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Wednesday, March 05, 2008

waiting for a diagnosis

About a week ago, I was scratching Ginger’s ears and neck and I felt some lumps in her throat. Her lymph nodes, I’ve since learned. I figured she had an infection or something. I didn’t really notice them for a few more days, so it slipped my mind. Then I noticed them again—they didn’t seem to be getting any smaller. I asked Stanley what he thought, and he agreed that they were enlarged.

Ginger, in Natick, Christmas 2007

Since one of Ginger’s teeth is cracked, we just assumed it got infected, or maybe something from a tick. We took her to see her vet, Dr. Re at Strawberry Hill Animal Hospital, yesterday. Dr. Re found more enlarged lymph nodes in her legs and mammary area, and said there were several possibilities, including lymphoma, a kind of cancer that Goldies are particularly prone to. So Dr. Re aspirated the lumps to send samples out for testing. We were supposed to hear today, but had gone out to dinner with our friend George by the time Dr. Re had a chance to call. Her message just said she’d call in the morning to talk about what to do—since she didn’t say, “It’s not cancer,” we assume that’s what the diagnosis is. I’m still hoping we’re wrong. So if it is cancer, lymphoma, it is treatable, according to articles we read on vet sites on the Internet. Something like 85% go into remission for about a year after chemotherapy, which, the articles all say, dogs seem to handle well. Waiting sucks. It’s going to suck even worse if we’re right about the diagnosis. She just turned seven years old. I can’t stand this.

posted by lee on 03/05/08 at 08:42 PM
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Friday, February 29, 2008

keeping smart and other things

Link-a-rama: SharpBrains has lots of resources about keeping your brain fit and trim and gunk-free: http://www.sharpbrains.com The top-ten neuroscience brainteasers is fun—you can even participate in an experiment. It’s going to take me a long time to get through all these wonderful links ... I’m frustrated because I still haven’t finished the last Sunday New York Times crossword puzzle. Most of it is done—maybe ten more clues to figure out before it’s done. So I figure my brain needs some sharpening as I can usually finish them. Eventually.

WEBSERVER WOES
Last Saturday, we got a phone call from one of our web hosting clients. She couldn’t get her email. I was zzzing away—it was still morning after all—so Stanley went down to the office to reboot the email server. At least, that’s what we assumed was the problem.

It wasn’t. He dragged me out of bed, telling me he needed help. We tried to reset the site, but couldn’t, then tried to reboot the server—nothing. It wouldn’t come back. Trouble ticket in—we got our answer: disk drive was failing. Parts of it corrupted already.

The good news is that there were techs around over the weekend to take care of setting up a new webserver and transferring our sites over—I was kind of dreading having to wait until Monday. Our webserver provider, Netsonic, is a small company as far as companies like this go. That’s why we chose them—gee, it’s been more than five years ago now. So I was surprised that they sprang into action so fast. Even so, I knew it would take hours. It’s like getting a new computer—it takes a long time to prep the new one, transferring files and setting up programs and configuring stuff to work.

The disk, apparently, had been failing for a while—which explained all the reboots we needed to make, was driving us nuts. So the crash was actually a Good Thing. Despite the pain, we have the latest and greatest control panel software, the latest versions of PHP and mySQL, a bigger hard drive, a faster processor, and I guess the latest versions of apache and Linux (we have Fedora).

We did lose some of our database tables, but very few. I was able to salvage the templates for the updated version of our company website I’ve been working on (forever, it seems). Adam lost data for a school alumni site of his—I hope he can recover it. I had to fix some software that got buggy with mySQL 5, but it wasn’t that onerous once Bleau from Netsonic pointed me in the right direction. We still need root access and a link to our remote reboot (which I hope we never have to use) and to fine-tune our backups, oh and make sure we keep all the email servers out there happy by adding verification, but we’re happy.

I’m sure there are a few more things that have to be reset on our spiffy new box—they’ll shake out sooner or later. But the bulk of the pain is over.

Now I’m just scrambling to make up for the lost days.

posted by lee on 02/29/08 at 05:05 PM
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Friday, February 22, 2008

friday storm mid-way through

Imagine that, snow in New England in February!

We’ve been very lucky this winter—I think this is only the second significant snowstorm we’ve had this season. By significant, I mean deep enough so that we have to do some shoveling out. Mostly Stanley. Like 95% Stanley. I dug out the car and sprinkled salt (click to enlarge):

Ginger had been a bit lethargic the past couple of days, but she perked right up and did the bunny hop around the yard a few times (click to enlarge):

So far, we got about 6.5 or 7 inches of snow. That was the first wave. They keep talking about the second wave coming through but so far (knock on wood), it’s been very scant. It’s very pretty, but that’s enough, thank you very much! It’s really close to freezing, so things are getting a bit sloppy. It’s not supposed to be over until after midnight. Mostly it’s just really dark out—none of the brightening that usually happens indicating it’s nearly over. The prediction is 6-14 inches. These pictures were taken around 12:30-1:00 p.m. so that gives an idea of how heavy the skies are.

I put a few more photos up in the gallery.

posted by lee on 02/22/08 at 11:25 AM
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Tuesday, December 25, 2007

not a creature was stirring, not even a mouse

Because the mouse was dead. Twitch doing his duty as a good guest. This one was a bit messier than most though: he must’ve hit the mousie’s jugular because there was blood all over the landing—on Maureen’s freshly painted walls. While Maureen was pleased to get rid of a mouse, she wasn’t pleased with the new color scheme. Jeff cleaned it up though, and gave the mouse a decent burial. Twitch was full of himself all day.

And it was a good Christmas too! More later when I’m not so tired. (click to enlarge)

posted by lee on 12/25/07 at 08:43 PM
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Sunday, August 19, 2007

we’re finally in oHIo

We finally got out the door at 1:00. We would’ve left about 40 minutes earlier, but Slink decided to play hide-and-seek in the crawl spaces in the cellar. Ben and I could hear Stanley’s curses as the damn cat kept slipping out of his grasp. We tried very hard not to laugh.

Not too bad a trip—only one bad patch of traffic where a tractor trailer jackknifed, probably due to slippery roads due to the rain. Oh, yeah, it rained. Most of it was just annoying rain, but there were many miles where it came down hard and Stanley was very tense. But we made it to the Comfort Inn in Warren, Ohio, which has become our traditional stopping place now. There’s a sofa bed in the room for Ben, and our room, a different one than usually, still faces Courthouse Square.

It took us about 7.5 hours to get from Norwalk to Warren. We’re listening to the new Harry Potter, and are up to disk five or six. Slink settled on Ben’s feet, sort of under Stanley’s seat, and stayed either there or on the seat next to Ben for the trip. Twitch sat with Ben—and Ben even got Twitch’s traditional starting gift of regurgitated cat food. Ben handled it much better than I do.

Right now, Ginger is waiting to go out, and Slink is hiding under the bureau and Twitch is exploring—Twitch is one of the few cats I’ve traveled with that likes hotel rooms. Expands his little world, I think. Right now, he’s sitting in the window watching the traffic and rain—though there’s not much traffic.

Stanley, is, I think, in Dreamland. Ben is reading. And USA is out on the cable here, so we can’t watch this week’s 4400—bummer. But it’s so nice to be heading to see Mom and Dad!

posted by lee on 08/19/07 at 06:39 PM
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Monday, July 16, 2007

setback

When I opened my eyes to see why Ginger was so agitated this morning (not barking agitated, just tense and pacing and whimpering agitated), I saw Stanley cleaning something up off the bathroom floor. I told him to stop; that I would clean it up—I didn’t want him moving around so much. He said, “I need help.” He was mopping up big splotches of blood.

He said his incision split open about three inches from the end and started gushing blood—he said it filled up his sock. So I said, “Let me call Dr. Gagne,” and followed the blood trail downstairs to get the number. This was about 8:15 or so. I got his service and they said they’d page him right away—but, I later found out, he was in surgery and couldn’t call back. Nor could any of the other surgeons in the practice, apparently. I generally like the staff at his office, but they need to call back when they say they’re going to call back, particularly during an emergency. They never did. (Dr. Gagne did call around noon, but too late, we were long gone.)

After trying to get some kind of an answer for more than an hour, I ended up calling the on-call nurse at Oxford to find out what to do. I’m really glad they have that service, though I would’ve called all of my numbers until I got some answers. The nurse established that Stanley wasn’t in danger of going into shock from blood loss (or panic), and after asking a bunch of questions, she said, “Take him to the ER.” Ack. I hate the Norwalk Hospital ER—we never get any answers from them. (Today was no exception.)

So, since the blood gush had abated considerably, I had time to cancel his appointment with the infectious disease doc and oh, yeah, brush my teeth and suck down some coffee so I could drive without getting into an accident. Trouble with late nights is that early morning (for me, anyway) emergencies are really rough. Stanley said he’d drive. “Yeah, right, like you can guarantee you won’t pass out from blood loss if the gusher starts up again.” He agreed that maybe he was less than rational at the moment. I drove.

What’s the point of valet parking for ER if you have to walk half a block back to the ER door? There’s not even a place for anyone to sit ... stupid. Anyway, I got him in there and we were stashed in one of the old rooms way back in the corner. Which was fine with me—there was a tv in there and a bathroom attached to the room. Except that the floor was filthy: dirt and clumps of hair (not strands, clumps—looked like the aftermath of a hair-pulling fight) and monitor tabs, really cruddy. Eventually, a nurse came in to find out what was up. She used that doppler stethoscope to check the pulses in Stanley’s foot and, wondrous day, the pulse was good and strong. So the bypass didn’t rip out or anything. I was so, so, so relieved—I could feel my blood pressure dropping.

Eventually, Dr. McGovern showed up. Asked some questions, eventually looked at the incision after Stanley asked him if he wanted to. The bad part was the swelling—we could see it get puffier. The more it swelled, the worse the pain. Dr. M says, “well, we’ll watch it” or something like that—he seemed so hyperactive he was almost twitching. Maybe it was too much caffeine. He never completed a sentence and he never really answered our questions, so we still don’t know why the incision split. “Well, that just happens so ... do you want something for the pain? I’ll call your surg ... well we’ll just watch it, we don’t want to cut it open, more scarring, more scarring that way and we don’t need to ... just pools low, see the bruising, just pools ... ”

So we watched the noon news on Channel 8 and most of Judge Lopez and eventually Dr. M came back and said, “he said he’ll see you at his office Wednesday, we’re gonna let you go, just stay off it ... I’ll have the nurse put a dressing on it ... ” and left. And forgot to ask the nurse to dress it.

But she did anyway, at my request. Pressure bandage, which Stanley took off and re-did as soon as we got home because he can’t stand the smell of those sticky Ace bandages. Stanley finished the infusion he had to stop and we cleaned up puddles of blood. (The floors are almost 200 years old—what’s another stain or two?) I remade his infectious disease doc appointment for tomorrow (I don’t like the people at that office so far—the receptionist and the scheduler were both abrupt to the point of being rude. And I didn’t know we’re seeing someone other than Dr. Saul because he’s on vacation—not that I mind since I don’t care for him much.) And made the appointment with Dr. Gagne for Wednesday afternoon.

That blew away my day. I’d almost gotten that quiet spot back (an uneventful weekend helped a lot) but that’s been shot to shit again. And I got no work done, or almost nothing done. But he’s okay. And maybe we’ll find out the why on Wednesday.

My next project is getting copies of all Stanley’s medical records so I can have them all together—I am so sick of having them spread all over Fairfield County with different pieces here and there. I need them consolidated so nothing is missed—it’s so damned hard to remember everything each time we have to recount his medical history for the latest specialist. I figure it might cost me a couple of hundred in copying fees and an entire file drawer, but I’ll feel much better. I wish the hospitals and docs would digitize their record keeping—would love to be able to put it all on a memory stick so I could have it when we travel.

Ah well. Off to Stratford tomorrow—maybe we can even stop at the Habitat for Humanity Re-store on the way home, see what they have there.

posted by lee on 07/16/07 at 08:59 PM
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Tuesday, July 10, 2007

a lot more complicated

Stanley is watching tv now, starting to look at little better now that his anti-nausea stuff and the morphine kicked in. Looking at the tv? No, I mean sleeping—that binary state he’s in post-operation.

The surgery took 4.5 hours. He’s got a good strong foot pulse again, and his foot has pinked up again (though he’s still pale in the face). Dr. Gagne was hoping it would be a fairly straightforward procedure where he could just go in a remove the clot or, if the clots were too old, do a short bypass.

But that was not to be. Dr. G said it took quite a while to figure out what was going on because there was so much inflammation and then they saw there were just too much to be able to salvage, so they bypassed the bad stretch of artery which, from every indication, is the length of his calf. So not a short bypass. Too many old clots (which wouldn’t have been old if the endocarditis would’ve been caught during the cardiologist’s checkup ... yes, I’m very angry still). Dr. G. said he managed to not cut much of the muscle to get at stuff and tried to keep it as minimally invasive as he could.

So, the clots are bypassed. Finally. But Stanley won’t be getting out tomorrow—Dr. G. said he thinks maybe Friday. I hope he was just being conservative, but S is having such a rough time of it now (throwing up a lot of blood from when some tube was put in him during general anesthesia or something—and he didn’t want pain meds until the nausea stuff stopped, and it took quite a while to get that ordered ... ) that it wouldn’t surprise me. Whatever—I just want him better.

The waiting room here at Norwalk Hospital is way better than the Bridgeport Hospital waiting room. Free coffee (that pod stuff), located next to the cafeteria (cafe coffee is good, and some of the food, but the choices are extremely limited and nothing but diet stuff to drink—all with that crap aspartame ... ), very comfortable chairs (I managed to fall asleep for an hour!) and the blue coats actually helped people out. I hope I never have to see it again.

He’s had good nurses so far. One pretty strict one who kept trying to get him not to watch the blood draw (he always watches the blood draw) and they’ve managed to do everything through his PICC line so he’s not being stabbed every few hours for more blood. So I’m glad they left the line in, as much as he hated it.

So, the progress report is “so far, so good.” The only problem would be is if the leg pulse is diminished or goes away. I’ll feel better when his face is less pale—hopefully tomorrow. He’ll get to eat breakfast, I think—he hasn’t had anything for almost 24 hours—the last bit was some red jello the tech gave him last night.

Long day. Heading home at around 10:30 or so—it’s not fair to the dog to leave her much longer, though she’s a very good girl.

Springfield, Vermont? I don’t picture any nuclear plants in Vermont ... a weird choice. I voted for Springfield, Michigan, even though I’ve never heard of it.

posted by lee on 07/10/07 at 05:53 PM
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Friday, July 06, 2007

clotty stuff & an einstein update

This morning, Diana from Dr. Gagne’s office called with the news that Oxford approved Stanley’s operation. What a relief! I was dreading the prospect of another appeal and Stanley’s despair at ever getting his leg fixed. So we’re to call Monday morning early to find out when he’s supposed to check in, and on Monday they’ll do an EKG and blood tests to prep for the operation on Tuesday. I think he’ll also get prophylactic antibiotics as well, though Dr. Saul extended his antibiotics regimen for another week so I doubt there’s an organism, good or bad, that could survive in Stanley’s body. I hope.

The operation is scheduled for 1 p.m. Tuesday. I don’t know if Stanley will have to stay overnight on Tuesday.

Stanley was really looking forward to getting his PICC line yanked out this week and was upset that the antibiotics were extended. I told him to suck it up—better another week than another month+ going down with a staph infection. It’s not that I’m unsympathetic. I just have a better memory of what happened two years ago than he does. And I’m just too exhausted to face another catastrophe.

Stanley also canceled his appointment with Dr. Lomnitz on Tuesday and said he’d call back about making another appointment. The scheduler warned him that Dr. Lomnitz will be booked up solid so unless he makes an appointment soon, Stanley will be out of luck. Hmm. I think I’ll keep my thoughts to myself about that one.

I’m glad the operation is a Norwalk—it’s much easier to run home and take care of Ginger and the kitties. Less than two miles (vs. 16.5); less than ten minutes unless I manage to try it during rush hour. Parking rates are much saner than at Bridgeport Hospital, too. And the nurses are allowed to tell us what’s going on.

The only thing I’m wondering about now is if Stanley has to get general anesthesia or local. I hope local—I’ll find out Monday or Tuesday morning.

Einstein is now a year old. A year and a week or so. She is a gorgeous cat who looks like she’s very self-assured and knows who’s in charge (and it isn’t my mom or dad!) Here’s her latest portrait, taken by Dad (click to enlarge):

The comment included with the photo is: “This is as close to outdoors as she gets. Unless she scoots between my legs and makes a break for freedom, which she tries on a daily basis.” It’s going to be very interesting to see what happens when we get there in late August: three cats, one dog. Ginger loved Einstein when she was a tiny kitten last summer so I’ll be curious to find out if she still does. Ginger barks at Slink, and always has—I think she’s jealous (I’m her human!) and she has caught Slink stealing her food. The latter reason is probably the more important one. As far as Twitch goes, Ginger and Twitch are utterly indifferent to each other most of the time, though Twitch is really in charge. Twitch can sleep all day in Ginger’s bed in our office, and the silly dog doesn’t care. But if Slink tries to curl up in the bed, Ginger chases him out. And Twitch will curl up with Ginger if the house is really cold, like it gets on very windy winter days. Right now, I’m still shocked that it’s already July. It was May, and I was figuring out where to plant my seeds and planning on roto-tilling the garden Saturday (as in May 26) then in the blink of an eye it’s July. The two tomato plants I got in before the trip to the ER seem to be thriving, with a tomato on each and lots of blossoms (they’re container plants). But the ones I put in when I could around June 7 are healthy, but very short. Very few seeds were sown—just a couple of pots I put together. I did get some cleomes in and some of them are blooming and just gorgeous. I wonder, if I plant some seeds this weekend, such as cosmos and zinnia, will they grow and bloom? I guess it can’t hurt to try a few and see what happens. So much I didn’t get done. But some things are starting to look up. Not everything. I will feel better when Stanley is able to walk without pain again. But right now, I have about a quarter inch of cope left. I have a yoga dvd and I think I’d better start using it to learn some yoga so I can be sane when I’m needed for other problems that have to be dealt with. Wouldn’t hurt to be limber, too ...

posted by lee on 07/06/07 at 08:59 PM
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Thursday, June 28, 2007

bad thursday morphs into good thursday, kinda

The day started with phone calls to the vascular surgeon’s office to find out what’s happening as far as Stanley getting his calf clot dealt with. I’d been trying to speak to the doctor or at least find out if he read the CT test and find out the next step since Tuesday morning. Gee, Tuesday, that was just a coupla days ago. What’s the rush? Somebody limping around in pain and unable to go back to work is the rush. I got two “we’ll call you right back"s today until, miracle of miracles, Dr. Gagne (Southern Connecticut Vascular Center) called! He didn’t have the film, he said, only the report, and he can’t make a surgical decision based on the report ... I asked him why he didn’t have the films since Norwalk Radiology said they’d be delivered in a couple of hours. I offered to get them and hand deliver them to Dr. Gagne wherever he wanted me to ... I was pretty close to tears I was so frustrated.

Dr. Gagne called me back a little while later, explaining that, through the miracle of the Internet, he was able to access the CT scan online—he said he wasn’t sure if the new software they just had installed would work, and he seemed pretty pleased that it does. Not as pleased as I was. (Wow, medicine is up to Internet speed—1998 Internet speed.)

He said the best deal for long-term success is to go into the artery via Stanley’s knee (doesn’t have to cut muscle that way) and clear the clots (yes, there is more than one, alas) or bypass the artery with a vein from his leg if the clots are too, well, clotty I guess. Inpatient, since it’s an operation, and recovery is relatively quick since no muscle would be cut—about a week. He said he’d proceed on getting things set up, cautioning me that he is going to proceed as if everything will be approved by Oxford, that there were things that had to happen to make it all happen, and would try for Norwalk Hospital. I told him we’d go to any hospital at any time, the sooner the better, with the only requirement that it be a hospital in the Oxford network.

A little while later, Diana called and said that Stanley’s operation is scheduled for July 10th at Norwalk Hospital at 11 a.m.—assuming approvals from Oxford go through in a timely manner. He has to check in on July 9th, and she said she’d send me a packet with all the information we need so I’ll know exactly what is going on and when it’s supposed to happen. I really, really hope Oxford doesn’t screw around with this—I’m still worried that parts of the clot will break off and wreak more havoc and I’ll be scared about this until it’s, rather they’re, removed.

As it is, we’re both very disappointed that Stanley has to endure this almost two more weeks more. He was hoping to get back fully to work by July 6, when his coumadin and transfusions would be finished, but now it won’t be until July 16th. And he’s just so frustrated with not being able to walk very far. Not to mention the thousands more it will probably cost us since we’ll be in a new “fiscal year” with our health plan—I’m hoping like hell that it’s a calendar year before out-of-pocket zeros out again, but I doubt it. I will find out next time I call Oxford ... maybe. But, while disappointed that it’s taking so long, what a relief that we finally have a date for when the problem will be fixed!

Meanwhile, between phone calls and emails that I had to deal with, I’m trying to finish up the last bits of five stores I’m working on—so very close to finished! Just a few more hours of work if I can just be left alone to do it—which I thought would be this afternoon and early evening since we had no place we had to be and no plans other than grilling salmon for dinner. Then I could move on and put together another store for a very patient client, spec out a website for another, and begin building yet another one for a third client, start a small ad campaign for another, plus concentrate more on editing http://www.westportnow.com ... a lot on my plate, but all interesting.

But that was not to be. But not for a bad reason. My nephew Brian, the truck driver, called. He has a layover in Milford at the Pilot truck stop there, and could we please come and get him. Stanley went to get him and I was very happy to see him—I always am. I waited for Stanley’s drug delivery because someone has to sign for them, and tried to get some work done, otherwise, I would’ve gone as well. I think he lucked out that this run brought him so close to us and gave him time to stop over night because he’s between paychecks and had nothing but molecules of air in his wallet. Not one dollar. No money in the bank until well after midnight when he paycheck dropped in, and no credit card. So he was glad we answered the phone!

We talked for quite a while, catching up on his life and family things, and he told us about his new house, which he recently bought. It’s in Dearborn Heights, about halfway between his mother’s house and his Aunt Jamie’s house, with a good 6.2% 30-year fixed mortgage and his payments, including taxes and insurance, are not much more than he’d be paying in rent. He said he paid about $13K less than its appraised value. He’s hoping that the piss-poor market in the Detroit area will turn around sooner or later and he’ll be able to sell at a profit some day—but at least he’s got a place to live that he’s not throwing money away on so even if it doesn’t appreciate much, he’ll get his money back. And that’s a pretty good mortgage rate for someone in his early 20s! His brother Aaron and a friend and her daughter are living there—as roomies— now. They help defray expenses and the house isn’t empty when Brian is on the road. We’re looking forward to seeing it when we hit Michigan later this summer.

We wanted to barbecue chicken for Brian, but it was storming out, so Stanley made grilled ham and cheese sandwiches. We watched Earl and The Office and chatted until it was time to take him back to his truck. We couldn’t bear the thought of him being on the road with not even a dollar, so we gave him a bit of cash for his birthday, which is July 3. It was kind of nice taking a ride up to Milford. Stanley and I tried to stop at the Dairy Queen in Fairfield on the way back, but we got there about 15 minutes too late. Damn—I’ve been craving a blizzard for about three years now. Will just have to wait.

So the day started out overwhelming and teary and frustrating, but we got an end-date for Stanley’s clot problem and I got to see my nephew, so it turned good. Although I’ll have to hustle to get stuff done tomorrow, it was worth the visit.

I’m still grappling with my mother’s diagnosis. I find I can only accept it a little bit at a time. So many things fit, it’s hard to deny it as much as I long to.

posted by lee on 06/28/07 at 09:37 PM
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Monday, June 18, 2007

frustration

Today we tried to find out if Stanley’s CAT scan was authorized and if so, when. Diana, the scheduler from Dr. Gagne’s office, said she was frustrated because she hadn’t heard anything from Oxford yet other than it was under medical review. So I asked her for the referral number and called Oxford to see what was going on. Oxford has always been very good about approving diagnostic tests—in fact, when Stanley was prepping for his first heart valve replacement with the bypass, an MRA was approved and, to this day, we still can’t figure out why one was even ordered since the surgeon didn’t need it and the decision to replace the valve and do the bypass had already been made. MRAs are, from what I’ve been told, are pretty far up there expense-wise.

So I called Oxford and spoke with a customer service rep. She told me that the authorization for the CAT scan had been denied on June 13. I asked her why, and she said she didn’t have that information on her screen. So I asked her who did have that information, and was told the doc’s office did. I said they didn’t, because they would’ve told me already. She then said the authorization dept. had the info, so I asked for the number and was told they don’t talk to patients, only doctors and related medical people, so I could not get the denial reason from them. I asked why not, since I’m the one paying the bills.

I told her that Stanley’s calf clot needed removing and they would’ve done it in the hospital but they decided he was undergoing enough trauma and decided to wait and have him see Dr. Gagne after he was discharged. We followed the treatment plan. And I told her that Stanley couldn’t return to work until it was fixed. I think she picked up on the looming hysteria and said she would call authorization to find out what the story is if I would just hold.

Ten minutes later she told me that the authorization was denied because the medical reviewers needed some more medical information and she mentioned somethng about a doppler, which I assume is some kind of blood flow test but I’m not sure, and neither was the rep. I asked her what we could do about the denial of service, and she said we could submit an appeal, but said the appeal would take about 15 days to get processed. I was dismayed—Stanley has to limp around for at least two or three more weeks? He can’t go back to work with his leg like that.

So I asked her: “If I had to take Stanley back to the emergency room because of the unbearable pain in his calf from just walking, the CAT scan would get done and the clot would get treated right away, wouldn’t it? And Oxford would have to pay for it all plus the ER costs because we’ve already hit our out-of-pocket ceiling, right? So if a CAT scan gets approved in mere minutes in the ER, why does an appeal take more than two weeks? There’s gotta be a way to get it done faster.

She checked for me. (I really do like the Oxford customer service people—even when they claim something is impossible, they always seem to manage fixing things that are broken even if it is impossible. Plus they’re nice on the phone, even with a wife about to lose it.) Turns out there is an expedited appeal, with a two-day turnaround, and they have to notify me within 24 hours if they are not going to hear the appeal. She gave me the instructions for setting it in motion and recommended that I also get Dr. Gagne’s office to fax an expedited appeal.

I called Diana at Dr. Gagne’s office, who said she’d get right on the appeal (I told her about the reason for denial, which she said they were never told about and I believe her—that group has a good reputation for getting things done.) And we wrote the fax up and got that off. It was about 5:30 when we sent it so I don’t imagine we’ll hear anything until Wednesday morning (hopefully not—which would mean they accepted the appeal for review). I expect to know one way or the other by Friday.

Stanley really wanted it taken care of while he was in the hospital, but the docs decreed otherwise. I hope the medical second-guessers at Oxford just authorize the damned test—they don’t cost that much, but a lot more than we can afford to pay ourselves right now since we’re out so much money already. And he needs the problem fixed—it’s not getting any better. And I will take him back to the ER if I see him in the kind of pain he was in on May 22, or even half the pain he was in then. I suspect the denial was the result of the hospital report not being included with Dr. Gagne’s request. I have to remember to fill out the paperwork to get all of Stanley’s medical records.

Today’s dealings took two hours. Dealing with this kind of stuff takes up so much time ... just figuring out who to call and what information you need to have at your fingertips is a challenge.

posted by lee on 06/18/07 at 10:11 PM
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