This past week was more than hectic. Between the two of us, we had 3 visits to do tests and doctors visits in Dallas, and then a new doctor for Jim here in Ennis. In the middle of all of those, we had news that I am losing my insurance at the end of the year, our car acted up, I spent hours on the phone getting the insurance company, the doctor’s offices, and our pharmacy to do their jobs. We actually got our rugs cleaned yesterday, even while dealing with both of us in pain, and being worn out from the previous 4 days of being so busy. I was thrilled to see Saturday morning roll around for a change.
If I told the entire story of how many phone calls I made this week to the insurance company, to doctors offices, and the pharmacy, you would probably not believe me.
I think the one thing I got out of all of it, is that I spent MY TIME doing THEIR JOBS! That is what I just don’t get. All of us spend our hard earned money to pay for services, yet why is it we have to stay on top of people to make sure things get done correctly. If I had caused some of the issues I had this week when I was working, I would have lost my job for sure. I was flat LIED TO by one doctors office in Dallas. They claimed to have spoken to my insurance company, and that my insurance told them they would NOT pay for a very expensive evaluation that the INSURANCE COMPANY requires before I can have the pain pump surgery. I guess they thought they would collect almost 300.00 from ME, and I would not check up on them. I made a call that afternoon to my insurance company who first of all said they NEVER TALKED to anyone from that doctors office, and secondly, that visit WAS COVERED! Sure enough (as they HOLD MY FUNDS UNTIL INSURANCE PAYS), that visit will be paid for by the ins. company, all but my small co-pay! I have to wonder if they do that knowing the insurance does not pay all that well, so they tell certain patients that collecting cash from the patients knowing they must have that test first, before the can proceed.
That was just one instance, not including the other several things like another doctors office not faxing what the insurance needed about a new medication that I needed approval on... that the pharmacy first messed up by not sending the form to the doctor. Then the doctors office in spite of several phone calls from myself and my insurance did not fax over what the insurance company needed in order to approve the medication. And I have been waiting now for almost 4 weeks and it still is NOT approved.
Then another physician has a new nurse, that has been at the office long enough to know 3 of my medications come from a specialist pharmacy in Dallas. The doctor has to approve the medications, the pharmacy has to pick those up, then process them, and then MAIL them to me here in Ennis. Yet, the past two months I have had to make 2 follow up calls to remind the nurse that I am in Ennis, and she needs to do her part a couple of days earlier than some, because of them having to mail them. She messed up last month and we had to make a rush trip to North Dallas to pick my medications up because I would be out before they could get them to me. I have been seeing this doctor now for 4 years, and I have been getting my medications the same way all that time. Yet, I still have to make follow up calls in order to get my meds on time.
Then Thursday we both had visits in Dallas. Jim’s was first and we were told it might take over an hour to do all of the paperwork. So, we scheduled my MRI/arthrogram, which was in East Dallas, and his appointment was in West Dallas, several hours later, so we would not conflict with mine. Well, his paperwork only took about 30 minutes, and we had 3 hours or more to spend, waiting on mine. Well, we went ahead thinking maybe they might get me in early, and they could on the arthrogram, but not the MRI, which had to be done within about 30 minutes or so from the contrast being put in my shoulder. Thus luckily it was a beautiful day, so we spent a couple of hours just sitting in the sun, reading and resting in the parking lot of the hospital. The MRI actually ran late due to the patient in front of me, so it was at least 2:30 before they got me in (I had been told it would be at 1:30)... but we managed to get out of Dallas just before rush hour got really bad. We were totally exhausted by that time, but got home safe. Our car overheated on Jim Wednesday afternoon. We thought it was a broken radiator hose or the thermostat stuck wide open. But, hopefully it was just because of it being such a small radiator, it was a little bit low of water and antifreeze, so it just needed more of those. So far around town it did not overheat on us, but would did not want to chance it in traffic in Dallas, so we took my Mom’s car instead. Jim’s not sure about his new doctor. I went with him and can relate. The doctor changed his medication, to something Jim had never had, but did NOT explain anything to him, like it would take 3 to 5 days before it built up enough to work. He also did not tell him some of the bad and adverse side effects. Things that any physician, especially a new one, giving out a new medication that has some potentially adverse side effects, should tell every patient. So, as far as a doctor, he seems to be good, but he has no communication skills with patients.
The good thing is that I am a step closer to finding out whether I do have another tear or more tears in the rotator cuff in my shoulder, plus arthritis bad enough that I need a shoulder replacement (I know that does not sound good really, but I want to know for sure what the problem is), plus I am now going to be where I can have the “trial” for the pain pump. Once I have that trial time, and it works, then I can have the surgery, which from everything I have heard from all of my physicians, along with all I have heard from patients, and online, I will be much more less in pain, with much less medication with the pain pump. So, even though it entails a major surgery, the end result is a very positive thing for me. The issue for me is that my chronic pain is from Lupus, degenerative joint disease, degenerative disc disease, & other issues, such as probably Rheumatoid Arthritis. Thus, even replacing the shoulder, and all of the surgeries I have already had does not stop the pain. There is nothing they can actually “fix” that can stop all of it. They can stop the shoulder pain by a replacement, but my body will still hurt, first due to the Lupus. My other joints like toes, feet, ankles, wrists, fingers, hands, etc. still will give me fits. So will my neck, etc.... thus a pain pump for me is the answer. Hard to accept for sure, but I totally understand why.
In between all of the above, I also spent several hours online researching a new health insurance policy to begin on January 1. The issue with that is I have to try and make sure all of my doctors take it, and all of my medications are covered. Not an easy task, but it seems I may have found one. I need to verify for sure my doctors are going to take it, along with also making sure they are going to cover my medications, but the indication online initially makes me think this one make work out. ☺ A very good thing, since I have several specialists, and quite a few medications.
I could moan, groan and fuss. Believe me I was not a very happy camper at times due to those that are supposed to do their jobs, seemingly not doing them. Yet, it seems that I am definitely not the only one. There are many, many people out there going through the very same as myself, and some much worse.
Yes, the pain is bad. Yes, fighting with insurance, pharmacies and doctors offices is frustrating. Yes, having to go to Dallas more than once a week here lately is an exhausting situation.
But, I have to accept that is a part of my life. Even though I don’t know why I am dealing with the physical realms of these chronic illnesses... only to think it opens doors for me to tell others my story. It opens doors to new places and people online. So, there is a reason for it all.
When we are in a rough patch, it seems it is never ending. Yet, the good times in life always prevail. Once the rough patch is over, what comes next is life at its finest. ☺
Again, I will make two trips to Dallas next week. I soon face that trial couple of days for the pain pump. Then I will spend time again in surgery and recovering, but in the hopes that the results will be very good.
I take one step at a time, one or two feet up that mountain, never looking down, always looking up at where the peak it, and the light shines above....
"Through my heart's work of writing, I share with you my complex journey a top the mountain, sliding down, crawling up, & living through the realms of Autoimmune Arthritic Illnesses. Taming "The Wolf" Thru each Day... One Step at a Time … Together We Are Learning to Survive. Please follow along, to New Beginnings - looking Thru the Window Pane of Pain in life where we shall find our journey leading us to - New Perspectives
Saturday, October 16, 2010
Saturday's Winding Thoughts
Subscribe to: Post Comments (Atom)
How can our kids feel safe when WE as adults don't???? I fear Wal-Mart or just walking across the parking lot at HEB in my small lo...
New Post for Pseudogout, Blood transfusion, Severe Anemia, RA Severe Pain & COVID Virtual Visits & more...I really have SO MUCH to try & catch up here on, so I am going ton"Post"n some of my ongoing chronic health issues, things abo...
After "many" strange" symptoms, DO I ADD yet "another diagnosis" to me endless list of crap wrong with me??? "CPRS"????I finally made a trip to Urgent Care with what I feel is a very bad Lupus and RA flare, but there are several "symptoms" strange t...
Post a Comment