Showing posts with label complacent. Show all posts
Showing posts with label complacent. Show all posts

Wednesday, March 11, 2015

How DO You Deal with Doctor's Offices, especially the Nurses and Staff When they just REFUSE to HELP YOU get proper care

It it to the point we sometimes must question "why" our doctors, dentists, an other medical professionals get into the business of "patient care". My family has had several events over the past month, and 99 percent of it all, is due to "lack of doing their job properly"! Of course we had the horrible weather in the area for several days over a couple of weeks prior, but all of that has been behind us since last Friday at the very least. I had to make the TWO trips to Dallas, two days in a row, because my internal pain pump, although "refilled" seemed to not have been "updated" properly. Thus it was not set correctly to give the proper dose of medication and so forth. I had to drive like a bat out of heck... trying to NOT get a ticket, because they were closing early that day, and I had to have it done, due to the fact they were not going to be there from like a Friday to the following Monday. So, I through my teeth in, jumped into some jeans and a shirt and headed that way. Well, I got there within about 45 minutes. Traffic happened to have been good at the time. I told the receptionist I was there, and to let the woman that would get this resolved I was there. Well, they had a waiting room full, but they were coming and going pretty quickly. The nurse came out at least 6 times, and I was sitting in the chair RIGHT BESIDE the door to the inside offices! So, there was no way she could miss me. So, over an hour passed and they were almost ready to go to lunch! Finally the nurse comes out and says, "Gosh I didn't see you!" WE thought you had not made it yet.... duh!!! Really!? So, I go in finally, get that done, and was back on my way home... but rather than being a couple of hours, it was more like 4 since the receptionist never told the woman in the back.
So, the week before that is when we had all of the really terrible snow, ice, sleet, especially in the Dallas area. Many offices including that doctors office was closed off and on during that week, and then the next also... but I had called my medication in - giving them PLENTY of time BEFORE the weather got too bad, to send the script over to the specialty pharmacy so they could get it out in priority mail. That would have came in within a day or two at the latest. Well, I never heard back, and this was like 3 days after leaving messages both with the doctors office and the pharmacy. When I would call the doctors office, all I got was recordings. Yet, they never mentioned they were out due to weather, no one ever called any patients... they just "assumed" we as patients would either "not come in" for appts, etc. Talk about nuts!!! Some people travel several hours away to see him... and to think I go and it takes about an hour... and that is bad enough... so this was like a Wednesday. I called through Friday and never got a soul on the phone, and no one answered any of my messages. On Monday, I call, and leave word again. I had checked with the pharmacy and they had not received a script yet. Then, they were the ones who first told me that the doctors office had been closed off and on for several days, and didn't get many of the scripts out! So, I call AGAIN the following WEDNESDAY, a week later (and I was to run out of medication on that Sat/Sun BEFORE) and finally I get someone to call me, and tell me "Oh it is not your fault, we just weren't open due to the weather"... no duh? Really!!? And not one person thought to try and get a list of patients and call them... it is just nuts... It took a over a week, several phone calls later, and I finally got my medication. So, last week Jim's monthly visit and to pick up scripts was supposed to be I believe Wednesday. Well, he calls because that was the day here the weather was horrible. Snow, Ice, Sleet... both here and Dallas were no place to drive... so he tries to call them and again, no answer, no message saying a word about being open, closed, etc... nothing... it is NOW Wednesday! They promised him last Friday they would mail his scripts to us, and set his appt up for later in the month. We asked them to at least send it priority mail, and oh no they didn't want to be put out that much, and besides they had told us they would be open last Friday afternoon (they usually close on Friday at lunch and only work half a day) so we asked if we could drive up and get the scripts... well NO they were NOT going to stay open Friday afternoon after all... they changed their minds. Okay, well Jim is running out of meds, and they promise they will go out Friday, and we should get the scripts if not Saturday, by Monday at the latest. YESTERDAY!!!! Tuesday! NO SCRIPTS!!!! NaDA! He calls, and the nurse tells him, well we mailed them on Friday, but we think the mail man didn't pick them up until Saturday!!!!!!! You have got to be kidding me!? So, we shall see once again a WEEK later than this should be, actually more than that for him... but those scripts better arrive.... this is insanity.... and if they would have DONE THEIR JOB right away, like with mine... I would have had my medication right on time, no problems... and so would Jim... but it is like they just don't care! Well, if you "hate" your job, or just don't want to do it, and don't care that people can get extremely ill, wind up in the ER, suffer needless pain... for more than just a day...or more than once.... but several times.. and each time I gripe (because it is usually ONE of the nurses that pulls this and we know it) - she does it I think for spite... yet even though I had been told she was being "replaced" that was months and months ago... and she is STILL doing the same thing.... It sucks....


PLUS>>> I can guarantee you, this doctors office has all kinds of signs posted about "what they will and will NOT do" if you don't make an appt on time, or don't call in ahead to cancel, or whatever... they will charge either an entire VISIT, or they may deny you medications, until you "reschedule" AND come in for the visit. Even if you are 10 minutes LATE (usually I am on time, but I have had to call and let them know I am stuck in traffic)... and all kinds of if's, and or but.... if the "patient" does NOT comply!

What about the PATIENTS TIME?! When you go to a physician, especially out of town, that is YOUR time... you get there, you are on time, and then you sit and wait for 5 hours! I've seen it happen to us even right here at our PCP office! He would be hours late, keeping you sitting in a cold cramped room, not even have a nurse to come in and say why.... but that is supposed to be OKAY?! OUR time is just as important as their time... we also have family, jobs, other schedules and appts. in our daily lives also.... it has always been beyond me to see some of the ridiculous stuff the medical profession will state to "patients"... yet it seems we have no "recourse"... if it happens to us....

Another great example just recently for me again. I called my dentist office LAST WEEK! I wanted to make sure I had the "dollar amount" right to finish up my "mini implanted" pins for the bottom dentures. I have the "treatment plan" that was initially drawn up BY THE DENTIST HIMSELF! We in fact, due to "HIS" mistake, paid for 11 MORE TEETH at $147.00 EACH to be pulled after my dentures came in and all of the back teeth were gone! By then, I had no choice! I couldn't just walk away and say forget it. Here are my full set of dentures, that I have to have... already have paid thousands out of pocket to get this far... and yet even though HE LEFT THAT OFF THE TREATMENT PLAN - about CHARGING for EACH TOOTH left in front when my dentures came in!!! I could NOT get them to come down, to give us a break on the price... you add it up $147.00 x 11!!!! NOt Cheap and WELL ABOVE AND BEYOND what I "agreed" to when I signed that treatment plan..of course they "had me over a barrel" by then! If I went somewhere else, I am not sure any other dentist would have touched me since this other one had so far done all of the work!PLUS my new dentures were sitting there, that gosh cost (just themselves) almost $3,000.00!!! And they can't be in unless the rest of those teeth are out! So? I am stuck, whichever way I turn... thus again, they get their way...

So, before the dentures were put in and while he was pulling some of my top molars, a piece of "bone" between my maxillary sinus PASSAGE and MY MOUTH!!! I WOULD GO TO RINSE MY mouth out and WATER would pour out of my nose!!! So, I called, went in and he felt like it would "close itself" off. So, I was put on another month worth of antibiotics, and we "hoped" it would seal itself off. Now, this is also where he had to "split my gums" and then they were sewn back together, and he removed stitches 10 days later... so it was "sealed" with sutures initially.

Well, weeks went by, and nothing stopped. Same thing, between the "air" I could hear coming in and out, and the "feeling" of water from my mouth, to the sinus cavity, to my nose... it kept happening. We waited about 8 weeks, and he decided to go another procedure, to close it off. It was called a "buccal" flap (and here is a very good look at what the heck was going on and can lead to scar tissue in the sinus passage etc...  http://www.surgical-dentistry.info/files/Closure_of_OAF_with_buccal_flap.jpg

So, I went through that and believe me, he gave me "gas" BUT THAT DID NOTHING!! This was a painful scary process sitting in a dentist chair. Honestly, at that time when I think about it, he should have immediately sent me to a "true trained ORAL SURGEON)... one that could have at least given me "twilight" or something... it was nuts... But I went through it...

again stitches, and again taken out 7 to 10 days later... well guess what??? Nothing closed... EVEN WITH my new dentures in, covering it over... (now this had been like 4 months at least) and it didn't fix it..

Well, next is a "bone implant or graft".... and he was sending me to what I thought was an M.D. - a "true oral surgeon" like that can put you to sleep in an "OR" setting... I went and had my wisdom teeth cut out at 19 years old at the Baylor Dental College, and the head Oral Surgeon did my surgery.... and I was expecting to see someone like that... besides if I had gone there, my "insurance" since this was not caused by a "dental" but "physical illness - Sjogren's) may have paid for some of it...

But, he sends me to an idiot about 25 miles away, that is a crazy person. First, they told me NO CHARGE for me to come in and be seen and have a consultation. 2nd I had just had Xrays done of that area less than a week or two before showing the bone piece missing, which was about almost an inch between the maxillary sinus and my mouth.... but he insists on taking another Xray - and then charges me almost 200.00!!! too do NOTHING! HE wanted (HONEST to the Lord) to DO THE EXACT SAME THING MY DENTIST DID THAT FAILED! PLUS he knew nothing about "Sjogren's" and less about autoimmune illnesses, and he acted scared to even touch me, due to all of my "medical issues".... so again here I am STUCK... if I DON'T PAY UP, then there goes my credit score... he absolutely (and he is another one I sat waiting on him until after 5 pm in the evening, and my appt was like at 2pm).... and he could not do a damned thing to help me... PLUS he tried to go ahead and schedule the procedure.. and told me it would cost about 3,500.00!!!!!! NOPE you read that right!!! $3,500.00!!! REALLY!!!???!! You have to be joking right..?

I literally hurried paid, AND ALMOST RAN TO MY CAR... I felt like I was in the "Twilight Zone" of hell with dentists!!!!! Nuts, insane, no compassion, no care... and he is old as Methuselah... he had been a "dentist" for eons...


As I drove back home, late in the evening, my husband and family worried... I finally jumped on the cell, and told my husband I was fine, mad but on my way home....

Again though, no RECOURSE!!! Where are those PATIENT RIGHTS!!?? I sure as hell have not seen them.... and there are more, but these really stick out...

Now back to my "current" dental status. I called last FRIDAY, to get the proper charge, and make an appointment (by the way after about 6 months enough scar tissue filled that hole, and even though the bone is probably still missing, the air and any liquid seems to not be coming through... but it took it that long to seal itself over... and that is insanity... I could have and already had massive issues, with lots of maxillary scar tissue in that sinus passage. I had been told that after having a CT scan of my head and neck... they could see the chronic scarring from one sinus infection after the other when I was a bit younger.... but I could have had a massive infection, and/or all kinds of things can happen when you leave that "open" for bacteria etc to get in.... it could have even caused osteomyelitis... or a bone infection.... that URL above will give you a good look into why that was nothing to mess with....

Okay, it is NOW WEDNESDAY of the following week! The receptionist had the audacity to tell me, "Well, that plan was done almost a year ago" and prices have went up! WHAT!!??? So, she said she would talk to the "office manager" and call me back... well, here it is almost again a week later... no call... nothing...

and again, what is my recourse....???? Those mini pins HAVE to be put in because my bottom dentures WILL NOT STAY IN PLACE without them! So, they have to be "modified" to snap down onto those pins, and until that is also done, my top dentures tend to "move around" if I am not careful. Even with the "Fixodent" powder, and everything like "training" your muscles to help hold them in... if I allow my mouth to dry out in the least way, or I have a long conversation, or if something "gets under" that top denture due to the bottom one shifting around, they both will literally fall out!!

How the hell can I deal with that? Plus I am NOT able to EAT PROPERLY YET! I can't "chew" most stuff, but very little on one side... I have had to stop eating many things that are healthy and I love... many fresh fruit, veggies, just so many things that I think I "might" be able to eat, and there is no way... either the dentures move, or something happens so if they don't line up, then there is no way to chew food... I can't bite anything off. I have to even take lettuce and Jim cuts it up almost like it is chopped parsley or something tiny, just so I can have salad... but things like cucumbers... forget it, can't eat apples, no matter how small I cut them up... it is insanity....

















Wednesday, February 26, 2014

Do Your "trust" your Own "instincts" Over some of the Medical Professionals (AutoImmune Illnesses or Not)

Being Caught in an Upheaval Between An Insurance Company, A Physician's Office, My Own Autoimmune "Flaring" Body, A Pharmacy, and What to Trust? Myself, My Doctor... Any of us... we are all susceptible to "Medical Mistakes"... And How do We Avoid those? Or Can We?

I will always be one of the first to admit, "no one" is perfect. We don't live in a "perfect world". Everyone of us are human beings. It matters not whether we are highly educated professionals, or a Mom or home maker. Whether you are the President of the United States, a banker, lawyer, and of course a DOCTOR, even though we want to "think" these people are more "immune" to errors, and yes they should be, we live in a "too fast" paced world, that for the most part offers "little" time to try and "double check" every thing we do in a day's time. 
I will also say that for the most part, I "trust" my physicians. If I didn't then I would and I have moved on before. If you "lose faith" in someone whether it be your physician, a banker, or anyone you do business with, must confide in, or within the very people that you have to rely on to sustain daily life necesseties, where do you turn to, and where do you go from there?

 I was so totally hopeful that the new year would bring "hope", a new vision, less symptoms, more ability to help make changes in this system of errors when it comes to ALL of the horrid evils of autoimmune illnesses, medications, insurance, or lack thereof, doctors, pharmacies, and the entire realm of what the hell is happening to cause such grief with those that seem to just NOT care about patients, about their own people, and how we are supposed to try and "cope"? Each day seems to be worse, not better. Things seems to go from hoping it will be "less complicated", to more red tape, and less reasoning with any human beings when it comes to the health rationalizations of life. Never have I seen such a lack of regard for "humans" from the medical world. I sound like I am on one of those "rampages". But, it is very difficult NOT to feel that way, when each place you turn to, each physician, each pharamcy, every phone call to your insurance company, every email you send... each medication, every step you make, turns around to slap you in the face, and make you wonder is any of the struggle worth it? I cannot possibly be the only one feeling the overwhelming stress of things getting worse when it comes to our health, and our health care workers. More and more I see doctors who are supposed to have taken an oath to "help humans", turn their heads and watch people become more ill. When you are reading daily, that those in dire need of medications such as the biologics trying to cope with THOUSANDS of Dollars of out of pocket costs due to this once again "tier system" of how we are "told" we can have medications, it makes me literally sick! Who, and mostly NONE of us with chronic illnesses can afford to pay $5,000.00 a MONTH out of pocket to get the one medication that may help keep you able to just live your life?  It is total insanity. I realize I am NOT the only one! That makes it even more difficult to deal with. Day after day, month after month, rather than watch "head way" being made, what we see is a government that absolutely DOES NOT care about their own people! Anyone that can take office, and turn their backs, to line their own pockets, in the name of cutting benefits so much that in 2015 Medicare Advantage Plans will CUT paying physicians/medical professionals (the "term" used in the original article was "insurers". That is so it does NOT sound like it is our doctors/medical professionals that are getting cut - another "loop hole for them) 20%! How can I (WE) even begin to rely on that kind of nonsense? What happened to taking care of your own people? It is very obvious greed, greed, greed and more greed fills our nation and our world. I was going to put this up on another "friends" feed, but there is no reason I should "push" my own issues off on those that may not feel the same way. The entire dilemma that has prevailed over my life in the past 3 months, is one that sounds like it belongs in a tale of horrors. Even when I "KNOW" for a fact everything I am "saying" is true; as I go back to either read it or email the ordeal to a friend, it is so hard for me to say "yes" this is really how it is! Where did we as a nation and world go so horribly wrong? When did it get to where "money and power" rule over it all? And where do you really find answers? I of all people, have always been able to "stand" within the power of faith and hope. I don't pretend to "cram" my own beliefs down anyone else's throat. Never have, never will. Everyone has their own personal and private feelings when it comes to how they view hope, faith and all of what might be considered "religious" in nature. But, the problem I feel is the "lack" of it all. There is little hope left. Medically speaking, is just one issue. Turn on your news every day. What do you hear that gives you any kind of true hope? Because we are finally backing out of wars, where we probably may have stayed out of them in the first place? Thousands that die daily due to lack of water, lack of food... and now we face yet another HIGHER scheme of things on the very thing that sustains us? FOOD!? Why? Because we lack water, we are facing drought circumstances that we have never seen in our own country since before the 1800's.... how can our "elected" officials sit around on Capitol Hill and justify the ridiculous insanity of "cutting" benefits for those that can barely afford to buy decent food to sustain us, much less "pay" for medications that although should be considered a "necessity" become things that are more a luxury. 
Those of us on a "regular salary", or disability, or making minimum wages... even those making a bit better salary, cannot possibly afford to pay THOUSANDS, even HUNDREDS of DOLLARS a month out of pocket for medications! I often wonder whose fingers are in whose pockets? If you could be one of these "minute" insignificant "bugging" devices that could fit in a clock on a wall, or under a lamp in some of our places in government, in our local doctor offices, within the pharmaceutical companies in the world, in the very places that things such as "lack of caring" goes on, how shocked would we be? How shocked would you be, just like a dear friend of mine told yesterday on her FB page. Her doctor wants her to have a "special type" of MRI on her heart. Yet, when the doctor calls the order in at the hospital, he is told, "that procedure" can't be done there. Now you tell me, if he is a doctor and he is that has been dealing with a hospital, outpatient or whatever type of facility in the same area for any length of time, he knows "what procedures" that place can do or can't do. Doctors are around for the most part long enough to know whether they need to send a patient to a "special facility" for a specialized type of MRI on the heart or not. SO, why all of a sudden does he get this type of information, that he must relay right there to his patient? He has to tell her that "I'm sorry"... for "some" reason, I can't get it done at that hospital? Then do they fully expect for us to say, Oh, Okay, well, if you find some place that it can be done, give me a call? How ridiculous does that sound? 
Just as ridiculous as a NURSE in my own PCP office, that has been seeing me now for well over 4 years, "hide" and NOT intervene as that nurse basically is allowed along with a "PA" there to tell my husband "well, if you don't like my care, take "her" meaning me, to the ER! What the hell kind of doctor is that? Talk about losing confidence in your physician! Then he is not even courteous enough to "check" on the situation and try and find out what the hell went wrong, and why the hell would ANY "PA" get her "feathers so ruffled" due to a patient and her spouse being concerned and just questioning why a certain treatment would be given, when there is a very strong chance that very type of medication is exactly what got me in the situation I am IN in the first place? If a doctor, or PA, or nurse, is that big of a "chicken" and they are NOT willing to try and get hold of the matter to straighten it out, and thus TAKE CARE OF THEIR PATIENT, who should have been NUMBER ONE, then how the hell do you trust any of them? If this had just been one incident, or a "new doctor" or someone "not familiar" with my complex case, I "may have" been able to justify a portion of their lack of brain power and intelligence. But, when you cannot even have your physician call you, return a call from you, trying to find out what the heck is going on, why would I bother to put my life in this medical "so called" professional's hands? 

I've written an email to a friend of mine explaining the total amount of crap I went through over the past about 7 days! I am going to post most of it here, and I know you are going to think I have to be making this story up! But, BEFORE I get more into that, let me tell you what just happened! Here it is BEFORE 8AM in the morning. My phone rings, and guess what? It is from LEXINGTON KY! NO NAME on caller ID, just that town name. A "woman" announces she is from "Humana" and asks for my Humana ID number!.... in the first place, it is BEFORE 8 AM CENTRAL TIME! IN THE 2ND PLACE, WHY WOULD I (I did NOT call them) give out my insurance ID number to someone I have NO idea is, what they want, and why they would call ME at this time of the morning? I told her I WOULD NOT give out that information, and in the 2nd place I AM SICK! Where were they this past two weeks when I tried to get them on the phone and get my ENBREL??? You sure can believe I jumped through 50 hoops to get anyone on the phone, it took them 10 days or longer to even get medication to me that I should have had 7 weeks ago or more. I probably WOULD NOT BE SICK, if HUMANA would have DONE THEIR JOB! Now, I hang up, and I call THEM BACK! Guess what they tell me... THEIR OFFICE IS CLOSED! NOW how can "they be closed" when they just called me and asked me for my ID number? Ever since I FINALLY GOT MY ENBREL LAST THURSDAY, I have had A PHONE CALL EVERY DAY SINCE FROM THEIR PHARMACY wanting to TELL ME HOW THEIR NEW SERVICES COULD HELP ME!!! THEY COULD FREAKING HELP ME BY DOING THEIR DAMNED JOB, GETTING ME my medications and not delaying me to the point that I am almost to the place of being ill enough to go to the hospital! THIS is the very KIND OF CRAP THAT I HAVE HAD MORE THAN ENOUGH OF! 
How funny it is WHEN I NEED THEM... forget it... you cannot get anything off of their website (although they always say go there), you can't get anyone on the phone, but boy they surely can call you day, night and weekend to tell YOU about HOW THEY CAN HELP YOU!!! 

Now, back to the Other issue at hand.... I've told most of the story... from this, I did NOT get my Rituxan.... due to HUMANA NOT wanting to pay at they should... the entire 'BIOLOGIC" ISSUE. So, when I am severely ill, with flares 6, 7, 8 weeks later, at my doctors office... and the PA decides even though I say nothing about any type of "infection"As far as I was concerned showed no and had no signs of a "sinus infection. Yet, she insists on giving me an antibiotic, after I am already very immune compromised due to NOT having my medication, having 2 flares, and she gives me of all things "Omnicef"! Now I am not sure how many of you check out medications. I am sure for the most part, all of us, or the majority of us with these autoimmune issues DO watch what we are given as far as medications. In the first place, many of our "autoimmune medications" do NOT mix well with other meds. It can cause all types of complications, thus we are probably for the most part pretty good about double checking medications, especially "new" ones we are given. BUT, as I say, what about those that are elderly, or they don't have access to look up medications, or they just "trust" what their doctors say, and take the medications. We are supposed to be "pro-active" about our own health. Yet, as I have found out, being pro-active with some physicians is just like stabbing yourself in the foot. They HATE patients that are educated! They DO NOT want to be questioned, and they fully expect US to believe them hook, line and sinker, without any disagreement. 
Well, even though I did NOT think I had this "sinus infection" I began the antibiotics a week ago, tomorrow. I took 2 that day, and Friday morning I took one. By Friday evening, something was just not right. I could tell my stomach/intestines/colon were not "happy". Of course antibiotics, many of them can upset your stomach. Sometimes if you "eat" with them it is better, but sometimes you are NOT supposed to eat with them. This happened to have been one that still I was quite disturbed over getting. Without being extremely ill with signs of an infection, it still did not seem right I would be given such a broad spectrum, high powered medication. I even mentioned that it had been YEARS since I was given these type of meds. The ONLY time I've taken them is when I go to the dentist and I am having work done. He prescribes "2" for me to take one hour before I go in for dental work. He does that due to me having "knee implants", shoulder implant etc.... Dental work "can" lead to an infection sometimes of those types of implants. BUT mine have been in place long enough now, that really it is not a huge concern. In fact the other dentist that does other dental work on my teeth, says that taking those now is kind of "old school". He does not even prescribe them, unless the implants are very new, less than a year old, or there is major dental work, that could possibly lead to a greater chance of infection. So, even with two dentists right here in town, there are two totally different opinions about giving this even when it could be "slightly necessary". Well, within 24 hours of taking these antibiotics, I began to have what I consider not just slight diarherra, but what I consider a type of "colitis' symptom, due to the medication 'Killing out" all of the needed bacteria in the colon. I went through this in 2010. After several abdominal surgeries, due to an issue with my gall bladder, and a collapsed bile duct, that landed me in the Methodist Hospital in Dallas for over 6 weeks... I got this type of colitis. I will NOT go into the gory details of it all, but I will tell you that I had NO CONTROL over it. I literally woke up wrapped in blankets, cold, and was covered from head to toe with diarrhea... this happened night after night... and I was so ill, I could barely even stand... the nurses would try and put me in the shower, half cold water, and had to clean me up, head to toe, several times a night (and I was NOT eating anything)..I was totally being fed with an IV line...

Well, that experience all came rushing back into my head once I realized that the antibiotic I had been put on is one of the worst for causing this type of colitis.....

Here is more information on it:   http://www.mayoclinic.org/diseases-conditions/antibiotic-associated-diarrhea/basics/definition/con-20023556

this is just one article. There is LOTS more, just do a Google Search if you would like to found out more....

Needless to say, I was very FAMILIAR with the signs and symptoms of this potentially can be "deadly" type of colitis.  It is NOT something to mess around with, especially if you already have a severely compromised immune system. At this time, mine is certainly severely compromised. So, as you or anyone in my situation would do, of course you are going to "question" why would you try and put me on yet another "same family" of antibiotics that COULD be causing this? Here they are as  I have in a redundant way said trying to treat me for a "sinus" infection, and I am worried about this type of bacterial colitis! thus coming back to me on the phone Monday morning and saying the PA is calling in "Keflex" was not what I expected to hear at all. I thought I was going to hear at the very least they would put me on Flagyl or Vancomycin, and then also possibly do the "test" to see if I indeed had this type of bacterial colitis. Never did I expect that she would in an almost flipant manner tell me that "the PA went to school, and SHE knows better"! Well, ummmm let's see here... did I excuse anyone of NOT knowing their job? NO what I was "questioning" was "what she was treating me for and why?"... Are you giving me "more antibiotics" thinking okay well the "sinus infection"??? Yes, again, the nurse NOT taking the message stating THE PATIENT IS CONCERNED ABOUT whether she has a colon problem, a stomach bug problem, or is it antibiotics causing this.... not one word of "can we try to see who is asking what" and "why" one person in an entire office can't put two plus two together to get a proper message through.

Now comes another issue in all of this. For six WEEKS, I have non-stop tried to get through to Humana about the Rituxan, what the deal is, why they are NOT paying as they said they would.... and  you can bet I heard everything but the right answer. Most of the time, I was either speaking with someone who has NO CLUE about a "code", about it being used for RA, or even what it was used for. After I finally drove the infusion center, and my Rheumatologist's office nuts trying to get SOME TYPE OF BIOLOGIC to take.... knowing that each day that passed meant me having more and more change of a severe flare, I worked my fingers to the bone trying to get medication, it was days and days and days and more days of waiting, paperwork, more waiting, more paperwork.... and then FINALLY last Thursday it comes in. I take it about the same time I the appointment to try and get the flare under control, before it got worse.

NOW, every freaking day, sometimes twice a day, and like this morning BEFORE 8AM my time, Humana (wow they really exist) CALLS ME! They leave messages, they want to talk to me this morning BEFORE 8AM, and the "woman" asks for my ID number before she even told me who she was,  or what she wanted. I politely, told her I was SICK, and they sure as heck did not make any connection with me while I needed them, yet now all they do is call day and night with their stupid automated calls, wanting to have me "call" them back"... for what????  there is NOTHING they can do or say now that will "fix" what I did need, when they cared to not even answer me back or call me back.

Yet, the huge looming question remains, how the heck do "we" fix this? Unless you have money, power, people you know.... and whatever else it takes to "get" what you "need" out of this kind of issue.

I am so totally disgusted with all of them.... and as far as how to "handle" any of getting these issues fixed... I am at the place, that I honestly don't see that anything will get better for us... only worse.....

With my "current health" as it is, and NO support from the very physicians that SHOULD be giving me support, I may not be able to make the very trip that I've looked so forward to and that is to go to DC in 4 weeks to give my "story", just so others someday do NOT have to deal with these things. Yet, I can't go if I am too ill to go!

I am so totally and utterly upset over the entire ordeal, that I am to this place that I am ready to give up! WHY! should I FIGHT for something that I have NO WAY of  Winning???? As far as I am concerned ALL of my efforts, ill or well.... sick, or feeling good are all for none.... This battle is just not one to win....

I am not sure I even want to continue to post on this blog, or FB, or participate in any type of organization anymore.... It seems it causes more aggravation, All I see is doubt and dismay in others eyes, and I hear it in their voices and I see it in what they are going through....

For me, I am beginning to feel and see this is a no win situation.... and for others they may have far better luck than I... but I know when it is time to throw in the towel....










Thursday, February 13, 2014

Trying to Absorb Everything that seems to be "bouncing" my way...or getting run over?



Now I am sure you are wondering what the hell I have put this up for. Unless you've been to my FB page, or have seen the latest "venture" that the IFAA (International Foundation For Autoimmune Arthritis), about now you are scratching your head figuring what else I could possibly have my fingers involved in now.


Well, the story began when I "found" Tiffany the Founder and CEO of what came from a bracelet, made with a bit of leather, a belt buckle, and was a "movement" until now they stand proud and tall as one the instrumental foundations of Patient Centered Research in Autoimmune Arthritic Illnesses. So, what does that mean to me, and then of course what does that mean to yourself? That is a very long answer that shall become clarified in the days to come, and in my book to come also. A portion of my book, will be about my relatively "short time" I've been with a Foundation, that I have watched make almost impossible changes in the way others, including doctors, researchers, patients, and people from around the globe sit up, take notice, and SEE the REAL issues that "we" the patients deal with daily.

None of our lives are "daily".... or the events in them are not for sure. We may get up in the morning, much more slowly than anyone else, "walk" some of the stiffness out. Next may come a cup of coffee, that it takes all of your energy in both hands to pour it in a cup. I've not truly been able to get a "grip" on the entire next few months coming up and all that is involved, until last night. 

After I have spent the last 6 days at least arguing over insurance, my biologic medication, the infusion center, driving my doctors office crazy, along with myself, it hit me square in the face, that in 6 WEEKS I will be going to Washington DC! Here I have been wanting to do this all my life. It has been a dream, for me to stand in front of the White House, hopefully not speaking to just myself, but someone even if people just coming to be those to take a look at the White House and happen to "hear" my story. So long, I've thought about what I would say, how I would say it, and what I would want to get across to the officials in those buildings. It is almost like trying to reach the "Pope" or a movie star, or anyone that is in any type of place of "authority". Your chances of really getting to even shake their hand might be slim to none. Much less get their attention long enough to gripe about your illness, what the government is NOT doing to help it, and what they are DOING WRONG to make it worse! My thought has been unless you have lots of money to "slide" under the door of any one of our local, state or federal officials, you might as well, jump in the back of a truck, while it goes 30 miles an hour, down a dirt road and spit... And when the spit lands back on you mixed with dirt... that is just about how much you would get while the officials in Congress scrape you off of them like they scrape mud off their shoes. 

This from here down was written this morning... I am have a very difficult time between what I feel are flares of RA/Lupus, and way overly stressed... I am a total mess, mentally, physically and emotionally... I am wondering why I even try anymore... it always turns out to be a mess for me, rather than a help.... thus the reasoning behind this post.. (I also began posting the bottom portion of this on FB and changed my mind. I decided to post it here, and just put a link in to FB...


LOL!!!! I have been seeing the new "T-Shirt" on their Foundation's Website and wondered about it. When I was filling out the registration yesterday at the end it asked for your "T-Shirt" size! That is when I got the hint we would be receiving one! Honestly, over the past week I've been really struggling with all of this. I have actually began a blog post that I am still working on about my own internal, some physical, but more "mental" revelations about how quickly all of the things that are happening in my life right now are coming on me so very fast! Much of it "good" things, but entangled in the "good" are some challenges that I am definitely struggling with. I have just taken an immense "slide down through the rocky side" of my "mountain" of autoimmune illnesses right at this moment. Since I've not gotten the Rituxan infusions as I should have weeks ago, all of my RA symptoms have hit me like I just ran into a brick wall. I know I am in not only a RA flare of sorts due to the part where the bottoms of my feet hurt, especially when I first wake up and try to put my feet on the floor, to the stiffness and pain in my toes, thumbs, ankles and fingers, which is making trying to type a nightmare. it is not that it is so much "pain", I do have that, but it affects my "ability" to type. I hit wrong keys, I am constantly correcting myself, or having to back up because I've spelled something incorrectly as I typed it, and so on. Then it the "mental" true "brain fog" that this time has me terribly aware that these illnesses are takng their toll on my body in several ways. My ability to type issues are also because of the fog. I tend to try and spell words, or type normal, everyday words, and cannot remember them, and have to stop and think about what I am trying to say, or again due to the stiffness it seems my fingers are constantly on the wrong keys. And I am at the moment "brain and physically "fatigued". I feel as if I have mentally been in a prize fight. It is just almost painful to think. I want to just scream I can't take anymore!!!!!! I AM SO UPSET about NOT GETTING MY RITUXAN, that I could scream! It is one of the most frustrating situations for me. That is the ONE biologic, that has "worked" more for me than any of the others. There is just so much going on right now I feel like I am on a spinning top, and each day it goes faster and faster. I am battling the insurance even over just getting the Enbrel. I found out it is the ONE biologic of TWO that Humana will pay for. Yet, I still have to Jump through every hoop you can name to even be on that. I even got the prior authorization myself and faxed it to my doctors office myself to make sure they had it. And now I've called the "specialty pharmacy" two days in a row, they see the script and yesterday the woman on the phone says, "well, it appears maybe they got the "prior authorization form" but they are requesting "more" information from your doctor??? What the hell more information do they need? I've been going in this circle with them now for at least 4 years and each year it gets worse, rather than better. When I first began all of this autoimmune illnesses whirlwind, Humana, rarely questioned anything. For the most part, even all the surgeries I went through even 8 in ONE YEAR, there was no hassle. Many of them were performed and the insurance never even need a "prior" request on those. Then it began about two years ago. I began to notice my doctors would try to send me to a specialist, and the specialist would not be a "preferred provider"... and I had not had that before. Then they would "piss and moan" over certain medications with these "prior authorization" forms... not many but a few ... year before last, it was SO BAD that the first part of the year January and February, they made me get a "PA"(Prior authorization" on JUST ABOUT every medication I had been on for 5 years!!!! Heart med, Muscle spasm meds, you name it, they wanted this "PA" form for it. I argued with them and the answer I ALWAYS RECEIVED FROM THE INSURANCE WAS "it it MEDICARE(the government) MADE ALL THESE CHANGES" thus "they" the insurance company HAD TO request these even on medications for my heart, blood pressure, stomach and so on. That was the most asinine thing I had ever heard of. I spent hours and hours and untold hours getting that nonsense stopped! My doctors of course were all annoyed, and I don't blame them! They "put a patient" with high blood pressure, or stomach issues on medications, they are on them for years, then all of a sudden here comes the very insurance that paid for them asking for the doctor to fill out forms? In the first place the doctors do NOT have time for this. In the 2nd place it as ridiculous! Well, all of that finally went away I think. Come last year I noticed ONLY if it was a medication that was new to the patient and for the most part a "specialty" med they would then request a "PA" form. Yet, even then, the doctor filled it out, faxed it in, and I had my medicine quickly, there was no wait, there was no 72 hour "review"... and I certainly did not HAVE to wait 10 DAYS or more for my "prescription" to be processed once all of the other stupid paperwork was done!!! To add insult to injury, then, me not really realizing that Humana WILL NOT PAY for any "specialty" biologic medication (even though on their website they will "price" it to you at your local pharmacies", and I had checked prior to all of this and knew my local Wal-Greens did carry it and they had a specialty department that did the paperwork and then would let the pharmacist know when it was all done and when he could fill the script. Well, guess what? Then I come to find out that Humana will NOT pay for the local pharmacies to fill these medications, it MUST GO through Humana's own "Right Sour Specialty Pharmacy"... so guess what that means, more delay, and it was delayed even further because the "local pharmacist" could NOT understand I HAD to have the prescription faxed over to Right Source!! I asked 5 different times to "fax" it to Right Source and kept continued to try and "run it through" to the insurance! And of course the insurance kept "denying" it!!! It he done it a hundred times, Humana is NOT going to pay for it, unless it comes from "their own" Specialty pharmacy! Wonder where the kickbacks etc go on that one?????? Of course FINALLY I honestly think my doctors nurse faxed the script herself to the correct place Monday morning. Then she gave me the fax number their and reminded me that she knew a "prior authorization" form would need to be sent to her and filled out, then sent back to Right Source! SO, I was lied to because Wal-Greens told me they had gotten the "PA" form. If they had then there would not be a call for another one I was told at Right Source, because it would have been in Humana's website, thus they would not NEED one, the one would suffice!!! So, let's start the phone calls and the whirlwind again! Now I had to "dig" through Humana's website (which I already knew the drill on this one) find that form, get online and fax that form to her (the nurse) at the doctors office. Because if I had WAITED for then "pharmacy" to request it, that might delay it for weeks because that mean the doctors office would have to dig it out, fill it out, and send it to Humana for approval. So rather than jump through another 25 steps, I tried to save a few and sent it to her myself. Which I am not sure even made a difference. For two days I continue to get the same response. Well, it looks like we are "waiting" for something... in fact yesterday's phone call to "Right Source" is what led me down the track to even when we receive all of the information it will take "72 hours" for review? What more is there to "review" when you have everything but it signed in blood and stamped by the President stating I need this medication!? And it just continues to float around and around within the spinning, ever spinning, world of what we should NOT have to go through! Now, with all of this, plus I KNOW without a doubt, it is not long, until the Sjögren's has taken everyone of my teeth and crumbled them to nothing. I have at least 4 right now, that are just "pieces" of teeth. I barely have any jaw or chewing teeth at all. And the ones up front are so fragile I fear biting into anything... I have my 4 bottom front ones that "so far" have not shown or I've "felt" them having issues. But that is just the problem. They can "seem" fine one day, and the next you are eating, and suddenly there is a "space" where part of a tooth was! No Kidding! It is insane. That is usually how it happens for me. And it does not have to be something difficult to chew and so on... just normal eating, and then my tongue will suddenly "know" something is missing... sure enough an entire side, or back of a tooth will be totally gone! I have two of my very back jaw teeth, one of which he could not even "fill it" permanently because the cavity was so deep, he said I would not be able to withstand the pain because of it being so near the root. So, he put some of the "temporary" type of filling in their but it has already itself became partially gone... and the one just like it began hurting and feeling "odd" yesterday, thus I am almost sure it will have to go soon also. Right now I would bet I have 6 that either need to be pulled or slightly a possibility a filling may help them. But since it feels as if an entire side of it is gone, I am betting all of them but possibly one have to be extracted. That would have me literally with maybe 3 jaw teeth in the top, and my 6 or 7 top and bottom front teeth... and those in the top are just "patched" together... they are trying everything to keep those in as long as possible.... So, I ONLY "saving" grace in the matter of my teeth is that there is a possibility due to all of this damage being from "Sjögren's. the insurance MAY pay for a specialist. In fact one of the "nicer" women at Humana even gave me the name of a doctor who is more of an oral surgeon that might be able to "screw" the teeth into my jaw bone (seeing that my jaw is not totally messed up with the osteoporosis) because "dentures" are NOT the answer for anyone with Sjögrens'. Due to no saliva or very little those will not "hold" properly in the mouth. I just am not able to fathom the amount of pain, expense, and what I will have to go through to have these teeth "fixed" or something done with them. Hell a "root canal" and crown is over $3,000.00, much less that kind of thing to be done! So, within the spinning web of ALL that is so amazing, and yes my birthday is Saturday... all of the horrid nightmare of bad stuff keep putting a damper on the good things coming my way. I am ready to throw in the towel... and just sit on the sofa, and forget it all. I've fought this battle way too long, and way too hard... and I am reaching the place that that mountain top is way too high for me anymore... I don't know where to turn... and I certainly really do not want to go anywhere over the weekend... I know it is planned to go, but between money, and the operation, and me not feeling well, I am just not in the state of mind to go anywhere right now. Hell i need to go grocery shopping and I'm having a huge struggle in trying to convince myself to go and do that. I am just tired of it all.....

Saturday, December 21, 2013

Holiday "Lost" Spirit & The Apparent Lack Of Giving of Self To Find Your Light

Taking The "Money" Out of the Holidays to find the true Reasons for This Wondrous Season




I usually have posted my "annual Christmas letter" by now. I decided this year to wait. I was not sure I even wanted to post it here and on my blog. I have first hand watched so many people that are dear to me, both "right here" and those that are my "FB Family", go through so much pain, suffering, fear, shock, and dreadful things especially within their health, that I find it very difficult to try and make this holiday season "Happy" and feel "Blessed". How do you feel "blessed" when it is like the entire universe has fallen in on you, and that black hole that the universe came from, has now swallowed you up in it, and pulled everything in on top of you??? I know, I know... Faith!!! I've lived in the footsteps of "faith", "hope", & trying to just "be". I have tried my best to "take all the bad" and try to see that positive side that is supposed to come from the resonating facts that it seems nothing lately is very good. In fact if anything, there is just too much "bad". I managed to write my Christmas Letter this year and I did put it in the Xmas cards I sent out. But, even as positive as I tried to be, I feel the ones who read it, will think I want them to "feel sorry" for us, or think I am griping and moaning. Or they will think "Wow" what a mess? I am holding on by my "fingertips" to the rope of faith that always in the past, has "sustained" me, no matter how bad things got. In my past life, things at one time or the other probably have been "worse" in many ways. But, as far as health wise, for myself, my family, and so many of you, it cannot get much worse! I hear it, I see it, I read it daily, everywhere you turn, people are hurting. I know in other ways we hurt also, but I am speaking more about the "physical" pain so many of us are dealing with. From all of the drama around autoimmune diseases, which seem to be running rampant in our world, to those I know that are so dear to me battling cancer, several with diabetes that have now had to begin having dialysis due to kidney failure. These are people in the prime of life! Many my age, and like myself, they are seriously ill in one way or the other. Yesterday, I open our tiny daily paper, and TWO guys 19 YEARS old, were in the "Obituary" column! I was just flabbergasted to say the least! I could not believe my eyes. And what makes it worse, it has been that way now for months. It seems like each day, I open our "Daily Paper" there are people who are in there early 50's and some much younger that are passing away! I realize Ellis County is not tiny, but it certainly is not some huge county with many large cities in it! We have no "cities", but more like towns. Even our county seat, Waxahachie, is not a huge city by any means. So, how can so many people, at such a young age, in a smaller community like this, be so very ill?? It seems like insanity! I had a talk with Jim after seeing the "evening news" yesterday, that all we hear on the news or read, is "bad". Nothing "good" is ever broadcasted. As we talked about it, he said it is because "good news" does NOT sell! In other words, our news is full of the "bad" because that is what brings readers and watchers in! How sad is that? As I began to repute his statement, I began to wonder if what he said is really true? Have we become a society so complacent, so weary, so looking for the dramatic and the shocking, that "good news" does not sell? I have to think he is probably quite right. Look around. Even with the "spirit" of what this season is all about... greed, money, more about "how much" you buy and give for gifts, how "pretty" your tree or decor is, how many gifts under the tree, how many parties you attend, with the latest dress and accessories on... along with how many toys the kids get, how much you spend on your kids, getting them the "latest and best" and most wanted toys on the market, not sparing what you spend at all. I've watched my "debit" card purchases lately be so slow in going through the system. I thought about it, and it is because SO MANY people are going DEEP into Debt, for the New Year that is not even here yet! Those credit card limits are moving to the max fast for many, because rather than being about the "pure" meaning of this holiday, the monetary portion has become number one! The part about the birth of Christ, and what His journey on this earth meant, until the day His "mortal" life was taken, so He could stand in the place of us for all of our many transgressions. I know that the "season of giving", pretty lights, and festive decor are a part of the celebration of His birth. But, we have become totally wrapped up in buying, spending, and thinking about the material things, that the spiritual has been thrown out the window, bath water, bucket, baby and all... as the old saying goes... Rather than getting "better", it seems to just get worse every year. I've witnessed it here my hometown for weeks!!! No matter WHEN I go to the market, or any store in town, no matter the time, the day, everyone is packed like sardines in the stores!!! I have to wonder how people are shopping constantly??? In the middle of the week during the early morning, and early afternoons, the stores are full! I told Jim it appears that people just stay in town, and it is vicious circle... they just drive and shop from one store to the other and must never go home! It sounds like a joke, but heck how can people afford to be in stores constantly??? I try MY BEST to STAY away from shopping!!! The longer I can remain at home, out of all the stores, the less money I am throwing out the window. I've found that "stuff" that I used to think was so necessary, I have come to not need nor miss at all. So, when I began to "make do" with what I have at home, I dramatically lowered our "cost of living" each month. Yet, even with all of the coupons, sales, free stuff, stock piling, and shopping as wisely as possible with always a list that I try my best to never swerve off of, we are basically in the hole monetarily like everyone else. Between the two of us, just the medical bills have been ridiculous the past month or two. Jim has no insurance, so when you are a "cash pay" patient, it does not take long for the "cash" to run out! And we have just about "cash paid" ourselves to be considered in the poor house. I am rambling on. I so wanted this to be about the "sunny" and positive light of the season. But, when every day you run into those that have the same horror stories in their own lives, it makes it difficult to find the "light" in that black hole of darkness. I still "stand" on my rock of faith. But, at times it feels like the waters of life have "broken" down that foundation some. I lately, have not felt as strong and sturdy on my faith's foundation as I usually do. Maybe all of us feel this way, but just don't want to admit it... So, call me a scrooge... or think I am crazy, maybe feel like I am giving myself a "pity party", but no this is not about "me" but about the "droves" of us all around, everywhere I look... I DO WISH YOU a Better Day, and beautiful warmth of family, friends, food, peace, understanding, good health & most of all love during this holiday season. I also pray with all my heart, we each find "our" foundation sturdy once again... As I try to cast my burdens off my shoulders, and give them over to my Higher Power, I pray we are all healed, mind, body, heart and soul.... Merry Christmas!!! Rhia





Thursday, November 28, 2013

Thankful... Grateful... Blessed... A Holiday for Reflection...

What Will You Reflect Upon this Holiday Season...



Well, as superficial as this is to be a morning to be thankful for so much. Right now I am very thankful my new I MAC came in yesterday afternoon very late may I say.  LOL! I sat here on pins and needles all day long, listening for the FEDEX truck. Of course I must have been the very last stop on his delivery schedule. It was almost 4pm before I finally heard that truck from down the street! I had hoped all day long that my computer was not sitting in a broken down truck, or got left in Hutchins accidentally at the hub and so forth. Well, my fears were squelched because it arrived safe and sound. Gosh, thankful?! I am thankful for so many things in my life. My husband, my family, friends, as horrible as my health seems at times, I am still up right walking, and bless people's heart I still can speak, some probably think too much!  I am much like most of us. It is purest "human nature" to fuss, gripe, whine, moan and groan. Whether it is about family, spouses, kids, finances, jobs, bills, health and healthcare for sure, and the list is endless of things that tend to grate our nerves. But, today is one day to reflect upon the many, many blessings we have in health, family, homes, kids, and in life. As I said a moment ago in a post, it is a cliche' to say, "It could be so much worse". Well, yes, in our heart's, even though there are days our minds don't quite follow, we know it could be a great deal worse. As we open our newspapers, or look at our favorite news reader; perhaps listen to the "nightly news", all around us is much, much worse. Some of it almost too terrible to even speak of. We have seen it so much, heard it so much, talked about it so much, from politics, to foreign nations, from job loss, to the horror in our nation from human willing to hurt others like themselves, that we truly have become complacent to it. Or, I don't think so much as we've become "complacent", for myself I just almost don't want to "stomach" more of the same. There seems to be very little to no "good news". We don't hear about the puppy saved down the street, or how a town completely rebuilt itself after a flood, fire or some horrific incident. Oh, we hear about the horrific incident all right. In fact to me that is the main problem ALL we HEAR and SEE are the "bad" things happening around the globe. I've questioned that numerous times, whatever happened to "good" news? My husband answers because "good" news doesn't sell. For the most part, people want the "blood, guts, and horror". Take a look at all of our movies, our television shows, the games that our kids and that some of us as grown ups play on our latest video's boxes. Is there much good anymore? What happened to "Pac Man or Woman"? What happened to "Mario"? What happened to "Pretty Woman", or "City of Angels"? Look around and yes there is violence, horror, man kind against their own, floods, droughts, fires, loss... a great sense of loss... and no one knows more about loss that each and every family with military folks. Those people know loss. Even though they may not physically have someone they "lose" as far as that route of eternity. Yet, they suffer "loss" from all sense of direction, when they come home from what they have had to endure, see, hear and do. So, as you spend time today with family, with friends, with just your spouse, or possibly maybe just yourself... let's try to reflect upon all of the true goodness we do have. Even though it "could" go away tomorrow, try in the next days ahead to "hold onto" those good thoughts. The world CAN be a better place. Just look around, and you might just see something good right at your own door step. Happy Thanksgiving, and I am very Happy to have my family, and my "online" family! Be blessed, Be safe, and please ..... Don't get too sick on all of the fantastic food!  Rhia