against him. No one believed he could get rid of his pain. His procedure at Spine Institute Northwest proved the naysayers wrong. A fusion and a repair of a herniated disc that was causing pain cured the numbness and the pain in his foot and back.

Watch his testimonial in the video below:

Mary Halabi: Herniated Disc Injury

Mary never thought that a routine weightlifting session would lead to something much worse than a pulled back or a sprained muscle. Self-diagnosing her pain to be nothing more than a pulled muscle was not a wise move for Mary, as her pain did not go away and only went from bad to worse. The pain got so bad that it caused Mary to miss class.

After a minimally invasive procedure relieved the pressure on her spine. Mary says, ” If you have pain, have it looked at professionally.”

Disabled From a Ruptured DIsc: Jim Perri

A problem with Jim’s L5 (lumbar vertebrae) caused him intense, debilitating back pain. Coupled with sciatica that caused more pain in his right leg, Jim’s pain level was, in his words, a twelve (12) on a scale of 1 to 10. All the pain he was experiencing meant that he effectively could do absolutely nothing but rest on the floor all day.

After his procedure at Spine Institute Northwest, his pain level dropped to a zero, for which he is extremely grateful.

Dwayne Burnell: Twice Treated for Two Different Spine Conditions

Dwayne has been a patient of Dr. Kamson twice. Once in 2003 for leg and back pain and again more than a decade later, for an unrelated condition in his spine. What brought Dwayne to the Spine Institute both times was the very thorough and analytical approach to diagnosis and care he received that ensured that he was well taken care of. Hear Dwayne relate how his experience in the YouTube video below:

Margo Witters of Spokane

Margo used to rely on her walker or her wheelchair to go anywhere. Not that she could really go anywhere since she was in chronic pain that made even the simplest of tasks impossible.

Her pain ended after coming in to the Spine Institute Northwest which treated her back through a lumbar fusion procedure.

“I felt really good right after the surgery…I can do things I haven’t done in four or five years.”

Dr. Kamson with Margo

Dr. Kamson (middle) with Margo and her husband after her successful procedure are Spine Institute Northwest.

 

Dr. Kamson’s Patient Reviews

Read through Doctor Kamson’s patient testimonials and watch their stories in the videos below.

“I’m back to doing things that I’ve always enjoyed. I couldn’t have worked 30 minutes before.”

– 89-year-old Irma Stennes, on the change her life underwent after Doctor Kamson helped fix the chronic pain in her back

“It is amazing. I’m back to all my normal activities. I can go and do sports.” 

– Jaselyn Lee, lumbar discectomy patient at Spine Institute Northwest, on the daily activities she can once again do after her procedure

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Stopping the Pain for Our Returning Troops!

Our troops are suffering significantly from chronic back pain once they have returned home. Although our veterans have had to tolerate the pain long enough to finish their tour, there is no need for continued suffering. Chronic pain has a way of infiltrating many aspects of their lives and Doctor Kamson would like to stop the pain.

Common back pain is usually a result of sitting too long or poor posture – civilians can remedy the pain by simple lifestyle changes. However, our troops suffer chronic pain caused from time on the battlefield. Though there are certainly troops who have desk jobs, those whose assignments involve carrying lots of equipment or wearing heavy protective gear for long periods of time are prone to wear-and-tear injuries. Veterans may also experience back pain as a result of injury, which can complicate the treatment process.

It’s unfortunate that returning troops may experience common problems caused from chronic back pain. For ‘anyone’ experiencing chronic pain, there is the risk of developing feelings of frustration, despair, and depression. This risk can be even greater for veterans, even those returning from non-combat missions. Back pain and back injuries can limit your ability to work. For those who have made serving their country their career, back pain can seriously inhibit successfully performing their duties.
We want our military to have easy access to medical help to stop back pain. However, this isn’t possible with the VA. Beginning in 1998, the Veterans’ Administration has used a protocol for handling veterans’ pain issues known as the National Pain Management Strategy. However, the lengthy wait times and inefficiencies of the VA system have been well documented. Returning troops are faced with bureaucratic hurdles and frustrating lags, especially for seeing specialists. Though efforts are being made to overhaul the VA, chronic pain can make each day feel like an eternity.

If you would like to stop chronic back pain, don’t wait! The Spine Institute Northwest offers a comprehensive array of treatment options, and we make every effort to make sure you don’t need to wait to come see us.

Low-Cost Back Pain Treatments

For some people who deal with back pain, the thought of taking on surgery may bring on as much discomfort and concern as the pain itself! Though the kind of minimally invasive spine surgery practiced by physicians like Solomon Kamson is less invasive, with a smaller incision and a briefer recovery period, it’s important to know that back surgery is still reserved for cases where more conservative treatments have failed. Unless it is a case of acute injury, there are other forms of treatment that can be tried first. Some can even be done with minimal cost. These kinds of treatments should still be undertaken under the guidance of a doctor. It’s important that you keep track of what works — and what doesn’t — and that your physician is aware of any changes in the nature of your pain.

Eat Right
Altering your diet to ensure you are getting the nutrients that will be most beneficial to your spine is one low-cost way to support your back health. While it’s always important to have a balanced diet, if you are experiencing pain you may benefit from eating foods that compliment a specific kind of healing. Certain foods like pepper are known to have minor painkilling properties (and in fact, capsaisin is often used in topical painkillers). Make sure you are getting enough calcium and vitamin D in order to support your bone health.

OTC Medications
For some people, limited use of supplements or over-the-counter medications can help ease pain. However, for others this may not be a good option. Depending on your liver and heart health, you doctor may or may not want to prescribe you a regular dose of OTC medications like NSAIDs. For these patients, selective use of supplements may provide some relief.

Heat or Cold Therapy
Heat and cold are best used for different kinds of injuries (heat for muscle soreness, cold for swelling). Some people benefit from alternating between the two. Cold packs that you put in the freezer and hot packs that you warm in the microwave are inexpensive and reusable. Keep both on hand, and make note of what works.

Tame Tension
Many people suffer neck, shoulder, and back pain that is exacerbated by physical stress. Whether it comes from overexerting your muscles through keeping a tense posture, sitting in an unhealthy position all day, or performing physically demanding tasks, this tension can have a very real impact on your back health. Trying stress relief measures can reduce the amount of pain you experience as a result of tension, which in some cases can also help prevent further injury. Relaxing by indulging in a favorite hobby, reading a good book, or meditating are all inexpensive ways to reduce your physical tension at the end of the day.

When it comes to treating back pain, more isn’t always more — sometimes simple and inexpensive changes like these can help relieve your pain. If you are experiencing persistent, intense pain, it’s important that you see a specialist like Dr. Kamson to get a proper diagnosis and treatment plan.

Alternatives to the Spinal Pump

Spinal pain pumps are one option for people who are dealing with intractable chronic back pain. These devices, which are implanted into the back, work by delivering a pain medicine in regular doses over a specified period of time. A doctor will “refill” the pump each month, and the pump will then administer the medicine over the course of the month to help control your pain. Solomon Kamson notes that it is important to know that spinal pumps ease your pain, but do not treat underlying disorders or conditions. It is critical that you have an accurate diagnosis in order to have a pain pump be effective: You don’t want to mask symptoms of a problem that could become worse, so it is important to understand the causes of the pain. There are numerous methods that can be used to manage chronic back pain; a treatment like the spinal pain pump should only be used when more conservative treatments have failed to decrease your pain.

Physical Therapy and Medication
Physical therapy is one of the least invasive means of treating back pain, and so it should generally be your first option in situations where you are experiencing minor to moderate back pain that has not been specifically diagnosed. Prescription or over the counter oral medications can be used to supplement physical therapy as your doctor considers appropriate.

Other Forms of Medication
In some patients, medications that are not indicated for back pain (like antidepressants and anticonvulsants) can help with chronic pain. These medications have been linked to a decrease in neuropathic pain experiences. Of course, this course of treatment can only be attempted with a physician’s guidance.

Massage and Yoga
While the relief from massage and yoga may seem temporary, for some people regular use of these therapies can lead to a long-term decrease in back pain. With regular use, the muscles supporting your spine can become stronger, more flexible, and more relaxed, helping to relieve pain.

Spinal Injections
Spinal injections treat pain through much the same mechanism as a spinal pump, injecting pain medication at the site, but are of course less permanent. Doctors will frequently use spinal injections not only to treat localized back pain, but also to try to identify the underlying causes of the pain. The extent to which injections help ease pain can give your physician valuable information on the nature of your condition. Injections are preferred to treatment with oral medications as these work more quickly.

Treating Other Areas of the Body
Many people are shocked to discover that a pain they have been experiencing as back pain is actually being caused by a problem in another part of their body, such as the hips or feet. Identifying and treating the source of this pain can provide the best source of pain relief in these cases. This is another instance that underscores the importance of an accurate diagnosis from a physician like Dr. Kamson.

Regenerative Therapy
If you discover that your back problem is related to natural wear and tear that results from everyday use or from an old injury, you may be a candidate for regenerative therapy. These are not pain treatments. Instead, regenerative treatments like platelet-rich plasma therapy help encourage new cell growth and healing. The immediate result is not necessarily pain relief, but relief from pain can be the net result as your body repairs and replaces worn-out tissue.

If these kinds of therapies do not provide enough relief or a lasting solution, a spinal pain pump may be one option that you can pursue. Back pain that is related to structural damage to your spine, however, like vertebral compression fractures or a herniated disc, is better suited to intervention with minimally invasive spine surgery. When a physical issue like one of these is the source of your pain, it’s important to treat the problem, not only the symptom.

The Impact of Really Hard Jobs on the Back

Due to increasingly sedentary lifestyles, the average American is now more likely than ever to experience back pain at some point in his or her life. But what about people who do not have sedentary lifestyles? There is research to support the claim that people are more active tend to have far fewer complaints of back trouble. But on the flip side, people who have jobs that require lots of repetitive motions or lots of standing for long hours are at high risk to develop back pains. Beyond that, there are some jobs that put strain on the back in very particular ways. Here are a few careers that go along with some very particular kinds of stresses for the spine and its supporting muscles.

Doctors and Nurses
Medical professionals are very likely to spend a lot of time on their feet in the average workday. Exacerbating the problem, most surgeons and nurses will have to spend at least some of their time holding odd and uncomfortable positions. Even when the surgeon is able to sit down during a procedure, they still have to hold their neck and back in a particular way for a long period of time. For nurses, there is the additional stress of having to often lift patients of all sizes on to and off of their beds or out of their wheel chairs. Especially with very large patients, this can actually lead to severe back problems for nurses if even the slightest misstep occurs in the process of lifting a patient.

Athletes
While for most of us tend to think of the pain we feel after exercising in a “no pain, no gain” way, for professional athletes that kind of pain can have serious repercussions. This is an especially big problem for professional athletes like football players who regularly collide with each other, leading to injuries of the head, neck, and back. In fact, recent studies have shown that a disturbingly large number of professional football players have experienced a concussion or other injury to the nervous system that can lead to long-term pain as well as problems with cognition and physical functionality.

Astronauts
Space travel is an experience that is so outside our normal frames of reference that it seems filled with excitement and wonder. But for those who have actually experienced it, the hard truth is that being an astronaut is a physically demanding profession. Recently, Gennady Padalka set the new record for the longest time spent in outer space with a 168-day stay on the International Space Station. In all, Padalka has spent 879 days in space. Researchers are hoping to study Padalka to better understand the long-term effects of space life on the human body. According to an article by NPR, extended periods in outer space can lead to atrophy of the muscles, a decrease in bone density, and spinal extension, which may lead to health issues even after returning to Earth.

Dr. Kamson notes that almost no one goes without experiencing some kind of difficult pain at some point in their lives. Regardless of the nature of your job, you have the chance of developing a back problem. It’s important to know what your risk factors are, and what preventative measures you can take to prevent work-related back injuries.

Key Exercises for Back Health

To prevent or alleviate back pain, one of the most important things that patients can do is increase their exercise routine in ways that specifically focus on back health. But, if you’re new to the concept of exercising for a specific muscle group or body part, how do you know which exercises will be most beneficial? Here’s a quick guide to the core relevant muscle groups to help you get started:

The Back Itself
You might be surprised to discover that many times when patients experience back pain, it is not from overuse but actually from underworking the muscles surrounding and supporting the spine. People who experience back pain will sometimes avoid strain and exercise, which actually ends up making matters worse.

Here’s a quick set of moves that helps strengthen your back by stretching muscles while using mild resistance: Using dumbbells (pick a weight that’s comfortable for you), spend five to ten seconds in each of the following poses with one weight in each hand. First, hold your arms directly in front of you parallel to the ground. Then, slowly bring your arms straight up above your head. Last, extend your arms straight out to your side.
yoga-exercise-group
The Core
The muscles in the core—the long muscles that wrap around your torso, supporting your spine—are extremely important for back health. The following exercises are just some of the ways you can work on strengthening your core:
• Yoga poses including cat/cow, sunbird, and the boat pose
• Traditional floor mat exercises like crunches, bicycles, leg lifts, or jackknives
• Taking a vigorous walk for ten to twenty minutes. Though it might not seem like it helps your core, this kind of cardio both engages your muscles and can potentially release endorphins, which in itself can reduce the perception of pain.

The Thighs and Glutes
In many people, a flat backside is a good indication of poor spinal strength and health. Your hips and tailbone are critical for spinal functionality; so don’t neglect training the muscles in those groups.
• Squats and lunges are extremely good for working out your thighs and glutes. You don’t need to use weights, though you can add free weights to these exercises. What’s most important to focus on is and positioning, as poor form in squats and lunges (especially when using weights) can lead to injury.
• Use a treadmill or elliptical trainer set to an uphill incline. This will exercise your core and back, as well as strengthening your glutes and thighs.

Plus the Brain!
Though your brain isn’t a muscle, you can still give it a workout. It’s important you don’t neglect mental health and stimulation when addressing back pain. Boredom, depression, and fatigue can all exacerbate chronic pain, so keeping yourself happily engaged with hobbies, work, reading, or conversation, can all help you lessen your experience of pain.

Don’t forget: Before you begin any exercise program, it’s important to consult with a physician first. You need to ensure that the exercises that you are doing will not cause injury, as well as that they are properly supporting your back health. If you are experiencing chronic back or neck pain, contact a specialist like Solomon Kamson of the Spine Institute Northwest.

How Can I Appeal a Rejection By My Insurance Provider?

Even if you have a completely successful minimally invasive spine surgery, all too often if you can’t provide evidence that your insurer feels is sufficient to deem the procedure medically necessary your claim will be rejected. Unfortunately, there can be a wide gap between what your insurance provider considers necessary and what feels necessary to you, especially when you’ve been suffering from chronic pain. What are your options?

Medical Tourism
For some people, the best option is to explore options elsewhere. In fact, insurance rejection is one of the biggest motivators for people to research getting a specific procedure in another state or another country. If you don’t want to fight your insurer or deal with miles of red tape and medical bureaucracy, exploring your options in other locations can be ideal. For example, many patients who come to see Dr. Solomon Kamson at the Spine Institute Northwest in Washington travel from states like Alaska, North Dakota, Idaho, and Hawaii.
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Your Rights to Appeal
Regardless of the type of healthcare you have (including Medicare and Medicaid), you always have the right to appeal a coverage decision at least once. If your appeal is rejected, you may be barred from appealing again, so it’s important that you make your case as strong as possible. Your primary responsibility is to provide evidence that your spinal procedure is medically necessary. If you do decide to appeal, here are some helpful tips:

• Read the guidelines for making an appeal by the North American Spine Society. In cases where a mistake can lead to days of bureaucratic delay, it’s always smart to be sure you’ve thoroughly understood the directions.

• Make sure you have your physician on your side. Your surgeon knows more than you do about what makes this procedure medically necessary, and is basically your “expert witness.” Talk with your doctor about the possible complications of waiting to have the procedure or of failing to get the procedure altogether. If this could be an issue, it can motivate an insurer to cover a procedure, particularly when left untreated the problem will be more expensive in the long term.

• Keep a folder of all of the paperwork that you think might help you prove your case. This could be documentation that confirms your doctor’s recommendation, the confirmation of a second opinion if you have one, proof of the undue financial burden of the out-of-pocket cost, proof of your attempts to undertake alternative and preventative practices, and proof of your long-term attempts at treatment as well as the progression of your disease or injury.

• You should also be keeping a record of your communications with your insurance provider. This will help you prove that you have followed all directions, submitted the proper paperwork, and so on.

• Even when you’re struggling with pain, keep your cool and remain courteous but firm. If you become angry, people may write you off or even refuse to help you any further. You want every encounter you have with your insurer—whether in person, over the phone, or via email—to be good and productive, while making it clear that you don’t intend to relent anytime soon.