Monday, August 1, 2016
I mentioned that my medical insurance folks try to be very helpful, but next to nobody accepts my insurance. They often send me emails or call me to urge annual checkups and mammograms and the like, and even offer incentives - like after I saw the doctor last month, I discovered a $25 gift certificate in my Amazon account, from them, for having a checkup.
So, anyway, after the past two months of medical excitement, last week something rather weird happened. I had just left the surgeon after the followup visit, was in a store looking for something to drink and munch on, and my phone rang. It was deep in my purse and I had to dig it out, and I assumed it was Daughter calling for a report, so I answered it without looking.
It was my insurance company.
The very young-sounding lady on the phone had called to urge me to get my annual checkup and mammogram, and embarked on an obviously scripted explanation of why it was so important.
I exploded. I'm afraid I was not very gracious. Probably a lot of released tension. I interrupted her and informed her that I'd had a diagnostic mammogram and ultrasound six weeks ago, had been diagnosed with breast cancer, had a slew of pre-op testing, had surgery just the week before, and had left my surgeon's office minutes ago, and I'm shocked that she didn't already know that!
This was off script, and the poor girl didn't know how to handle it.
Maybe I should feel bad, but I don't.
.
Showing posts with label insurance. Show all posts
Showing posts with label insurance. Show all posts
Monday, August 01, 2016
Monday, January 18, 2016
5045 Brush fire 4 - homeowner's insurance
Monday, January 18, 2016
A little history: I closed on the city house in October of 2010. I was mostly living in the country house, going back and forth, few days camping in the new house, few days sorting and packing in the old house, moving small stuff bit by bit. In fact, Jasper was living upriver until January 2011, when I finally brought him down. The old house needed a lot of work before I could sell it, but I figured that I could finish everything by summer of 2012 at the latest. In fact, if I finished by then, I even had a buyer.
And then on April 1, 2011, I had the kidney problem. The mistakes and ineptitude of doctors had me out of action all summer. Simply driving for 10 minutes or climbing a flight of stairs had me bleeding and cramping, and then after that it took me many months to get my strength back. In 2012 I was starting to get in gear again, and then Sandy hit, and I spent the end of 2012 and the beginning of 2013 in the hospital with what they said was a very bad case of pneumonia, but I suspect was actually an infection from the rampant mold left over from Sandy. (Probably actually Legionnaires.) So, more months of trying to get my strength back. That was most of the summer of 2013. In the meantime, I got older. So did the country house.
By 2014 I'd lost my buyer, so there wasn't the urgency. I got lazy. I was more interested in playing with the Nugget. Plus, in the winter I had to contend with snow and ice on the long uphill driveway, which I didn't feel capable of climbing by foot anymore especially if it was too slippery to drive it (I am in fear for my hips, NO falls allowed), and in the summer the air conditioning was kaput, so I had lots of excuses to avoid going up there.
In 2015 I had new a/c installed. You know, I thought I hadn't gone up there all summer, but actually I visited in June, July, August, September, and October, so I wasn't as bad as I thought. I was up there two weeks ago.
Anyway --- the insurance on that house. Back in the beginning, when I was between houses, I explained the situation to my homeowners' insurance folks, and they were fine with it, especially since I wasn't planning to rent it out, so my policy stayed the same coverage at the same rate. Well, it's a few years later, and I guess someone took a look at my file and wondered what's going on. I got a letter from the local rep up there asking me to call and fill them in. So my next trip up (two weeks ago) I stopped in their office. I wanted to explain this (and plead my case) in person rather than on the phone. "So, this is not your primary home?" "No, but all my furniture and most of my books and clothing still think it is...."
She said she'd check on what they could do. They'd probably still cover it for fire, but only the structure, not the contents. I shrugged and said that's fine, most of the valuable stuff is out, all I'd be sad about is the dining room suit and the antique Chinese bed. She said she'd get back to me soon. I haven't heard from her. I don't know what that means, but at least they do have to notify me if they cancel, and I'm not going to push it. Until they notify me in writing, I still have the same coverage.
You know, there are a LOT of summer and weekend homes up around there. Ski lodges. Fancy hunting cabins. Rich folks from the city. Some major estates. Some little cottages. At least one house two doors down from mine (belongs to some semi-famous writer). I wonder how their insurance is handled?
One of the things we discussed is the amount the house is insured for. As usual, the insurance companies increase the coverage every year, with no regard to the housing market. I think they go by inflation or something. It can get ridiculous, because if something happens, they will pay what it will cost to rebuild or repair, which is WAY less than what they had boosted you to and you'd been paying premiums on. Turns out, they had me insured for twice what I could sell the house for. I asked if we could reduce that, because even if the house burned up or flew away, I'd still have the 1.3 acres of ridge-top land, the fantastic views, the foundation, and the well. All I need it insured for is demolition and rebuild costs, and I'm sure that's much less than the market value of the house and land, especially when that's been inflated. You know, she actually had to think about that.. Man, I think it's obvious.
Anyway, that's another thing that was hanging over my head and emotionally sapping. Still waiting for the other shoe to fall.
.
So many religions. So
little God.
-------------------------------------------------------------------------
A little history: I closed on the city house in October of 2010. I was mostly living in the country house, going back and forth, few days camping in the new house, few days sorting and packing in the old house, moving small stuff bit by bit. In fact, Jasper was living upriver until January 2011, when I finally brought him down. The old house needed a lot of work before I could sell it, but I figured that I could finish everything by summer of 2012 at the latest. In fact, if I finished by then, I even had a buyer.
And then on April 1, 2011, I had the kidney problem. The mistakes and ineptitude of doctors had me out of action all summer. Simply driving for 10 minutes or climbing a flight of stairs had me bleeding and cramping, and then after that it took me many months to get my strength back. In 2012 I was starting to get in gear again, and then Sandy hit, and I spent the end of 2012 and the beginning of 2013 in the hospital with what they said was a very bad case of pneumonia, but I suspect was actually an infection from the rampant mold left over from Sandy. (Probably actually Legionnaires.) So, more months of trying to get my strength back. That was most of the summer of 2013. In the meantime, I got older. So did the country house.
By 2014 I'd lost my buyer, so there wasn't the urgency. I got lazy. I was more interested in playing with the Nugget. Plus, in the winter I had to contend with snow and ice on the long uphill driveway, which I didn't feel capable of climbing by foot anymore especially if it was too slippery to drive it (I am in fear for my hips, NO falls allowed), and in the summer the air conditioning was kaput, so I had lots of excuses to avoid going up there.
In 2015 I had new a/c installed. You know, I thought I hadn't gone up there all summer, but actually I visited in June, July, August, September, and October, so I wasn't as bad as I thought. I was up there two weeks ago.
Anyway --- the insurance on that house. Back in the beginning, when I was between houses, I explained the situation to my homeowners' insurance folks, and they were fine with it, especially since I wasn't planning to rent it out, so my policy stayed the same coverage at the same rate. Well, it's a few years later, and I guess someone took a look at my file and wondered what's going on. I got a letter from the local rep up there asking me to call and fill them in. So my next trip up (two weeks ago) I stopped in their office. I wanted to explain this (and plead my case) in person rather than on the phone. "So, this is not your primary home?" "No, but all my furniture and most of my books and clothing still think it is...."
She said she'd check on what they could do. They'd probably still cover it for fire, but only the structure, not the contents. I shrugged and said that's fine, most of the valuable stuff is out, all I'd be sad about is the dining room suit and the antique Chinese bed. She said she'd get back to me soon. I haven't heard from her. I don't know what that means, but at least they do have to notify me if they cancel, and I'm not going to push it. Until they notify me in writing, I still have the same coverage.
You know, there are a LOT of summer and weekend homes up around there. Ski lodges. Fancy hunting cabins. Rich folks from the city. Some major estates. Some little cottages. At least one house two doors down from mine (belongs to some semi-famous writer). I wonder how their insurance is handled?
One of the things we discussed is the amount the house is insured for. As usual, the insurance companies increase the coverage every year, with no regard to the housing market. I think they go by inflation or something. It can get ridiculous, because if something happens, they will pay what it will cost to rebuild or repair, which is WAY less than what they had boosted you to and you'd been paying premiums on. Turns out, they had me insured for twice what I could sell the house for. I asked if we could reduce that, because even if the house burned up or flew away, I'd still have the 1.3 acres of ridge-top land, the fantastic views, the foundation, and the well. All I need it insured for is demolition and rebuild costs, and I'm sure that's much less than the market value of the house and land, especially when that's been inflated. You know, she actually had to think about that.. Man, I think it's obvious.
Anyway, that's another thing that was hanging over my head and emotionally sapping. Still waiting for the other shoe to fall.
.
Saturday, December 14, 2013
3810 Estate sale
Saturday, December 14, 2013
Well, I have medical insurance for 2014. I suspect I'm not going to be happy with it, but, we'll see. The cost is low, but it's a Medicare Advantage plan, and it's an HMO. I always swore I'd never go into an HMO, but there it is. The only plan of any type that I was eligible for that allowed me to choose my own doctors was extremely costly. So. At least that's done.
-----------------------------------
The country house is under storm alert this weekend. 10" of snow and then sleet. Since the house is higher up, I suppose there will be at least 12" of snow. We always got about 20% more than lower down. Or more. Temps in the low 20s. I am worried about losing power there. Sigh. Another week I won't be going north.
------------------------------------
I got an email a few days ago from my old auctioneer, George, saying he was going to be on a show on the Travel Channel, so I watched it. It was another of those stupid shows that seem to be so popular recently --- you know, where we follow some "experts" while they buy unseen storage facility contents, or race through antique centers looking for bargains, or poke around mountains looking for gold.
This time, we had three "expert bidders" at George's auction. It was very obvious the whole thing was staged. He had a full room of bidders, but no one else bid on any of the boxes that were obviously solely for these "experts" to battle over.
It was so stupid. THEY were so stupid. They were bidding on unopened boxes and bags, no idea what was in them. Number one, George never sells unopened stuff. Number two, these "experts" didn't do their research. One idiot kept saying "There's lots of mansions in [this village]. Huge estates. This is an estate auction so these boxes are coming from the attics and basements of these wealthy mansions. You KNOW it has to be good stuff!"
First of all, the statement that there are lots of mansions in [the village]. Yeah, that general wider area is full of mansions, yeah, but most of them are run as tourist destinations by the national park service, like the Vanderbilt, Astor, and Roosevelt places, and a few other piles of marble with names and history. There are a few private mansions around, but these days almost all of them are empty, like the place where Chelsea Clinton's wedding reception was held. (It's for sale and the owner volunteered it hoping for free advertising.) So, there's no good stuff coming from mansion attics! Do your research, you fool!
Second, the "expert" doesn't even know what an estate auction is!
"Estate" in this sense doesn't mean mansions and land, anyway. It means somebody's Aunt Sally died and left all her worldly goods to somebody who is now selling off the excess. "Estate" in the sense of the disposals of a legal will. Sheesh. And these folks are "experts"?
(Sometimes George does sell items from a mansion, but when he does, he tells you where it came from, "Sale of the Contents of Blah Blah Mansion", and the auction is exclusively those items. In 10 years, I've seen only two of those auctions - one being Larry (Hustler) Flynt's place. Usually George's estate sale stuff is bits from hither and yon all over the northeast.)
Third, one of the "experts" attempted to figure out what was in a locked duffel bag by SITTING ON IT! Well, there goes that Faberge egg, eh! How stupid is that. The other guy was shaking boxes violently. Duh.
It got to where I was yelling at the TV.
I will never watch any of those things again. Bleck. I will not miss cable.
.
Well, I have medical insurance for 2014. I suspect I'm not going to be happy with it, but, we'll see. The cost is low, but it's a Medicare Advantage plan, and it's an HMO. I always swore I'd never go into an HMO, but there it is. The only plan of any type that I was eligible for that allowed me to choose my own doctors was extremely costly. So. At least that's done.
-----------------------------------
The country house is under storm alert this weekend. 10" of snow and then sleet. Since the house is higher up, I suppose there will be at least 12" of snow. We always got about 20% more than lower down. Or more. Temps in the low 20s. I am worried about losing power there. Sigh. Another week I won't be going north.
------------------------------------
I got an email a few days ago from my old auctioneer, George, saying he was going to be on a show on the Travel Channel, so I watched it. It was another of those stupid shows that seem to be so popular recently --- you know, where we follow some "experts" while they buy unseen storage facility contents, or race through antique centers looking for bargains, or poke around mountains looking for gold.
This time, we had three "expert bidders" at George's auction. It was very obvious the whole thing was staged. He had a full room of bidders, but no one else bid on any of the boxes that were obviously solely for these "experts" to battle over.
It was so stupid. THEY were so stupid. They were bidding on unopened boxes and bags, no idea what was in them. Number one, George never sells unopened stuff. Number two, these "experts" didn't do their research. One idiot kept saying "There's lots of mansions in [this village]. Huge estates. This is an estate auction so these boxes are coming from the attics and basements of these wealthy mansions. You KNOW it has to be good stuff!"
First of all, the statement that there are lots of mansions in [the village]. Yeah, that general wider area is full of mansions, yeah, but most of them are run as tourist destinations by the national park service, like the Vanderbilt, Astor, and Roosevelt places, and a few other piles of marble with names and history. There are a few private mansions around, but these days almost all of them are empty, like the place where Chelsea Clinton's wedding reception was held. (It's for sale and the owner volunteered it hoping for free advertising.) So, there's no good stuff coming from mansion attics! Do your research, you fool!
Second, the "expert" doesn't even know what an estate auction is!
"Estate" in this sense doesn't mean mansions and land, anyway. It means somebody's Aunt Sally died and left all her worldly goods to somebody who is now selling off the excess. "Estate" in the sense of the disposals of a legal will. Sheesh. And these folks are "experts"?
(Sometimes George does sell items from a mansion, but when he does, he tells you where it came from, "Sale of the Contents of Blah Blah Mansion", and the auction is exclusively those items. In 10 years, I've seen only two of those auctions - one being Larry (Hustler) Flynt's place. Usually George's estate sale stuff is bits from hither and yon all over the northeast.)
Third, one of the "experts" attempted to figure out what was in a locked duffel bag by SITTING ON IT! Well, there goes that Faberge egg, eh! How stupid is that. The other guy was shaking boxes violently. Duh.
It got to where I was yelling at the TV.
I will never watch any of those things again. Bleck. I will not miss cable.
.
Thursday, December 12, 2013
3808 Maybe I can see Jasper's vet? He makes house calls....
Thursday, December 12, 2013
A week, already? Egads!
I didn't go north last week. I didn't get everything finished that I had to do before I left, and, in fact, I'm not finished YET.
I really screwed some stuff up. For the past 19 years, along about October, I'd get the package from IBM about the medical insurance coverage for the next year. Choices/changes had to be made by the end of December (earlier, if you wanted the new medical cards by January 1). If there was nothing you wanted to change, you did nothing, and you got the same coverage continued. For 19 years, IBM taught me that the package could be safely ignored.
So I ignored it.
I should have known better. IBM is (surprise) no longer offering the group packages. They have seized the opportunity to dump all the retirees and "allow" us to get individual coverage through an exchange. After all these years of experience with IBM, why am I surprised? I should have expected that.
They are being so gracious about it, they have contracted with a company to discuss our needs with us, and help us choose what works best for us. In other words, they hired people to navigate the government website for us.
So I freaked out last week and started studying the materials. I will still have Medicare, of course, but I still will need a medical supplement, and something for prescriptions, and of course I don't know what I'll do for dental and vision. (Oddly enough, dental and vision insurance coverage is the ONLY advertising junk mail that hasn't been arriving.) And if I don't have the prescription thing nailed down by 12/31 and then find out I have to go with Medicare part D, I will have to pay a penalty for the rest of my life.
So, I read all the materials and went to the recommended we-will-help-you website and tried to set up my profile. Yeah, sure. It wouldn't accept it because "You must provide a number greater than 0" --- but I had filled in every space, and all numbers were greater than 0, and the site wouldn't tell me where I went wrong. Nothing was flagged. I tried everything, including starting over from scratch, and after four hours I gave up.
So I called the we-will-help-you folks, the option for people without computer access. There was only an hour and a half wait. The woman asked me if I had my Medicare card in hand. Well, I said no (I can be stupidly honest. I can't find it, haven't seen it since my hospital stay last January), but I have all the information from the card. She informed me she couldn't help me until I had the actual card, and, in effect, hung up on me.
I called Social Security and asked for a replacement card, was told ok, we'll mail it, but it will take 4 to 6 weeks to arrive! No, they can't expedite it. Yes, if I don't sign up for Part D by 12/31 and it turns out I need it, I will pay the penalty rate every year for the rest of my life.
I freaked out. Then I remembered that my doctor's office had made a copy of my Medicare card, so I called there, and I now have a copy. Not the original, but I'm not going to tell anybody that. Turns out Medicare had screwed up my name slightly on the card, and if I don't use the exact same name nobody can accept it, and I had naively thought they'd used my real name. (I'm beginning to hate the world.)
So tomorrow, I call again, and try again.
--------------------------------------------
In the meantime, cash flow is a problem. I'm waiting for a large check from my investments, but my car insurance and the insurance on the country house were due, so I went to their websites and put those payments on a credit card.
I have only two credit cards, by choice. Also by choice, one of them has a very high limit, and the other has a very low limit, also by choice. I use the low limit card for all low-trust online business and anytime anyone wants to walk away with it so that if anyone "steals" it, they can't get much.
Yup. I screwed up. I used the low limit card for both, and together they are going to blow the limit, so ONE of them will "bounce", but I don't know which.
I spent several hours today on calls to the insurance companies, the credit card company (I had them transfer cash from one of my checking accounts to the credit card, THEN found out that will take 4 to 6 days!) So I tried to have the limit raised, but was told I had to go to the issuing bank to have that done. So, I call the issuing bank. They need to send me an application to raise the limit, which I have to have notarized and send back. (I call B.S. on that! They used to send me letters telling me they'd raised my limit, isn't that wonderful, and then I'd have to call them and say no, I WANT to keep that low.) That's not going to help.
So, one of my insurance policies is in jeopardy, and I don't know which. I guess when I get the cancellation letter, I'll just call and switch it to the other credit card.
-----------------------------------
On top of all that.............................................
Blah.
Let's just say I've been running flat out for more than a week, I'm tired, I still have to get the van inspected, there's four inches of snow out there, the van is covered in ice, the BMW has ANOTHER tire losing air, and we can expect below freezing temperatures (way below average for this time of the year) for the foreseeable future. I haven't made it to the country house yet, so I haven't put antifreeze in the toilets and drains yet (I think I did at least leave the water turned off after the last visit), so if the house loses power, well, I don't want to think about it. Especially if it's that insurance that might get temporarily cancelled.
I am way way behind on correspondence.
I think I'll go to bed now.
.
A week, already? Egads!
I didn't go north last week. I didn't get everything finished that I had to do before I left, and, in fact, I'm not finished YET.
I really screwed some stuff up. For the past 19 years, along about October, I'd get the package from IBM about the medical insurance coverage for the next year. Choices/changes had to be made by the end of December (earlier, if you wanted the new medical cards by January 1). If there was nothing you wanted to change, you did nothing, and you got the same coverage continued. For 19 years, IBM taught me that the package could be safely ignored.
So I ignored it.
I should have known better. IBM is (surprise) no longer offering the group packages. They have seized the opportunity to dump all the retirees and "allow" us to get individual coverage through an exchange. After all these years of experience with IBM, why am I surprised? I should have expected that.
They are being so gracious about it, they have contracted with a company to discuss our needs with us, and help us choose what works best for us. In other words, they hired people to navigate the government website for us.
So I freaked out last week and started studying the materials. I will still have Medicare, of course, but I still will need a medical supplement, and something for prescriptions, and of course I don't know what I'll do for dental and vision. (Oddly enough, dental and vision insurance coverage is the ONLY advertising junk mail that hasn't been arriving.) And if I don't have the prescription thing nailed down by 12/31 and then find out I have to go with Medicare part D, I will have to pay a penalty for the rest of my life.
So, I read all the materials and went to the recommended we-will-help-you website and tried to set up my profile. Yeah, sure. It wouldn't accept it because "You must provide a number greater than 0" --- but I had filled in every space, and all numbers were greater than 0, and the site wouldn't tell me where I went wrong. Nothing was flagged. I tried everything, including starting over from scratch, and after four hours I gave up.
So I called the we-will-help-you folks, the option for people without computer access. There was only an hour and a half wait. The woman asked me if I had my Medicare card in hand. Well, I said no (I can be stupidly honest. I can't find it, haven't seen it since my hospital stay last January), but I have all the information from the card. She informed me she couldn't help me until I had the actual card, and, in effect, hung up on me.
I called Social Security and asked for a replacement card, was told ok, we'll mail it, but it will take 4 to 6 weeks to arrive! No, they can't expedite it. Yes, if I don't sign up for Part D by 12/31 and it turns out I need it, I will pay the penalty rate every year for the rest of my life.
I freaked out. Then I remembered that my doctor's office had made a copy of my Medicare card, so I called there, and I now have a copy. Not the original, but I'm not going to tell anybody that. Turns out Medicare had screwed up my name slightly on the card, and if I don't use the exact same name nobody can accept it, and I had naively thought they'd used my real name. (I'm beginning to hate the world.)
So tomorrow, I call again, and try again.
--------------------------------------------
In the meantime, cash flow is a problem. I'm waiting for a large check from my investments, but my car insurance and the insurance on the country house were due, so I went to their websites and put those payments on a credit card.
I have only two credit cards, by choice. Also by choice, one of them has a very high limit, and the other has a very low limit, also by choice. I use the low limit card for all low-trust online business and anytime anyone wants to walk away with it so that if anyone "steals" it, they can't get much.
Yup. I screwed up. I used the low limit card for both, and together they are going to blow the limit, so ONE of them will "bounce", but I don't know which.
I spent several hours today on calls to the insurance companies, the credit card company (I had them transfer cash from one of my checking accounts to the credit card, THEN found out that will take 4 to 6 days!) So I tried to have the limit raised, but was told I had to go to the issuing bank to have that done. So, I call the issuing bank. They need to send me an application to raise the limit, which I have to have notarized and send back. (I call B.S. on that! They used to send me letters telling me they'd raised my limit, isn't that wonderful, and then I'd have to call them and say no, I WANT to keep that low.) That's not going to help.
So, one of my insurance policies is in jeopardy, and I don't know which. I guess when I get the cancellation letter, I'll just call and switch it to the other credit card.
-----------------------------------
On top of all that.............................................
Blah.
Let's just say I've been running flat out for more than a week, I'm tired, I still have to get the van inspected, there's four inches of snow out there, the van is covered in ice, the BMW has ANOTHER tire losing air, and we can expect below freezing temperatures (way below average for this time of the year) for the foreseeable future. I haven't made it to the country house yet, so I haven't put antifreeze in the toilets and drains yet (I think I did at least leave the water turned off after the last visit), so if the house loses power, well, I don't want to think about it. Especially if it's that insurance that might get temporarily cancelled.
I am way way behind on correspondence.
I think I'll go to bed now.
.
Sunday, September 23, 2012
3621 US- amputate, Canada- save, is that our choice?
Sunday, September 23, 2012
People who are against "Obamacare" point to the Canadian healthcare system as something awful, something to avoid at all costs. And somehow they seem to be able to find some Canadians who don't like it. But it seems to me that there are a lot more Canadians who like it. Like this one:
http://highlyirritable.wordpress.com/2009/08/19/at-least-she-can-still-give-me-the-finger/
Oddly enough, those Canadians who don't like it are alive and kicking. And it seems to me that there are a lot more Americans who are dying from depredations of insurance companies, or are financially devastated by the American health care system.
Really, is it only rich Americans, Congressmen, and rich foreigners who deserve American medical care?
I don't understand.
.
Success can be redefined.
-------------------------------------------------------------
People who are against "Obamacare" point to the Canadian healthcare system as something awful, something to avoid at all costs. And somehow they seem to be able to find some Canadians who don't like it. But it seems to me that there are a lot more Canadians who like it. Like this one:
http://highlyirritable.wordpress.com/2009/08/19/at-least-she-can-still-give-me-the-finger/
Oddly enough, those Canadians who don't like it are alive and kicking. And it seems to me that there are a lot more Americans who are dying from depredations of insurance companies, or are financially devastated by the American health care system.
Really, is it only rich Americans, Congressmen, and rich foreigners who deserve American medical care?
I don't understand.
.
Tuesday, May 08, 2012
3527 Expect the unexpected
Tuesday, May 8, 2012
Yesterday, Daughter and I took the Nugget for a walk. Nugget likes to walk until she gets tired. She walked to the end of our street and down a steep maintenance road toward the bay. She saw a rough trail into the woods, so she and Daughter took off down that while I trundled the umbrella stroller on down the maintenance road. After they came back out onto the road, we cut down a steep rock and sand bank to the seawall, where there's a new smooth cement sidewalk above the edge of the water.
After all that rough walking with no difficulty Nugget took about three steps on the smooth walkway and suddenly pitched forward, landing on her palms and chin. LOTS of blood, all down the front of her shirt. Only a little crying, though. Daughter scooped her up and ran for home. Washing, ice packs.
The damage, as of today:
You can see the two teeth up top that did the damage to her swollen lower lip. Her chin looks terrible. Daughter was worried that bone might have been chipped, but there's no bruising, so I think we escaped with just abrasion.
It doesn't seem to bother Nugget, though. She still eats crackers happily.
--------------------------------
We also heard yesterday that a neighbor's cat had brought home a dead bat. The neighbor's first impulse was to toss it down into the ravine, but then she called animal control just in case, and it was tested, and yeah, it had rabies.
The animal control people didn't say anything else.
Her cat had been vaccinated, but her children had touched the bat and played with the cat. Anybody know what the danger might be, if any?
----------------------------------
These two issues - the rabid bat and the sudden oops on the walk - helped Daughter to make a decision. Hercules is changing jobs, and the three of them will be without health insurance for somewhere between one and two months. Because he's leaving voluntarily, they aren't eligible for COBRA.
Daughter checked into short-term insurance, and the same plan that's $700/month in Pennsylvania is $2000/month in New Jersey. Ouch. She can get into a group plan through her professional association for a lot less, but it's still expensive for one or two lousy months.
Hercules hates insurance companies, and wants to do without until his employer's plan kicks in.
Daughter has asked her friends through Facebook what kind of medical expenses they could expect at Nugget's age, and everyone's all "Ho Hum","occasional colds", advice like "don't go to a doctor, go to the urgent care center, it's cheaper", and so on.
They've been going 'round and 'round about it. Me? I'm freaking out. I told Daughter that you don't get insurance for expected things. You get it for the unexpected. Insurance is a bet you make with the insurance company, a bet you hope to lose and they hope to win. I advised her to get a catastrophic policy, something with a high out-of-pocket, like $10,000, and then full coverage after that. "You realize that if something unexpected happens, you could lose your house." (I didn't tell her, but I was remembering Jay. Until his first seizure, he was very healthy. In fact, he had just got off the treadmill when it hit. After the seizure, it was $400,000 or more a year. We were very lucky to have an excellent policy. You never know what could happen.)
Well, until yesterday, Daughter couldn't imagine a catastrophe. She couldn't even imagine "unexpected".
Now she can.
.
You can't shake hands with a clenched fist.
-- Indira Gandhi --
---------------------------------------------------------------------------
Yesterday, Daughter and I took the Nugget for a walk. Nugget likes to walk until she gets tired. She walked to the end of our street and down a steep maintenance road toward the bay. She saw a rough trail into the woods, so she and Daughter took off down that while I trundled the umbrella stroller on down the maintenance road. After they came back out onto the road, we cut down a steep rock and sand bank to the seawall, where there's a new smooth cement sidewalk above the edge of the water.
After all that rough walking with no difficulty Nugget took about three steps on the smooth walkway and suddenly pitched forward, landing on her palms and chin. LOTS of blood, all down the front of her shirt. Only a little crying, though. Daughter scooped her up and ran for home. Washing, ice packs.
The damage, as of today:
You can see the two teeth up top that did the damage to her swollen lower lip. Her chin looks terrible. Daughter was worried that bone might have been chipped, but there's no bruising, so I think we escaped with just abrasion. It doesn't seem to bother Nugget, though. She still eats crackers happily.
--------------------------------
We also heard yesterday that a neighbor's cat had brought home a dead bat. The neighbor's first impulse was to toss it down into the ravine, but then she called animal control just in case, and it was tested, and yeah, it had rabies.
The animal control people didn't say anything else.
Her cat had been vaccinated, but her children had touched the bat and played with the cat. Anybody know what the danger might be, if any?
----------------------------------
These two issues - the rabid bat and the sudden oops on the walk - helped Daughter to make a decision. Hercules is changing jobs, and the three of them will be without health insurance for somewhere between one and two months. Because he's leaving voluntarily, they aren't eligible for COBRA.
Daughter checked into short-term insurance, and the same plan that's $700/month in Pennsylvania is $2000/month in New Jersey. Ouch. She can get into a group plan through her professional association for a lot less, but it's still expensive for one or two lousy months.
Hercules hates insurance companies, and wants to do without until his employer's plan kicks in.
Daughter has asked her friends through Facebook what kind of medical expenses they could expect at Nugget's age, and everyone's all "Ho Hum","occasional colds", advice like "don't go to a doctor, go to the urgent care center, it's cheaper", and so on.
They've been going 'round and 'round about it. Me? I'm freaking out. I told Daughter that you don't get insurance for expected things. You get it for the unexpected. Insurance is a bet you make with the insurance company, a bet you hope to lose and they hope to win. I advised her to get a catastrophic policy, something with a high out-of-pocket, like $10,000, and then full coverage after that. "You realize that if something unexpected happens, you could lose your house." (I didn't tell her, but I was remembering Jay. Until his first seizure, he was very healthy. In fact, he had just got off the treadmill when it hit. After the seizure, it was $400,000 or more a year. We were very lucky to have an excellent policy. You never know what could happen.)
Well, until yesterday, Daughter couldn't imagine a catastrophe. She couldn't even imagine "unexpected".
Now she can.
.
Friday, February 10, 2012
3461 So, um, don't use it
Friday, February 10, 2012
The above - so true. Nobody wants to marry an unhappy person (except that guy who married the blogger with the headaches, never did understand that, she's ALWAYS unhappy). Nobody even wants to be around someone who is unhappy all the time. It's a drag and it's draining. People who manage to be happy with their lot are just --- happier. Married or not.
-------------------------------------
The Catholic Church is all het up because they don't want to pay for employee's insurance coverage that includes coverage for contraception.
Some people are all het up because they say forcing the Catholic Church to pay for contraception coverage is a violation of the first amendment, which provides for the free exercise of religion.
Huh? I don't understand. Just because insurance covers it doesn't FORCE you to use it. My insurance covers prostate exams, but I assure you I'll never use it. So Catholics who refuse birth control will not be forced to use it. They still have free exercise of their religion.
Many employees of the church, and dependents of employees, are not even Catholic. Why should they be forced to practice Catholicism? If anyone's first amendment rights are being abridged, it's theirs. And it's no secret that most Catholics DO use birth control anyway.
I don't understand.
And all those priests and bishops going on TV telling folks that Obama won't get the Catholic vote if he allows any of their employees easy access to birth control even if the church isn't paying for it! should remember that they will lose their tax exemptions if they tell their congregations how to vote. Isn't there also something about "separation" in the tax laws? They are not allowed to influence elections. (Which brings up another topic - how come so many religious groups do get away with both electioneering AND tax exemptions? I thought that was illegal.)
Way to piss me off.
.
Dilbert’s coworker - "Someday I want to get married because studies show
that married people are happier."
Dilbert's response - "A smarter interpretation
is that no one wants to marry an unhappy person."
-- "Dilbert", 2/10/12 --
-------------------------------------------------------------------
that married people are happier."
Dilbert's response - "A smarter interpretation
is that no one wants to marry an unhappy person."
-- "Dilbert", 2/10/12 --
-------------------------------------------------------------------
The above - so true. Nobody wants to marry an unhappy person (except that guy who married the blogger with the headaches, never did understand that, she's ALWAYS unhappy). Nobody even wants to be around someone who is unhappy all the time. It's a drag and it's draining. People who manage to be happy with their lot are just --- happier. Married or not.
-------------------------------------
The Catholic Church is all het up because they don't want to pay for employee's insurance coverage that includes coverage for contraception.
Some people are all het up because they say forcing the Catholic Church to pay for contraception coverage is a violation of the first amendment, which provides for the free exercise of religion.
Huh? I don't understand. Just because insurance covers it doesn't FORCE you to use it. My insurance covers prostate exams, but I assure you I'll never use it. So Catholics who refuse birth control will not be forced to use it. They still have free exercise of their religion.
Many employees of the church, and dependents of employees, are not even Catholic. Why should they be forced to practice Catholicism? If anyone's first amendment rights are being abridged, it's theirs. And it's no secret that most Catholics DO use birth control anyway.
I don't understand.
And all those priests and bishops going on TV telling folks that Obama won't get the Catholic vote if he allows any of their employees easy access to birth control even if the church isn't paying for it! should remember that they will lose their tax exemptions if they tell their congregations how to vote. Isn't there also something about "separation" in the tax laws? They are not allowed to influence elections. (Which brings up another topic - how come so many religious groups do get away with both electioneering AND tax exemptions? I thought that was illegal.)
Way to piss me off.
.
Wednesday, December 21, 2011
3422 The world is crazy
Wednesday, December 21, 2011
It turns out I was right about the traffic. I left at 7 pm, took the parkway, and the usually 2.25 hour trip took 3.5 hours. Heavy traffic, accident, 10 mile backup at about 5-15 mph. But, I made it, 10:30 last night. I slept very well.
You know, I love this house. It's falling apart - the dishwasher, the deck, the toilets, the A/C, the driveway, all need replacing. It desperately needs a water softener and filter system - the pipes are full of salts and silt, so the water pressure is low. But all that can be fixed. I simply LOVE the way the house is laid out. And the windows. And the quiet. And the forever view. And the huge garage. I even love the sunny clean basement.
-------------------------------
I read an article about how people aren't getting married much any more, and those who do are marrying later. A short excerpt from http://entertainment.verizon.com/news/read.php?rip_id=%3CD9ROE9JG0%40news.ap.org%3E&ps=931:
Maybe that's the point of the suppression of women in much of the rest of the world, the fundamental religion parts. It's the only way to make sure every man has a woman to do his cooking and laundry. Who else would marry some of those guys.
--------------------------------
I spent all day running around. I went to the DMV and turned in the old NY plates for my cars. Then I wandered around Poughkeepsie for two hours trying to find my insurance agent - they'd moved twice since I'd last been to the office, and the letter I'd brought from home was an old one with the old address. I eventually found them, and discovered that even though Travelers' does insure in NJ, they can't simply transfer my old policy. I had to apply for a new policy. And contrary to what the rep at the main Travelers' office had told me, it's NOT cheaper in NJ. The new policy has only two cars (since I'd given Suzie to Daughter) but it's about $500 more per year.
Sigh. Remind me why I moved....
Anyway, they were able to get it all done and I got the "proof of" cards that I need to get the cars inspected in NJ. That has to be done next week.
Then I drove to Saugerties to my attorney's office to pick up the files from the closed estates - Jay's and his fathers. After going through them there, it turned out there was nothing I didn't already have copies of.
In the meantime, three different people over the past two days have tried to kill me, or at least seriously injure Hal. On three occasions, as I was driving down narrow city streets with cars parked along the curb to my right, the driver of a parked car suddenly opened their car door fully, swung it fast all the freakin' way, right into my path. I've heard of this happening, but until yesterday I'd never actually experienced it.
Hal is pretty nimble, so on two of those occasions I was able to swerve left and miss the door. But the third time, there was a car coming toward me on the other side and I wasn't able to swerve. I hit the brake so hard Hal took a nose-drive. I was doing maybe 25, and stopped in three feet, about six inches from the woman's door, stalling Hal. I'm just lucky there was no one behind me. The woman looked startled. I said nothing. Just backed up so she could close the door, and left.
Crazy people. I'm not going to yell at crazy people.
You know, I can't help but wonder if it was because I was driving a car registered in NJ, with NY insurance. Hmmmm. Now that my insurance is copacetic, maybe I will have no more threats.
.
When Jesus said to love your enemies, He probably meant don’t kill them.
----------------------------------------------
----------------------------------------------
It turns out I was right about the traffic. I left at 7 pm, took the parkway, and the usually 2.25 hour trip took 3.5 hours. Heavy traffic, accident, 10 mile backup at about 5-15 mph. But, I made it, 10:30 last night. I slept very well.
You know, I love this house. It's falling apart - the dishwasher, the deck, the toilets, the A/C, the driveway, all need replacing. It desperately needs a water softener and filter system - the pipes are full of salts and silt, so the water pressure is low. But all that can be fixed. I simply LOVE the way the house is laid out. And the windows. And the quiet. And the forever view. And the huge garage. I even love the sunny clean basement.
-------------------------------
I read an article about how people aren't getting married much any more, and those who do are marrying later. A short excerpt from http://entertainment.verizon.com/news/read.php?rip_id=%3CD9ROE9JG0%40news.ap.org%3E&ps=931:
Heading into 2012, trend watchers note that barely half of all adults in the United States are married, and the median age at the time of a first marriage has never been higher — slightly more than 26 years old for women and nearly 29 for men.IMHO, it's due to two things:In 1960, 72 percent of married adults 18 and older were married. The percentage fell to 57 percent in 2000 and today it's just 51 percent, according to a new Pew Research Center analysis of census data.
The share of marrieds could dip below half in a few years as single-person households, single parents and couples living together outside the bounds of legal marriage multiply.
- Women's liberation - when there were few lucrative opportunities for women, they pretty much had to get married to survive. Now, a woman can take care of herself; a husband is nice, but no longer a necessity. Therefore a woman can have higher standards and more choice.
- Collapse of moral values - once upon a time, living with someone you weren't married to was "shacking up", and socially unacceptable. An unmarried woman could not get a prescription for birth control. A young unmarried pregnant woman "went away" for a while, and the secret baby was put up for adoption, so her life wouldn't be ruined forever. That's just the way it was done, as late as the '70s. Now nobody needs a ring for sex. It's free and easy. This makes it easier for men to delay or avoid marriage.
Maybe that's the point of the suppression of women in much of the rest of the world, the fundamental religion parts. It's the only way to make sure every man has a woman to do his cooking and laundry. Who else would marry some of those guys.
--------------------------------
I spent all day running around. I went to the DMV and turned in the old NY plates for my cars. Then I wandered around Poughkeepsie for two hours trying to find my insurance agent - they'd moved twice since I'd last been to the office, and the letter I'd brought from home was an old one with the old address. I eventually found them, and discovered that even though Travelers' does insure in NJ, they can't simply transfer my old policy. I had to apply for a new policy. And contrary to what the rep at the main Travelers' office had told me, it's NOT cheaper in NJ. The new policy has only two cars (since I'd given Suzie to Daughter) but it's about $500 more per year.
Sigh. Remind me why I moved....
Anyway, they were able to get it all done and I got the "proof of" cards that I need to get the cars inspected in NJ. That has to be done next week.
Then I drove to Saugerties to my attorney's office to pick up the files from the closed estates - Jay's and his fathers. After going through them there, it turned out there was nothing I didn't already have copies of.
In the meantime, three different people over the past two days have tried to kill me, or at least seriously injure Hal. On three occasions, as I was driving down narrow city streets with cars parked along the curb to my right, the driver of a parked car suddenly opened their car door fully, swung it fast all the freakin' way, right into my path. I've heard of this happening, but until yesterday I'd never actually experienced it.
Hal is pretty nimble, so on two of those occasions I was able to swerve left and miss the door. But the third time, there was a car coming toward me on the other side and I wasn't able to swerve. I hit the brake so hard Hal took a nose-drive. I was doing maybe 25, and stopped in three feet, about six inches from the woman's door, stalling Hal. I'm just lucky there was no one behind me. The woman looked startled. I said nothing. Just backed up so she could close the door, and left.
Crazy people. I'm not going to yell at crazy people.
You know, I can't help but wonder if it was because I was driving a car registered in NJ, with NY insurance. Hmmmm. Now that my insurance is copacetic, maybe I will have no more threats.
.
Wednesday, October 05, 2011
3362 Nuttin'
Wednesday, September 5, 2011
I've been eating a lot of pistachios lately, and I found a trick that really works. Know how there are always a few nuts that aren't opened, and the shells are so hard it's next to impossible to get them open? They almost always have a frustratingly tiny crack.
Simple method. Take a half-shell from an earlier nut, insert the edge of that half-shell into the tiny crack in the reluctant nut, and twist it, lifting toward the point of the nut. It'll pop the shell open. Works every time.
--------------------------------
Daughter and I and the Nugget went north Sunday evening, stayed in a hotel in Kingston, NY, and then picked up Suzie the Suzuki Monday morning. Daughter drove Suzie back. Suzie has four doors where Daughter's Honda has two, which makes it much easier to get the Nugget in and out of the car seat, so I'm going to give Suzie to her. Sadness - I really enjoy driving Suzie. For a small car she has lots of room, a huge trunk, her high windows allow a marvelous view, and she has a smooth ride. But I don't really need her, and Daughter's life will be much easier with her.
-------------------------------
I've been checking out car insurance. My NY insurance (Travelers) currently covers the three vehicles: 2011 BMW, 2000 Dodge minivan, and 2003 Suzuki, and costs about $1,800 per year. I called my agent to tell her I'd moved to NJ, and that I'd be dropping the Suzuki, so please rewrite the policy. She said "Oooo, it's a lot cheaper in NJ". I'm still waiting for the new quote, but in the meantime I've got quotes from other companies for the two vehicles, and I'm freaking out.
Geico, you know, the ones that are supposed to be pretty reasonable? Their quote was close to $1700 for six months! I had palpitations! Liberty Mutual says $1164 per year, so maybe there's an error somewhere in Geico's quote.
--------------------------------
Heading north again this evening.
.
Love is blind, but the neighbors are not.
------------------------------------------------------------------
------------------------------------------------------------------
I've been eating a lot of pistachios lately, and I found a trick that really works. Know how there are always a few nuts that aren't opened, and the shells are so hard it's next to impossible to get them open? They almost always have a frustratingly tiny crack.
Simple method. Take a half-shell from an earlier nut, insert the edge of that half-shell into the tiny crack in the reluctant nut, and twist it, lifting toward the point of the nut. It'll pop the shell open. Works every time.
--------------------------------
Daughter and I and the Nugget went north Sunday evening, stayed in a hotel in Kingston, NY, and then picked up Suzie the Suzuki Monday morning. Daughter drove Suzie back. Suzie has four doors where Daughter's Honda has two, which makes it much easier to get the Nugget in and out of the car seat, so I'm going to give Suzie to her. Sadness - I really enjoy driving Suzie. For a small car she has lots of room, a huge trunk, her high windows allow a marvelous view, and she has a smooth ride. But I don't really need her, and Daughter's life will be much easier with her.
-------------------------------
I've been checking out car insurance. My NY insurance (Travelers) currently covers the three vehicles: 2011 BMW, 2000 Dodge minivan, and 2003 Suzuki, and costs about $1,800 per year. I called my agent to tell her I'd moved to NJ, and that I'd be dropping the Suzuki, so please rewrite the policy. She said "Oooo, it's a lot cheaper in NJ". I'm still waiting for the new quote, but in the meantime I've got quotes from other companies for the two vehicles, and I'm freaking out.
Geico, you know, the ones that are supposed to be pretty reasonable? Their quote was close to $1700 for six months! I had palpitations! Liberty Mutual says $1164 per year, so maybe there's an error somewhere in Geico's quote.
--------------------------------
Heading north again this evening.
.
Friday, July 01, 2011
3294 Dear Diary
Friday, July 1, 2011
One purpose of this blog is to act as a diary for me, so I kind of know what happened when. I don't always remember what I did three days ago, let alone last month. Of course, I also often don't realize the significance of small things when they happen, so they get left out and lost. So the usefulness is often compromised. Eh.
I wanted to go upriver this past week, probably Tuesday evening through Thursday, and had told the Hunk I'd be up. But it didn't happen. And I'm already starting to forget why.
Nugget had a pediatrician appointment on Wednesday afternoon. Daughter had managed to convince the doctor to delay Nugget's first immunizations for a month, so she'd be getting them Wednesday, and Daughter was a nervous wreck. She asked me to go with her. She was so afraid herself that I think she was almost afraid she'd have to leave the room. Ok, Gramma can be the bad guy. So I didn't go upriver Tuesday evening. I can go Wednesday, and return Friday.... (Yuck. Garden State Parkway, Friday on a holiday weekend, heading toward the shore points?)
Tuesday afternoon Daughter and had I spent some time looking up baby carriers on the internet. She wanted one that could be used on the front with the baby facing in or out. I pointed out that Nugget would soon be too heavy for a front carrier, so maybe she should look for one that could also be used as a back carrier. We found a few that looked good. I emphasized that she shouldn't buy it online, though, at least until she'd tried one on for size and comfort.
So Wednesday after the pediatrician appointment, Daughter suggested that we locate a selection of carriers on Thursday. Wednesday, by the way, was a long day. Daughter is pokey anyway, but she stops dead every two hours or so for 20 minutes or so, to breastfeed the Nugget.
On the way home from the pediatrician we had stopped at a huge Target to see if they had any carriers (no, not a single one), and while I was standing at the counter in the Target snack bar a man next to me set a cup of coffee on a small bit of shelf set there to hold a debit card reader at the front of the counter, while he paid his tab. The unsecured shelf tilted, the coffee slid off and hit the floor, and the hot coffee shot straight up, a veritable volcano, and splashed my neck, tiny boiling droplets from behind my right ear to my shoulder.
No, I don't need 911. No, I don't need the store nurse. I would like a cloth with some ice, please. Now!, if it wouldn't be too much trouble? Yes, I would like to see a manager. Yes, I would like to fill out an incident report - for the sole purpose of bringing attention to that unsecured shelf, which should be removed or secured, because the next person burned could be a Nugget-type. Or a litigious type. Who would certainly have a case now that I am reporting it.
The manager removed the shelf immediately. Next time I'm in Target, I'm going to check.
Then Daughter asked me to watch Nugget that evening while she worked on some medical insurance problems** and wrote an article for an organization newsletter. So I didn't make it up river Wednesday evening, either. Ok, I can go Thursday evening, then return Saturday evening, and that's better for traffic anyway.
So Thursday Daughter, Nugget, and I headed for the largest Babies R Us in the area, south of here, just a bit north of Asbury Park. We tried on several carriers. Daughter ended up with a frame backpack - the Cadillac of carriers. Good for hiking with Nugget. By then it was close to 5:30 pm, and she suggested we visit the Asbury Park boardwalk, Hercules works near there so he can join us, and we can have dinner there.
Boardwalk? Yeah, ok. Asbury Park, by the way, has gone through about 50 years of depression, despite the ostentatious (and pretentious) mansions lining the roads in. The city and boardwalk are just now starting to sort of recover. The boardwalk is bracketed with buildings showing obvious decay, but also apparent recent attempts at restoration. We walked the full length and back, with dinner in the middle (overpriced and not that good). During a Nugget diaper change and feeding, I decided to walk down to the water. I'd forgotten how difficult it is to walk on soft sand, and with the dead nerves in my right ankle and shin, my foot dragged, and I ended up pulling something in the top of my right thigh.
We didn't get home until after 10:30 pm. Nope, not going upriver Thursday evening.
Now it's Friday and there's no way I'm going anywhere near the parkway or the turnpike today. Not to mention that the top of my right thigh clenches every so often.
Maybe Saturday evening? No, that would be returning Monday evening, eeeeek! Sunday evening? Returning Tuesday? No. I have a mammo scheduled down here for next Wednesday, and I need to pick up my old mammogram films (CD) up there, and they won't be ready until Thursday, so I may as well wait until then to go up, or it would be another week before I get the films.
I wonder why I never get anything done.
--------------------------------
**The insurance problem. It's a lot more complicated than this one example, but I'll describe one of the problems that has me shaking my head.
When Daughter's water broke early in her labor, there was a lot of thick meconium, which is a bad thing. Then she didn't dilate beyond 9. Then she developed a fever, and they were worried about infection, both her and the baby. They actually piped saline through her uterus to wash out the meconium when her fever kept going up and the baby's heartrate increased. And Daughter's blood sugar was too high. She had poorly controlled gestational diabetes, so the Nugget was likely to be born with too much insulin in her system, which could result in hypoglycemia.
So finally there was an emergency caesarian, and the Nugget went into the neonatal ICU for two days while her risk of meconium inhalation infection and hypoglycemia were assessed and controlled. Daughter was breastfeeding, so she visited the Nugget every few hours. Then they had a day and a half of rooming-in, with both of them on IV antibiotics.
It was altogether, from the time Daughter arrived at the hospital very early in the morning until they were released, four days. (Or something like that. I forget and I'm not going to look it up now.) Anyway, it all sounds like medical necessity, right?
Surprise. The insurance company allows three days for a birth. Period. And they count the first full day as the day you arrive at the hospital, so if you arrive Monday night at 11:45 pm, that's the first one of the three days. They don't count from the birth, but from the mother's arrival. Duh? Does this mean that if you arrive late one evening, and are in active labor for two days, which is not unheard of, the hospital is expected to kick you out an hour before the baby is born?
I guess this is to discourage anxious mothers from arriving too early. BUT!!! Daughter's water broke early, and there was heavy meconium. ALL medical advice is that this is a concern, and to call your doctor, and then do as you're told. Daughter was told to go to the hospital immediately. Why is there no exception for emergency cases?
So, the insurance company is refusing to pay for the fourth day.
Second, although Daughter had originally wanted a home birth, but all kinds of obstacles were thrown in her way, she ended up with a hospital 40 minutes away, which is what the insurance company insisted on, because she was considered high risk. Got that? That the insurance company wanted this particular hospital because it was a high risk birth?
Surprise surprise. The neonatal ICU at this hospital is (for some unexplained reason) considered OUT OF NETWORK! The fact that Nugget ending up in the ICU was not exactly planned, but should have been a consideration, given that it was a high risk birth, and the fact that it was an emergency, doesn't seem to matter to the insurance company. When Daughter asked what else she should have done, she was told that she should have had the baby transferred to another NICU that was in network. The fact that Daughter was breast feeding was not a consideration. So no, they're not paying for two days of NICU since they hadn't given prior approval. Duh?
Um, why did they insist on this particular hospital again? When you say "high risk", doesn't that presuppose the risk of NICU? Wasn't that implied?
It sounds to me like the insurance company is giving them a hard time just because parents of a new baby are unlikely to pull out the big guns, being tired, depressed, and busy with higher priorities.
I say fight it.
This is stupid.
.
How "good one is in bed" has more to do with the combination than with any skill.
-- Silk --
-----------------------------------------------
-- Silk --
-----------------------------------------------
One purpose of this blog is to act as a diary for me, so I kind of know what happened when. I don't always remember what I did three days ago, let alone last month. Of course, I also often don't realize the significance of small things when they happen, so they get left out and lost. So the usefulness is often compromised. Eh.
I wanted to go upriver this past week, probably Tuesday evening through Thursday, and had told the Hunk I'd be up. But it didn't happen. And I'm already starting to forget why.
Nugget had a pediatrician appointment on Wednesday afternoon. Daughter had managed to convince the doctor to delay Nugget's first immunizations for a month, so she'd be getting them Wednesday, and Daughter was a nervous wreck. She asked me to go with her. She was so afraid herself that I think she was almost afraid she'd have to leave the room. Ok, Gramma can be the bad guy. So I didn't go upriver Tuesday evening. I can go Wednesday, and return Friday.... (Yuck. Garden State Parkway, Friday on a holiday weekend, heading toward the shore points?)
Tuesday afternoon Daughter and had I spent some time looking up baby carriers on the internet. She wanted one that could be used on the front with the baby facing in or out. I pointed out that Nugget would soon be too heavy for a front carrier, so maybe she should look for one that could also be used as a back carrier. We found a few that looked good. I emphasized that she shouldn't buy it online, though, at least until she'd tried one on for size and comfort.
So Wednesday after the pediatrician appointment, Daughter suggested that we locate a selection of carriers on Thursday. Wednesday, by the way, was a long day. Daughter is pokey anyway, but she stops dead every two hours or so for 20 minutes or so, to breastfeed the Nugget.
On the way home from the pediatrician we had stopped at a huge Target to see if they had any carriers (no, not a single one), and while I was standing at the counter in the Target snack bar a man next to me set a cup of coffee on a small bit of shelf set there to hold a debit card reader at the front of the counter, while he paid his tab. The unsecured shelf tilted, the coffee slid off and hit the floor, and the hot coffee shot straight up, a veritable volcano, and splashed my neck, tiny boiling droplets from behind my right ear to my shoulder.
No, I don't need 911. No, I don't need the store nurse. I would like a cloth with some ice, please. Now!, if it wouldn't be too much trouble? Yes, I would like to see a manager. Yes, I would like to fill out an incident report - for the sole purpose of bringing attention to that unsecured shelf, which should be removed or secured, because the next person burned could be a Nugget-type. Or a litigious type. Who would certainly have a case now that I am reporting it.
The manager removed the shelf immediately. Next time I'm in Target, I'm going to check.
Then Daughter asked me to watch Nugget that evening while she worked on some medical insurance problems** and wrote an article for an organization newsletter. So I didn't make it up river Wednesday evening, either. Ok, I can go Thursday evening, then return Saturday evening, and that's better for traffic anyway.
So Thursday Daughter, Nugget, and I headed for the largest Babies R Us in the area, south of here, just a bit north of Asbury Park. We tried on several carriers. Daughter ended up with a frame backpack - the Cadillac of carriers. Good for hiking with Nugget. By then it was close to 5:30 pm, and she suggested we visit the Asbury Park boardwalk, Hercules works near there so he can join us, and we can have dinner there.
Boardwalk? Yeah, ok. Asbury Park, by the way, has gone through about 50 years of depression, despite the ostentatious (and pretentious) mansions lining the roads in. The city and boardwalk are just now starting to sort of recover. The boardwalk is bracketed with buildings showing obvious decay, but also apparent recent attempts at restoration. We walked the full length and back, with dinner in the middle (overpriced and not that good). During a Nugget diaper change and feeding, I decided to walk down to the water. I'd forgotten how difficult it is to walk on soft sand, and with the dead nerves in my right ankle and shin, my foot dragged, and I ended up pulling something in the top of my right thigh.
We didn't get home until after 10:30 pm. Nope, not going upriver Thursday evening.
Now it's Friday and there's no way I'm going anywhere near the parkway or the turnpike today. Not to mention that the top of my right thigh clenches every so often.
Maybe Saturday evening? No, that would be returning Monday evening, eeeeek! Sunday evening? Returning Tuesday? No. I have a mammo scheduled down here for next Wednesday, and I need to pick up my old mammogram films (CD) up there, and they won't be ready until Thursday, so I may as well wait until then to go up, or it would be another week before I get the films.
I wonder why I never get anything done.
--------------------------------
**The insurance problem. It's a lot more complicated than this one example, but I'll describe one of the problems that has me shaking my head.
When Daughter's water broke early in her labor, there was a lot of thick meconium, which is a bad thing. Then she didn't dilate beyond 9. Then she developed a fever, and they were worried about infection, both her and the baby. They actually piped saline through her uterus to wash out the meconium when her fever kept going up and the baby's heartrate increased. And Daughter's blood sugar was too high. She had poorly controlled gestational diabetes, so the Nugget was likely to be born with too much insulin in her system, which could result in hypoglycemia.
So finally there was an emergency caesarian, and the Nugget went into the neonatal ICU for two days while her risk of meconium inhalation infection and hypoglycemia were assessed and controlled. Daughter was breastfeeding, so she visited the Nugget every few hours. Then they had a day and a half of rooming-in, with both of them on IV antibiotics.
It was altogether, from the time Daughter arrived at the hospital very early in the morning until they were released, four days. (Or something like that. I forget and I'm not going to look it up now.) Anyway, it all sounds like medical necessity, right?
Surprise. The insurance company allows three days for a birth. Period. And they count the first full day as the day you arrive at the hospital, so if you arrive Monday night at 11:45 pm, that's the first one of the three days. They don't count from the birth, but from the mother's arrival. Duh? Does this mean that if you arrive late one evening, and are in active labor for two days, which is not unheard of, the hospital is expected to kick you out an hour before the baby is born?
I guess this is to discourage anxious mothers from arriving too early. BUT!!! Daughter's water broke early, and there was heavy meconium. ALL medical advice is that this is a concern, and to call your doctor, and then do as you're told. Daughter was told to go to the hospital immediately. Why is there no exception for emergency cases?
So, the insurance company is refusing to pay for the fourth day.
Second, although Daughter had originally wanted a home birth, but all kinds of obstacles were thrown in her way, she ended up with a hospital 40 minutes away, which is what the insurance company insisted on, because she was considered high risk. Got that? That the insurance company wanted this particular hospital because it was a high risk birth?
Surprise surprise. The neonatal ICU at this hospital is (for some unexplained reason) considered OUT OF NETWORK! The fact that Nugget ending up in the ICU was not exactly planned, but should have been a consideration, given that it was a high risk birth, and the fact that it was an emergency, doesn't seem to matter to the insurance company. When Daughter asked what else she should have done, she was told that she should have had the baby transferred to another NICU that was in network. The fact that Daughter was breast feeding was not a consideration. So no, they're not paying for two days of NICU since they hadn't given prior approval. Duh?
Um, why did they insist on this particular hospital again? When you say "high risk", doesn't that presuppose the risk of NICU? Wasn't that implied?
It sounds to me like the insurance company is giving them a hard time just because parents of a new baby are unlikely to pull out the big guns, being tired, depressed, and busy with higher priorities.
I say fight it.
This is stupid.
.
Saturday, April 16, 2011
3221 The hospital bill
Monday, April 18, 2011
I got the bill from the hospital stay today. I cannot BELIEVE it! I went in through the emergency room Saturday noonish, and left Tuesday early afternoon.
$17,004.00
That's SEVENTEEN THOUSAND!
I don't know for sure how much of that will be covered by insurance. Almost all of it, I think, but I shudder to think of what it would mean if I had no insurance.
When Jay was battling the brain tumor, 1998-2001, he had an MRI with contrast about every other month or so. The MRIs were about $800 then. They said then that a CAT scan (or CT - the terminology seems to be changing) would have been cheaper, but wouldn't show what they wanted to see.
My CAT scan was $1891. Holy crap! That's at least three times what it was ten years ago!
They cultured my urine twice. Total for two cultures - $1134.00! That's totally ridiculous.
I am fully aware that different patients are charged different amounts for the same services, depending on what insurance they have, and what deals the insurance companies have struck with the hospitals and doctors. That's what "in network" means. It means your insurance company has a deal with that provider.
When I was working for The Company in St. Louis, one of my customers was the billing department of a large hospital, and I read computer core dumps when they had a problem. I could see what the hospital expected to receive from all sources. I was incensed to see that some people were charged as little as 20% of what others were charged for the exact same procedures.
Guess who was billed the highest?
People without insurance.
They'd have to pay as much as five times what an insurance company would pay. That looks to me like the uninsured were SUBSIDIZING insurance companies. The hospital had to make up the difference somewhere, right?
And guess who paid the second highest?
Medicare. Apparently the federal government doesn't set limits on what they'll pay like the insurance companies do.
Gah!
I wonder if my bill is so ridiculous ($567 for one urine culture? My doctor's office sent it out to a lab, and charged $50 for the same thing) because Medicare is now my primary payer, and The Company is now secondary, and they know they can get away with it with Medicare?
.
There are those who will believe only what they see,
and those who will see only what they believe.
The potential for reward is far greater if we are neither.
-- Silk --
------------------------------------------
and those who will see only what they believe.
The potential for reward is far greater if we are neither.
-- Silk --
------------------------------------------
I got the bill from the hospital stay today. I cannot BELIEVE it! I went in through the emergency room Saturday noonish, and left Tuesday early afternoon.
$17,004.00
That's SEVENTEEN THOUSAND!
I don't know for sure how much of that will be covered by insurance. Almost all of it, I think, but I shudder to think of what it would mean if I had no insurance.
When Jay was battling the brain tumor, 1998-2001, he had an MRI with contrast about every other month or so. The MRIs were about $800 then. They said then that a CAT scan (or CT - the terminology seems to be changing) would have been cheaper, but wouldn't show what they wanted to see.
My CAT scan was $1891. Holy crap! That's at least three times what it was ten years ago!
They cultured my urine twice. Total for two cultures - $1134.00! That's totally ridiculous.
I am fully aware that different patients are charged different amounts for the same services, depending on what insurance they have, and what deals the insurance companies have struck with the hospitals and doctors. That's what "in network" means. It means your insurance company has a deal with that provider.
When I was working for The Company in St. Louis, one of my customers was the billing department of a large hospital, and I read computer core dumps when they had a problem. I could see what the hospital expected to receive from all sources. I was incensed to see that some people were charged as little as 20% of what others were charged for the exact same procedures.
Guess who was billed the highest?
People without insurance.
They'd have to pay as much as five times what an insurance company would pay. That looks to me like the uninsured were SUBSIDIZING insurance companies. The hospital had to make up the difference somewhere, right?
And guess who paid the second highest?
Medicare. Apparently the federal government doesn't set limits on what they'll pay like the insurance companies do.
Gah!
I wonder if my bill is so ridiculous ($567 for one urine culture? My doctor's office sent it out to a lab, and charged $50 for the same thing) because Medicare is now my primary payer, and The Company is now secondary, and they know they can get away with it with Medicare?
.
Sunday, February 13, 2011
3162 Health Insurance then and now
Sunday, February 13, 2011
An observation on the deterioration of health insurance: Back in the late '60s and early '70s, if my doctor prescribed aspirin, my insurance paid for it. Same with any OTC meds and supplements. There were NO copays or deductibles. No premiums other than what the employer paid. Once when I was hospitalized, in 1970, I was covered by two insurance plans - my employer's and Ex#1's employer's - and both paid in full. I was worried that it was a mistake, but both companies said no, that it was ok, and if I had money left over I could keep it. "If it makes you feel better, use it for costs associated with time off work, pet care, bed jackets to wear in the hospital, whatever."
In the '80s, Daughter was covered under my policy with The Company, and under her father's (Ex#2's) policy, also with The Company. Although by then coverage had been reduced (we had copays and deductibles, and no double payments), because she was covered under both, one policy covered the copays and deductibles on the other, so she was covered 100%.
Compare that to now.
--------------------------------
Something else to compare then to now: Under those health plans, for everything except hospital charges, you had to pay the bills and submit the receipts for payment. Ex#2 and I were divorced, and I had full custody. I took Daughter to the doctor, paid all the bills, filled out the forms, and submitted the receipts to my plan, with Ex#2's plan as secondary payer.
The Company cut the checks, and sent them to him! Not me! And he, of course, never notified me that he'd received any checks. He cashed or deposited them without a blink, without a word to me. Since all the paperwork from The Company went to him, too, I had no idea that payment had been made, or for how much. I had to call Human Resources and ask. And that SOB often claimed he'd never received the checks (not out of meanness - he'd just "forget", and he was a tightwad and didn't want to give me any money).
I was furious with The Company. They said it was company policy to send checks to the father, regardless of court dispositions, regardless of who paid the bills and submitted the claims. It took me more than a year and the threat of a sexual discrimination suit to get them to change the policy, and even then the policy applied only to me, and only because I was also a Company employee. I wondered how many other non-employee women weren't getting their checks and had no recourse, had to beg their exes for the insurance checks.
Compare that to now.
People now seem to think calling a woman a feminist is some kind of insult. They don't know what it was once like, and how hard it was to change the rules.
.
“The first man to compare the cheeks of a young woman to a rose
was obviously a poet; the first to repeat it was possibly an idiot.”
-- Dalà --
----------------------------------------------------------
was obviously a poet; the first to repeat it was possibly an idiot.”
-- Dalà --
----------------------------------------------------------
An observation on the deterioration of health insurance: Back in the late '60s and early '70s, if my doctor prescribed aspirin, my insurance paid for it. Same with any OTC meds and supplements. There were NO copays or deductibles. No premiums other than what the employer paid. Once when I was hospitalized, in 1970, I was covered by two insurance plans - my employer's and Ex#1's employer's - and both paid in full. I was worried that it was a mistake, but both companies said no, that it was ok, and if I had money left over I could keep it. "If it makes you feel better, use it for costs associated with time off work, pet care, bed jackets to wear in the hospital, whatever."
In the '80s, Daughter was covered under my policy with The Company, and under her father's (Ex#2's) policy, also with The Company. Although by then coverage had been reduced (we had copays and deductibles, and no double payments), because she was covered under both, one policy covered the copays and deductibles on the other, so she was covered 100%.
Compare that to now.
--------------------------------
Something else to compare then to now: Under those health plans, for everything except hospital charges, you had to pay the bills and submit the receipts for payment. Ex#2 and I were divorced, and I had full custody. I took Daughter to the doctor, paid all the bills, filled out the forms, and submitted the receipts to my plan, with Ex#2's plan as secondary payer.
The Company cut the checks, and sent them to him! Not me! And he, of course, never notified me that he'd received any checks. He cashed or deposited them without a blink, without a word to me. Since all the paperwork from The Company went to him, too, I had no idea that payment had been made, or for how much. I had to call Human Resources and ask. And that SOB often claimed he'd never received the checks (not out of meanness - he'd just "forget", and he was a tightwad and didn't want to give me any money).
I was furious with The Company. They said it was company policy to send checks to the father, regardless of court dispositions, regardless of who paid the bills and submitted the claims. It took me more than a year and the threat of a sexual discrimination suit to get them to change the policy, and even then the policy applied only to me, and only because I was also a Company employee. I wondered how many other non-employee women weren't getting their checks and had no recourse, had to beg their exes for the insurance checks.
Compare that to now.
People now seem to think calling a woman a feminist is some kind of insult. They don't know what it was once like, and how hard it was to change the rules.
.
Sunday, February 06, 2011
3253 A political observation
Sunday, February 6, 2011
From Asecular.com, on March 22, 2010. I find it interestingly prophetic.
-------------------------------------
Some things kinda neat, but not covered in the news reports from Egypt:
You know how praying Muslims form lines and blocks? We see them praying in the square in Cairo in news reports and photos. What we haven't seen is that during prayer times, Christians, non-Muslims, and others have been forming shoulder to shoulder protective rings facing outward around the ones praying.
Also, shoulder to shoulder protective lines are circling the museums.
--------------------------------------
When I saw "The King's Speech", it didn't occur to me then, but later I realized, "Hey, the wife was the Queen Mother! Wow!" I was once about five feet from her. The real Queen Mother, I mean. Not the actress.
.
"Nobody realizes that some people expend tremendous energy merely to be normal."
-- Albert Camus --
-----------------------------------------------------------
-- Albert Camus --
-----------------------------------------------------------
From Asecular.com, on March 22, 2010. I find it interestingly prophetic.
Another striking thing about this Obamacare story is what it says about the difference between Republicans and Democrats when it comes to the wielding of power. This is an oversimplification I know, but the basic difference is that Democrats believe in the value of government and campaign so that they can win elections and then do things to improve government and run it competently. Republicans, on the other hand, don't believe government has any value and so campaign so that they can win elections so they can do the things necessary to win more elections and consolidate their power. This was summed up nicely in Gingerich's remarks about health care just before it passed in the House, "[If Democrats pass health reform,] they will have destroyed their party much as Lyndon Johnson shattered the Democratic Party for 40 years [by pushing civil rights legislation]." Not only was he saying that Democrats had just done a foolish thing by passing a bill that hadn't been polling well, but he was also implying that their passing the Civil Rights Act had been foolish because it hadn't been in the service of holding onto power. These guys are all completely Machiavellian, and it's great that we have days such as today when their masks are ripped off and we are shown, to be frank, how evil they are.This was brought to mind yesterday by all the Regan-worship going on now. His record has been whitewashed. I was there. I remember. And Field remembers, too. Read http://field-negro.blogspot.com/2011/02/glossing-over-history-for-gipper.html
-------------------------------------
Some things kinda neat, but not covered in the news reports from Egypt:
You know how praying Muslims form lines and blocks? We see them praying in the square in Cairo in news reports and photos. What we haven't seen is that during prayer times, Christians, non-Muslims, and others have been forming shoulder to shoulder protective rings facing outward around the ones praying.
Also, shoulder to shoulder protective lines are circling the museums.
--------------------------------------
When I saw "The King's Speech", it didn't occur to me then, but later I realized, "Hey, the wife was the Queen Mother! Wow!" I was once about five feet from her. The real Queen Mother, I mean. Not the actress.
.
Tuesday, June 10, 2008
1846 Odd Thoughts
Tuesday, June 10, 2008
We've hit 100 degrees four days in a row now. The heat is supposed to break when a cold front moves in this evening, which means a storm with "large hail and winds capable of taking down trees and power lines".
I mentally cataloged my trees. The black locusts are all sick from some bug and/or virus that has been killing them, and several are leaning toward the driveway and house. I think I'll move the car to the end of the driveway to ensure I can get out, and I caught myself hoping that if any trees fall, they hit the house.
That's not as weird as it sounds. If they fall and don't hit the house, it will cost me well over $500 per tree to have the remains removed. If they do hit the house, the insurance will pay for having the house repaired, AND having the tree removed.
A few years ago a huge locust (which is VERY heavy wood) was gradually falling over, and was guaranteed to eventually take out the roof over the back bedroom. The estimate to have it cut down by a tree service was $1,000. I tried to get the insurance company to pay for at least part of the removal, on the theory that if it were not removed, the cost to them could be much higher. They refused. I think that's silly.
I was tempted to let it go ahead and hit, but it might be years before the tree fell, and I have some very heavy antique beds, dressers, and screens in that room that I didn't want to risk and couldn't move, so I ended up eating the bill.
So maybe the insurance company was not so silly. That's what they do - they place bets.
--------------------------------
There was a notice on the bulletin board in the deli, for an apartment to rent, described as "five minutes to" the college and "seven minutes to" the parkway. I want to know who timed that! And I want them to alert me when they plan to be on the road. No matter what route you take, the college and the parkway are at least 22 minutes apart.
--------------------------------
Later - the worst of the storm is to pass north of us.
--------------------------------
The Man's laptop (Dell Inspiron 9100 - not so much a laptop as a portable desktop - that thing's heavy and loaded! It's twice as thick as my 1501) sputtered, sizzled, and died yesterday. He can't cope without it, so I've spent a good part of today searching for a decent barely alive one for sale that he can cannibalize. They're rare. And even barely alive they're expensive.
On the other hand, I do love searching for deals....
.
We've hit 100 degrees four days in a row now. The heat is supposed to break when a cold front moves in this evening, which means a storm with "large hail and winds capable of taking down trees and power lines".
I mentally cataloged my trees. The black locusts are all sick from some bug and/or virus that has been killing them, and several are leaning toward the driveway and house. I think I'll move the car to the end of the driveway to ensure I can get out, and I caught myself hoping that if any trees fall, they hit the house.
That's not as weird as it sounds. If they fall and don't hit the house, it will cost me well over $500 per tree to have the remains removed. If they do hit the house, the insurance will pay for having the house repaired, AND having the tree removed.
A few years ago a huge locust (which is VERY heavy wood) was gradually falling over, and was guaranteed to eventually take out the roof over the back bedroom. The estimate to have it cut down by a tree service was $1,000. I tried to get the insurance company to pay for at least part of the removal, on the theory that if it were not removed, the cost to them could be much higher. They refused. I think that's silly.
I was tempted to let it go ahead and hit, but it might be years before the tree fell, and I have some very heavy antique beds, dressers, and screens in that room that I didn't want to risk and couldn't move, so I ended up eating the bill.
So maybe the insurance company was not so silly. That's what they do - they place bets.
--------------------------------
There was a notice on the bulletin board in the deli, for an apartment to rent, described as "five minutes to" the college and "seven minutes to" the parkway. I want to know who timed that! And I want them to alert me when they plan to be on the road. No matter what route you take, the college and the parkway are at least 22 minutes apart.
--------------------------------
Later - the worst of the storm is to pass north of us.
--------------------------------
The Man's laptop (Dell Inspiron 9100 - not so much a laptop as a portable desktop - that thing's heavy and loaded! It's twice as thick as my 1501) sputtered, sizzled, and died yesterday. He can't cope without it, so I've spent a good part of today searching for a decent barely alive one for sale that he can cannibalize. They're rare. And even barely alive they're expensive.
On the other hand, I do love searching for deals....
.
Monday, December 25, 2006
1036 The Hellhole - Clove Lakes, Staten Island
Monday, December 25, 2006
[Update, 11/13/09. I've decided to tell the name of the hellhole, Clove Lakes Health Care and Rehabilitation Center, in Staten Island, NY, and the names of the a**hole doctors, Fealey and Nadler, because this is all true, and it's a disservice to the world to protect them. We can only hope that the place has improved in the past 8 years, but I seriously doubt it.]
Again, as with the previous entry, I'm putting all this here, in my personal journal, to preserve it from hard disk destruction and floppy deterioration. Don't bother reading it unless you have lots of time and an overwhelming interest in medical sadism.
When it was time for the next cycle of immunotherapy, we moved Jay to a skilled-nursing home in Staten Island, close to the Nalitt Cancer Center. (They described themselves not as a nursing home, however, but as a physical rehabilitation facility.) Because they were out of network, our insurance would pay for his stay there only if he was getting physical therapy (PT). He could also have been admitted to the Staten Island University Hospital, but I had promised Jay he would never have to go there again.
Something I learned later - Medicare and other medical insurers won't pay for ordinary nursing home care except for a short recovery period after a specific incident. Otherwise, only long term care plans will pay. To get around this (and get the money) many nursing homes call themselves rehab centers. They can then take in nursing home candidates, and by offering a piss-poor physical and occupational therapy program to the residents, they can charge a heck of a lot more, and be sure of getting it. Beware of these places. They are cynical, just out for the money. Also beware of places that, as part of the intake process, ask you to sign a DNR form.
The following is our experiences during the first of two months at the Hellhole, from a notebook I kept at the time. I made the 5 hour round trip five or six days a week, arriving to be with Jay about 9 am, and leaving about 9 pm. The other one or two days a week were insurance battles, lining up ambulette transportation to and from the cancer center for Jay's treatments, taking care of the animals, paying bills, doing laundry (the nursing home did not do the residents' laundry) and so on.
I shall not use the name of the place for legal reasons (but the first word is a spice that usually goes well with cinnamon, and the second is a large body of water), and the foul doctor's names have a letter replaced to foil searches. But if anyone comes after me for this, it is all absolutely the truth as I experienced it, and I stand by it. Of course, this was all in 2001, six years ago. One hopes they have improved since then. [Insert cynical snort.]
The worst was the medications. In addition to the screwups documented here, medications were always dispensed late, and at much longer intervals than prescribed. Every three hours or so a nurse - ONE nurse - would set out with the meds cart, to cover the entire floor. Jay was supposed to get certain meds every four hours, but they would arrive three hours late, so they'd just shrug and skip the next dose. This is unforgiveably sloppy when the purpose is to control, for example, intracranial edema.
-----------------------------
At this point I got super-proactive. I read ALL the nursing notes and charts every morning and evening. I asked more questions. I raised Hell. I became a royal pain, but I made things happen. The "keeping of the journal" suffered. Notes are sparse and usually undated.
I discovered that Jay hadn't had a bowel movement in ten days and no one had done anything about it. The nurses were not aware that rectal stimulation with a brain tumor does not cause the same feedback problems as with spinal injury, and that they cannot use water ememas, it must be oil, but a simple stool softener would do wonders. I tried to educate them, and then just went out and bought the stuff myself. Occasionally I locked the door and removed rocks the old-fashioned way.
He was supposed to get a shower once a week, but for three weeks in a row, the aides had a meeting during Jay's shower time, and he was not rescheduled. I gave him showers myself, a few times a week, late at night when the shower was free.
I discovered what "not medically indicated" meant, as pertained to his PT. His diagnosis had been high-grade oligoastrocytoma, but after the last surgery it had been downgraded to oligodendroglioma, a less virilent tumor. The worst is a glioblastoma multiforme (GBM). I had, right from the beginning, asked all his doctors if the astrocytic component could be GBM, and they always said no, that the cells didn't have the characteristic look. Which is good, because the prognosis for GBM with Jay's history of recurrance is extremely bad. Well, under "diagnosis" in his charts, someone had at some point changed it to GBM!, apparently without having consulted any of the doctors who mattered. The "indication" for PT is a possibility of going home and living. GBM says not expected to live. And that's the REAL reason the PT was stopped.
I attempted to get a copy of that page. Copies were something like $1 per page (an obvious attempt to discourage copying), and you were not allowed to make the copies yourself. An "order" had to be placed. I bit the bullet and ordered copies of like 50 pages, which were not delivered to me for more than a week. And when the copies arrived, all the bad stuff in there, like the misdiagnosis, the lack of bowel movements, the overlap of Lortab and Oxy-IR, the big holes where prescribed meds had not been dispensed, all of it had all been "corrected". How cute.
I helped him brush his teeth morning and evening on the days I was there. If I was away one day, the next day I found food packed between his left jaw and cheek. With his left-side neglect, he was not aware it was there and was not able to remove it with his tongue. It was obvious no one was helping him to brush his teeth when I wasn't there. When I asked the nurses why not, I was told "there wasn't any point", and I was shown the intake form, where under "teeth", it said "missing, broken, decayed ...", all the bad stuff. This was a man who brushed his teeth three times a day, who visited the dentist for cleaning every six months, and was never in there more than 20 minutes. His teeth were perfect.
It took some digging to find out what had happened. An aide explained it. They had our address wrong. Instead of our village, they had a similar-sounding section of NYC - a section by the docks, populated mostly by people who, well, "you don't want to look in their mouths", as the aide said. Because of the wrong address, they had made a bunch of assumptions without ever checking, like that he never brushed his teeth, and wouldn't mind not having had a shower in a month. You can bet I set a few people straight on that!
I asked if we could bring in private nurses (to ensure proper monitoring and medication, and personal care). Dr. Feal3y said no, it wasn't necessary, and would not possibly be approved. I hated him.
This was a multistory building, and Jay was on the third floor (I think). There was only one bank of two elevators, and they were taking people downstairs in wheelchairs for PT/OT all day long. During meal delivery times, three times a day, for like two hours every time, the kitchen staff "locked" one elevator for their exclusive use. Three days a week, Jay had to go to Nalitt for immunotherapy. The ambulette would arrive, and the driver would come up the stairs to get Jay, and, this is not an exaggeration, we often had to wait up to two hours before we could get on the elevator to take him down. It made for a very long and difficult day for Jay.
Having been in a fire, escape routes concern me. I asked how they planned to get residents out if there was a fire, and no one had an answer. There was no coherent plan for getting people out. They'd point to all the fire stairs, but almost all the residents were incapable of handling stairs. I thought it odd that most of the ambulatory people were on the first floor, which made no sense to me.
Our insurance company always wanted and paid for a minimum of three weeks of meds at a clip. The Hellhole doctor would arbitrarily D/C meds, but I never found out what happened to those unused pills. We never got a refund. The nurse's cart had a "chamber" for each person, and when something was stopped, the bottle just disappeared from the chamber. When they were arbitrarily restarted three days later, we had to buy a whole new batch. When Jay was discharged, a new three-week supply of all his meds had just arrived like two days before. I foolishly assumed we would be taking them with us, and then found out that they would allow only a five-day supply to be taken home. This was serious - it takes our little local pharmacy more than a week to dispense Oxycontin and Fragmin, because they had to be specially ordered and required special handling. I freaked. I insisted that either they allow us to take the whole supply, or they refund the moneys paid for them (it was over $800 worth of meds we'd paid for and they refused to allow us to have). I got the insurance company in on it too. I won. We took it all with us.
There are places online where you can get all the state inspection reports on nursing homes, and can see all the complaints and incident reports. It is state law that ALL mistakes in medication MUST be reported. Also, all complaints of thefts and so on must be reported. I had checked these sites before we agreed to the Hellhole, and the Hellhole looked good. During Jay's stay, I filed multiple complaints about medication errors (the wrong stuff, the overlap of Lortab and Oxy-IR, the yellow highlighter causing arbitrary D/Cing) and the theft of his radio. I continued to check the website after we left and for the next year, and, surprise!, there were NO medication errors or thefts reported to the state. Unfortunately, I have no proof. I suspect the Hellhole's paperwork will show no errors, no thefts, and no reports filed.
In early May, when the Hellhole's opthamologist had STILL not made it in to see Jay, after numerous requests and promises, and Jay's eyesight was almost totally gone, I made an outside appointment with an independent othamologist. Believe it or not, the Hellhole staff attempted to prevent me from taking Jay to the appointment. The opthamologist was aghast. The optic nerves (I forget what that point in the back of the eyeball is called) were completely and utterly eroded, to a point past redemption. He said it was due to too much intracranial pressure. No shit, George. Wanna tell Dr. Feal3y that?
I had to get him out of there.
Jay had another round of immunotherapy during late April and early May, I think. At the end of that round, he was to have six weeks or so off before it would restart. I wanted to take him home, where he would get his meds on time, where I could take REAL care of him. We could have a physical therapist come in, and Sunnyview had taught me how to exercise him, lift him. help him. We could do it. But the Hellhole told me that if I took him out before they were ready to discharge him, he could not come back. What was required to discharge him? He had to complete the physical therapy and be certified capable of ... whatever. Duh? The physical therapy you keep stopping? At that point, I told them that I'd seen REAL PT at Sunnyview, and this Hellhole was just playing at it.
So Jay and I talked about it, and I bought the ramp-equiped van, and I brought him home. And we weren't going back. He was completely blind now, and so he couldn't sit comfortably, let alone stand, transfer, walk, feed himself, anything, because he couldn't see his left side to control it. His mind was actually pretty much fine, even with a quarter of his brain gone.
When his "back home" doctors saw his condition, and heard what had gone on in the Hellhole, they wanted Dr. Feal3y reported. They said that at the very least, Dr. Panullo should report him for failing to respond to her phone calls and faxes. Some pressure was put on her, but she was very reluctant. Her assistant told me that Dr. Panullo would have other patients that would need a place to stay while undergoing therapy, and she didn't want the Hellhole to refuse to accept her patients.
Politics.
Looking back, I suspect that a lot of Dr. Feal3y's stupidity was territorial. He didn't like other doctors telling him what Jay's care should be, therefore he had to do it differently just to exercise his power. The understaffing at the Hellhole that led to Jay's not getting his meds on time was purely budgetary. They really didn't care.
At the end of the six week hiatus, it was obvious that Jay would not be able to withstand another round of immunotherapy. We had looked into having it done in Albany, a trip he might be able to handle, but he was too weak.
The Hellhole and Dr. Feal3y had damaged Jay badly. In later MRIs, it seemed that the immunotherapy had been working. But the blinding caused by the poorly controlled edema kept him immobile, which led to physical deterioration, in spite of my exercising him almost constantly. His liver and kidneys were damaged. That's what eventually killed him - organ failure. Not the brain cancer. That, we almost beat.
[Update, 11/13/09. I've decided to tell the name of the hellhole, Clove Lakes Health Care and Rehabilitation Center, in Staten Island, NY, and the names of the a**hole doctors, Fealey and Nadler, because this is all true, and it's a disservice to the world to protect them. We can only hope that the place has improved in the past 8 years, but I seriously doubt it.]
Again, as with the previous entry, I'm putting all this here, in my personal journal, to preserve it from hard disk destruction and floppy deterioration. Don't bother reading it unless you have lots of time and an overwhelming interest in medical sadism.
When it was time for the next cycle of immunotherapy, we moved Jay to a skilled-nursing home in Staten Island, close to the Nalitt Cancer Center. (They described themselves not as a nursing home, however, but as a physical rehabilitation facility.) Because they were out of network, our insurance would pay for his stay there only if he was getting physical therapy (PT). He could also have been admitted to the Staten Island University Hospital, but I had promised Jay he would never have to go there again.
Something I learned later - Medicare and other medical insurers won't pay for ordinary nursing home care except for a short recovery period after a specific incident. Otherwise, only long term care plans will pay. To get around this (and get the money) many nursing homes call themselves rehab centers. They can then take in nursing home candidates, and by offering a piss-poor physical and occupational therapy program to the residents, they can charge a heck of a lot more, and be sure of getting it. Beware of these places. They are cynical, just out for the money. Also beware of places that, as part of the intake process, ask you to sign a DNR form.
The following is our experiences during the first of two months at the Hellhole, from a notebook I kept at the time. I made the 5 hour round trip five or six days a week, arriving to be with Jay about 9 am, and leaving about 9 pm. The other one or two days a week were insurance battles, lining up ambulette transportation to and from the cancer center for Jay's treatments, taking care of the animals, paying bills, doing laundry (the nursing home did not do the residents' laundry) and so on.
I shall not use the name of the place for legal reasons (but the first word is a spice that usually goes well with cinnamon, and the second is a large body of water), and the foul doctor's names have a letter replaced to foil searches. But if anyone comes after me for this, it is all absolutely the truth as I experienced it, and I stand by it. Of course, this was all in 2001, six years ago. One hopes they have improved since then. [Insert cynical snort.]
The worst was the medications. In addition to the screwups documented here, medications were always dispensed late, and at much longer intervals than prescribed. Every three hours or so a nurse - ONE nurse - would set out with the meds cart, to cover the entire floor. Jay was supposed to get certain meds every four hours, but they would arrive three hours late, so they'd just shrug and skip the next dose. This is unforgiveably sloppy when the purpose is to control, for example, intracranial edema.
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- 03/19/01 Monday - Arrival at the Hellhole, apx. 3 PM. List of medications and prescriptions had been sent ahead, including
- Hydrocodone/APAP 10/500 1 to 1 1/2 every four hours or 2 every 6 hours (prescribed by the neurologist),
- Fragmin 5000u 1 every day,
- Dilantin 300mg twice a day,
- Topamax 25mg at bedtime,
- Dexamethasone 4 mg (Decadron) every 8 hours.
- 03/20 Tuesday - I discover that the nurse’s meds list does not include the Hydrocodone, and the Fragmin had been D/C’d (discontinued). Jay had just come off Tamoxifen, which is famous for causing DVT, he needed that Fragmin! Also they don’t plan to use the Teds (pressure stockings). They plan to treat the headache with Tylenol. I explain that the headache is due to a TUMOR!, that he’s had a constant blinding (literally) headache since mid-December, and Tylenol alone just doesn’t do it. The immunotherapy actually creates an infection in his brain. Swelling and pain is expected. There will be pressure on the eyes, ears, brainstem, etc., and increased blood flow. The Hydrocodone will dull the pain, and if you then give 2-3 Tylenol when the hydrocodone starts to wear off in about 4 hours, you can sometimes hold it for another 4 hours. Jay: bad headache, nausea, visual disturbances including vertical double vision and “gray patches”. Evaluated for PT/OT.
- 03/21/01 Wednesday - To Nalitt Institute for white cell collection. He is there from 8 AM until about 3 PM. No meds have been sent with him. Dr. Pannullo suggests an eye patch for the double vision - may help with the nausea and will certainly help him to see better. Jay: headache, dizziness, nausea. Collection doctor finds so much clotting he can’t use the right groin, left side also has clots but he is able to push through them. (And the Hellhole doctor D/C'd the Fragmin!) Back at CL, I insist on Teds (we had brought three pair), and ask nurse to inform Dr. Feal3y about eye patch to help Jay see. Lortab has been prescribed by Dr. Feal3y for headache, instead of Hydrocodone. My pointing out that Lortab contains a lot of acetaminophen, and Jay's been getting too much acetaminophen for someone who's been on heavy chemotherapy for two years, seems to have no effect.
- 03/24 Saturday - Jay: Vomiting and severe headache behind right eye since Wednesday. We can’t seem to get Lortab often enough or soon enough to control it.
- Note - sometime along about here I discover that he is not getting the Decadron consistently. They “D/C” orders by crossing it out with yellow highlighter. It seems the yellow had bled through from D/Cing something on the other side of the page, and depending on who was dispensing the meds, they thought this order had been D/C’d. I point out the problem. (When we left, they were still using the highlighter, and it was still bleeding through.) It's no wonder the edema is increasing.
- 03/26 Monday - I discover that Lortab is dispensed 1 tablet every 6 hours! This is 1/2 to 2/3 the dose he needs, especially given that it lasts on average only 3 1/2 hours. By the time he gets a pill, the headache is too bad for the pill to do much. Also, it’s on request only! When it’s REALLY bad, it doesn’t occur to a lethargic suffering Jay to ask, especially at night. Especially when bedside bell is NEVER answered at night. Especially when they keep putting the bell button on the left, and I keep explaining to the that he can't find it on the left. "Left" does not exist. I ask nurse to ask Dr. Feal3y to increase dose to at least the level prescribed by the neurologist for the hydrocodone. To Nalitt for first infusion of cycle.
- 03/27 Tuesday - Jay: Mental confusion, pain in neck, headache. Meds have NOT been corrected. They “don’t want to overmedicate him.” Dr. Feal3y obviously has no concept of what's going on, and is ignoring the edema. Dr. Panullo has given up on Dr. Feal3y returning calls, and has faxed him a letter. From external appearances, with the weak exception of the eye patch, the letter was also ignored.
- 03/28 Wednesday - Eye patch ordered pending exam by “eye guy” Dr. All3n, who comes to CL once a week. To Nalitt for second infusion. Jay: headache, having some trouble holding head up, but otherwise ok. I discuss headache situation with Dr. Panullo, she says meds must be given every 4 hours to prevent the headache. I ask CL nurse to ask Dr. Feal3y to adjust the meds, based on Jay’s neurosurgeon(Panullo)’s recommendation, that he should call Dr. Panullo if there are any questions.
- 03/30 Friday - Still on Lortab 6 hour PID for headaches. To Nalitt for third infusion. Jay: headaches, badly slumped over in chair, back of head parallel to floor, vomiting, vision is worse, he’s almost blind. Jay’s appearance worries Dr. Hayes, so she reduces dose of IL-2. It was the third infusion that wiped him out last time, and so I am worried that with the weekend coming, the nurses won’t know what to do if he crashes. Dr. Panullo writes three scripts to take to Dr. Feal3y---1. Oxy-IR every four hours for headache (she’s also worried that he’s been taking heavy doses of acetaminophen since Jan, Oxy-IR is oxycodone without acetaminophen), 2. if excessive nausea, lethargy, vomiting, or headache, give a “booster” of 8 mg Decadron, and 3. if excessive etc. increase Decadron to 4 mg every 6 hours. I give them to the nurses and they put them in the book, and I discuss the potential problem and logic with Dr. Szel3s, who is on duty at the Hellhole that afternoon/evening. The nurses ask “what’s excessive?” so I write a page defining "excessive" lethargy, vomiting, etc. which also goes into the book. That evening, I find Jay is still on Lortab every 6 hours, and the Decadron has already been increased, AND they have the booster of Decadron “every day for three days”. I freak, and call Dr. Panullo at home. Several phone calls later between Dr. Szel3s and Dr. Panullo, she and I think it’s all fixed. In the meantime, Jay got nothing for the headache from noon to 7:30 PM. Meg and Nelly came to room apx. 3 PM for PT/OT, they said that he was doing very well at PT/OT and improving. This is amazing - asking him to do PT would be like asking a migraine suffer to dance. The floor nurses have also commented that he is trying to use his left arm a lot more, too. I had noticed he bridges better, and doesn’t dangle the left arm.
- 04/01 Sunday - Still on Lortab every six hours. The Oxy-IR “has not yet arrived from the pharmacy.” Jay: Very bad headaches. Has been throwing up meals for two days (but not excessive - excessive would be several times in a few hours, or just stomach acid, or dry heaves). Very lethargic, but still interested in my reading to him from Scientific American, good commentary from him.
- 04/02 Monday - To Nalitt for fourth infusion. Jay: bad headache, double vision. Dr. Pannullo faxed a request for Oxy-IR to Dr. Feal3y. When we got back to CL, I looked at Meds orders. The order written the previous Friday said “Lortab every six hours PID for 7 days, then reevaluate”. Reevaluate what!?!?!? I freaked again. A nurse told me that Dr. Feal3y didn’t want to go to the Oxy-IR, and didn’t want to go to four hours, because he didn’t want to dope Jay to the point where he couldn’t participate in PT. (Actually, it a wonder he has been able to so far with the screaming headaches he’s had.) Later, at 5 PM, we asked for headache medicine, and got only Tylenol. The nurse told me that the Lortab had been D/C’d, and the Oxy-IR had not yet arrived (they use a pharmacy in Long Island). I said something to the effect of “don’t you think that’s rather stupid?” She called a doctor and got the Lortab back on until the arrival of the Oxy-IR.
- 04/03 Tuesday - Oxy-IR has arrived, to be given every four hours while awake. Jay somewhat confused on phone in AM, but has no pain. In PM, he says someone offered him a Lortab and he refused it. I called nurse, and she said of course not, Lortab is D/C’d now that Oxy-IR is here.
- 04/04 Wednesday - A nurse (Maria?) asked me if Jay should still be getting the Lortab. It had not been D/C’d! They're giving him both Lortab and Oxy-IR! Jay says he refused Lortab again this morning. This may explain his mental confusion yesterday morning. They could have put him into a coma! To Nalitt for fifth infusion. Jay: feels much better, is sitting up well, still some headache but better controlled, still vertical double vision. Dr. Pannullo again suggests eye patch.
- 04/06 Friday - To Nalitt for sixth infusion, last of this cycle. Jay: feeling and looking great. Meg was enthusiastic about his performance in PT, says he did 20 left leg lifts, and was asking “What’s next?” after each exercise. She said he did very well. The Oxy-IR is helping, as we'd predicted.
- 04/07 Saturday - Jay: sounded good on the phone.
- 04/08 Sunday - Jay: pain in right ear, lethargic, couldn’t cooperate with PT. (Hindsight - I should have recognized ear pain as first sign of increasing edema pressure in brain.) Reported ear pain to nurse. Must be bad if it breaks through Oxy-IR. Threw up in evening.
- 04/09 Monday - Dr. Feal3y saw him as usual in AM, but didn’t have an otoscope - said he’d return with one, never did. Jay: pain in ear, mental confusion, lethargic but still responsive, very nauseated.
- 04/10 Tuesday - Saw Dr. Feal3y (for the first time! He'd never before been in the building when I was there) in lobby on way in, told him I was worried that the edema was increasing, “I haven’t seen him yet today”, but Jay has been getting steadily worse since Saturday, it looked very much like pressure to me, it may be time to increase the Decadron. He said no, “we don’t want to overmedicate”. (Doesn’t he see the symptoms? Doesn't he understand the edema?) However, he would order the eye patch, “might help with the nausea”. (Like nausea is the big problem? Like it’s ok that he has been virtually blind, that he can’t tell what his left arm or leg are doing unless he can see them, and he can’t see them with the visual confusion, but people keep asking him to move them in certain ways, but that’s ok? That wasn’t enough reason already?) When I get upstairs, I discover that the eye patch has been ordered since 3/28, but that Dr. All3n still hasn’t seen Jay yet to approve it. (Dr. All3n had been in on 4/7, but did not stop to see Jay.) Jay: almost falling out of the wheelchair, the Ommaya is too hard (definite sign of high intracranial pressure), he is almost unresponsive, vomiting AM and PM. He gets worse as the day goes on, and when I leave, I tell the nurses to have Dr. Feal3y call me from Jay’s room in the morning. I want to point out the symptoms while the example is there in front of him. Frankly, I wonder if he isn’t annoyed at me for insisting on the Oxy-IR, and has decided that Jay is merely “doped up”. I get home at 11:30 PM, and find a telephone message from the nursing supervisor They are very worried about Jay, he is unresponsive, they have consulted the dr on call, and have already given him the decadron booster (only 4 mg, not the 8 mg Dr. Pannullo wanted), have increased the decadron, and if he doesn’t improve during the night, they will send him to the hospital.
- 04/11 Wednesday - Dr. Feal3y doesn’t call from Jay’s room. He calls about noonish, (I am in Jay's room then) after I asked the nurse to remind him. He says Jay has responded to the decadron and is looking better, and has his eye patch. I am very proud that I don’t scream at him. Jay: lethargic, but not like Tuesday, some nausea, but no throwing up, headache.
- 04/12 Thursday - Jay: threw up breakfast and lunch, lethargy, overemotional, mentally more alert, projectile vomit in PM. His 11 AM Dilantin arrived at 1:30 PM today, I’ve noticed that for the past week, that timing of meds seems to be very loose. Also, I worry about his vomiting up meds, they don't do any good if they don't stay down. I also noticed that they give him the decadron on an empty stomach. That alone will cause nausea. (Jay gets excess acid.) Have asked nurses to give cookie or milk with decadron. (They say ok, write it down, but never do it.)
- 04/13 Friday - Jay: nausea in AM, but no throwing up.
- 04/14 Saturday - Jay: holding head up again, looking better, a little nausea, but no throwing up, active and interested, says eyes are working a little better. Effects of the infusions are apparently wearing off, edema decreasing.
- 04/16 Monday - Meeting this morning , supposed to be to discuss “his care”. Attendees were from dietary, recreation, social services, and the nurse supervisor Carrie. Dr. Feal3y was not there, nor was anyone there from PT/OT, until they called in Nelly (OT) at my request. I was shocked to learn that PT had been D/C’d as of the previous Wednesday, 04/11. I was very angry that I had not been informed. I was told that “the team” felt that he had not been participating, and was not progressing. I maintained that if they went back to 04/06 and before, the opinion was different, and that any more recent non-participation was due to inadequate medication. I requested a reevaluation now that he has the proper headache dosing and the edema is under control. The Dietary guy was pleased that Jay, at 222 lbs, had gained 20 lbs. I didn’t mention to him that when the aides had weighed him and got 202, the arm of the scale was resting partly on the bed. He had weighed 240 when I brought him in. Jay: very good today, sitting up straight, eating well, no nausea. I sat in on a bit of his OT, not much to see. Asked if I could attend all future OT sessions, Nelly said OK. The 11 AM Dilantin arrived at 1:45 PM today. This is getting really sloppy!
- 04/17 Tuesday - Caught Dr. Nadl3r (OT/PT) in the hall on the way in and asked him to reevaluate Jay. He was very negative, obviously didn’t want to talk to me, didn’t feel there was any point, that Jay had been making no progress and his participation was very ragged. I said that’s not what his therapists had been saying a week back, that the recent deterioration was a side effect of his immunotherapy. I even asked (begged) if it wasn’t sufficient to go on to keep him from physically deteriorating, prevent atrophy (not my real point - I think Jay will do much better now that there will be a three week break in immunotherapy and win them over), but he responded (and I was shocked!) that “keeping him from deteriorating is not medically indicated.” What does that mean? Jay: very good today, head straight, good appetite, no double vision. In OT, sat up for what seemed like a long time with no support, back slumped when he got tired, balance improved - withstood prods from back, a bit from side, but fell over when prodded from front. Reaches with left hand, but with flailing motion. But at least he’s reaching. That’s a big improvement.
- inadequate medication for his headaches, even after requests from his neurosurgeon, who knew best what he was experiencing
- side effects of the immunotherapy, (edema and associated lethargy) also inadequately and belatedly treated
- inadequately and belatedly treated visual problems which made it difficult for him to see and therefore control his left limbs.
At this point I got super-proactive. I read ALL the nursing notes and charts every morning and evening. I asked more questions. I raised Hell. I became a royal pain, but I made things happen. The "keeping of the journal" suffered. Notes are sparse and usually undated.
I discovered that Jay hadn't had a bowel movement in ten days and no one had done anything about it. The nurses were not aware that rectal stimulation with a brain tumor does not cause the same feedback problems as with spinal injury, and that they cannot use water ememas, it must be oil, but a simple stool softener would do wonders. I tried to educate them, and then just went out and bought the stuff myself. Occasionally I locked the door and removed rocks the old-fashioned way.
He was supposed to get a shower once a week, but for three weeks in a row, the aides had a meeting during Jay's shower time, and he was not rescheduled. I gave him showers myself, a few times a week, late at night when the shower was free.
I discovered what "not medically indicated" meant, as pertained to his PT. His diagnosis had been high-grade oligoastrocytoma, but after the last surgery it had been downgraded to oligodendroglioma, a less virilent tumor. The worst is a glioblastoma multiforme (GBM). I had, right from the beginning, asked all his doctors if the astrocytic component could be GBM, and they always said no, that the cells didn't have the characteristic look. Which is good, because the prognosis for GBM with Jay's history of recurrance is extremely bad. Well, under "diagnosis" in his charts, someone had at some point changed it to GBM!, apparently without having consulted any of the doctors who mattered. The "indication" for PT is a possibility of going home and living. GBM says not expected to live. And that's the REAL reason the PT was stopped.
I attempted to get a copy of that page. Copies were something like $1 per page (an obvious attempt to discourage copying), and you were not allowed to make the copies yourself. An "order" had to be placed. I bit the bullet and ordered copies of like 50 pages, which were not delivered to me for more than a week. And when the copies arrived, all the bad stuff in there, like the misdiagnosis, the lack of bowel movements, the overlap of Lortab and Oxy-IR, the big holes where prescribed meds had not been dispensed, all of it had all been "corrected". How cute.
I helped him brush his teeth morning and evening on the days I was there. If I was away one day, the next day I found food packed between his left jaw and cheek. With his left-side neglect, he was not aware it was there and was not able to remove it with his tongue. It was obvious no one was helping him to brush his teeth when I wasn't there. When I asked the nurses why not, I was told "there wasn't any point", and I was shown the intake form, where under "teeth", it said "missing, broken, decayed ...", all the bad stuff. This was a man who brushed his teeth three times a day, who visited the dentist for cleaning every six months, and was never in there more than 20 minutes. His teeth were perfect.
It took some digging to find out what had happened. An aide explained it. They had our address wrong. Instead of our village, they had a similar-sounding section of NYC - a section by the docks, populated mostly by people who, well, "you don't want to look in their mouths", as the aide said. Because of the wrong address, they had made a bunch of assumptions without ever checking, like that he never brushed his teeth, and wouldn't mind not having had a shower in a month. You can bet I set a few people straight on that!
I asked if we could bring in private nurses (to ensure proper monitoring and medication, and personal care). Dr. Feal3y said no, it wasn't necessary, and would not possibly be approved. I hated him.
This was a multistory building, and Jay was on the third floor (I think). There was only one bank of two elevators, and they were taking people downstairs in wheelchairs for PT/OT all day long. During meal delivery times, three times a day, for like two hours every time, the kitchen staff "locked" one elevator for their exclusive use. Three days a week, Jay had to go to Nalitt for immunotherapy. The ambulette would arrive, and the driver would come up the stairs to get Jay, and, this is not an exaggeration, we often had to wait up to two hours before we could get on the elevator to take him down. It made for a very long and difficult day for Jay.
Having been in a fire, escape routes concern me. I asked how they planned to get residents out if there was a fire, and no one had an answer. There was no coherent plan for getting people out. They'd point to all the fire stairs, but almost all the residents were incapable of handling stairs. I thought it odd that most of the ambulatory people were on the first floor, which made no sense to me.
Our insurance company always wanted and paid for a minimum of three weeks of meds at a clip. The Hellhole doctor would arbitrarily D/C meds, but I never found out what happened to those unused pills. We never got a refund. The nurse's cart had a "chamber" for each person, and when something was stopped, the bottle just disappeared from the chamber. When they were arbitrarily restarted three days later, we had to buy a whole new batch. When Jay was discharged, a new three-week supply of all his meds had just arrived like two days before. I foolishly assumed we would be taking them with us, and then found out that they would allow only a five-day supply to be taken home. This was serious - it takes our little local pharmacy more than a week to dispense Oxycontin and Fragmin, because they had to be specially ordered and required special handling. I freaked. I insisted that either they allow us to take the whole supply, or they refund the moneys paid for them (it was over $800 worth of meds we'd paid for and they refused to allow us to have). I got the insurance company in on it too. I won. We took it all with us.
There are places online where you can get all the state inspection reports on nursing homes, and can see all the complaints and incident reports. It is state law that ALL mistakes in medication MUST be reported. Also, all complaints of thefts and so on must be reported. I had checked these sites before we agreed to the Hellhole, and the Hellhole looked good. During Jay's stay, I filed multiple complaints about medication errors (the wrong stuff, the overlap of Lortab and Oxy-IR, the yellow highlighter causing arbitrary D/Cing) and the theft of his radio. I continued to check the website after we left and for the next year, and, surprise!, there were NO medication errors or thefts reported to the state. Unfortunately, I have no proof. I suspect the Hellhole's paperwork will show no errors, no thefts, and no reports filed.
In early May, when the Hellhole's opthamologist had STILL not made it in to see Jay, after numerous requests and promises, and Jay's eyesight was almost totally gone, I made an outside appointment with an independent othamologist. Believe it or not, the Hellhole staff attempted to prevent me from taking Jay to the appointment. The opthamologist was aghast. The optic nerves (I forget what that point in the back of the eyeball is called) were completely and utterly eroded, to a point past redemption. He said it was due to too much intracranial pressure. No shit, George. Wanna tell Dr. Feal3y that?
I had to get him out of there.
Jay had another round of immunotherapy during late April and early May, I think. At the end of that round, he was to have six weeks or so off before it would restart. I wanted to take him home, where he would get his meds on time, where I could take REAL care of him. We could have a physical therapist come in, and Sunnyview had taught me how to exercise him, lift him. help him. We could do it. But the Hellhole told me that if I took him out before they were ready to discharge him, he could not come back. What was required to discharge him? He had to complete the physical therapy and be certified capable of ... whatever. Duh? The physical therapy you keep stopping? At that point, I told them that I'd seen REAL PT at Sunnyview, and this Hellhole was just playing at it.
So Jay and I talked about it, and I bought the ramp-equiped van, and I brought him home. And we weren't going back. He was completely blind now, and so he couldn't sit comfortably, let alone stand, transfer, walk, feed himself, anything, because he couldn't see his left side to control it. His mind was actually pretty much fine, even with a quarter of his brain gone.
When his "back home" doctors saw his condition, and heard what had gone on in the Hellhole, they wanted Dr. Feal3y reported. They said that at the very least, Dr. Panullo should report him for failing to respond to her phone calls and faxes. Some pressure was put on her, but she was very reluctant. Her assistant told me that Dr. Panullo would have other patients that would need a place to stay while undergoing therapy, and she didn't want the Hellhole to refuse to accept her patients.
Politics.
Looking back, I suspect that a lot of Dr. Feal3y's stupidity was territorial. He didn't like other doctors telling him what Jay's care should be, therefore he had to do it differently just to exercise his power. The understaffing at the Hellhole that led to Jay's not getting his meds on time was purely budgetary. They really didn't care.
At the end of the six week hiatus, it was obvious that Jay would not be able to withstand another round of immunotherapy. We had looked into having it done in Albany, a trip he might be able to handle, but he was too weak.
The Hellhole and Dr. Feal3y had damaged Jay badly. In later MRIs, it seemed that the immunotherapy had been working. But the blinding caused by the poorly controlled edema kept him immobile, which led to physical deterioration, in spite of my exercising him almost constantly. His liver and kidneys were damaged. That's what eventually killed him - organ failure. Not the brain cancer. That, we almost beat.
Wednesday, November 08, 2006
967 More Things I Don't Understand
Wednesday, November 8, 2006
Bath Towels
The Orlando hotel I stayed in had big thick fluffy soft towels.
I don't understand why people think big thick fluffy soft towels are best - the bigger, the thicker, the softer, the better?
Smaller towels are easier to use, to handle. Thinner towels actually dry your skin better. Too thick and fluffy doesn't get into the crevices so well. Soft is nice, but not-so-soft leaves your skin feeling cleaner, like it's been burnished.
So what's the fuss over big thick fluffy towels? Is it all just show? Give me a small thin towel, followed by a big thick fluffy soft robe, and I'm happy.
Name Pronunciation
I'd always been told that you are allowed to pronounce your own name any way you want, and you can insist that others pronounce it your way. You can spell it "Smith" and pronounce it "Jones" if you want. (But you shouldn't be surprised if others think you're crazy.) I can understand that, within reason. It's YOUR name.
I don't understand why a public figure would insist bucking the current. If you are a public figure, such that most of the people who come into contact with your name are not personal acquaintances who have the opportunity to learn your preference, and especially if your name is a common name, then it seems like you should bow to the common pronunciation, at least with your public. What's got me going is a newswoman named Bang-Jensen, who wants it pronounced "Bong-Yensen", as in Denmark.
Yes, "Bong-Yensen" is technically ancestrally "correct", but the average Joe America on the street already has a pronunciation for "bang" and for "Jensen", and that ain't it. Why disconcert people?
Car Insurance
Lets say you have one car, and you have two drivers. You drive the car 1000 miles a month. The insurance company's risk of a claim is x. Your insurance premiums are, say, $1000 a year. Then you buy a second car (of approximately the same value) and put it on the same policy. Your premiums go to, say, $1500 a year.
I can understand this, because with two drivers, it is probable that the total per month mileage will go up, and it's possible that both cars will be on the road at the same time, and therefore the risk of a claim goes up, possibly even doubles.
I don't understand why if I am one driver only, and I buy a second car and put it on the policy, the premiums go up by about the same amount as with two drivers. This makes no sense to me.
The mileage won't go up, both cars will not be on the road at the same time, and the risk of a claim will not go up. Everything actually stays the same. Do they really think I can drive two cars at once? So why should the premiums go up?
I think I'll call my insurance company and ask. Especially since the second car I just put on the policy is worth half as much as the minivan. The risk has not gone up, but the amount of possible collision claims has gone down. They should REDUCE my premiums!
Phase/Faze
I don't understand why no one uses "faze" anymore. Instead, they misuse "phase".
"Phase" is a noun. It means a period or stage in a chain of events.
"Faze" is a verb. It means to disconcert or upset.
I was reading an 18-page glossy brochure in the auto service garage this morning (oh, yeah, the minivan's power steering is now fixed) on how to set up and run a de-icing operation adjunct to your winter plowing business. It went into what chemicals to use, when and how, how to generate customers, how to figure costs, and so on. I was very impressed with it until I got to the penultimate paragraph, where it said "... but don't let that phase you", and the whole effect was ruined.
Faze, folks! Faze!
[Later edit] While we're on the topic. "peek", "peak", and "pique" do NOT all mean the same thing. Your interest is "piqued". "Site", "cite", and "sight" are not the same word. "Lose" and "loose" are even pronounced differently, and they don't have the same meaning. Sheesh.
I went to school in the days when you got an automatic "F" if you confused homonyms, especially "to" and "too", in any paper. Don't people learn stuff like this in elementary school anymore? I blame the teachers more than the students. You won't know something you've never had the opportunity to learn.
Bath Towels
The Orlando hotel I stayed in had big thick fluffy soft towels.
I don't understand why people think big thick fluffy soft towels are best - the bigger, the thicker, the softer, the better?
Smaller towels are easier to use, to handle. Thinner towels actually dry your skin better. Too thick and fluffy doesn't get into the crevices so well. Soft is nice, but not-so-soft leaves your skin feeling cleaner, like it's been burnished.
So what's the fuss over big thick fluffy towels? Is it all just show? Give me a small thin towel, followed by a big thick fluffy soft robe, and I'm happy.
Name Pronunciation
I'd always been told that you are allowed to pronounce your own name any way you want, and you can insist that others pronounce it your way. You can spell it "Smith" and pronounce it "Jones" if you want. (But you shouldn't be surprised if others think you're crazy.) I can understand that, within reason. It's YOUR name.
I don't understand why a public figure would insist bucking the current. If you are a public figure, such that most of the people who come into contact with your name are not personal acquaintances who have the opportunity to learn your preference, and especially if your name is a common name, then it seems like you should bow to the common pronunciation, at least with your public. What's got me going is a newswoman named Bang-Jensen, who wants it pronounced "Bong-Yensen", as in Denmark.
Yes, "Bong-Yensen" is technically ancestrally "correct", but the average Joe America on the street already has a pronunciation for "bang" and for "Jensen", and that ain't it. Why disconcert people?
Car Insurance
Lets say you have one car, and you have two drivers. You drive the car 1000 miles a month. The insurance company's risk of a claim is x. Your insurance premiums are, say, $1000 a year. Then you buy a second car (of approximately the same value) and put it on the same policy. Your premiums go to, say, $1500 a year.
I can understand this, because with two drivers, it is probable that the total per month mileage will go up, and it's possible that both cars will be on the road at the same time, and therefore the risk of a claim goes up, possibly even doubles.
I don't understand why if I am one driver only, and I buy a second car and put it on the policy, the premiums go up by about the same amount as with two drivers. This makes no sense to me.
The mileage won't go up, both cars will not be on the road at the same time, and the risk of a claim will not go up. Everything actually stays the same. Do they really think I can drive two cars at once? So why should the premiums go up?
I think I'll call my insurance company and ask. Especially since the second car I just put on the policy is worth half as much as the minivan. The risk has not gone up, but the amount of possible collision claims has gone down. They should REDUCE my premiums!
Phase/Faze
I don't understand why no one uses "faze" anymore. Instead, they misuse "phase".
"Phase" is a noun. It means a period or stage in a chain of events.
"Faze" is a verb. It means to disconcert or upset.
I was reading an 18-page glossy brochure in the auto service garage this morning (oh, yeah, the minivan's power steering is now fixed) on how to set up and run a de-icing operation adjunct to your winter plowing business. It went into what chemicals to use, when and how, how to generate customers, how to figure costs, and so on. I was very impressed with it until I got to the penultimate paragraph, where it said "... but don't let that phase you", and the whole effect was ruined.
Faze, folks! Faze!
[Later edit] While we're on the topic. "peek", "peak", and "pique" do NOT all mean the same thing. Your interest is "piqued". "Site", "cite", and "sight" are not the same word. "Lose" and "loose" are even pronounced differently, and they don't have the same meaning. Sheesh.
I went to school in the days when you got an automatic "F" if you confused homonyms, especially "to" and "too", in any paper. Don't people learn stuff like this in elementary school anymore? I blame the teachers more than the students. You won't know something you've never had the opportunity to learn.
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