We are all capable or more than we realize. I fought for my own survival, and so can you. Everyone has a piece of the puzzle. Blogging makes mine ours. Joy is possible even in dire circumstances. You're welcome to travel down the the road with me a piece.

Monday, November 29, 2010

I couldn't walk

I was scared by the time I got to see a Doctor for the first time in my sober adult life. Not about my blood pressure, or my (now back to normal) vision, but my feet. My earliest memories are of my feet hurting. Now there were bricks where my feet had been, I could not bend my toes or rotate my ankles. I barley walked in baby steps. Unable to step off a curb unaided I scanned for poles and posts. Uneven pavement caused me to see stars several times daily.
I had seen my share of discrimination: taunted, tormented, denied, hounded and hunted; "marginalized" they call it. This word sucks. Even so, I thought health care would be like a television show; sexy , brilliant professionals that care. I was in for a rough ride.
Right away I was told some bad news and offered a bag of pills and a wheel chair. I didn't want to risk getting high, or getting in the wheelchair (something I had always joked about "looking forward to"). I left with a non-narcotic pain reliever and a cane. I felt like a I had missed a bullet getting out of there without Vicondin or Oxy.
That bad news was: the Doctor didn't know what was wrong with me. The good news was there would be some tests! Lots of 'em.

Saturday, November 27, 2010

Therapy

I had health insurance. My advocate had done his job and was free of me. I could now call the customer service number on the card like everyone else. Membership has it's privileges.
Calling to get an appointment with a Doctor was a hassle,but not the Byzantium of getting coverage.There was a primary care physician in my neighborhood accepting new patients. By Autumn, I could meet her. I knew I needed referrals for an eye exam and therapy. I couldn't shake the nagging suspicion that I'd be better off dead.
I was having trouble with my joints too, real trouble this time. Not the mid-range trouble I had treated with fistfuls of ibuprofen and vodka before I got sober, but meter in the red troubling trouble. I couldn't walk right or eat with utensils.
Wanting to kill myself seemed more urgent somehow, so I tried to get a mental health referral from MGH before meeting my Dr. This was slow going,and I was ticking.And afraid to in through the Emergency Room.
Suddenly after a long time I noticed I could call my insurance company for a mental health referral. Civilization!
This was another rare instance of things working the way they do on TV. I called, got an appointment, and had an intake interview the next day. Exhale.
Just getting the intake interview with North Suffolk Mental Health over with helped me to take the next step and bring my swollen joints to the ER. I was still a few weeks away from meeting my PCP (primary care physician). The ER doc prescribed a steroid, prednisone. This isn't addictive because it makes you high; it's addictive 'cause it makes you young again. In my case, twenty-one.
I was becoming disabled physically and losing my apartment and my business. When I got to the therapist's office, I didn't want to talk about any of that. I spent the next month or so telling a time line of childhood, adolescence and young adulthood. The last thing I though I wanted was another label on my box. Sometimes another label is just what you need. I got a diagnosis, I had identified a problem. I could work on it.

Everything’s all set!

Now I have an advocate to help me process my application for public health insurance, all my ducks are in a row. Finally.
Wait
.
What?
No, it's never that simple. Getting my foot in the door was a real gift of the universe; I don't know how other people do it. I can't delineate every phone call, correspondence and meeting that took place to get my file processed at Network health.
I developed a strategy. Before every phone call I would clear my schedule for a few hours. Make sure I was at home to use a land line, you can't do this with limited minuets or a battery. Then, before dialing, I would use the bathroom, make a snack and lay out some reading material. Now I could wait on hold and be transferred or dropped without bursting into tears. It's also a good idea to get everyone's name and number to their direct line so when the call is dropped during transfer you can pick up where you left off without having to listen carefully to the automated greeting "menu options which may have changed" all over again.
My search for health insurance began in the financial aid office of the Mass Eye and Ear Infirmary, conveniently located in the emergency suite of the hospital, You can speak to a financial aid officer while in cue for triage. This was a reassuring experience. This crew was hip and efficient, unlike their coworkers in every other department I visited, they worked. Now, my connection at Network health told me I couldn't use the insurance retroactively because five months had passed since the original billing date and only new charges would be applied.
The truth is I had begun the process of filing for subsidized health insurance before I saw a Doctor and had done due diligence daily submitting and resubmitting bank statements, tax returns and utility bills. They know they made me jump through hoops. They've heard that excuse before. I needed a lie.
My eye patch had recently come off, and I had an appointment with a primary care physician coming up soon (my first ever). I lied and said I had been to sick to apply, practically blind, and unable to assemble the documents necessary until now. My advocate/case worker at Network health didn't flinch, he'd been to this rodeo before. I needed more and bigger bullshit.
"Has any patient ever received retroactive coverage?"
"Well yes, but.."
"Wouldn't it be inappropriate to deny a whistle-blower like me any conceivable amenity without looping in your supervisor? I mean, maybe you should confer with the board before you decide, it's only fair..."
Check mate.

Friday, November 26, 2010

Health care for the indigent (me)


It's scary to be sick and not have access to health care.
The bills turned into demands and I wasn’t getting all that much better. I had been wearing an eye patch for a while and paying for my prescriptions with credit cards.
I couldn’t earn a living. I turned to public assistance; few state employees missed an opportunity to be cruel to me. I applied for food stamps, and was denied. My poverty buddies assured me that was just the first step toward getting them. Unregistered mail goes unopened, Take names, kick ass.
Public health insurance seemed to operate on the same principle. You don’t get it just because you qualify. We elect legislators to enact laws that create social programs administrated by employees who write their own rules.
Sometimes the dealer calls "joker's wild" and deals you a hand. You can make a wild card anything you want. I get a lot of 'em.
After a volley of applications and rejections from "Network Health" (the applications are unedited for punctuation or grammar, our answers can be rejected this way or that). I got lucky. Sent along with my rejection letter was a list of four other Ma. residents slated for same. Names, addresses, phone numbers, Social Security numbers and the reasons for their rejections. Ace's high.
Now I had something to bargain with, but as The Wicked Witch of the the West will tell ya', "these thing must be handled delicately".
The voice mail system at this health care provider did not provide an opportunity to leave a message. In order to play my card, I had to think outside the in-box. I called another local agency located in the same building and asked for the number "upstairs". I got the public health insurer's unlisted phone number; I felt good for the first time in a long while.
When I called the guy who answer refused to give his name.
"How did you even get this number?" he demanded.
"I have a lot of numbers I'm not supposed to have" I demurred.
"huh? wha'?"
I explained about the egregious breech of patient confidentiality and that I wanted to speak to someone one with enough authority to give their name. No one likes a smarty pants, but when you look like a pirate, you can become a cut-throat.
I was transferred to another guy with a name. He asked for the proof. "I haven't decided what to do with my evidence" I said. "I want to make sure my file is processed without prejudice after I blow the whistle. I need an advocate. Should my advocate come from within your office or outside"?
Nervous as a pudgy drunk after last call, he offered himself to me.

Thursday, November 25, 2010

Age defying eye roller

In February of 2006 I was two years sober and began to work at cleaning up the wreckage of my past. Specifically: dark circles, crepe-y eyelids, and crow's feet. I choose a brand represented by models dressed as sexy Nordic scientists. I wanted a treatment for my sagging skin, not make-up.
I applied my laboratory tested botanical with serenity, secure that I was finally taking responsibility for myself by fighting the visible signs of aging. I slept the sleep of the righteous.
The next morning my vision was double, like on booze. Two horizon lines: one, as level as the strings on the neck of a violin; the other a bow angling up and down across the first in a nauseating movement. I was betrayed by Sweden's sexy-ist scientists. Damn Helsinki!
My right eye was suddenly untethered in it's socket sloshing around like the last ice-cube in a melty vodka. Hoping this would go away by itself, I stumbled around like that for three days.
On my way to the emergency room I bought a pirate patch at the drugstore. It helped me to not fall, but mostly I wanted feel as though the nurses wouldn't think I was stupid. Oh well...
The first ER took a look at the pirate patch and sent me to the "Main Campus" at Charles Circle, where they suggested I go to the ER at the hospital "right next door". Three ER's in ten hours, and I hadn't been triaged. Finally a neuro ophthalmologist suggested I might have nerve palsy, and no one should touch me 'cause I probably had high blood pressure and should be sent back up Fruit St. to MGH. They sent for a wheelchair, but after fourty-five minuets I decided to walk up. On TV they always put pressure cuffs on people in emergency rooms, why not in real life?
After ignoring the nurse's admonishment that I should wait for a wheelchair, I walked up the hill. Thinking that maybe I had nerve palsy (they say it does just go away) and high blood pressure. Well of course I'd have high blood pressure; I'd been bamboozled by bimbos dressed as scientists and then turned away by nurses dressed as bimbos.
Now I returned to the ER a few hours later and this time there was screaming. A team of EMT's and Firefighters were bringing in some dead burnt kids from a car wreck. The last thing I remember thinking was that the fireman looked like he was in shock. Then the smell, the boy, and I was in shock.
I made it home. I guess I fled.
The next morning I went back to the emergency room where I had started. The day before I hadn't gotten anyone's name or business card. To this day I haven't made that mistake again. I asked the receptionist for her card before I would answer any questions. I was holding up the line. I would not step aside. She lost her English.
The nurse who had originally sent me away the day before came out from behind the Plexiglas to "handle this". I didn't look very good, so she said. Her attitude suddenly got all professional and fast acting. I was guided into the exam bay. A younger gansta' style nurse got into an argument with a clerk (or gangsta's assistant) over who got to ask me the questions. Typically, I find a pissing contest good sport and love to play or wager, but not this day.
I pulled out my phone. The bickering stopped.
"What are you doing?"
"Calling myself a fucking ambulance"
"Wait, wait, wait! Don't do that"
"I need to a Doctor right now, no more questions" and I launched into the whole story.
I was interrupted, told to be quiet. I told the story anyway, loud enough for everyone to hear, as I was ushered into the company of a small frightened Doctor.
My blood pressure was dangerously high, it had crushed the nerves around my eye. I was admitted into the Emergency room to be given intravenous drugs to get my pressure down to a safer level. Palsy does just go away if your blood pressure goes down. The bills do not. Plus the meds were expensive. I was going to need free health care.


Wednesday, November 24, 2010

Why Blog?

A few years ago I got sick and poor. And had a fabulous time doing it. This is my story.