Oh well, force of habit...
Long afternoon naps might be a good thing for most of us. Clearly, some cultural traditions have figured this out. For Sarah, it looks like a necessity. So she is again sound asleep in mid afternoon. But, her nights are still somewhat disrupted by the breakthrough of pain, bathroom needs, and even a little anxiety.
Many phone calls were needed today to line up the multiple follow-up visits in store for February and to connect Sarah with the cardiac rehabilitation program at Concord Hospital. In addition to her insurance on my private plan through Crotched Mountain, Sarah also has Medicaid and Medicare. However, I discovered today that her QWMB (pronounced Quimby) status has been pending since September. The state Medicaid office thought that this was highly unusual, but said they couldn't fix it - I had to call the Concord Regional office instead. (Which I did twice, left voice mails, and had no return call.) Frankly, I have no idea what QWMB stands for or the the significance of this. However, it seems to create confusion about which public insurance program (Medicare or Medicaid) is responsible for Sarah's medical expenses after her private insurance has paid whatever it will pay. It also seems to be interfering with coverage for her prescriptions. I expect that it will take some time to sort this out particularly since every call reaches someone's voice mail (if the line is not busy), and returned calls come days not hours later. Meanwhile, notices from her private insurer indicate that bills for this long, complicated, and continuing "episode of care" are beginning to roll in. I will try to develop a running total once more of the bills are assembled. I long for a sensible, single payer health system, but it looks unlikely in my lifetime without moving to another country.
One positive insurance note is that our private plan will cover the rental/purchase of a "point of care" device for measuring the INR (the test of Sarah's blood clotting needed to adjust her Coumadin dose). This is a hand held device about three iPhones tall and two iPhones long. It requires a single drop of blood from a finger stick. This is much like the devices used by people with diabetes to test their blood sugar. In the long run it will make us less tied to hospital labs and reduce the need to draw blood from a vein (once the in-dwelling catheter that Sarah has (PICC line) is removed). Apparently, there are studies that show that when patients measure their own INR tests, they have better overall outcomes with respect to Coumadin therapy.
That reminds me, do you know what Coumadin is? It is warfarin, and it's the active ingredient in most common rat poisons. As Sarah took her 6 mg of Coumadin last night, we thought, omg, we're giving our lovely, beloved daughter rat poison. Sometimes it doesn't pay to reflect on things too much.
Sarah had a great noon time visit to her wonderful colleagues at the Disability Rights Center of NH. It was her first outing since her hospitalization. She brought her lunch (ham sandwich with light mayo on cinnamon raisin bread - don't ask!, pretzels, and diet coke) and joined the gang at the communal lunch table for half an hour or so. She was so happy to see everyone, but was careful to remind everyone of her new work limitations - no lifting of anything over 7 pounds.
Sarah's brother, Reed, and Lucy are arriving late tonight from Brooklyn to spend the weekend. It will be fun yet again to have all of the family assembled for some meals and conversation.
Long afternoon naps might be a good thing for most of us. Clearly, some cultural traditions have figured this out. For Sarah, it looks like a necessity. So she is again sound asleep in mid afternoon. But, her nights are still somewhat disrupted by the breakthrough of pain, bathroom needs, and even a little anxiety.
Many phone calls were needed today to line up the multiple follow-up visits in store for February and to connect Sarah with the cardiac rehabilitation program at Concord Hospital. In addition to her insurance on my private plan through Crotched Mountain, Sarah also has Medicaid and Medicare. However, I discovered today that her QWMB (pronounced Quimby) status has been pending since September. The state Medicaid office thought that this was highly unusual, but said they couldn't fix it - I had to call the Concord Regional office instead. (Which I did twice, left voice mails, and had no return call.) Frankly, I have no idea what QWMB stands for or the the significance of this. However, it seems to create confusion about which public insurance program (Medicare or Medicaid) is responsible for Sarah's medical expenses after her private insurance has paid whatever it will pay. It also seems to be interfering with coverage for her prescriptions. I expect that it will take some time to sort this out particularly since every call reaches someone's voice mail (if the line is not busy), and returned calls come days not hours later. Meanwhile, notices from her private insurer indicate that bills for this long, complicated, and continuing "episode of care" are beginning to roll in. I will try to develop a running total once more of the bills are assembled. I long for a sensible, single payer health system, but it looks unlikely in my lifetime without moving to another country.
One positive insurance note is that our private plan will cover the rental/purchase of a "point of care" device for measuring the INR (the test of Sarah's blood clotting needed to adjust her Coumadin dose). This is a hand held device about three iPhones tall and two iPhones long. It requires a single drop of blood from a finger stick. This is much like the devices used by people with diabetes to test their blood sugar. In the long run it will make us less tied to hospital labs and reduce the need to draw blood from a vein (once the in-dwelling catheter that Sarah has (PICC line) is removed). Apparently, there are studies that show that when patients measure their own INR tests, they have better overall outcomes with respect to Coumadin therapy.
That reminds me, do you know what Coumadin is? It is warfarin, and it's the active ingredient in most common rat poisons. As Sarah took her 6 mg of Coumadin last night, we thought, omg, we're giving our lovely, beloved daughter rat poison. Sometimes it doesn't pay to reflect on things too much.
Sarah had a great noon time visit to her wonderful colleagues at the Disability Rights Center of NH. It was her first outing since her hospitalization. She brought her lunch (ham sandwich with light mayo on cinnamon raisin bread - don't ask!, pretzels, and diet coke) and joined the gang at the communal lunch table for half an hour or so. She was so happy to see everyone, but was careful to remind everyone of her new work limitations - no lifting of anything over 7 pounds.
Sarah's brother, Reed, and Lucy are arriving late tonight from Brooklyn to spend the weekend. It will be fun yet again to have all of the family assembled for some meals and conversation.
Getting to work around 9 and an afternoon siesta would make the workaday life infinitely more agreeable. And a 4 day work week.
ReplyDeleteThe running $$ total of this adventure would be way too scary. Scarier than rat poison. We used to have to visit the doctor regularly for blood drawings to keep Danny's Coumadin right.
Have a wonderful weekend!