My rant for today:

Dear HMO Provider,

Thanks a lot for once again denying the authorization request for an MRI. I guess you don't quite understand the excruciating back pain I suffer whenever I move in certain directions. I must always be on guard to avoid moving in any way that might exasperate the pain.

I don't quite understand the denial. As per your last communique I did go see an orthopedic surgeon. It was my understanding that this would lead to approval if he deemed the MRI to be necessary. Now you are once again telling me I need to take more conservative measures - pop some anti-inflammatories and do four to six weeks of physical therapy.

Need I remind you that I have had prescriptions for all the anti-inflammatories that are allowed per my HMO plan? I have also paid out of my own pocket for anti-inflammatories that aren't covered by my HMO plan. They don’t work.

I should also remind you that I already did the physical therapy rituals. I have dutifully done all the exercises to the best of my ability. I also attended back school where I learned how to sit, stand, walk, sleep, brush my teeth, vacuum, lift, and get in and out of bed.

I have spent hundreds of dollars of my own money for heat therapy, cold packs, back chairs (an antigravity recliner and an ergonomically correct office chair), relaxation tapes, back exercise videos and books, special pillows and mattresses, chiropractors, massages, therapies and gooey blue stuff.

To think that five years ago I carried a 40 pound backpack up to the top of the tallest mountain in the lower US and today I can't even carry a 5 pound sack of potatoes home from the grocery store. I used to hike but now I walk slowly and methodically, as if on eggshells, because the slightest twist or slip sends immense jolts of pain through my spine.

I'm going to be a grandma soon. I'll not be able to hold that little baby boy for fear of dropping him if he innocently inflicts a painful jab. When he crawls I'll not be able to get down on the floor to play with him. When he walks those first steps towards me, I hope he understands why I can’t bend down and hug him.

Everyday every movement from the moment I get out of bed in the morning is mindfully thought out to prevent the excruciating pain. I can't tell you how many times I have been in a grocery store line, elevator or on public transportation and cringed in response to a slight nudge of someone near me. Sneezes, coughs and hearty laughter trigger instant agony.

I don't know what I expect from the MRI. I know it won't cure the problem. But I sure as heck think it's only fair that I at least get the authorization for procedures needed for an accurate diagnosis. At least then I would know what to expect for the rest of my life.