Tag: Health

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One of the continuing irritations with the present medical system is the administrative confusion that arises when it is time to pay the bill. For some reason, the provider and the insurance company make me the middle man in their struggle for payment or for non-payment as it were. Now the only value, to use corporate speak, that I bring to the argument is I don’t want to pay the bill.

Nonetheless I am continually being dragged into these discussions where my growing irritation is the only clear relevance I am bringing to the debate.

My participation usually begins when the provider, after numerous attempts, has failed to get payment from the insurance companies. They then decide to bill the patient which seems fair and reasonable as the patient ultimately received the service.

Let’s stop here for just a moment. I thought that this was a service that was paid for by my insurance company. I never expected to be billed more than the co-pay. All I can add to the discussion is I didn’t expect to be billed. The provider, rather cleverly, has pulled me into the argument.

But why? I don’t know the arrangement between the provider and the insurance companies. I don’t know how the provider is supposed to code their bills in order to get payment. All I can do is complain to the provider for billing me which is where the provider explains their dilemma — the insurance company won’t pay.

Apparently the ire of the patient helps the insurance company to do the right thing. I grudgingly can accept this tactic although I am baffled why the provider can’t just work it out with the insurance company without involving me. I suspect it is based in confrontation avoidance of the young office workers tasked with resolving these matters. For some reason, they would rather piss off me over pissing off the insurance companies.

Any way, this is where things get truly irritating. The provider wants me to contact the insurance company in order to get payment. WTF. Why am I the one calling the insurance company? Why can’t the provider call them? I am embarrassed to say I fell for this little gambit numerous times mostly because I fear having to pay a large dollar amount bill.

So, I would call the insurance company who then tries to explain to me what the provider needs to do in order to get payment. I am not the one who needs this information. I am not billing them. I don’t care what the provider needs to do, the provider does. At this point I suggest that the insurance company calls the provider to explain. This is usually greeted with mumbles and vague promises to contact the provider. Speaking from personal experience this rarely happens.

Because the insurance company has provided me with some useful information that might help the provider get their money, I try to pass that on to the provider the best I can with the suggestion that they themselves might themselves call the insurance company to ensure I have my information straight. More mumbles and more promises. Speaking from personal experience this rarely happens. I know I repeat myself.

The good news is I have came up with a new strategy that sometimes works. I don’t pay the bill and you know the provider and the insurance company seem to find a resolution without involving me. It sometimes takes awhile but they eventually work it out without me paying a thing or becoming the middle man.

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I have always taken pretty good care of my body. The underlying hope from all this care was that my body will get in shape. I will look and feel better from the effort.

I have reached an age (68) where I realize that no matter how hard I try that my body isn’t going to get better. The best I can hope for is maintaining what I have. I am beyond improvement. Indeed, chances are it will get worse and there is very little I can do about it.

Maybe some plastic surgery could buff up the exterior but I am afraid I’ve waited too long to get much benefit from it. Why go through a tummy tuck or a face lift and then drop dead the next day? If I am going to spend plastic surgery kind of money, I want to get plastic surgery kind of bang for my buck. So that ship has sailed.

I am trying not to be depressed about it because this is one of the many sad realizations you have as you get older. In the past I could look 20 years into the future and see a future. Now I think 88, there is a good chance I will be six feet under or spread across the Pacific Ocean (still haven’t decided yet).

There is no future really. Age forces you, at some point, to live in the moment. I don’t put things off any more. Things like saving money for retirement. Well, I am retired. What am I waiting for. Spend the fucking money now while I still can get some pleasure out of it.

Age is letting go of what you were. It is sad but also liberating. Fuck them. The good news for the rest of the world is that I don’t have a lot of energy for causing too much trouble. I won’t be leaping in and out of people’s beds, driving cars too fast, or robbing banks. Mostly I will just be a grumpy old man. But, on that, I can guarantee, so watch out.

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OK, I have a bit of a beef with Visine eye drops. The product is fine. Pretty much instant relief from itchy eyes. However getting the protective plastic wrap at the tip of the container is a challenge.

I am sure there is some easy way to rip the protective plastic wrap off but whatever that may be eluded me. It broke me. It got to the point I was trying to determine what form of physical force I could use to open the fucker. I am afraid to say that pounding it on the bathroom marble doesn’t work which led to me considering chewing through the wrapper.

The only thing that stopped me from this method was the embarrassment of having to explain my cracked tooth to my dentist who already thinks I am of an asshole because I won’t fix a tooth that he says is due for imminent collapse, something he has been saying for the last 7 years and has weathered the most rigorous assault from the vast arsenal of dental tools at my dental hygienist’s disposal. My tooth beats them every time.

I think it is pure orneriness on my part that I haven’t gotten it fixed. I get a great amount of pleasure in depriving my dentist of the couple of thousand dollars it would take to repair it. They have definitely toned down their pleas that I will be in Paris some day and my whole trip will be ruined when my tooth falls out. Now they just say I might put it on my calendar for this year.

So I am overdue for the damn tooth to come out. I would hate for it to break my tooth for such a lame reason that I lost my temper with the plastic wrapper on my eye drops that I, in a moment of uncontrollable anger, I decided to rip it off with my teeth. I couldn’t bear the look he would give me. After 7 long years of them trying to knock that fucker off with every dental instruments known to man, all it took was a plastic wrap to do the trick. I am afraid it would break him.

Anyway, back to the plastic wrap. I had to use my nose hair scissors to finally get underneath the plastic enough to remove it. It was a minor trauma in a life filled with minor traumas.

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It has come to this. A woman in Florida was in labor. Her doctor advised her that their might be a problem if she decided to have her baby vaginally. They advised a C-section. She wanted to continue with vaginal delivery. In a normal world, the doctors and the woman would make a decision based on the medical circumstances involved. This is far from a normal world and Florida is being pretty much at the center of the weirdness that now revolves around pregnant woman delivering a baby. The woman, while in labor, had to discuss her delivery choices with a judge who then made a decision on how she could proceed.

This type of decision is, even in the days before Roe versus Wade, a medical decision. No ruling from a judge is needed. The woman and the doctor would work it out based on the woman’s circumstances. Why does a judge have to be involved at all?

Well, because now, the fetus, in Florida, has protected rights. In the past, there was an assumption that since the woman wanted the baby and the doctors wanted to deliver a health baby, then everyone involved was working together for this same happy ending. But, because Florida’s abortion laws are so restrictive, doctors now are worried that if something were to go wrong with the delivery, they may be held liable if the baby were to die in the process. Hence a judgement from the courts was required before the doctors would proceed.

This is worrisome for a number of reasons:

  1. The law was intended to protect fetuses from abortion not delivery. This case does not involve abortion in any way, yet the courts were dragged into it because the anti-abortion laws make any tricky delivery suspect. Did the baby die in delivery or was the doctor sneaking in a late-term abortion? If a doctor wants to cover her ass, she will make sure that a judge knows what she is doing and she goes on record with the courts what she is trying to do. Hopefully this will prevent any busybody from claiming otherwise later thus protecting the doctor from future legal hassles but also delaying medical attention to the woman in labor.
  2. Delivering a baby involves a woman’s health. It needs to happen when it needs to happen. Waiting for a court to make a decision on the best way to proceed is ridiculous here. Delaying medical procedures in order to get this decision is criminally stupid because both the mother and the baby are at risk. In this case, the judge decided for the woman with the caveat that the doctors could perform a C section if the vaginal delivery became difficult. This is how the doctor and the patient wanted to proceed in the first place. What possible wisdom did the judge add here that the doctor and the patient hadn’t already discussed?
  3. The doctors were over reacting you say. This should never have happened. Florida’s draconian abortion laws have nothing to do with this case and it was unnecessary for a judge to be notified. Well, probably, but try telling that to doctors who are trying to avoid going to court over their handling of women going through childbirth. Any state with such restrictive laws will have this problem. Better to go to court to check that you are right, then to go to prison if you are wrong.

The irony here is that laws instituted to protect the fetus from abortion are now causing delays in health care that both endangers the mother and the baby. It is also making it more difficult for medical professionals to advise women how to proceed during a difficult delivery. What if the judge makes a decision that the doctor’s and the patient disagrees with? How will the doctors proceed? A certain amount of good faith needs to be given doctors trying to navigate on how to proceed in a difficult situation. Florida’s abortion laws have only created confusion not better health care for pregnant women.

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Why is it that every time I see a new doctor, I have to complete the same questionnaire. This is so irritating. I thought the whole point of having your information on line was every medical professional now has easy access to your data and you won’t need to keep supplying it every time you go to a doctor.

This is not my experience. Every time I walk into a new doctor’s office, I am handed a clipboard with a questionnaire asking for my details. You know name, address, emergency contact, medical history, medications you are taking and why you are visiting the doctor. Yes, I get it that they need to get it right but to see my questionnaire sitting unconsulted on the doctor’s desk while she asks me the same questions yet again is a bit insulting.

Or to have the office hound me with texts and emails too complete the an on line questionnaire before my appointment with the caveat these replies will make it easier and faster for the doctor who is treating me, only to be asked to fill out a paper version of the same questions when I arrive at the doctor’s office.

Sometimes I will be working on the questionnaire and I am called into to see the doctor. I will let the nurse know I haven’t completed the questionnaire yet, only to be told don’t worry about it, she never looks at it in the first place. Then why am I filling it out? Are they giving me busy work to keep me occupied while waiting for the doctor? Quite frankly, I’d rather being perusing the People magazines stacked on the tables than completing yet another form with my medical history.

If I were a smart ass, I would advise them I already given them this information and could they possibly retrieve the data there. Thank God, I am not a smart ass. More of a coward I suppose. I don’t want to look like trouble to the doctor’s front desk staff. They have a lot of power for you, they can offer you an 7:30 AM appointment tomorrow or a 1PM appointment sometime after the first of the year. Neither choice is good. You can keep asking but the choices are never good. Whatever you do keep on the good side of the office staff or else you will never get a decent appointment time.

And keep filling out those damn questionnaires or your chances of seeing the doctor are pretty darn slim.

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I think if you want to get plastic surgery and it makes you happy, by all means, get it.

I won’t. Mostly because it won’t make me happy. I just don’t have the time or the energy or the money to keep working on my looks. It is, after a certain age, a losing battle.

No matter how much plastic surgery I get, I am still 68 years old. A 21 year old guy, even just a regular old 21 year old guy, not some super good looking movie star/model type of guy, walks into the room and then I walk into the room. The half way good looking 21 year old guy has me beat. By a mile. By 10 miles. By 100 miles. If I get talked about at all, which, let’s face it, is a very big if, it won’t be about my good looks but on how he has had work done.

Then there is the cost. People who I know investigated plastic surgery are talking thousands of dollars and, with my luck, it will turn out making me look worse. I know some people who have had excellent plastic surgery. I also know people who were disappointed with their surgery (see awful plastic surgery). It is a roll of the dice and if I am rolling the dice, I would much rather be rolling the dice in Las Vegas than rolling it on surgery.

Besides, I am that age where I need procedures and surgeries just to stay healthy. If I were to also get plastic surgery with the other surgeries I need, I might never leave the hospital. I just don’t want to take up residence in a hospital, at least not yet.

At this point in my life, I would rather fall back on my vast supply of charm and joie de vivre than attempt to alter my looks any further.

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One of the vows I made when I started exercising many years ago was that I would never exercise when injured or if I felt sick. If I screwed up a knee or had a cold, I waited a couple of days and then start with a less vigorous routine until I returned to normal. Once I was back to good health, I returned to my routine. This has served me well.

Until now, at 68, it is impossible not to exercise without being sick or injured or both because I am always one or the other. If I stopped exercising every time I was sick or injured, I am afraid I will never return to exercise at all. It is that difficult for me to find a block of healthy days for me to keep this youthful promise to myself.

So another broken promise to myself in a string of broken promises to myself.

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I have reached the age where I realize that my body just isn’t going to get any better. As someone who has been exercising regularly since I was in my early 20’s, it has come as bit of a shock. My idea for exercising was eventually I would get it right — the perfect body. And, at some point, I whipped it into pretty good if imperfect shape. But not any more.

For the past 20 years, I have resigned myself to maintenance. Just keep the old boy presentable. But,in the past few years, it has dawned on me that even maintenance is no longer possible. The hairline keeps receding, what is left is grey. The stomach which I kept comfortably around a 34 inch waist simply won’t return. I’ve tried. I stopped running because when you run, you fall occasionally, the falls just took it out of me and I worried that the next fall would cause broken bones instead of scrapped knees.

More distressing is I have had to watch what I eat. For most of my life, I have been on the skinny side. Indeed, when I was an adolescent I could stuff myself to the point of sickness and not gain a pound. No more. Just a casual glance at a chocolate chip cookie can drive my weight higher.

I surrender. I donated all the 34 inch waist pants to the more in shape out there. I will try to maintain the 36 inch waist as long as possible but once the amount of work and diet I have to put into keeping a 36 inch waist exceeds the pleasure I have in living, well, the 36 inch waist trousers are gone as well.

It is both sad and liberating to feel this way. Sad that my body has seen its best days. Liberating in that I can focus on enjoying my life without guilt because no matter what I do to make my body better looking it is never going to make me better looking than the average 20 year old after gorging on pizza and beer. So I might as well enjoy the pizza and beer.

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Talking to a doctor’s office, not the doctor, but just the fucking doctor’s office has become nearly impossible.

In late September, I talked with my primary doctor about a skin problem I was having. He advised me to see a dermatologist and referred me to one. I called the dermatologist for an appointment where I was strongly advised to leave a message and that someone from the doctor’s office would call me back. I get an email that very same day saying that someone would investigate (I am assuming whether they take my insurance and they will pay for it) and get back with me. So far, things are going swimmingly.

But then no return phone call for a week. As I was going out of town, I put it on hold, thinking foolishly, that eventually someone would contact me with an appointment. When I returned to San Diego, still having not received a response from the doctor, I called the office to inquire about my appointment. I talked to a nice woman who apologized profusely about the failed response and booked an appointment for me. Success.

A day or so later, I received a phone call from the nice woman telling me that while they took my insurance this year, they weren’t taking it next year. Since it is now mid-October and the soonest they can get me an appointment for was mid-November, they didn’t want to start seeing me as a patient in cases their services were needed into 2026. All vaguely rational sounding, so I went back to my primary physician.

The assistant at my primary physician’s office, who has always been helpful, couldn’t understand why they just didn’t keep the appointment and, if I needed further treatment, refer me another dermatologist in 2026. She said I had a legitimate concern about a growth on my hand and they could, at least, get the ball rolling.

She told me she would take care of it. A day later she calls me back saying that they don’t want me as a patient and she find another dermatologist to look at my hand. She added it might take a little time because she now has to investigate which doctors will take my insurance in both 2025 and 2026. Towards the end October, she finds one.

I got swept up with other events in my life but was finally able to contact the new dermatologist at the beginning of November. A very unhelpful phone tree took the call. The recorded message kept advising me to use the on-line scheduling system. My experience with on-line scheduling has been horrendous. There is no response to my request or a continual back and forth about a suitable date for the appointment.

I opted to stay on the phone line where every so often I was encourage again to use the on line system or leave a message on the recorder and someone would call me back that very same day. My experience with this is I rarely get a call back and, if I do, it is never on the same day. I chose to stay on the line. Fifteen minutes into my wait, I was disconnected. Or I think I was disconnected. I stopped getting the annoying messages about using the on line system and my phone stopped timing how long the phone was. There was just silence which I deduced was a hang up.

I called again but this time I decided to look at the on line system. I completed the form as best I could knowing that there would be a back and forth about the actual appointment. I sent the form in while waiting because what the Hell, I was on hold any way, it was something to fill the time, I got some lunch and, after a half hour on hold, I surrendered. I would just have to trust that the on line system would work.

Later that day, I received a response from their on line system telling me that they were working on scheduling my appointment and I they would confirm an appointment soon. I don’t like the sounds of soon. Soon. That could be any time frame they choose.

So it is approaching the middle of November and I still do not have a scheduled date for someone to look at the growth on my hand. Think about that. A month and half just trying to get a fucking appointment.

Thank God I don’t live in a country with socialized medicine who knows how long I would be waiting for an appointment.

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Since Bob’s fall, I have learned the secret of getting what you want in the American Medical System — be aggressive. It is the one piece of advice I get from almost anyone who has had any dealings with the system. Be aggressive. You have to be an advocate for your loved one in order to get the treatment they deserve. This advice is given to me so often that it took me awhile to hear what people are actually saying.

I thought good medical insurance was sufficient for good treatment but it also helps to be a bit of an asshole. Now some of you will say being aggressive is not necessarily being an asshole. You can politely but firmly be aggressive. But that wasn’t the advice I was getting. People were actually saying be an asshole, get in their faces, don’t let them push you around. Some of this advice came from medical professionals.

Also, and this is important, why do I have to be aggressive at all? If my insurance covers it, why do I have to aggressively monitor his treatment at all. He should be getting it without asking. But this isn’t the impression of an awful lot of users of the American Medical system.

The saddest part of this advice is we passively accept it as they way things are. The only way to get good treatment is to be aggressive. So, yeah, mother fucker, I will do whatever it takes to get my loved one what he needs. My biggest worry since Bob’s accident is am I being aggressive enough. What did I fail to see or do. Who should I be chasing down. Will Bob get screwed by some mistake I made. This is hardly conducive to healing the patient and it is exhausting for his loved ones.