Friday, June 11, 2010

Insurance Insanity

You cannot see me, but I'm plucking my lips making a babbling sound. I had another round of the "yes you do, no you don't" game.

I didn't write about this before, but this isn't the first time I've played this game. I'm laughing my head off, so thought maybe you would enjoy the round of this game I played today.

Last Wed the Medical Oncologist ordered two tests, they were scheduled for Monday morning, 1/2 hour apart from one another in two separate buildings across the street from one another at the same medical center. One a CT scan is considered a radiological test, the other a MUGA scan (at first I thought I was going to have another mugging...(mammogram) but no, this one is a scan for the heart) is considered a nuclear medicine test...I think. Anyway, they are both going to be performed by diagnostic imaging. My DH, being the forward thinking man that he is (when it comes to dollars) wanted to make sure the insurance was going to cover everything...so he called the insurance company. They wouldn't give him any information because the test was for me, privacy act and all that, but they did say "hypothetically" that they would cover the CT scan with only the doctor's orders, but I would need pre-approval for the MUGA. DH called me. I then called my buddy who handles referrals at our local clinic where our primary care physician (PCP) is. My PCP only works Tuesdays and Thursdays so she would be NO help with a referral as I would have to go in for the tests before her next working day. My buddy has helped me in the past and since the appointments are EARLY Monday morning, I knew we wouldn't have much time if I did need a referral. She didn't answer her phone, so I left a message then called the insurance company. Now mind you, it's 3:30 on Friday afternoon. The clinic closes at 5:00.

The insurance company had one of those automated menus and I listened and punched numbers through 5 (yes 5!!) different menus before I got a lady who told me I had reached the wrong department, gave me the number for the person I needed to talk to and then forwarded the call. That lady was very nice, looked in her files for me, I have my own e-file in the insurance company computer/ether. Told me I didn't have authorization yet, but that I didn't need it beforehand, and I would have 90 days to file any necessary forms if I went ahead with the tests before I had approval. Hm....doesn't sound right, but hey, that sounds easy. I'll take her word for it! I thanked her and got off the phone.

Before I could walk away from the phone, it rang. It was my buddy at the clinic. She asked me about the tests, told me one would have automatically been pre-approved, but the other would need pre-approval or I would be responsible for payment, and looking in HER computer, it was an expensive test. She told me SHE would call the insurance company and call me back. I thanked her and got off the phone.

Before I could walk away, the phone rang again. It was DH asking what I had learned. So I told him of the conflicting report. He told me to call the medical oncologist office and ask them to request pre-approval. So, I got off the phone with him and called them. I got an automated voice message that asked me to leave a message and they would get back to me. By now it was 3:45.

Before I could walk away, the phone rang and it was my buddy at the clinic again. She asked if I had a copy of the doctor's orders. I did!! She said she would fax it in and get pre-approval because she had called the insurance company and they definitely needed pre-approval. She had then called the medical oncologist to request a copy of the doctor's orders but she got an automated message to leave a message and they would get back to her. She didn't want to wait, because it was getting late, so wanted me to drive over and give her a copy of the doctor's orders...only problem is, I'm not supposed to drive. I told her I would call DH and I would call her back.

I called DH, he said he would leave work early, come and get the orders, take it to the clinic and let my buddy fax it in but while I was talking to him, the call waiting beeped, it was the medical oncologist office. They wanted more information about what I was asking about. I told them what they wanted to know, they told me they would call me back. I thanked them and got off the phone.

Before I could walk away from the phone, my buddy from the clinic called, said she had talked to the medical oncologist and they had told her THEY had contacted insurance and I no pre-approval was needed for either test but she was sure that was wrong, then she said she had an idea could she put me on hold. I said yes, but as soon as she put me on hold, the call waiting beeped and it was the medical oncologist office. I debated whether to answer or not, I would lose the connection with my buddy...but decided to see what the other office wanted. They again told me no pre-approval was needed, that they had told my buddy the same thing. I thanked them and got off the phone.

Before I could walk away, the phone rang again, it was my buddy at the clinic who had found a doctor to write a referral (which is in essence a pre-approval) for the procedure we were questioning and she had already faxed it into the insurance company. Bases covered!! It doesn't matter who was right about needing pre-approval, I have it now and so I'm set to go. Whew!! A few minutes later poor DH, who had probably driven like a bat out of H E double hockey sticks to get home in time to pick up the doctors orders to hand carry them to the clinic, arrived. He took the orders and drove over to the clinic and picked up the referral. DONE!! He walked through the door at 5:00, just as all the offices were closing. Talk about a close call. That's 90 minutes of my life I'll never get back...LOL I'm going to have to send my buddy a thank you card and flowers, don't you think? What would I do without her?

The scary thing is, I've been getting statements on a regular basis from the insurance company about how much they'll pay for each procedure...but today I got a bill from my medical center for the procedure (the biopsies) on March 29th (nearly 90 days later...remember the cut off date for submitting claims after the fact???) that they claim the insurance company hasn't paid. It was for over $1100.00!!!!! The offices are closed until Monday morning *sigh* I wonder what kind of phone tag I'll be playing Monday over this?!?! I'm afraid after the tests Monday I'll be reduced to a babbling idiot again. Oh well, it's FRIDAY...I can't do anything about it until after the weekend...so I'm going to take a few Valiums and kick back and pluck my lips in a babbling manner until then. Life is good! LOL!!

Wednesday, June 9, 2010

Drainless!!

Yes, I said Drainless, not brainless...LOL

I had the last of my remaining drains pulled today. Ahhhhhh... Can you hear the relief? How do you spell relief? For me, it's D-R-A-I-N-L-E-S-S!! That means tomorrow I can take a long, warm, luxurious shower...I'll have one week of heavenly showers until the next surgery. I plan on staying in there a long, LONG, L-O-N-G time!!! No more weird sensations under my skin, no more emptying these silly things twice a day (I'm sure my live-in nurse, DH, is happy about this too!!), no more cleaning around the entry site, no more bandages under my clothing, no more sponge baths!!! Amazing what a little thing like taking a shower means when you've been without one for two full weeks!! *Doing the happy dance*!!

I visited my Plastic Surgeon today, he pulled the two remaining drains, then TRIED to set up an appointment next week to start filling the tissue expanders....and then I told him about my next surgery. I guess he hadn't gotten the pathology report, and I think he was as shocked as everyone else was, that they had found cancer in the sentinel nodes, three of the five removed had metastatic cancer cells. *sigh* So....he postponed that appointment for three weeks.

DH and I then went for a heavenly lunch at the Cheesecake Factory. Am I spoiled or what? I was sooooo good, I had the soup and salad lunch....and then I was sooooooooo bad, I had the Kaluah cocoa coffee cheesecake! Well I was partially good, I scraped off all the whipped cream LOL That counts for something doesn't it? Oh it was sinfully good!!!

Next we toddled around the Westfield Mall until it was time for the Medical Oncologist appointment, and then my day got really interesting. *HEAVY SIGH* I learned that because the cancer had spread to the sentinel nodes that not only would I have to have chemotherapy....and THEN radiation....I would have to have hormone therapy for possibly 10 years. 10 years...that keeps echoing around in my head. That's not 10 years from this moment, it's 10 years from the time radiation ends. Radiation doesn't begin until chemotherapy ends. *pregnant pause* What began as a simple operation and a few cosmetic perks, has turned into a marathon session that I wasn't expecting. Each day brings a few more months and now a few more years to the treatment process. All I can say is this... The Lord does not give you more than you can handle, and He knew that I would not be able to handle all this news at the very beginning. He has been giving me little bits here and there, giving me moments to catch my breath and internalize each bit of information. He's been holding my hand, helping me to catch my breath, and walking me through this whole process. Whether I make it to the end of all this with my mind and what's left of my body intact or not, I feel well cared for and loved by my Master. Am I scared? You bet! Who wouldn't be?!?! Am I ready to fight? Absolutely! Can I sleep tonight with all this rattling around in my head? Absolutely NOT! LOL Ah well, tomorrow is another day. I'm having an appointment with the home health nurse at 11 and then a friend is coming over to cross stitch at 12. I'm blessed with good friends!

I came home again today to find flowers at my doorstep...LOL I laugh because I've only received flowers a few times in my lifetime, and I think I've had more flowers in the past couple of months than I have had in the previous 49 years! Thank you Peggy and Bob, they are absolutely gorgeous! Pink and Purple, two of my favorite colors! It's been amazing how they've been scattered at such a rate, that as soon as one bouquet has to be removed, another one takes it's place! Just knowing I have all these people praying for me and supporting me is helping me to keep things in prospective and to keep moving confidently forward to face whatever needs facing at the moment. I'm truly blessed!! Thank you all so very much!

Off to see if I can catch some zzzz's. I have to be up early to take my shower before DH leaves for work (and he leaves VERY early in the morning). Wish me luck in the sleep department! LOL Good night! *Hugs*

Saturday, June 5, 2010

Standing Ovations

Tired of me yet? LOL

Well I have a few things to share about! I went out last night to what our church calls Ovations. It was a "black tie" affair, or is supposed to be compared to the Academy Awards. What fun! Everyone was supposed to get dressed up like they do for the Oscars. There was a carpet trip, a place to have our pictures taken, and an award ceremony like no other. This was a "Thank you" to all the children's workers in the church. Both DH and DS work with the kids at the church week after week and for a week during the summer for VBS. I'm proud to tell you that my son won an award for Upstreet Student Volunteer. And here's his golden statue to prove it! He loves working with the kids, and has been helping for a few years now. This was his first time "awarded" for his efforts. What a moment!! I can't tell you how proud I am of my son!! I know I complain about his teenage "attitude", but where the rubber meets the road, he's really a good kid, and it is humbling and sweet to have others tell me that. I keep praying that he'll always stay this way.

Can I just share, that a woman that helps with getting materials ready for my husbands classes came up to me last night and expressed how nice it was to see me there, only a week after I got home from the hospital. She said I was an inspiration and it meant a lot to those who had been praying to see me there. I was hoping no one would notice me, I wasn't dressed up like the others, and let's just say, I don't fill out my clothes the way I once did. She said if she hadn't known the type of surgery I'd had, she would never have known. I always wished I'd been the type of person that knew the right thing to say at the right moment. I can't tell you how much her words meant to me. I hope someday I can acquire that gift, because her few words lifted my spirits in ways I can't express in words. DH looked at her and said, "Doesn't she look good?" That felt great too!!

How did I get so lucky? DH has been a rock through this whole thing, and if you think I have a good attitude, it's because he's been behind me all the way with humor and comfort.

I love this time of year. My backyard explodes with color! I have a row of roses in my back yard. They have the longest thorns of any plant I've ever seen, but when they bloom, they knock my socks off. Here are a few pictures of the blooms exploding in my back yard. I wish there were smell-o-vision because they smell as pretty as they look. The day after I got home DH filled three vases with these roses and placed them throughout the house. Our whole house smelled soooooo good!


Ok, back to bed for me, last night wiped me out, that is if Thomas left room for me!

Hope you are having a great weekend!
*Hugs*

Friday, June 4, 2010

T-shirt of the year award!

Hi! You're probably sick of all the posts today but I promise this will be the last, I have to get off this silly machine and get something productive done.

One of the ladies in the Breast Cancer Support Group meetings that I attend on the first Wed. of the month just sent me this e-mail with this adorable picture and I just had to share. I burst out laughing when I saw it, and hopefully it will make you giggle too!!


On a down note...just to let you know, the pathology report came back and they've found cancer in a few of the sentinel nodes they checked. So....more surgery in the future. I have a date of June 16th.

Now, I don't want you feeling badly for me, it's just one more step in the process. To be honest, I was ready for this announcement. I was hoping they wouldn't find anything, but I'm ready for this and it's just going to be another notch on my belt. When I was being prepped for surgery and they were asking me this and that about illnesses and things, I haven't had anything really seriously wrong in my entire life. The only other surgery I've ever had was a dental implant and the only medication I take on a regular basis is a vitamin B-12 shot once a month for pernicious anemia. I'm healthy as a horse otherwise and they kept telling me how rare I was...but we knew that all along didn't we? LOL!!! So, I know that I'm not in this alone, God is holding my hand every step of the way. All I'm worried about is that I forget to glorify Him and thank Him on every step of this journey. Thanks again for those of you who have been praying. I'll keep you posted!

*Hugs*

Silly cat...tricks are for kids!

I've introduced you to Thomas before. Well, Thomas likes to sleep...

And sleep....

And sleep!!

The picture above reminds me of the scene in ET where ET is hiding in the closet amongst all the stuffed animals...can you see him amongst the pile of junk in DS's room? He'd be mortified if he knew this picture of his room was online *snicker* Maybe it will be incentive for him to CLEAN HIS ROOM!!! LOL

Thomas will find the most interesting places to lay his silly head, but he tends to like this one box in particular. It's the strangest thing how one moment he'll be laying this way...


And the next...

This way!

Sometimes it's hard to tell where his nose begins and his tail ends LOL

*Shaking head* He's a male, what more can I say? They can sleep in the most unusual positions and fall asleep at the drop of a hat. *sigh* I'm quite jealous actually! LOL

*Hugs*

Show and tell...

Hi, it's me again! Time for a little show and tell.

I mentioned last time that Bab's sent me a HUGE care package, so I'd like to show you exactly what she sent. Bab's you spoiled me!! I can't thank you enough for all the lovely gifts.

I've also been getting some of the most beautiful flowers! I LOVE flowers!! So here are a few that have made it to my door. The first is from my Mom, Sister and Brother-in-law. These I'll be able to add to my rose garden in my back yard...or maybe I'll just let them grow indoors...I'm not sure but they are loaded with buds (you can't really see them in this picture) so it will be beautiful in a few days when they all start blooming! Thanks you guys!!

The second is a bouquet that arrived the day I got home from the hospital. These are from a college buddy from days gone by. She's having her own troubles right now and she took the time and thought into sending these. It was a hug bouquet with purple roses (my favorite color is purple!) Thanks Chris!!

Last is a planter from my jury duty pal (I'll call her M). Now M and I served on jury duty a few years ago and from the first day we became pals. I can't explain how we happened to get to know one another, but she had me from hello! The reason I say that is because she is originally from Belgium and has the most exquisite accent. I could sit and listen to her talk all day. Not only that, but she has traveled around the world just as I have because of her husband's job and so we had so many shared experiences that we "clicked" from the moment we began talking. AND!! The best thing about M is that she has a wicked sense of humor. M seems like this shy unassuming perfect lady, but she has this underlying wicked side to her and it comes out at the most unexpected times. We always have a good time when we get together. Thanks for the lovely planter M but thank you more for the lovely afternoon we had together! (she showed up with chocolates and a WONDERFUL strawberry cake too!!)


I think I mentioned a while ago that Mouse sent me a card. I've had so many comments on this card that I thought I would post a picture of it here. I have it sitting on my dining room table and everyone that comes in sees it. It's just too cute for words!!

Lastly, is the UFO I worked on a little bit last night. I was enrolled in a SAL last year with the Wienhenburg sampler group. I fell a little behind while my Dad was ill last year and I've been having this UFO circling my stitching chair for ages. So it has become my new UFO to work on Thursdays with the Friendly Stitchers group. I'm getting there, but to be honest, there were something like 36 pages and I'm struggling in the mid 20's somewhere. My goal is to finish this year. Here's my progress so far. If you click on it, it will enlarge the picture if you want a better look.

That's it for this post. I'm going to add another to talk about my silly cat.
*Hugs*

Thursday, June 3, 2010

Mid week memories...

I guess it's time I checked in with you folks! Sorry I've been quiet for so long, it's been a hectic week as you can imagine!!

First, let me say, surgery went very well, I think. I'm not really sure, because I had the best sleep I've had in ages! I was in the recovery room twice as long as expected, but I woke up feeling a little groggy but so rested! I really needed that sleep!! Every health professional that has seen me has said I've been doing remarkably well, I'm not sure if they are just being nice or they really mean it. I have to say I have much more use of my arms than I expected and yes cross stitch fans out there I have been stitching since Monday!! You can't keep a good cross stitcher down!! LOL

The hospital I stayed in was AWESOME! The nurses were fantastic, the food was great (did I really write that about hospital food???), the bed they had me sleeping in was so comfortable I almost asked them if I could take it home with me. I've never felt anything so comfortable, and throughout the night (while I slept in ONE position, I don't think I moved a muscle all night) the bed kept moving underneath me to relieve any pressure points. I HAD to sleep on my back, and usually that bothers the small of my back, but this bed adjusted underneath me at intervals to help prevent me from having to move. It was great!

Those of you unfamiliar with this type of surgery may not know that they insert drains to help drain away fluids that accumulate under the skin while your body attempts to heal. I had 4 drains until my first visit with the plastic surgeon last Wed when he removed two of them. What a relief to have them gone!! He promised the other two would be removed next Wed. They always seem to be in the way so I'll be happy to have them removed. They require quite a bit of care and I'm sure my live-in nurse (DH) will be happy to see them go!! Though I must say, he has my drainage system working like clockwork. When I think of all the things he's had to help me through over the years, and I'm sure this ranks up there with the yuckiest of jobs, he's been the most courageous of the two of us. His kindness, compassion, strength and whacky sense of humor has helped me in ways unimaginable. Thanks Honey!! I couldn't have done any of this without you!!

Yesterday was one of the best days so far in my recovery. I've had folks stopping by with "drive by drop offs" of food and supplies. Thanks Sonya for being my stash enhancer supplier. She works at my LNS and has been supplying my fix by hand delivering the stash she knows I HAVE to HAVE! I've had some flowers delivered (Thanks Chris, Mom, Donna and Joe) and when I get a chance I'll post pictures. Babs sent me the most beautiful pin pillow with the saying "This too shall pass". You may not know this Babs, but I have a habit of saying that myself. It was the perfect phrase and in the most beautiful colors. Your stitching is AMAZING! I placed it in my china cabinet to keep it clean, but also in a place where I'll see it often during the day to remind me that this journey I'm on is only temporary and one day this will all be behind me! She also sent along a limited edition Lizzie Kate scissor fob kit, some note cards, and such an encouraging card. You really made my day, Babs! My coworker from work showed up with a bag full of up-beat romantic and hilariously funny videos. So between visits from my home health nurse, and the support group meeting last night, Christina and I sat on my bed and laughed til we hurt over nonsense and inside jokes about work. I think that had to be some of the best "medicine" I've received so far in my recovery. Then Sonya showed up with even MORE stash, but also sad news that she had to put her beloved Sophie to sleep that morning. Sophie her feline fur baby had been a big part of her family for 20 years and she's been slowly slipping away for a little while now. I know she's going to leave a huge hole in your heart, Sonya, just know I'm praying for you and thinking of you constantly. I can't believe, after the day you had, that you would still come to take me to the support group meeting...you are my rock!!

The support group meeting last night was one of the best so far. I wish all of you could meet these phenomenal women. I am awed by their courage and encouraged by their progress. Everyone is in a different stage of their recovery, and I've seen them at their worst, and I've seen them improve and looking great. I can't begin to tell you how encouraging it is to see them come to the group meeting no matter how they are feeling or looking (some of them sport some really interesting head gear and I find myself wondering where they find them because I'm thinking of picking up a few LOL) and I know as I look around the room at these courageous ladies that I can DO this, I CAN overcome this and I'm going to come out the other side with experiences that will change how I view the world. Is it ok to thank God for cancer? I mean I don't believe he zapped me on purpose, but I do believe he is allowing this experience to change who I'm going to be when this is over. I also know He hasn't left my side since all of this began so Thank you God! In all of this, I hope my actions will glorify You!

I have more news as I heard the pathology report yesterday. I don't know what everything means yet, so will wait until I do to post more about that. I have an appointment today and once I talk to my family, I'll fill you in on the rest. Thanks for "listening" to me and I hope this encourages you to face whatever you are facing today. This too shall pass!

*Hugs*