"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
Showing posts with label CFS/ME. Show all posts
Showing posts with label CFS/ME. Show all posts
Saturday, March 21, 2015
AS YOU Go to DC Next Week to Represent ALL with so many health issues, may WE ALL do our part to BREAKTHROUGH the disparities that hold back Cures...
Well the "day of infamy" is almost upon many of us! That is the packing, preparing, and getting on that flight to Washington DC for several activities going on there this coming week! I believe our Congress will be a bit on overwhelm at times with all of the health activists, Ambassadors, Volunteers, and many that will be telling their own personal story about their chronic illnesses, the different disparities and challenges they face, some daily, and how much more we need in research, in new technology, new medications, more specialized physicians, of course which all take lots of dollars to be able to fund some of these extremely needed actions. Life is already a huge enough daily challenge, to work, take care of family, kids, go to college, and participate in the "daily" life of living. Then you add on top of that, chronic illnesses, chronic pain, being unable to get the doctors and medications you need, further more possibly not being able to even get a "real and proper" diagnosis FIRST so you can receive the treatment you need. The amount of "challenges" that those of us with chronic illnesses face, especially when the diseases are often arthritis, autoimmune, or both, and we still have so many UNANSWERED questions about these illnesses. Are they genetic in nature? Is there something on Earth, in our water, food, land, air, that is causing so many more of us to become ill with these chronic diseases? It is almost unbelievable to actually think about the growing numbers of those (and especially once again women) at an alarming rate being diagnosed with autoimmune, autoimmune arthritic, arthritis, FM, CFS. MS. Myasthenia Gravis, and then the other "ailments" that follow along with these "main illnesses"... brain issues, heart problems, lung problems, bones, joints, spinal issues, and then with Sjogren's the "dental" problems that are so very severe so quickly, that within months, like myself you find you are losing every tooth to this horrid disease, and there is not a thing to do about it, but have dentures. You cannot stop it or even slow it down. I tried. I was meticulous with my dental health, always had been. but, even as meticulous as I was, also using the couple of medications available, along with keeping my mouth moist, chewing sugar free gum, you name it I tried it, yet I still lost ALL of my teeth in less than a year to Sjogren's. So, each and every person, whether you get to go to DC this week and tell your story, or you are sitting at home, possibly too ill to attend, and you do your "advocacy" work from your computer, you send emails, you send snail mails, tell your own elected officials, and not just "federal" but our STATE Officials, and even Local governmental officials need to be a part of this growing, ever enlarging issue of autoimmune illnesses, and rare diseases. All also goes along, with people getting the help they need, so they can afford their medications, they can afford and be seen by the proper physicians, they can afford the surgeries, or whatever their treatment needs to be, even like myself, trying to PAY out of MY POCKET over $15,000.00!!!!! cash for my dentures to be put in properly... there are not many people around with that kind of available money to spend in one whack at a dentist! THIS NEEDS to be PAID FOR MY HEALTH INSURANCE! IT is A HEALTH PROBLEM, NOT DENTAL THAT CAUSED ME TO LOSE EVERY TOOTH!!! But, we ALL need to stand up and say NONE of this is RIGHT, NONE of this is ACCEPTABLE, WE should have the medical, dental, eye and more CARE of PROFESSIONALS and experts that can help us live somewhat of a normal life. The ALMOST INTRACTABLE PAIN I've been in over the past week, SHOULD NOT BE!!! I SHOULD not have to wait, I should have been able to have my medication UPPED the next day, not a week later! I HURT! I HURT to the point, that it's stopping me from doing what I love the best, my advocacy, my writing, my helping others.... my taking care of my own home, shopping. and helping Jim and my Mom... ALL of this is just WRONG! AND ONLY YOU AND I can MAKE IT RIGHT! So, for ALL of you whether you will be in DC next and able to "stand on the steps of the White House" as I used to say, and plead my own case and the case of others that could not attend, or if you are home, and not able to attend you still MATTER! YOUR VOICE will STILL BE HEARD! We must RING OUT, CRY OUT, and say ENOUGH IS TOTALLY ENOUGH! WE are one of the MOST INTELLIGENT NATIONS in the entire WORLD! There is NO REASON that our incredibly talented researchers, doctors, professionals in these fields can't find solutions, but they need funds to get these types of things running and off the ground. Again, I wish ALL next week an incredible and memorable trip to DC. May your voice RING true for all of us... from patients, physicians, family, friends caretakers... researchers... may we FINALLY BREAK THROUGH the "thick headed" thinking of some, and get brilliant things accomplished! As tears roll down my face, I beg of all of you to stand up and tell your story... to stand up and tell a story of a friend, family member.... stand up and be heard!
Friday, October 24, 2014
Lupus?RA?Sjogrens?FM?CFS? Early Onset Parkinson's or Bartonella??? Here are some links and ideas to consider....
I am sharing this with all of you, especially those of us with Lupus,
RA, MS, FM, ME/CFS.... ALL of us have had years before a diagnosis, then
it seems we go through more than one most of the time... and then
wonder if "the doctors have it right" or if they are also grasping at
straws, and giving us a "diagnosis" to just calm out fears. I know for
myself that is true. About a month ago, I saw a dear friend from high
school, and am very happy she is back in our hometown. She had
mentioned some information about a particular illness that usually
comes from being around cats, or other animals, or things like fleas,
ticks, than can be carriers of the illness Bartonella .... she was
telling me about a doctor who of course more of them on the side of the
"animal type" cat scratch fever... that just about all of us have heard
of. The "symptoms" can be almost to the "Tee" of Lupus, RA, FM, CFS and
so forth... severe fatigue, low grade fevers, flu like body aches and
pains, joint pain, headaches... many of the exact same issues we have,
brain fog, that are associated with all of these illnesses. Well, I took
what she said to heart, about the doctor now believe that this illness,
can very well be, the great imitator of some of these illnesses.... and
later people have found out, they may not be "ill" with things like
Lupus, or RA, or be manic depressive, or even one woman was diagnosed as
schizophrenic... but they were infected with the Bartonella bacteria.
Thus, it also goes right along with being very close to Lyme disease,
and also I just has mentioned, after hearing from a friend that has
"early onset Parkinsons'" that Lyme disease can be the great imitator of
early onset Parkinsons.... so all of this kind of hit me like a ton of
bricks... it could be that there are "many" or at least some of us that
don't have any of these chronic illnesses, BUT have gotten Bartonella
one way or the other (by the way I've been bitten badly by one of my
cats in 2005 while in CA) and I've also had two dog bites in my life...
so I have to wonder if in fact there is a possibility that all of this
is some how related... I also know if you walked into one of your
doctors offices and mentioned it, they may look at you like you are
crazy and call the nut house to come and carry you away... but I have
one link I am putting here and will put this along with more links on my
blog....
http://www.galaxydx.com/web/human-health/ if you are also interested take a look... it sure does ring bells with many of my symptoms.
http://www.cvm.ncsu.edu/news/2012-05-04-Uncovering-Bartonella-the-Stealth-Pathogen.html
http://www.lymedisease.org/lyme101/coinfections/bartonella.html
http://www.cdc.gov/bartonella/
http://www.galaxydx.com/web/human-health/ if you are also interested take a look... it sure does ring bells with many of my symptoms.
http://www.cvm.ncsu.edu/news/2012-05-04-Uncovering-Bartonella-the-Stealth-Pathogen.html
http://www.lymedisease.org/lyme101/coinfections/bartonella.html
http://www.cdc.gov/bartonella/
Tuesday, October 21, 2014
When You are Fighting Chronic Illnesses, Chronic Pain, Doctors, Pharmacies, and Medicare Advantage Plans - you need lots of ammunition and tenacity...
I have wanted to be able to get to this subject for all of you over the past couple of days. Of course about the time I have a "clear slot of time" open, my email decided to blow a gasket on me. I had also not known about a follow up appointment Mom had to have her semi-annual "cardio-sonogram" yesterday. So, I had to pick her up and take her to have that done yesterday. It's not that it takes that long, but by the time you dress, pick her up, have the testing ran, then get back, visit for awhile, and I also had a couple of errands to run, I felt like my day was gone and I did not get anything I wanted to get done accomplished.
Plus, I had "overdone" it and used to too many of my "spoons" last Friday, so all of the plans I made to do things around the house both Saturday and Sunday, got basically chopped in half. Saturday I was in so much misery, between stiff, sore, pain, a splitting headache, almost as if I had another Lupus or RA flare hitting, that I spent Saturday on the sofa for the most part, and that really frigged up what my plans had been. I have SO MANY things I want to get accomplished around the house, from repainting my kitchen, painting and redoing our spare bedroom that is our "music room", getting the floors put down in the kitchen and bathroom, and laundry room, we still never got all of the outside of the house painted... and things just really took a nose dive when Jim had the car accident, was in the hospitals for so long, in rehab for so many weeks, thus lots got put off until we could get back into some kind of whatever normal was as far as a routine. Well, we have still to find that "normality" or routine. I feel like I fly by the seat of my pants most days... either waxing and waning one way, or flopping around like a fish out of water in another. Nothing ever seems to come easy, no matter how simple, you can guarantee there will be some kind of snag in the line.
But, when I got this ridiculous letter from Humana, My Medicare Advantage Plan. I have had them ever since I first got my Medicare parts A and B, which was about 2006 or so. They have now decided I guess to probably NOT Pay my PCP enough OR my PCP has gotten "greedy", thus he will no longer be a "preferred provider" come Jan 1, 2015!!!! Which totally sucks green pecans, if you know what I mean. This primary care physician of mine is the ONLY ONE who out of all of the tests, doctors, surgeries, and so forth I had had, the LUPUS, RA< SJOGREN"S, and the list continues. Well, Dr. "B" as I will refer to him as, had just gotten to my home town and I was one of his very 1st patients. At the time he was brand new, he was "brilliant" when it came to "discovering" the unusual, he looked at everything with a "fresh" eyes, and he was "up" on the latest when it came to autoimmune illnesses. But, even though I was one of his very first patients, including I got MANY others to move over to him, because I so so pleased. He got me on the right medications, and I did go and find try to find a Rheumatologist, in which I did. But, the Rheumatologist were more on the end for the Rheumatoid Arthritis end of the ball park, Dr. "B" took care of the Lupus. When I have flares, he is the one that gives me the Solu-Medrol injections, the larger 14 days step down doses of prednisone. He also prescribes my MTX, Plaquenil, and small daily dose of prednisone. So, without him I would be back and forth to some doctor in Dallas, that would be the waste of an entire day, more money, more time, for something that can be handled here, usually by a phone call, me coming in, getting an injection, a script and I am on my way.
I am not quite sure who is the issue, probably both... it is a well known fact Medicare and especially the Medicare Advantage Plans don't pay worth a darned when it comes to the physicians, But, if you have someone within 5 minutes of home that can do the exact same thing, you save time, the doctors save time, gas, and things run much more efficiently that a trip to somewhere else for a Lupus Flare.
So, this letter that I receive from Humana explains to me that if I have "certain" health conditions that Dr. B takes care of, then they will make an exception and pay him as they always have. So, out of about 15 health conditions names on this paper, Lupus was one of them. So, I fill in the paperwork, send it off to Humana, and about a week later, very late one evening someone from Humana leaving a message about that paperwork. She said she would call back the next day, and so I expected to get a phone call from them the next day. But instead about 3 days later I get this ridiculous letter, stating that "Lupus" and Hip Pain (I have NO CLUE where "hip pain" came in what so ever") did NOT qualify and they would NOT continue after Jan 1 to pay him as a "in network provider". OMG, I was so livid, had it not been late in the evening by the time I got the letter Humana would have gotten a piece of my mind...So, of course you can send in a written grievance in which I did. I also boldly told them they were not going to get by with blowing me off like that. My "condition" of Lupus was serious, it was something that Dr. B is the very doctor who diagnosed it, he is the one that since 2009 or 2010 had taken care of me, which every time he fills my medications, he does the follow up blood work, he takes care of the "side illnesses" that go along with the Lupus, and not one other PCP is going to want to take on my complicated case due to it is a complexity that has to be kept up with. As Dr, B always knows exactly what is going on. If I have a "new" symptom, he knows if it is related or not to the Lupus, and he also takes cares of my mouth ulcers, thrush, stomach problems from Lupus. As I had said and we know for a fact, I can go from "well" to ill enough for ICU within minutes under some circumstances... just like I had double pneumonia back in April. No one was here but myself, so I did not realize I was running such a high fever I was all but see things and hallucinating. Thank goodness I thought to check my temp and even though I never run fever, I did not usually do so, and if it had gotten any higher I may have went into convulsions. Luckily, I was still smart enough and scared enough not to drive alone, so I called my Mom and had her pick me up that Sunday afternoon and carry me to our Urgent care Center. But, if that had been any other time during the week, I would have called Dr. "B" quickly, and found out I was running 103.9 fever, and had double pneumonia!!!! It was so bad the doctor on call at the center wanted at first to send me to the ER and possibly have me admitted. Well, at the time Jim was in Baylor after the car accident, which he was still in Acute Care and had just gotten out of ICU with all kinds of broken bones, a very long 9 hour back surgery, 17 broken ribs and it continued on. The very last thing I needed was to be put in a hospital down here, and have him in the hospital up in Dallas....
So, having a physician that KNOWS my health issues, ALL of them, how the interrelate to one another, and what has taken place, from surgeries, to the 6 weeks I spent in two hospitals, and almost died from what they can surmise had something to do with the Lupus. But, even in the huge hospital in Dallas, and all of the highly specialized doctors there, many of them were NOT familiar with Lupus, nor any of the health problems that come along with it.
So, I got to thinking about this entire scene, and it just makes me even madder than I was when I first got the letter from Humana! In the first place, IF HUMANA was PAYING the doctors better, then the doctors WOULD NOT be dropping out of being "Preferred Providers"... and if the DOCTORS were NOT SO MONEY HUNGRY they would be "settling" FOR WHAT THE INSURANCE pays them, and not setting their GOALS OF MONETARY GAIN so high they cannot either afford to pay the doctors better OR WORSE they take FOREVER TO PAY THE DOCTORS!!! This is NO JOKE and it came directly from the mouth of one of my physicians!!!!
He had TWO SURGERIES, and I know he meant very EXPENSIVE SURGERIES, because it was probably something like having a pain pump internally put it or something like a stimulator put in internally, which the doctor has to implant. Both of them are very expensive. Just the devices themselves run upwards of 50,000.00 or so.
Anyway, he had two patients that AFTER TWO YEARS OF dragging their feet, the Doctor had to take Humana Medicare Advantage plan to COURT IN FRONT OF THE JUDGE, and the JUDGE MADE THEM PAY MY DOCTOR!!!
But, it took him 2 YEARS to get paid on those two surgeries!!! If he has to wait to get paid on many of those expensive procedures, they will all go broke trying to keep up an office, pay employees, pay taxes, and keep an office up and running. It was insane to hear how long he had to wait and then for a judge to have to demand they pay him what they owed him. I just about let my jaw hit the floor. Now, I also know doctors charge WAY TOO MUCH, to try and compensate for what they are trying to make up on those cases they do not get paid, or certainly not enough. So, it is a circle in circle around and around the merry-go trying to get one hand to a one to pay the other. In the mean time guess who suffers through this??? Yes, you have it.... US, the PATIENTS!!! We suffer added money out of our pockets, paying for doctors and the clinics and tests, and in the end, half the time no one has a straight answer for us anyway. So, now this puts myself, my Mom, and Lord knows how many other patients just like us are suffering through the exact same issues. It is damned if you DO, and you be damned if you don't.
I have even threatened NOT TO go to a PCP anymore, but just use our "urgent Care center" here. They have their heads on straighter than most of the primary care physician. The 3 or 4 times I've been out there, one of which was for a Lupus flare during a weekend, and then I could go there and get checked in, checked out, have my injections, get my prescription and be on my way. To top it off they are the ones as I said above that diagnosed me with double pneumonia, took the X-rays right there, right away, were on the ball and I was out the door and headed home without any hassle. And out of pocket for me was my $40.00, plus I did not get exposed to an entire room full of germs and people running fevers, and possibly get something else, other than what I already had. It was a "pleasant"(if you can call having double pneumonia pleasant" experience, just due to the fact there was no hassle, and I was home and on my sofa within an hour and a half. It took longer for the pharmacy to get my script ready than it did to get through the Urgent care in itself.
Now you can get your flu shots, pneumonia shots, even tetanus and so forth at the pharmacy, they will even sometimes check your cholesterol, blood pressure and so on, including hearing test for free at different times. It is getting to where people don't want to step into the room of a doctors office, because it takes too long, they never answer your questions, once you spend hours getting in, they then herd you in and out like a bunch of cattle, not really bothering to answer a question one you may have. I've gotten to where even my "tricK" of taking my LIST of all the thing I NEED to talk about them with, and he is running out the door before I can ask the 3rd question. As someone who believes in researching everything myself, and also believes that MY TIME, YOUR TIME, OUR TIME IS JUST AS IMPORTANT AS THAT DOCTORS TIME!!! So WHY do WE wait for HOURS FOR THEM!!!
Then they have the audacity to post a sign if a patient does NOT call in 24 hours ahead of time to cancel, they can charge you anyway. But, I've had doctors CALL ME ON MY WAY TO DALLAS FOR AN APPOINTMENT and they tell not to come, because the doctor is out in an emergency or had gotten called away suddenly!!! So, now my day had been half ruined getting ready, getting dressed, wasting, time, gas, and everything else, yet it seems to be perfectly "okay" for them to cancel at the last moment. Believe me I felt like sending them a bill for my time and see what they thought about that.
I had read an article a couple of years back where I woman did just that. She had a doctor cancel on her two times in a row or something, so she did send them a bill for her time and trouble!!! Whether she ever got able paid or not, but I bet it did put it on their minds. OUR TIME is just as valuable as anyone else's is... whether the doctor, nurse, surgeon or the Pope!!!!
Again though it takes time and tenacity to do that I can see where under the right circumstances it would get the attention of those who think they are "better" than use.
I would be interested in knowing how many of you with Medicare Advantage Plan and possibly have gotten the exact same thing. A letter telling us that our doctors won't keep them on and be "preferred provider" after January1st 2015. If you HAVE either post here, or send me an email because I would love to hear from you. Then also what are you going to do under the circumstances? Change, try to keep your doctor, just pay the "extra" amount and stay, or does it even matter....
Plus, I had "overdone" it and used to too many of my "spoons" last Friday, so all of the plans I made to do things around the house both Saturday and Sunday, got basically chopped in half. Saturday I was in so much misery, between stiff, sore, pain, a splitting headache, almost as if I had another Lupus or RA flare hitting, that I spent Saturday on the sofa for the most part, and that really frigged up what my plans had been. I have SO MANY things I want to get accomplished around the house, from repainting my kitchen, painting and redoing our spare bedroom that is our "music room", getting the floors put down in the kitchen and bathroom, and laundry room, we still never got all of the outside of the house painted... and things just really took a nose dive when Jim had the car accident, was in the hospitals for so long, in rehab for so many weeks, thus lots got put off until we could get back into some kind of whatever normal was as far as a routine. Well, we have still to find that "normality" or routine. I feel like I fly by the seat of my pants most days... either waxing and waning one way, or flopping around like a fish out of water in another. Nothing ever seems to come easy, no matter how simple, you can guarantee there will be some kind of snag in the line.
But, when I got this ridiculous letter from Humana, My Medicare Advantage Plan. I have had them ever since I first got my Medicare parts A and B, which was about 2006 or so. They have now decided I guess to probably NOT Pay my PCP enough OR my PCP has gotten "greedy", thus he will no longer be a "preferred provider" come Jan 1, 2015!!!! Which totally sucks green pecans, if you know what I mean. This primary care physician of mine is the ONLY ONE who out of all of the tests, doctors, surgeries, and so forth I had had, the LUPUS, RA< SJOGREN"S, and the list continues. Well, Dr. "B" as I will refer to him as, had just gotten to my home town and I was one of his very 1st patients. At the time he was brand new, he was "brilliant" when it came to "discovering" the unusual, he looked at everything with a "fresh" eyes, and he was "up" on the latest when it came to autoimmune illnesses. But, even though I was one of his very first patients, including I got MANY others to move over to him, because I so so pleased. He got me on the right medications, and I did go and find try to find a Rheumatologist, in which I did. But, the Rheumatologist were more on the end for the Rheumatoid Arthritis end of the ball park, Dr. "B" took care of the Lupus. When I have flares, he is the one that gives me the Solu-Medrol injections, the larger 14 days step down doses of prednisone. He also prescribes my MTX, Plaquenil, and small daily dose of prednisone. So, without him I would be back and forth to some doctor in Dallas, that would be the waste of an entire day, more money, more time, for something that can be handled here, usually by a phone call, me coming in, getting an injection, a script and I am on my way.
I am not quite sure who is the issue, probably both... it is a well known fact Medicare and especially the Medicare Advantage Plans don't pay worth a darned when it comes to the physicians, But, if you have someone within 5 minutes of home that can do the exact same thing, you save time, the doctors save time, gas, and things run much more efficiently that a trip to somewhere else for a Lupus Flare.
So, this letter that I receive from Humana explains to me that if I have "certain" health conditions that Dr. B takes care of, then they will make an exception and pay him as they always have. So, out of about 15 health conditions names on this paper, Lupus was one of them. So, I fill in the paperwork, send it off to Humana, and about a week later, very late one evening someone from Humana leaving a message about that paperwork. She said she would call back the next day, and so I expected to get a phone call from them the next day. But instead about 3 days later I get this ridiculous letter, stating that "Lupus" and Hip Pain (I have NO CLUE where "hip pain" came in what so ever") did NOT qualify and they would NOT continue after Jan 1 to pay him as a "in network provider". OMG, I was so livid, had it not been late in the evening by the time I got the letter Humana would have gotten a piece of my mind...So, of course you can send in a written grievance in which I did. I also boldly told them they were not going to get by with blowing me off like that. My "condition" of Lupus was serious, it was something that Dr. B is the very doctor who diagnosed it, he is the one that since 2009 or 2010 had taken care of me, which every time he fills my medications, he does the follow up blood work, he takes care of the "side illnesses" that go along with the Lupus, and not one other PCP is going to want to take on my complicated case due to it is a complexity that has to be kept up with. As Dr, B always knows exactly what is going on. If I have a "new" symptom, he knows if it is related or not to the Lupus, and he also takes cares of my mouth ulcers, thrush, stomach problems from Lupus. As I had said and we know for a fact, I can go from "well" to ill enough for ICU within minutes under some circumstances... just like I had double pneumonia back in April. No one was here but myself, so I did not realize I was running such a high fever I was all but see things and hallucinating. Thank goodness I thought to check my temp and even though I never run fever, I did not usually do so, and if it had gotten any higher I may have went into convulsions. Luckily, I was still smart enough and scared enough not to drive alone, so I called my Mom and had her pick me up that Sunday afternoon and carry me to our Urgent care Center. But, if that had been any other time during the week, I would have called Dr. "B" quickly, and found out I was running 103.9 fever, and had double pneumonia!!!! It was so bad the doctor on call at the center wanted at first to send me to the ER and possibly have me admitted. Well, at the time Jim was in Baylor after the car accident, which he was still in Acute Care and had just gotten out of ICU with all kinds of broken bones, a very long 9 hour back surgery, 17 broken ribs and it continued on. The very last thing I needed was to be put in a hospital down here, and have him in the hospital up in Dallas....
So, having a physician that KNOWS my health issues, ALL of them, how the interrelate to one another, and what has taken place, from surgeries, to the 6 weeks I spent in two hospitals, and almost died from what they can surmise had something to do with the Lupus. But, even in the huge hospital in Dallas, and all of the highly specialized doctors there, many of them were NOT familiar with Lupus, nor any of the health problems that come along with it.
So, I got to thinking about this entire scene, and it just makes me even madder than I was when I first got the letter from Humana! In the first place, IF HUMANA was PAYING the doctors better, then the doctors WOULD NOT be dropping out of being "Preferred Providers"... and if the DOCTORS were NOT SO MONEY HUNGRY they would be "settling" FOR WHAT THE INSURANCE pays them, and not setting their GOALS OF MONETARY GAIN so high they cannot either afford to pay the doctors better OR WORSE they take FOREVER TO PAY THE DOCTORS!!! This is NO JOKE and it came directly from the mouth of one of my physicians!!!!
He had TWO SURGERIES, and I know he meant very EXPENSIVE SURGERIES, because it was probably something like having a pain pump internally put it or something like a stimulator put in internally, which the doctor has to implant. Both of them are very expensive. Just the devices themselves run upwards of 50,000.00 or so.
Anyway, he had two patients that AFTER TWO YEARS OF dragging their feet, the Doctor had to take Humana Medicare Advantage plan to COURT IN FRONT OF THE JUDGE, and the JUDGE MADE THEM PAY MY DOCTOR!!!
But, it took him 2 YEARS to get paid on those two surgeries!!! If he has to wait to get paid on many of those expensive procedures, they will all go broke trying to keep up an office, pay employees, pay taxes, and keep an office up and running. It was insane to hear how long he had to wait and then for a judge to have to demand they pay him what they owed him. I just about let my jaw hit the floor. Now, I also know doctors charge WAY TOO MUCH, to try and compensate for what they are trying to make up on those cases they do not get paid, or certainly not enough. So, it is a circle in circle around and around the merry-go trying to get one hand to a one to pay the other. In the mean time guess who suffers through this??? Yes, you have it.... US, the PATIENTS!!! We suffer added money out of our pockets, paying for doctors and the clinics and tests, and in the end, half the time no one has a straight answer for us anyway. So, now this puts myself, my Mom, and Lord knows how many other patients just like us are suffering through the exact same issues. It is damned if you DO, and you be damned if you don't.
I have even threatened NOT TO go to a PCP anymore, but just use our "urgent Care center" here. They have their heads on straighter than most of the primary care physician. The 3 or 4 times I've been out there, one of which was for a Lupus flare during a weekend, and then I could go there and get checked in, checked out, have my injections, get my prescription and be on my way. To top it off they are the ones as I said above that diagnosed me with double pneumonia, took the X-rays right there, right away, were on the ball and I was out the door and headed home without any hassle. And out of pocket for me was my $40.00, plus I did not get exposed to an entire room full of germs and people running fevers, and possibly get something else, other than what I already had. It was a "pleasant"(if you can call having double pneumonia pleasant" experience, just due to the fact there was no hassle, and I was home and on my sofa within an hour and a half. It took longer for the pharmacy to get my script ready than it did to get through the Urgent care in itself.
Now you can get your flu shots, pneumonia shots, even tetanus and so forth at the pharmacy, they will even sometimes check your cholesterol, blood pressure and so on, including hearing test for free at different times. It is getting to where people don't want to step into the room of a doctors office, because it takes too long, they never answer your questions, once you spend hours getting in, they then herd you in and out like a bunch of cattle, not really bothering to answer a question one you may have. I've gotten to where even my "tricK" of taking my LIST of all the thing I NEED to talk about them with, and he is running out the door before I can ask the 3rd question. As someone who believes in researching everything myself, and also believes that MY TIME, YOUR TIME, OUR TIME IS JUST AS IMPORTANT AS THAT DOCTORS TIME!!! So WHY do WE wait for HOURS FOR THEM!!!
Then they have the audacity to post a sign if a patient does NOT call in 24 hours ahead of time to cancel, they can charge you anyway. But, I've had doctors CALL ME ON MY WAY TO DALLAS FOR AN APPOINTMENT and they tell not to come, because the doctor is out in an emergency or had gotten called away suddenly!!! So, now my day had been half ruined getting ready, getting dressed, wasting, time, gas, and everything else, yet it seems to be perfectly "okay" for them to cancel at the last moment. Believe me I felt like sending them a bill for my time and see what they thought about that.
I had read an article a couple of years back where I woman did just that. She had a doctor cancel on her two times in a row or something, so she did send them a bill for her time and trouble!!! Whether she ever got able paid or not, but I bet it did put it on their minds. OUR TIME is just as valuable as anyone else's is... whether the doctor, nurse, surgeon or the Pope!!!!
Again though it takes time and tenacity to do that I can see where under the right circumstances it would get the attention of those who think they are "better" than use.
I would be interested in knowing how many of you with Medicare Advantage Plan and possibly have gotten the exact same thing. A letter telling us that our doctors won't keep them on and be "preferred provider" after January1st 2015. If you HAVE either post here, or send me an email because I would love to hear from you. Then also what are you going to do under the circumstances? Change, try to keep your doctor, just pay the "extra" amount and stay, or does it even matter....
Monday, March 17, 2014
An Autoimmune Arthritic Systemic Life: More on the Continuing Saga of "Rhia's Law" If it ...
An Autoimmune Arthritic Systemic Life: More on the Continuing Saga of "Rhia's Law" If it Will Happen Then It Will Be Rhia...Honestly, when I go back and read some of the things that I've been through, put up with, did do, did not do... and all of the "happen to me... it seems impossible that ONE person could have gone through so much in just 8 years! Of course there were other things well before all of the autoimmune illnesses began, and I thought those were horrible. I had moved several times. From Lancaster CA (Whish I loved and still do), back to TX to have a knee surgery, then from Ennis to Austin TX, where I rehabbed the knee an was ready to take a job, then something happened and I came back to Ft. Worth TX. Well that is when 9/11 happened. So, I quickly got back to Ennis (as quickly as I could at that time), and within 6 weeks was headed for Seattle WA. That is where my entire life changed "for the good". I got somewhat "healthy" ... I had a job a loved!!! .. I was making decent money... had a "man" in my life that I was not really sure of, but I did make good friends with his family, and other people around so by the time he pulled a stunt, went to Florida to see another "friend" who turned out to be a woman he had bought a cell phone to talk to every night. He Thought I did NOT know, but I found all of the bag, box and everything in the trunk of the car when I went o get groceries ... PLUS I KNEW E woULD NECER go through the halls for hours normally each night. He done a quick run through usually that took about 25 minutes and he was back. When it started to be an hour, more than an hour, 2 hours, 3 hours and I confronted him with cell phone box and bag in hand... he admitted he was "planning" to go to FL to "see" his friend... Well hell I am NOT stupid! So, he went all right... but I TOOK MY MONEY out of the acct... and left him ONLY WHAT WAS HIS... (He had already taken some out so he was screwed when he got there, and she really was WEIRD. and kind of not interested in him.... anyway... I thought after having to be "on the run" from a "husband" at that time I was trying to "divorce". The ONLY way I could keep him from abusing me physically, mentally and emotionally, was to GET out of TX! He still FOUND ME twice or three times! Each time I thought I was "safe", someone would tell him, and the next thing I know he is around "haunting" me again. Even after I had been in Seattle for over 4 years, divorced him, he got hold of my phone number and began calling and threatening myself and my "finance" then, Jim. Even when we came back to Texas for my daughters' wedding (his daughter) he had told everyone he would "take care" of both of us while we were there. Finally, some of my daughter's new husbands' "buddies" removed him from the premises and told him to stay the hell away. He had almost killed me several times in the past. I put up and "hid" the abuse for many years. I was scared he would hurt me worse, or the kids, or do something terrible. So, I kept my mouth shut to everyone. No body, but my kids knew it, and I would not allow them to tell anyone. I kept them away at the worst times with their friends. Little did I know he was not only "addicted" to Meth.... I knew he was an alcoholic.... but he had "meth" hidden under our shed in my back yard... lots of it there at the last I was told... I did not find out about the drug abuse until just a few months before I moved back to TX, in 2005! Dad had passed away, and even though I never wanted to leave Seattle I had to come back to help my Mom. By this time the "ex", had not only been "caught" and arrested, but was in jail for a LONG time! So, when we first got here, there was about a year or more we never had to be concerned about him. But, I STILL to this DAY have "night terrors" that I wake up screaming, scared to death he is hurting me and JIM, or hurting me somewhere in town.... I carry mace with me everywhere I go. And I still find myself looking over my shoulders, for him even though I have been away from him since 2001, he still "haunts me"....
But, ALL of that, as HORRIBLE and as bad as it was.... and it was bad... still does NOT compare with what these immune illnesses have done to me.... they have also turned my life inside out, they have caused me to be unable to do SO MANY things, I've so wanted to do... EVEN just EVERYDAY. ordinary things... I am always either dealing with a flare, or a surgery, or getting over an infection, or my mouth full of ulcers and knots, or my throat so sore I cannot stand to drink anything. We make plans and I get ill so we have to cancel them. I am supposed to be taking care of my Mom. And I feel as If sometimes "She" is having to "take care" of me!!! NOW these teeth.... and my vision again being so bad!!! Yet, if I go to the physicians most of them are no further along, so their answers are it is the Lupus, RA, Sjogren's, Raynaud's the medications, like the prednisone, which my own PCP calls it a "necessary evil"... if I have a flare, it is the only thing to help get it kind of under control... THEN when my Rheumatologist FINALLY gets hold of the ONE medication a biologic, that finally "HELPS' with the morning stiffness, the pain in my legs and feet, the stiff and swollen fingers and thumbs, my wrists swollen and joints, the INSURANCE gives me A MAJOR SCREW UP, SO I GO 7 WEEKS WITHOUT MY MEDICATION! Which sent me into 2 MAJOR flares! Along with something that was a bacterial lung infection, which I though I was over, the flares came on, they gave me more antibiotics that caused me to have certain type of "colitis" caused by certain antibiotics, thus it was a nightmare because then my husband gets ill, and it seems we may have also contracted a stomach virus, but we could not find out because it took them A WEEK to get back lab work, rather than go ahead and treat me. Well, they finally "looked" at my lab work and said "nothing was wrong". THIS WAS ON A FRIDAY WHEN I CALLED THEM myself. So, the "FOLLOWING" TUESDAY I get a Call from the same doctors office, and the nurse says " the PA looked at your labs and you DO have a "BACTERIAL YEAST INFECTION IN YOUR COLON" AND they have "called in" medication for it!!!! There is MORE to the story about them, but you can be assured that I am Looking for another PCP!!!
Then of course is the entire matter of my teeth...
All of this is EFFECTING MY invitation to go to Washington DC for the Arthritis Foundation after I was invited to go. Now as I get ready, I am ill again, so I am not sure I will get to go Monday Morning!!!! I am totally devastated over the entire thing... and these are just "pieces" of what is happening... the "book" if I ever get to where I can write it will Tell ALL OF IT for sure!
Thank Goodness I have people praying for me all over the world! Wishing me positive thoughts That I will be "well enough" to go!!!!
What can I Say.. but I am so appreciative of those that are standing beside me holding my hand!!!!
Rhia
But, ALL of that, as HORRIBLE and as bad as it was.... and it was bad... still does NOT compare with what these immune illnesses have done to me.... they have also turned my life inside out, they have caused me to be unable to do SO MANY things, I've so wanted to do... EVEN just EVERYDAY. ordinary things... I am always either dealing with a flare, or a surgery, or getting over an infection, or my mouth full of ulcers and knots, or my throat so sore I cannot stand to drink anything. We make plans and I get ill so we have to cancel them. I am supposed to be taking care of my Mom. And I feel as If sometimes "She" is having to "take care" of me!!! NOW these teeth.... and my vision again being so bad!!! Yet, if I go to the physicians most of them are no further along, so their answers are it is the Lupus, RA, Sjogren's, Raynaud's the medications, like the prednisone, which my own PCP calls it a "necessary evil"... if I have a flare, it is the only thing to help get it kind of under control... THEN when my Rheumatologist FINALLY gets hold of the ONE medication a biologic, that finally "HELPS' with the morning stiffness, the pain in my legs and feet, the stiff and swollen fingers and thumbs, my wrists swollen and joints, the INSURANCE gives me A MAJOR SCREW UP, SO I GO 7 WEEKS WITHOUT MY MEDICATION! Which sent me into 2 MAJOR flares! Along with something that was a bacterial lung infection, which I though I was over, the flares came on, they gave me more antibiotics that caused me to have certain type of "colitis" caused by certain antibiotics, thus it was a nightmare because then my husband gets ill, and it seems we may have also contracted a stomach virus, but we could not find out because it took them A WEEK to get back lab work, rather than go ahead and treat me. Well, they finally "looked" at my lab work and said "nothing was wrong". THIS WAS ON A FRIDAY WHEN I CALLED THEM myself. So, the "FOLLOWING" TUESDAY I get a Call from the same doctors office, and the nurse says " the PA looked at your labs and you DO have a "BACTERIAL YEAST INFECTION IN YOUR COLON" AND they have "called in" medication for it!!!! There is MORE to the story about them, but you can be assured that I am Looking for another PCP!!!
Then of course is the entire matter of my teeth...
All of this is EFFECTING MY invitation to go to Washington DC for the Arthritis Foundation after I was invited to go. Now as I get ready, I am ill again, so I am not sure I will get to go Monday Morning!!!! I am totally devastated over the entire thing... and these are just "pieces" of what is happening... the "book" if I ever get to where I can write it will Tell ALL OF IT for sure!
Thank Goodness I have people praying for me all over the world! Wishing me positive thoughts That I will be "well enough" to go!!!!
What can I Say.. but I am so appreciative of those that are standing beside me holding my hand!!!!
Rhia
Thursday, December 5, 2013
Whittemore Peterson Neuro-Autoimmune Institute
More News on the World wide front of Autoimmune Illnesses... and another "term" new to me "Neuro-Autoimmune?
I just got a "newsletter" from the Whittemore Peterson Institute. It contains a great deal of the research their doing in regard to FM/CFS/ME. Of course their beginnings are from the 2 doctors that actually discovered CFS/ME - and FM as a "real illness". Most know the story about the small town in Nevada, where suddenly many residents that were very healthy suddenly, with no explanation became so very ill that they were unable to work. This "mysterious illness/syndrome" whatever you want to call it, was bringing in patient after patient to this small clinic where the 2 physicians quickly became overloaded. Years have passed since the first "signs" of these illnesses began. We have been through all kinds of phases, as patients and I can say doctors also. NO one knew much about these. Doctors thought for the most part patients were (especially female patients) were "depressed" stressed, or plain hypochondriacs. Often with a recommendation I am sure that you need a "shrink". Also it was a "waste basket" diagnosis for awhile. Doctors saw patients with some symptoms of FM, CFS/ME thus if they could not really get a good understanding of what may be wrong with a patient, they had FM. And they left a doctor's office horrified. I know I did! I was told this MANY years ago, back when it was either put upon mainly women who exhibited many of the symptoms, and were "busy" wives, Mom's, employees, "chief, cook and bottle washer" of their lives. So "stress" and "depressed" was how we were treated. No really know "reason".. not a virus, not an infection, not a flu (even though symptoms can and are often "Flu" like)... and not a whole lot out in the realms of medicine to explain it. It really wasn't until about the last 5 to 7 years, I've seen a dramatic change in how patients with these illnesses are treated. First of all, you are taken "seriously". Now, FM/CFS/ME are REAL illnesses, so you have a REAL DIAGNOSIS, thus you expect explanations of why, how, when, what, where and why?
Why? You also expect to be told what the "treatments" are, and when will I "get over this"... "yuppie flu" (another horrid term used)??? A couple of years back the Whittemore Peterson Institute became very well known throughout the world. They seemed to be "the beginnings of those questions, and also possibly how to get better, treatments, and mainly what it is, how did I get it? They came out with a huge "clinical trial" per se... that showed great promise to those inflicted parties. It was based on "mice" and a "viral" type manifestation, and it spread like wild fire throughout all of the social media, twitter, in news articles... patients, doctors, everyone was talking about this "answer" to these illnesses. It was a bit of a while, but after the glory came disappointment. It was told that these "trials" had not be as exact as the should have been. There were many errors made during all of these that caused for the entire study to be trashed. This "retro" virus that all had hoped answered the call, turned out to be not trustworthy, incomplete, and just brought a downer to those in the middle of these illnesses. Since then, WPI, has been doing some incredible research by many very great people in the medical world, and the discoveries that they are now making DO SHOW GREAT PROMISE! As I was reading over the newsletter a little while ago (and is the POINT to this long post, is that NOW these illnesses are being "grouped" more as "neuro-immune" diseases. In fact the WPI now has their clinic speciality labeled as "Neuro-Immune" Diseases. As I read this, what I have said for a LONG TIME, and what brought it really to hit "home" of course "immune". I've been SAYING for YEARS, these illnesses are in the same scenario and are "autoimmune illnesses". They just have not proven it, but now, "Neuro-Immune surely says it all. I told my husband I WISH so VERY MUCH, I had went onto BECOME A RESEARCHER, in these realms. If I were not so chronically ill, and taken over with brain fog, plus was still around 40 years old... I WOULD GO BACK TO COLLEGE AND GO INTO CLINICAL RESEARCH FOR THESE AUTOIMMUNE illnesses/diseases/syndromes.. it almost breaks my heart, that I long so much to be able to "find a reason, find ways to stop these, and a ways to treat those already with all of them. And I am speaking of All Autoimmune Arthritic and Autoimmune illnesses in general. Life hands us what we are so often not able to reason with... and I don't know "why" I did not more fulfill my college and so on when I was younger... plans change, you "fall" more like "trip" into love... and you let YEARS slip BY... you are 50 +, and chronically ill... thus your "research" is what I and all of you do... advocacy!!! I guess this post is for everyone... ill, not ill, young, elderly, college, high school, wherever you are, whatever you are doing, whatever your dreams maybe.... don't WAIT until all the YEARS PASS you BY... and then like myself, have to live with some regret, that what I almost feel I was "meant" to do, slipped through my fingers, like sands through a sieve. by the way I think I can attach their newsletter....I have their newsletter in a PDF... I'll try to put it on here and then let you now.... in the meantime here is their websitehttp://wpinstitute.org/index.html
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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...
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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...
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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...