I’m not okay, but I’m okay.

Do you know how sometimes you’re reading a really good book and then all of the sudden it starts to get boring and you want it to get better and you hope it will but it doesn’t and so you stop reading.  Has that ever happened to you?

I know it’s been a while since I’ve written and it wasn’t intentional. I just found it really hard to write anything.   My ability to over share and my quirky sense of humor have just been missing.  I’m not one to dwell on the things that I can’t change because I prefer to be the ray of sunshine in as many peoples day as possible, but lately, I’ve just been blue.

Im blue

I’m kidding, but not about feeling blue.  In fact, I’d say if I’m being completely honest, I’m slightly depressed.  But in order to get to my point and speak the truth I guess I need to start from where I left off and throw in a few facts from several years ago.  Buckle up, it’s a long ride.

Back in February I flew to Tennessee to meet my mom and I hung out with my family for a few days and then Mom and I drove back to Florida.  I had tapered off the steroids that my doctor had prescribed before I left Florida and while I was in Tennessee strange things started happening.

I started getting shooting pains up the back of my neck.  It feels like what I would describe as an electric shock that only last for a few seconds and then stops and then comes on again randomly.  I had gotten that same pain before, only it was back in 1994 when I had my first symptoms of Neurosarcoidosis and it was in the side of my face and my doctor called it Trigeminal Neuralgia although at that time he had no idea why I would have it and I’m pretty sure he doubted me.  A couple of years ago I got the same type of pain in my throat with the same sensation of an electric shock and I was told it might be Glossopharyngeal Neuralgia.

The neck pain wasn’t the only thing, there was also the pain in my shins that continued despite not running and icing constantly and I began forgetting things.  The forgetting things actually started before I left for Tennessee and I was forgetting things like how to get to the bank and the store when I was actually driving to them, even though I’ve used the same bank and gone to the same store for years.  And I forgot why I was in the store after I had gotten there several times.    And there were other things like eye pain, relentless pressure behind my eyes that would not stop and the need to pee a bazillion times throughout the night, skin rashes, bruises, thinning skin, and strange swellings that popped up here and there.  I just felt like I was falling apart and it scared me.  Luckily I had my Mom here.

So, after returning from Tennessee I saw my pulmonologist and explained the symptoms to her. She said that I could possibly be experiencing occipital neuralgia among other things but she was mostly worried because my blood pressure was very high, 178 over 115.  She also said that I may need to go back on medications if my symptoms were returning because my blood pressure and my calcium levels were really high.  She ordered an MRI of my brain and then she referred me to a rheumatologist and told me to get in there as soon as I possible could.  She also referred me to a neurologist but I couldn’t get in to see them until April so I’m still waiting on that one.

I got the appointment with the rheumatologist within a week and I explained to her that I had been diagnosed with chronic compression syndrome but that I hadn’t run and my legs still hurt very badly.  I also showed her where the pain in my neck is, where there is now a large swelling, and I told her about all of the other pains as well.  She listened to everything I had to say and then examined me.  Then she ordered a bone scan with contrast and an MRI of my cervical spine.  She looked at my past MRI’s and said that she wasn’t convinced I don’t also have MS, but I don’t think I do and I’ll discuss that with the neurologist in April besides I think Sarcoidosis is called a mimicker of diseases for a reason and I think it’s rearing its ugly head again.  Anyway, off I went to schedule the tests.

When I got to the scheduling department and handed them the orders they told me that the MRI of my head which had been ordered by my pulmonologist had been denied, but they scheduled the bone scan and put in a request for the MRI of my neck.  They also recommended that I call my insurance company to ask why the other MRI had been denied.  And thus began a cycle of me visiting all kinds of specialists, the specialists being concerned enough to order more testing and then me getting denied by my insurance company for any tests my doctors have ordered, other than blood test or x-rays.

In fact since February, I have been denied for 3 MRI’s, 1 Cardiac Ultrasound, a PET scan, and a recommended stay at the Mayo Clinic as well as the University of Florida.  The latter two are actual hospitals with sarcoid specialists who actually know a lot about this disease and could help me, but unfortunately my insurance company will not pay for any of it.

Blue cross blue shield sucksIn the meantime, when the results of my bone scan came in the doctor’s office called me and they told me it appeared that I have several stress fractures in both lower legs and one in the upper leg.  Typically to determine what is causing the increased tracer on the bone scan the doctor will order additional testing, such as an MRI or a CT scan which will show the damage in more detail, you know where this is going right, my insurance company isn’t approving any of those so my doctor ordered regular x-rays which didn’t show her anything.   So all we know is I have some stress fractures.

So that was that.  I’m just sitting here with some stress fractures in both legs, and as far as the pain in my neck goes, I’ve had a migraine headache every day of my life for 51 days straight.  FIFTY ONE DAYS!  Some days they are bearable, other days I can barely function but I have to keep going because I have an insurance company to fight with and it has seriously become a part time job.  And one that I will never be paid for.

This has all been super frustrating and I have spent hours and hours dealing with insurance people and seeing doctors who are also frustrated because they are limited in the testing they can do.  And sure, I can appeal with help from my overworked doctors but that isn’t really helping.   When I challenged the last MRI denial I was told that I wouldn’t be approved for advanced imaging unless it was absolutely medically necessary as stated by my doctor.  So the doctor resubmitted her request as medically necessary and the insurance company got another ‘specialist’ to say it wasn’t medically necessary.  Mind you, this specialist has NEVER seen me but that’s how the system works.

When I complained about this to the insurance company they reminded me that since the doctor ordered the tests, I could still have them, I’d just have to pay for them myself.  So I asked the customer service lady if she had any idea how much some of those scans are she recommended I start a GoFund me page, you know because apparently the 750 dollars they receive for my actual insurance EVERY SINGLE MONTH is not enough to justify any advanced imaging.  They say it is covered in the benefits but they require prior authorizations and that’s where they get you, because they never approve anything.  When did it become okay for insurance companies to determine my treatment as opposed to my doctor?

health insuranceAnd that has been my life thus far in 2019.

Don’t get me wrong, it hasn’t all been bad around here, it’s just that since February every time I sat down to write I just couldn’t.  And then one day I went back and read some of my post from the early days and I was really proud of some of those post.  Some were really funny and some were really informative.   It was really interesting until I got to the last few months and it then it went downhill.

I feel like since the first part of 2019, and maybe some part of last year, a lot of my posts were boring and I sounded like someone I don’t even know.  It felt like I was just posting about the mundane and ordinary things but trying to make it sound interesting because I didn’t want to share the whole truth, and it felt so fake.  I had somehow turned into the very same type of blog that I hate.  I had become that book that starts out really good and then gets boring and never recovers.  So I stopped writing and I promised myself that I wouldn’t post again until I felt like writing about, not only the good, but also the bad and ugly and if I don’t feel like writing at all, I won’t force it.

And now that I’m back I hope you won’t get bored of all my diatribes regarding my insurance company and doctors, but I’m sure I’ll write a lot about both of them in the coming months but it doesn’t mean that’s all I will talk about.   It just means that some days are better than others and you might get me on a funny day, an informative day, or a pissed off day but rest assured, it’ll be real.

On a scale of 1-10 how happy are you with your health insurance company?

Have you ever been denied for a medical procedure or test that your doctor ordered?

Thursday things, running, shopping and fighting with insurance companies.

I ran 6 miles this morning, and yesterday morning, and the day before that, and the day before that.  Our weather has been awesome, cooler, especially in the morning but awesome nonetheless.

running weatherPerfect weather.  MacGyver doesn’t feel that way though.  Yesterday the high never made it past the 60’s and he was in hibernation.  He didn’t leave the sofa until after 3 in the afternoon, Amateur!

I don’t remember if I told you that we finished our river resin table but anyhow, we did.  On Sunday I searched Craigslist and found some chairs that I thought would be perfect for it so we drove out to North Port to get them.  MacGyver isn’t really all that happy with them and constantly mentions it but everyone else has loved them.  We had to touch up the paint on them and I recovered them and I think they’re perfect.

Here is the table that we bought at an estate sale but it didn’t look like this, it was actually in pieces and laying on the ground.

table beforeThe picture came from the lady hosting the estate sale.  She gave it to us so that we could see what it was supposed to look like when put together.

We had no intention of putting it back the same way, instead, we made this:

New tableAnd here’s a better picture of the whole table and a close up of my awesome chairs.

river resin tablechairI’m in love with all of it.

I meant to post the pictures yesterday but instead any extra minutes that I had I was fighting with my health insurance provider.  Why, you ask?  Well, apparently they have decided that they are more skilled at handling my health than my actual doctor so they have decided to use an independent reviewer to determine what tests are medically necessary and so far they have denied all of the recent tests my doctor has ordered and deemed them medically unnecessary.

One of the tests is an echocardiogram and the other is an MRI of my brain.  The doctor is trying to determine if I have new lesions in my brain or if I have any signs of damage to my heart from the sarcoidosis.  The independent doctor reviewer doesn’t feel any of these test are necessary.

So, I called the insurance company to find out how exactly he determined that they aren’t necessary and all they would tell me is that they have a ‘formula’.

whatSo I tried to reason with them and I asked them what I could do since I really need these tests and the nice lady told me to ‘go ahead and have them and pay for them if you’re that worried about it.’  Seriously.  Over 5,000 dollars in tests.  Sure lady, I’ll just pay cash.  So I asked her what exactly my 734 dollar payment to them every single month actually gets me and this bitch tells me, ‘piece of mind that you’ll get the medical care necessary.’

As determined by them apparently.  Anything else, I have to pay for.

So I end the conversation by telling this lady that I will file an appeal and I also tell her that if anything happens to me in the interim, they will be hit with a lawsuit and she tells me that they are protected because I’ve been giving the option of paying for the tests myself.

are you kiddingI don’t think I’ve ever been so mad in my life.  And all the while that I’m fighting with them I was thinking how glad I am that I’m on steroids and have the energy to do this.  Imagine if I was debilitated. It’s ridiculous.  I’m still angry about it but I filed an appeal and we’ll see what happens.

We’ve got less than two weeks to get Christmas shopping done.  Are you finished?  I finally started yesterday.  I’m doing 95% of it online and hope to be finished by the end of the day tomorrow.

overachieverI’m such an overachiever.

How is the weather in your neck of the woods?

Have you ever been denied a test or treatment from your health insurance provider?

Have you finished all your Christmas shopping?

 

 

WTF Wednesday, Stress Kills and Florida Blue Steals

It’s been a little hectic and crazy over here but then, isn’t it always?  And as if we didn’t already have enough going on what with the two dogs and the rescue woodpecker, this guy showed up yesterday morning and tried to join the clan.

Turtle

I relocated him back to the pond pronto.  I have no time for any more additions to the brood.  None.  The shop is closed.  Momma is tired and besides, there’s just not enough hours in the day for all the things on my calendar, it’s enough to drive a person insane.

Last Thursday I went in to see my doctor about the twitch in my eye that refuses to go away and my crazy low heart rate.  Even though I’ve been there before, with the way the healthcare system works these days, you have to check in with a concierge and then you go to the waiting room.  My appointment was scheduled for 1PM in the afternoon and I was told to arrive 15 minutes early for check in so I got there at 12:30 because I’m anal retentive and obsessive compulsive.

Apparently so is the rest of the world.

Doctors office

Is this the future of health care?  Because I felt like I was in the checkout line at the grocery store.  It was ridiculous.

I finally got to the waiting room of my doctors office at 1:05PM  at which time the attendant said to me, ‘oh, you’re a bit late.’

eye roll

And if this situation wasn’t already messed up, guess who my insurance is?  Yeah, you guessed it.  Florida fucking Blue, because, Go me!   But I guess I should thank my lucky stars that I’m not Kristin Longberry because if they charged me $142,000 dollars a month for the shitty service I get, I’d probably have a heart attack for sure!

Anyway, I finally made it into to see my doctor and she looked at my eye and listened to my heart.  Yep, there’s definitely a twitch in my eye and yep, my heart rate is very low.  So, she referred me to a new cardiologist and gave me a prescription for xanax.  And then she told me not to stress out.  I just looked at her and said, ‘Do you have any idea who my insurance company is?’

Turns out she did not because the new cardiologist didn’t accept Florida Blue and she had to refer me to another one.

facepalm

And that’s where I’m going this afternoon.  However, immediately thereafter, we’re headed to Nokomis and I’m taking a vacation.  Stress free.  STRESS.  FREE.  Just me, MacGyver, Mom, the Dogs and the Woodpecker…wait, did I say stress free?

WTF, it’s Wednesday!  Who’s your health insurance company and how much do you love them?