What a day. When did it all begin? Never mind. We’re here now. It was not a great lab report, but it got the ball rolling.

 

In this time of corona, it’s difficult to see a doctor now with all the lock-downs in place. But that doesn’t mean we stop needing them. I can’t help but wonder just how many are scared and sick with other diseases and maladies that require regular checks and testing. Truly a frightening time to be sick and worrying about other illnesses besides the worry of this ominous virus.

I know first-hand how much red tape has come down in the medical system in order to deal with the global virus – we can’t go to our doctor for concerns, we can’t even get our blood pressure taken at our local pharmacies right now as they’ve closed off the machines. Now, anything that can’t be dealt with by telephone means having to go to an emergency hospital room, and most of us don’t like going there under normal circumstances, let alone with fears of crowded ERs and an invisible virus looming.

Elective surgeries everywhere have been postponed indefinitely, and elective is a loose term covering a huge umbrella which would cover things like – surgeries that people have chosen to have – or not, colonoscopies, which are nobody’s favorite but are life-saving, among many of other cancelled procedures and postponed testing that are necessary. Unfortunately, during uncertain times while protecting the health system from becoming overwhelmed, there’s going to be fallout somewhere.

But there are ways to deal with circumstances, and Tele-health calls are a good start with our doctors. And if we happen to be lucky enough to have an amazing doctor who knows us well as their patient and agrees with symptoms, they can request a test. We are our own best advocates when we know something isn’t right, so we must convey how we’re feeling to the doctor on the phone. And there it begins.

It was touch and go when I was informed that since there was only one operating room available, there was a possibility hub’s surgery time may be delayed. But we were halfway to the finish line. Dr. B was finally able to schedule Hubby for his long awaited procedure. You may be wondering how we managed to even get scheduled for the ‘elective’ surgery that suddenly became emergency when evaluated by the doctor, finally allowing him to schedule a surgery because it’s deemed necessary.

My husband’s recurring bleed out episodes had him losing a lot of blood. He’s usually facing one of these episodes annually ever since he had maximum radiation for his prostate cancer 10 years ago.. But this one decided act up 2 days before we were to fly home from Mexico, a mere 4 months after his last procedure.

I’d emailed Hub’s surgeon’s secretary, Lisa, who knows the drill. I told her we’d be home in 2 days and asked if she could book him a surgery for the following week, and we were elated to have an appointment for a week after our return.. But that was the same week the world changed and I got an email from Lisa at Dr. B’s office 2 days later, informing she was sorry, but no elective surgeries till further notice. Then she called to elaborate on the new hospital rules and  we did a Tele-health call with Dr. B and he said he was working on a plan to get Hub in.

The only other way into getting a surgery in Corona times is by having to go through the ER as an emergency. I know all the signs of Hubby’s health and I also know when it’s hospital time. Dr. B knows Hub’s history and knows my husband needs a fixing. But there is only one operating room for Endoscopy floor set up now and it’s for emergency surgeries. Since we’d spoken to Dr. B a few weeks prior, he gave me all that info and told me if Hub bleeds again to call his office and he’ll schedule him as an emergency. Well thankfully there’s been no episodes since the call 2 weeks ago as we awaited, but gratefully, Hubby has his lab blood-work done monthly and copied off to 4 of his doctors. And just because he hadn’t bled again didn’t mean that he wasn’t weak and tired from the 3 big bleeds since Mexico, and I knew last week’s labs were not going to be a good number based on Hubby’s weakness.

I was right, and so it turns out, his very low hemoglobin number at the lab, sent an alert to 2 doctors, one, our GP, and to Dr. B.  Our GP’s office called to let me know the number was low, which I’d already seen a copy online of the report. I told the secretary I took him to the pharmacy to check his pressure, but they closed off the area. She told me Dr. K would call me Monday. She did, we chatted about Hubby’s health and I told her he wouldn’t go to the hospital as she suggested, to check his pressure because he doesn’t want to be in the ER fearing the virus. So she was kind enough to invite me to bring him to her office and the secretary would check his pressure. And it was low.

We went straight home as I was expecting a call from Dr. B after receiving an email from Lisa earlier in the morning after Dr. B saw the report, informing he’d be calling us later. And he did. It unfortunately took my husband’s sorry labs for Dr. B to finally be able to deem his procedure an emergency, and Dr. B booked him in for Monday (yesterday), which was ultimately changed  when Lisa called me and informed me to relay that once again the hospital changed Dr. B’s surgical on call day to Thursday. My Hubby said, he’d waited long enough for Dr. B, he can wait another few days, not wanting another doctor involved. And another bonus was Dr. B had taken the liberty to set up 4 sessions of iron infusion at the hospital for Hubby because his iron levels are dangerously low. Personally, as I write this, I’m concerned at my husband’s weakness and am going to send another email to Lisa to inform Dr. B that he may well need a bag of blood as the infusions take a few weeks to be effective.

So, I took Hub to hospital last Friday for his first infusion, although this is not the first time he has had them. I was so impressed with the setup. Nobody allowed to accompany the patients past the entrance, so Hubby had a lot of anxiety over this visit without me with him to guide him around the hospital and answer questions and fill out forms. I told him it was all organized and I wrote a note for the nurses of allergies and meds and my cell phone number, asking to please call when he’s almost done. And it was perfect.

I parked in front of the door, took him in to a temporary station in the lobby where you tell them what you’re there for, they sanitize your hands and give you a mask (if you don’t have one on, of course we did!), ask you if you’ve been sick or traveled in the last 2 weeks then send you on your way with directions or to the attendants a few feet away for those who need assistance. So I asked if a volunteer could take Hubby in a wheelchair as he has no energy to walk for long, and of course a nurse aid gowned and masked wheeled him to the pharmacy first where he had to pick up the vial of iron infusion because for some reason it’s not covered under hospital medicine so required paying for, which our private prescription plan pays 80%.  Then the nurse administers it through intravenous in the clinic. The hospital was well setup with friendly cheery personnel and staff as usual, so I knew Hub was in good hands.

After I returned to pick him up, Hub told me the pharmacy said we were no longer covered for that drug and charged him $100 instead of the $20 I recalled from past infusions. I was pissed as I pay way too much monthly for that extra prescription coverage and that stuff was covered 2 years ago when we needed it for him then.

As soon as we got home I called the insurance company inquiring how to be reimbursed, got an incompetent agent who didn’t have answers, kept putting me on hold (which was my clue he was clueless), and finally told me we needed a special form from them that has to be submitted by the doctor who prescribed the medication. I laced into him asking what this run around was, and why I have to get a doctor to fill it out when he already prescribed it. I didn’t receive direct answers. Once I received it by email, I looked it over and the page for doctor to tick off and fill in was pretty foreign to me. So once again, I scanned the form into an email and sent it off to poor Lisa asking her if she was familiar with this  form, and I filled her in with a condensed version of how the hospital pharmacy charged us full price.

Lisa to the rescue, again! Ten minutes after sending her the email, my phone rings. Lisa informed me that she thought it was better to call and explain better than in an email. We ended up chatting for over an hour and I discovered just how much she is like me when it comes to injustice. Then she filled me in.

Apparently this drug is not on a list for insurance to pay without going through ‘the special form process. Why? Bureaucracy and BS method of insurance trying to get out of paying. The doctor must fill out the form and ‘code’ for the drug, of which there is no code because it’s considered a universal life-saving drug. Because there’s no code for the drug, it must get sent to the Ministry of Health for approval from the doctor’s office. If the Ministry approves it (which Lisa said there’s no reason they shouldn’t given the circumstances), then they will cover the costs for future infusions and reimburse me for the last one – EXACTLY what insurance hopes for. But if they’d decline, then they’d send the decline form to the doctor and Lisa would forward to me, then I would have to submit the decline form from the government, along with any unpaid receipts to my insurance, and then they would have to pay me back. THANK YOU LISA! And no thanks to you greedy, robber insurance companies.

So, as it stands now, we’re crossing fingers for Thursday that all goes well and that the procedure goes forth. Hopefully, we won’t have to lay out another $100 before the next infusion before the ‘yay or the nay’ comes back from the government approval. And lastly, am I ever lucky and glad to have such an amazing team of doctors and medical assistants. Compassion can actually extend beyond the call of duty!

Good rapports and asking a lot of questions can go a long way when we need our doctor to step up to the plate. My persistence has paid off. Now crossing my fingers Hubby gets his procedure Thursday and hopefully, no emergencies will push him to the end of the line. I’ll keep you posted!

 

©DGKaye2020