Overdue For One Of These

Had my monthly WC doctor visit today. Good timing for two reason… first, because it looks like we’re gonna get our first measurable snow tonight (possibility of 2 to 3 inches) and second, because my shoulder was bad this morning. 😣 Most of the time when I have my appointments with him, I’m in my typical / average condition. Not good, but not too bad. But luckily, every now and then, my shoulder has one of its little fits while I’m in the office so he can see in real-time what I deal with a lot of days. Of course I never want to hurt, but it’s like when you take your car to the repair shop and it just won’t “make that noise” for the guy… yeah… my shoulder was making all kinds of “noise” for the doctor today.

It kinda doesn’t matter though… πŸ˜• and that sucks. πŸ˜’ I mean, my treatment is based on my condition, and he already knows that’s part of my condition – so seeing it happening “live” isn’t gonna change anything about it. It’s hard to describe the frustration of just wanting to “feel okay” while also knowing that there really isn’t anything that can make that happen. 😐 (And yeah, I know, I’m far from the only person that feels that way.) I’m gonna have to ask him at my next appointment, how much WC is affecting what he’s able to do for me. Lord knows they look for any reason to fight even paying for the meds that I’m on now, so I could see where he might know that some options would just be “off the table” from the start.

Meh… gotta try to not dwell on that stuff. πŸ™πŸ» But that’s why I’m a little more twitchy than usual once a month. Every time my WC appointment comes around, it just brings up all the frustration that I go through, for treatment that just makes things tolerable, and the fun waiting and wondering if / when my pharmacy will be given approval for each of my meds, etc, only to do it all over again a month later. πŸ€¦πŸ»β€β™‚οΈ It’s just a shitty cycle that it seems I’m gonna be stuck in forever.

But like I told the doctor today… yeah, I might have times where I bitch about this stuff more than usual, but I also know that things could be a lot worse. I see the other people as they walk into the office… or, sometimes, as they’re rolled by in a wheelchair. 😟 I know that while my disability is definitely full of suck, there’s a lot of folks that have it a lot worse than me – so I try to keep my perspective. (But it doesn’t stop me from thinking that there’s got to be something out there that could still help me more.)

So, yeah, I haven’t done one of these rants for a little while… so there it is. πŸ˜πŸ€·πŸ»β€β™‚οΈ Honestly, if you took my doctor appointment off of today’s schedule, everything was about the same as any other day – a random mix of good, bad, frustrating, okay, painful, tolerable, etc. πŸ™„ It just happened that today, the worst of the tremors happened at the most influential time. So despite several paragraphs of complaining, I’m fine… just thinking out loud and getting shit off my chest like usual. πŸ™‚πŸ‘πŸ»Β It’s all good…

Something Like That

This heatwave that we’re currently going through… it’s a pretty good way to explain how I’ve been feeling over the past few days. Just go outside, walk around your property for about 15 minutes, then stand there a while… and that’s basically how I’ve been feeling each day all day. Again, not bitching, just trying to describe it in a way that people can understand.

Thankfully I’m almost half way through the process, so at least there’s a light at the end of the tunnel that I can look forward to. No matter what results I get, at least I can get back on my thyroid meds after the scan has been completed. It makes me feel bad for folks who have suffered with thyroid issues all of their lives, because the constant nausea, overheating, and dizziness… it’s no joke. Not thrilled that it has been made crystal clear that this will indeed be a medication that I’ll be taking for the rest of my life though.

I’m a cheap-ass, so I usually wouldn’t do this, but last night I turned the thermostat all the way down to 68 when I went to bed. I knew I’d be sleeping at least part way into the day and the house would heat up quickly, but despite it staying that cool in the house – I woke up early and completely drenched in sweat again. (Also… gross.) That’s why I mention how far along I am in the process… because if I didn’t know that there was an end to this, it would be some scary shit.

I’ve been drinking a lot more water, so the muscle spasms and dehydration hopefully won’t become an issue. It’s pretty shitty though, that the insurance industry has decided that this is an acceptable thing for patients to go through while preparing for their second radiation dosage. The alternative way, staying on your meds and just getting two injections before the scan… that costs several thousand dollars, so I guess you can’t blame them for trying to find somewhere to cut costs in what has likely been a very expensive surgery.

Again though, knowing that this is a temporary thing for me, it really makes me feel for those folks who don’t have insurance at all, and even for the people that do but have a chronic condition that still isn’t covered by their plan for whatever reason. As with most things like this, it’s something that we don’t think much about until it starts to affect us personally. So, yeah… still feeling super awful… and I feel like it’s continuing to slowly get worse, but I’ll be good as long I just keep reminding myself…

“It’s only temporary. It’s the lack of meds, not anything more scary. You’ll have more answers soon. Just (n) more days and this will all be over. Consider yourself blessed that you’ve made it this far. Plenty of other people have it worse than you, and it’s not temporary for them. Yeah, it sucks… but don’t be a pussy. It’s only temporary.” etc…

I’m trying to stay positive. I need to stay positive.

Bad At Feeling Bad

Saw my workers comp doctor on Thursday, discussed the additional pain in my neck and shoulder from relying on my cane (for my unrelated knee pain) this past month, but mostly discussed the upcoming WC mandated “review” – and he’s just as frustrated by what they’re trying to do as I am. πŸ˜’ Then I finally went back in to my prescribing shrink after taking a couple months’ break to get used to my new WC doc meds… and ended up spending an entire hour with him.

Granted, when you talk to a counselor you usually get an hour, but typically the pill shrink just wants to get you in and out of there, prescribing what he feels is appropriate based on the counselors notes and maybe a few followup questions. He talked to me about so many different possible meds, I have to admit that I don’t even know which ones he ended up calling in for me. I guarantee you that I’m going to be doing a lot of googling before I start taking anything… especially considering the other meds I’m already taking, and that in about a month I’ll have to stop taking my thyroid meds to prep for the next radiation pill treatment.

Meh… I’m not gonna get into all that. But I’m gonna try what he thinks I should, as long as I don’t find anything concerning that he maybe didn’t consider. πŸ€·πŸ»β€β™‚οΈ But for the past hour or so, I’ve been waking up and psyching myself up for the trip into the pharmacy. Three different doctors, multiple prescriptions, many new, some to be covered by WC, but still might not be, and then others meant to go through my regular insurance. 😣 For some reason they can’t mark it in their system, which meds go through which insurance, nor can I count on some of them being approved anyway, so this’ll be a fucking process today. 😠

I know. 😐 This is just what people have to do. The medical / workers comp / insurance programs in the US are shit, nobodyΒ does it without jumping through hoops, dealing with delays and irritation… but I’m still gonna bitch about it. 😏 And sure, whether it’s WC or traditional insurance… once, maybe twice, do what you have to do to verify that “Yeah he’s broken. Yeah he needs those meds.”Β (I get it… fraud prevention) but then just cover the shit plz. πŸ€• Go through that sort of bullshit long enough and you can totally understand why people, as they get older and feel more broken, just can’t or don’t want to have constant adversarial engagements with the whole system – and just stop bothering with some of it. 😒 Especially when the doctor’s hands are tied and they can’t even prescribe you the meds that could actually make you feel better – whether due to WC guidelines, insurance not covering it, or it simply being too cost prohibitive. 😠 Man it fucking pisses me off…

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I’m just bad at feeling bad when a)Β I’m denied treatments that could make me feel better, and b) people are still fighting to take the things away from me that merely keep my pain tolerable. πŸ˜–

Oh, and my insurance company… they keep leaving messages, saying that they want to schedule an in-home visit from a doctor that can evaluate me and give me his or her opinions as well. πŸ™„ Yeah, um, no. You’re insurance. Just be insurance. Get my health info from my records like a normal company… and don’t expect me to invite you into my house with another handful of hidden hoops behind your back. 🀨 Okay, I guess I’ve dragged my feet long enough, and should get in town and see what kind of luck I have with all this shit.

It Saves You Money, But Okay…

Woke up yesterday and finally dug into my mail, did my few bills, and presto – I now have double the doctor appointments in the next seven days. 😐 I guess it’s good I opened my mail when I did, but I now have more days reserved for doctors than I do for myself. πŸ˜’ The super-earlyΒ involuntary one is all the way up on the NW side of Columbus.Β Another “We want you to see our guy.” appointment mandated by workers comp, to determine (yet again… I’m losing count) if my injury/disability is worthy of the meds I’m being prescribed. πŸ˜”

Keep in mind, it was only a handful of months ago that my doctor was told WC was no longer going to cover my monthly doctor visits, because (as they were allegedly claiming) I missed appointments and didn’t pick up the meds that I am subscribed… just a bunch of nonsense stuff. πŸ™„ So me, trying to do anything to avoid more forced exams, more industrial commission hearings, the potential refusal of payment for my meds… I actually asked my doctor to switch me to something different, but with what sounded like similar positive treatment results. πŸ€·πŸ»β€β™‚οΈπŸ‘¨πŸ»β€βš•οΈ I did this because I wouldn’t have been able to afford the monthly Lyrica prescription if they decided to stop paying, and also because I legitimately never feel good and was hoping that the change might not only help me feel better, but also cost my former employer’s WC insurer much less – a possible win-win, which I foolishly thought would make them happy and maybe leave me alone.

But no… just a couple months later, now I have to see another examiner under the premise of justifying what I’m now being prescribed. 😣 I hate that the shit they’re doing is working… almost always delays in getting certain meds filled, that weird phase where they were making false claims and threatening to stop paying for visits, etc… and it worked. πŸ€¦πŸ»β€β™‚οΈ It spooked me, so I made a change that I stupidly thought would make those things go away, and instead that’s probably what triggered this new exam. “If you were taking (that) for so long, why are you now okay with taking (this)?” is the direction I’m expecting this to go. Yeah, I’m sure the guy who will have seen me once will know better than my doctor who has been treating me forΒ over a decade.

Of course this couldn’t come at a worse time. More on that in a later entry, maybe. πŸ˜”

(Unrelated…) I honestly don’t feel like doing anything. My chill is pretty much gone for the day. 😠 Oh, and the “wait, there’s more” from my “Chaos” entry the other day, when part of the town was without power? Nothing surprising. Everyone forgot how to drive, everyone was in a hurry and mad at anyone who dared to treat a dead traffic light as a 4-way stop, rude ass people in the stores acting as if the fucking sky was falling, and just the general unraveling of all the fragile humans’ brains pretty much like you’d expect. (GREAT idea, Skippy… rush to the opposite side of town to buy a whole bunch of fridge/freezer food, while also complaining that you have no idea when your power will be back on. πŸ™„πŸ€¦πŸ»β€β™‚οΈπŸ˜’)Β And then while driving again, this bizarre woman who had the right of way at our intersection actually started waving her arm wildly, mouthing something at me with an angry scowl on her face… which was her “polite” was of telling me to go ahead and turn in front of her, I guess. Fucking humans, man… a few hours without electric and they’re basically fucking cavemen again.

Tired of This Shit

I’m not sure how this month’s appointment with the WC doctors is gonna go. πŸ˜• I think I’m actually seeing Dr Walter this time, when it was the new guy that I had the in-depth discussion with about the state of my treatment last month. Regardless, since the WC insurer is coming at me with the shenanigans again, the conversation will have to revolve around that rather than the stuff that I started bringing up last month.

I’ve got to be careful, because it almost feels like a “trap” that WC could use against me, but this month I have to start discussing possible alternatives for the meds that I’m taking right now. Because if they are somehow able to weasel out of paying for what I’m currently taking, the cost of two of those medications would simply be too much for me to continue taking them long term. πŸ™ That’s where the “trap” part comes in.

When I start discussing more affordable potential alternatives for the meds I’m currently taking, I want it to be clear with my doctors and in my records that I have no desire or intention to make any changes now… and that the research and discussion is really just to act as my parachute if I get pushed out of the plane. But I can see where my fear of being forced to pay for my own meds, which has made me research cheaper (but likely less effective) alternatives, means that I nowΒ know that there are cheaper alternatives, so they’ll probably think that they have the right to force me to change to them – despite my preference to keep taking the ones that I’ve been taking. 😏 Heh… I know, that sounds a bit convoluted, but it basically make sense, no?

But until I’m able to discuss this with them, I know that I’m just taking barely-educated shots in the dark when it comes to what might or might not be suitable replacements. 🎯😎 I mean, even though I know that Lyrica has very specific actions – at its most basic level I know that it is considered an anti-seizure / anti-convulsant medication… so that’s where I start looking. πŸ€“πŸ“š And now I have four or five medications that I think could be good replacements… but for all I know, even though they’re anti-seizure, they may have totally different actions – and ones that aren’t even close to being applicable to my situation. πŸ˜’

So for now that’s all I can really do… look for “close” meds and make sure there are more positive side effects than negative. Then I’ll just hope that I’m actually on to something, and that information can be put in my back pocket until it is needed. Between now and then I just have to figure out how to condense all of this crap down into a tolerable three to four minutes. πŸ˜³β±πŸ‘¨πŸ»β€βš•οΈ Gotta impress the importance of this on him, while also not rambling so much that my point gets lost in the noise. I’m better at that than you’d think, actually… it just doesn’t seem that way here because I know I can go on and on about something and it doesn’t matter, since hardly anyone reads this blog anyway. πŸ˜πŸ€·πŸ»β€β™‚οΈ

Mid-Day Rant

I decided to come over here to the blog so I can take a break from the infuriating insurance-related calls I’ve been making this morning. 😠 I still haven’t made it past the first thing on my “to do” list, because what should have been simple turned into a shit show. πŸ˜’ When I originally signed up for my dental plan, the guy on the phone said that both of the dentists in my current dental practice were covered by the plan – but that, for some reason, he wouldn’t be able to have those dentists’ names indicated on my insurance card, so I’d just need to call in once I got my card and they’d update my information in their system. 🀨

So that’s what “item one” was supposed to be today. As is typical with customer service these days, I called in and was immediately connected to a live human… but a live human that I couldn’t effing understand due to her thick accent. πŸ™‡πŸ» I think even she was aware of this though, because she spoke slowly enough that I could barely get enough information to figure out what she was trying to tell me. I told her why I was calling, gave her my information, gave her my dentists’ information, and was put on hold.

When she got back on the phone she told me that she “regretfully” wasn’t able to add those dentists to my coverage, because they were not participants in my plan. I explained to her that I was told, repeatedly, that my dentists were covered by this plan when it was being offered to me – and that I knew those enrollment calls were recorded. 😠 She put me on hold again, then returned saying that she had just spoken to her supervisor and that she was authorized to cancel my plan without any penalty.

Normally, as I was told when I signed up, there’s a minimum contract length of a year once you agree… but this call… it just seemed suspicious. πŸ€” She didn’t seem surprised that my dentist wasn’t entered into their system when I signed up. She didn’t seem surprised that I was told I’d be getting coverage that they would not be able to provide. She didn’t seem bothered when I mentioned the initial recorded call, and that I wanted to speak to someone above her. And the way she (allegedly) spoke to a “supervisor” herself and only a minute later came back to tell me that she would be able to cancel my plan without any penalty… it just really seemed like something she’s been through plenty of times before. And it definitely makes me wonder if that’s Humana Dental’s routine to sucker people in. πŸ˜’Β Signing up people who won’t complain and will just continue to pay for a year of something that’s essentially useless to them.

So, yeah, it’s good that I was able to get out of that plan… but I still ended up getting fucked, because we’re now outside of the Medicare enrollment window – and I can’t make any changes to my plan, including adding a different dental plan, until October of 2019. πŸ™„πŸ˜  In trying to find the positives of this situation… most of my major dental work has already been done, so new coverage wouldn’t make a huge difference at the moment, plus I do still have default preventative dental coverage… so x-rays, cleanings, diagnostic stuff… a lot of that stuff is at least partially (if not fully) covered.

I’m pissed, but totally not surprised. With all of the medical/insurance/legal shit that I’ve had to deal with over the years, my default condition is expecting shit to go south and me, gritting my teeth, trying not to shout at the poor shmuck on the other end of the line. 😐 Okay, I guess it’s time to move on to item number two…

Awesome Timing, Thanks

I went and saw the new “physician’s assistant” fella yesterday. He first confirmed that Dr Walter is still my doctor of record and that everything will still go through him… but hopefully after this initial “getting to know each other” appointment (for which I’m sure he’ll have to confer with Dr Walter at least this time) he’ll be able to handle most everything while leaving Dr Walter’s time free to help patients that can actually still be helped, patched up, or even repaired. That’s where his time should go.

Thankfully though, I really like this guy. Dr Walter and I have a decade of history from me going to that clinic for the same problem… so, obviously, even starting to get new guy on the same page as us would be impossible in one visit. But that didn’t stop him from intently listening to everything I said, as well as already offering his preliminary thoughts and ideas about my condition and treatment. I don’t want to get ahead of myself, but the positive vibes were a pleasant surprise. I mean, it was really a crap shoot (what type of doctor I could have ended up with) but I should have known that their office wouldn’t hire a jackass when not a single one of them already there acts that way.

Okay, so that was the good part of the visit. Nothing has changed yet, but I told him that I appreciated having “new eyes” looking at the situation, and letting him know that I am willing to try changing some things up if he, Dr Walter, and I think that it could help with the problems which have slowly been getting worse over the months and years. I then began the walk to the front of the office to make my next appointment and hit the road, when I was told that Laura, the workers’ comp “saint” of the practice, needed to see me before I left.

She told me that my case manager contacted them and told them that I was non-compliant with my scheduled appointments, and that I was also non-compliant with getting my medications filled each month. Now, Laura has been there since the beginning with me, so she (like me) knew that what the case worker was saying was complete bunk. Before I could even say anything, Laura told me that she had already faxed more than sixty pages worth of documentation to them, to let them know that they are either full of crap and are trying to jerk me around again, or that they are incompetent. (My words, not hers.)Β I mean, how many times have I bitched here myself about how nearly every damn monthΒ I have to make multipleΒ calls, multiple visits to the pharmacy, and often still I’m not “allowed” my medications until days after they’ve forced me to run out?

Based on what they are claiming, they are now only willing to pay for one doctor visit every three months – while certain medications that I take require me to be seen every thirty days. (And it sure sounds like their eventual goal may be to straight up “kick me out” or void their obligation to me.) So, this is what I have to deal with now. And I really need some dumb shit like this, right now, when my plate is already overflowing with stuff that is pushing my health and emotions to their limits.

But that’s what I’ll be doing tomorrow, gathering up all of the current information about whoever is my acting case manager, figuring out which of my attorneys handles this type of issue, and probably trying to figure out how to get records from my pharmacy – and maybe a statement from the pharmacy techs who know how I regularly get the runaround – and get everything in some kind of order, to where I can start making calls on Friday.

I had a good day today, and I do want to blog about it at some point, but I’m still furious about this. Yes, it’s all easily, easily refutable… and there’s absolutely no way that I won’t win if this gets forced into another IC hearing or actual court case… but the fact that I have to do it at all, and that theyΒ stillΒ seem determined to deny me as much of my treatment as they can. I don’t understand how any human could or would take a job like that, where if they complete their task or reach their goal, a person’s life is ruined.

If I keep talking about it I’m not going to be able to sleep again tonight, but that’s the gist of how my Wednesday went. I’m glad Genesee is still in town, because today I had to just pretend that yesterday didn’t happen… just for this one day, so that my brain wouldn’t have a meltdown from immediately trying to fix all of this. I already spent the entirety of Tuesday night through dawn on Wednesday wide-awake, sitting in bed with my phone, looking up countless things regarding my case and treatment, and sending them to the printer so I could compile and highlight them later.

When there is a reliable, well-documented, years-long pattern of delaying or denying a patient’s medication or treatment, when multiple hearings and court cases have already made it clear that the patient is legally entitled to all of it… even if it’s done in a way that technically isn’t in violation of their obligation – you’d still think it might reach a point where a judge would see that it’s nothing less than harassment, and I have to believe that one of that patient’s litigating attorneys would smell blood in the water at that point, so to speak. I’m not a squeaky wheel. Why do they want to push it to that point?

(Okay, tomorrow’s entry will be a positive one. I just had to let this out, for better or worse.)