Random Thought of the Day

Quote: beachbumbabs

This may be the final straw.

Outsmarted by a puppy? He just
acts on instinct, you're the one
that left it where he could get it.
Dogs are incapable of linear thought.
You, on the other hand, should have
it mastered by now.

It has human scent on it and he may need salt.
Did you read the recent study on the ineffectiveness of inhalers in certain conditions depending upon either preserved or impaired ejection fraction values?

Quote: beachbumbabs

This may be the final straw.

Does that mean mom has to go?

Quote: petroglyph

Does that mean mom has to go?

Nailed it.

I said, "Hey, where's your inhaler? It was right here."

She said "I put it in by my bed."

The dog can't get in her bedroom. So I didn't get a flashlight and look at his debris field to doublecheck. This morning it was shredded beyond help.

My mistake was believing her. He had stolen it from the patio where we had dinner.

Called the pharmacy. They needed authorization.

Called the hospital. They don't reauthorize.

Called her primary doctor. Got voice mail.

Doctor called back. Wanted to know what pharmacy.

Pharmacy called. Can't fill the prescription until the 28th because it's a controlled substance, and the insurance won't authorize it until the 28th. Insurance didn't cover it last time, which is why it was $309 for a months worth. Must call back on the 28th to get it filled.

Call the insurance company. Ask if deductible has been satisfied. Yes. Tell them the dog ate the inhaler, could they waive the wait time.

36 minutes on hold later, insurance says yes. Presciption has been filled and is waiting. Miracle.

Call pharmacy. They have not filled the prescription, but will now that I've called again. Still. $82 copay, but better than $309 retail.

Drive to pharmacy, wait in line, get prescription.

Total time spent : 3.2 hours.

And I wonder where my days go, doing this home care thing. It's all like that. There are perfectly good reasons for each of them to be like that. But the total effect sucks.

Still better than the first time I filled the prescription. Was given script in the hospital Sunday, because controlled substance, they needed a physical script. Gave it to pharmacy at 3 pm taking mom home from hosp, along with other scripts, closing at five, ready just before.

4:45 I return to pick up meds. Pharmacy waits til then to say can't fill because the med they prescribed is not covered by medicare. They couldn't get hospital on the phone to fix it.

I call back 9am Monday when pharm opens.
I give them direct number for charge nurse. No answer. I drive to hospital (10 miles city driving, 20-25 min each way) to get script for different med.

All computers and phones are down for entire Healthcare system. They track down the hospital doctor and she writes a med script medicare will cover.

Drive to pharmacy. They refuse to accept the script because it's missing a code insurance needs to authorize the med.

Drive to hospital to get script fixed. They write a code on the script. All systems are down, all computers and phones, so they can't fax it. I go back to pharmacy.

Pharmacy says wrong code. I say, "well, you know the code, write it on there". They say, illegal. I say, then tell me the code you need, I'll write it on there. They say, illegal.

I go back to hospital. They say, never had this happen before. Let us find the code. They write a new script with different code.

Drive back to pharmacy. They accept code, 1/2 hour to fill, they have others in line. I say, I've been in line 23 hours and my mother is gasping like a fish out of water while I chase this down.

They fill it. Insurance rejects the med. Because she hasn't met her deductible. I pay $309 for the med and go shoot her up (inhalant-shooting, not needle).

The whole time, as I'm on the road, I'm on the phone. Need 3 doctor follow-up visits that week. Primary and 2 specialists. All of course part of network that's down.

Finally get through to primary. Doctor left office in disgust. They write our name down (novel idea) and will call us when system comes back up, try and see us tomorrow. (They did, with 10 minutes notice if we could get there, Tues 8am. Computers still down, but he's an old-fashioned gp and came to work anyway.)

Never do reach the 2 specialists that day. Computers finally recover Wed. (multiply Monday by a couple thousand patients system-wide and 2 full days of crash: we were lucky Mom didn't need critical care or something). How does an entire hospital system allow itself a single point of failure? ATC is triple-redundant.

Meanwhile, Monday continued: home care scheduled Sun before discharge shows up. (Mom's house) Skin in for that RN appt @9:30. Surprise visit by new maid service @11. Oxygen co. comes with equip @10. Nebulizer shows up at 12. Physical therapist at 1. I'm chasing the prescription before, during, and after all these appointments.

In the mean time, 10 days (before hosp) my house AC had died. Scheduled that Monday for replacement of handler and compressor. $4500 prepaid. Ran over there to get them started, did the rest, ran back there that afternoon to inspect and pay.

And the phone calls. Insurance. Family. Other stuff. Yikes.

Might have been.the most insane day of my life. Mom is gorked the whole time, has to have help with everything, on top of the rest. I don't know how anybody works in the medical profession. I really don't. Caregiver. Bah.

If you got this far, thanks. Felt good to write that out. /rant.

Quote: beachbumbabs

If you got this far, thanks. Felt good to write that out. /rant.

I did, and the pleasure was mine : }.

I'll start out by JFC ! Thank god you have the skills, tenacity and wherewithal that you do, or the ole gal is screwed.

The last few years here, I have went so far down the med/ insurance rabbit hole, sweety and I have considered ourselves so very lucky that we have those same traits. We wonder what "the Poe folk do". It's like a black hole, and it changes monthly. I see the staff at facility's drop like flies. Next time I see my PCP, I'm telling her, she is in my honest opinion, more of a hero than any fireman going. The pcp's are the frontline heroes, she doesn't make that much money [comparatively], takes lots of personal risk, is always catching some bug from a patient, and suffers for us. The list is much longer.

I have come to the conclusion that everyone that needs severe care, needs to be their own best advocate as most don't have someone like you. The Mayo told me that "the ones that survive this have the best support group". That is so true.

I use an inhaler, albuterol. When I started they were fifteen bucks. Now because they added a counter, [that lies] they are cheaper if I pay cash instead of go through insurance, I pay 39.

I went to the pulmonologist a few weeks ago, and she is big on free samples, so am I : ). She gives me a new drug, "Bovespa" which made me think when you first posted about the cost, if that's what your mom has, because of the price? The Dr. gave me a freebie and her assistant gave me a coupon for another, which I looked at and it was expired. I asked the assistant who isn't that friendly, about it being expired, and since I know the pharmacist, I told her he wasn't going to accept an expired coupon. She got a little indignant and said, "you don't know what he will take". I returned it to her, and she went and got me one that wasn't expired.

I didn't want another one till I tried that one, so I didn't fill it. When I went to the pharmacy anyway, there was a refill waiting for me, and I was puzzled and asked, how much? The clerk says, "its free", I said I'll take it. Free is free, right? Apparently there is a price for free. I got a copy of the billings from my insurance and they were charged around 400 bucks for this med. You know how big these are. 400 bucks, I choked. I think the Dr. must of somehow sent them a good coupon, which the pharmacy accepted, but still charged the insurance another 370 bucks.

This is another part to the sad tale. The albuterol works better. My neighbor goes to Los Algadonnes twice per year. Don't need a scrip and she picks me up 3 for five bucks. She could get six, for ten. I didn't know the insurance would be charged 400 for a tiny inhaler or wouldn't have taken it, at least until I had tried the freebie. Matter of principle.

I feel ya, maybe not all of this struggle. JFC, again. It didn't register in my brain, but I think I recall the doc saying the Bovespa is a controlled substance. I don't know if I can deal with another seemingly benign medicine on the controlled substances list, the hassle and the stigma? Narcotics ok, but an inhaler and a sleeping pill? Come on.

Thanks for sharing, oddly hearing your dilemma makes mine seem easier. I always ask for freebies, have you looked online for coupons?

What kind of dog? : ) A good dog will save you, and carry you through. So will music. What a day you had, they must going to be getting easier right?

She doesn't have any make-up on according to the story. I didn't recognize her, though I thought I knew what she looked like.

Quote: beachbumbabs

Felt good to write that out. /rant.

I'll bet. Hooboy. Hope it gets better for you.

Maybe you should hook up with one of those primary care giver support groups.

Thanks very much for the empathy, guys. I really appreciate it.

Petro, really something to hear that it's the same everywhere. I had no idea. And you live in a retirement zone, like we do, where it's a big, competitive business, senior healthcare. A real eye-opener to be navigating the systems.

You are so right about the advocacy. I'm beginning to understand how so many people get put in assisted living/nursing homes, rather than living withe family. Its 16-18 hours a day, every day; it's a good thing I'm retired, and mom has really good insurance (despite my story). I can't imagine how she could be expected to do this alone.

Despite the "/rant venting" I know it is difficult even if you do let off some steam via the rant.

I've had my share of this foolhardiness. On medicare funding, the Home Care people descend like vultures doing very little but billing Medicare for so much.

As you may know from my previous posts I have a BiPap machine which I often refer to as 'the rear end of a vacuum cleaner' since that is what it really is. I happen to know its actual cost and the Home Health Carecompany recoups that cost in two months rental but keeps charging and charging.

I have Quacks who keep wanting to put me on Fourth Generation Tricyclic antidepressants despite the fact that the Third Generation ones were the only ones that ever worked. Imipramine, originally from cobra venom, used to be available for five dollars. Now its a special order item that costs a fortune that I simply do not have despite Medicare's paperwork. So I had to do a bit of research and found that the spice, saffron, has been shown to have just about the identical response rate in human subjects. Believe me, saffron, while relatively expensive is sure a heck of a lot cheaper than any pharmaceutical.

Now I'm definitely weakening and ejection fraction is suffering due to not being on oxygen because a sleep test technician was a fool and the sleep doc despite having certified in writing that I needed an oxygen generator only a few months earlier will not amend the current Rx or perform a new sleep test unless I, rather than medicare, pay for the sleep test which of course is beyond all hope for me. I could get oxygen generators from China but they tend to supply industrial oxygen rather than medical grade therapeutic oxygen despite what the salesmen claim. So I'm barely able to toddle around due to lack of an oxygen device the quack had previously certified I needed and my cardiologist said I needed. Two cardiologists actually. I have no brain cells left because that super high vacuum cleaner blast has blown them all out of my ears.

Always hated quacks ever since I self diagnosed my problem as lack of oxygen in my early twenties and a doctor told me I was an idiot. Found a fallow terminal in a medical library running DXplain three decades later and it immediately spat out "obstructive sleep apnea". A prominent researcher told me I was the second lowest patient he had ever seen. That is why I hate Quacks so much.

Quote: Fleastiff

Despite the "/rant venting" I know it is difficult even if you do let off some steam via the rant.

I've had my share of this foolhardiness. On medicare funding, the Home Care people descend like vultures doing very little but billing Medicare for so much.

As you may know from my previous posts I have a BiPap machine which I often refer to as 'the rear end of a vacuum cleaner' since that is what it really is. I happen to know its actual cost and the Home Health Carecompany recoups that cost in two months rental but keeps charging and charging.

I have Quacks who keep wanting to put me on Fourth Generation Tricyclic antidepressants despite the fact that the Third Generation ones were the only ones that ever worked. Imipramine, originally from cobra venom, used to be available for five dollars. Now its a special order item that costs a fortune that I simply do not have despite Medicare's paperwork. So I had to do a bit of research and found that the spice, saffron, has been shown to have just about the identical response rate in human subjects. Believe me, saffron, while relatively expensive is sure a heck of a lot cheaper than any pharmaceutical.

Now I'm definitely weakening and ejection fraction is suffering due to not being on oxygen because a sleep test technician was a fool and the sleep doc despite having certified in writing that I needed an oxygen generator only a few months earlier will not amend the current Rx or perform a new sleep test unless I, rather than medicare, pay for the sleep test which of course is beyond all hope for me. I could get oxygen generators from China but they tend to supply industrial oxygen rather than medical grade therapeutic oxygen despite what the salesmen claim. So I'm barely able to toddle around due to lack of an oxygen device the quack had previously certified I needed and my cardiologist said I needed. Two cardiologists actually. I have no brain cells left because that super high vacuum cleaner blast has blown them all out of my ears.

Always hated quacks ever since I self diagnosed my problem as lack of oxygen in my early twenties and a doctor told me I was an idiot. Found a fallow terminal in a medical library running DXplain three decades later and it immediately spat out "obstructive sleep apnea". A prominent researcher told me I was the second lowest patient he had ever seen. That is why I hate Quacks so much.

There's a thing called a Walking test that takes 20 minutes, and qualifies you for O2 and breathing treatments if you fail it. With Medicare.

Might be considerably cheaper than a Sleep test and get you the same authorizations. Got us O2 concentrator, 1 rolling tank, 6 portable tanks, a nebulizer, and 3 different medications for COPD diagnosis.

Perhaps you can get what you need that way. Might be better done outpatient of a hospital or a walk-in clinic.