Bizarre and more bizarre

Back in this past winter and spring I posted a bit about health issues.

On September 1st my doctor died from a stroke. He was, I think, 61 or 62, and in otherwise good health. This in itself is a shock, but there's more. I was deeply immersed in my art making project in September and so wasn't reading the newspapers much and completely missed the obituaries that were published in the weeks following my doctor's death. I even missed the letter I got from my insurance company telling me my doctor would no longer be available. They didn't say he died, they said he would no longer be able to provide care.

Finally, about a week ago, I got a new insurance card in the mail with a new doctor's name on it. I got my mail too late in the day to call the insurance co., but I did call my doctor's office. I got the answering service. Not a machine, but an actual person. I said I assumed I was reaching the service, and they said yes, but the office was closed. I said, sure, it's 7pm, I figured that. And the woman said, no, the office is closed for business - the doctor has died. Well. I'm sitting there with my mouth hanging open. The woman apologizes, says she understands how shocked I must be, and every time she tells another patient she herself is shocked all over again. She tells me some details about how the doctor died (in a kayak, with his wife). There isn't much else to say, so I mentally note that I have to call the insurance co. and the doctor I've been assigned on Monday morning. 

Monday morning. I call a doctor who a friend of mine really liked, but she's not accepting any new patients. The office is at capacity. OK. They give me the name of a new doctor in town who is taking new patients. I try to find the phone number of the doctor I've been assigned by the insurance co., but I look everywhere and there is no listing for them. I look in the hard copy phone book, white and yellow pages, I look on line. I look under the doctor's name, I look under the practice's name. Nothing. Nada. So I call the friend's doctor's office and they, thank God, have the number. I reach the assigned doctor's office. They advise me they aren't taking patients outside their limited geographical area (even though this is who the insurance co. assigned me to). This area doesn't include where I live, and they recommend the same doctor my friend's doctor's office recommended. Apparently this guy is probably the only doctor in central Vermont who is taking new patients. OK  then. On to the new doctor. I call, I explain. They know all about it. We make an appointment for December (which I later change to January so it'll be an annual physical, and therefore covered by the freaking insurance). They say they will send me an introductory pack of forms, including a release of records form that I can use to get my medical records from my deceased doctor's office.

Which is really good, because it turns out the deceased doctor's office isn't releasing records directly to patients, but only transferring records to other doctor's offices. I find this out when I call the deceased doctor's answering service on Tuesday, because the answering service told me I could talk with someone there on Tuesdays and Thursday between 2-4pm. It turns out I couldn't actually talk with anyone besides the answering service, but they did clarify that I could drop my release form at the office during those hours, but only to drop it off (or fax it over), that I could not actually get my records. And how, I asked, would I know that, first, they'd recieved the request, and second, responded to it and sent it to my new doctor? Oh, they said, you could call your new doctor's office and check with them. As much as I wanted to argue the circular logic of this response I saw that the woman at the answering service couldn't help me, so I said thanks and hung up. 

One thing that took a day or so to sink it was a detail the answering service woman had told me (or maybe it was one of the receptionists at one of the other offices...it's kind of mushed together in my mind now). It's this - the deceased doctor's office will be processing requests to release medical records until the end of October. I called my new doctor's office yesterday (Friday) asking if they had the correct address for me, as I hadn't recieved the forms yet. They told me they had a big stack to send out, but they appreciated getting a confirmation of my correct address, and that they'd be sending the forms out shortly. I sure hope I can get my records transferred before Oct. 31st. I don't want to think about what I might have to do after that date. Sue? File a brief in civil court? What all?

Then, today, Saturday, I'm at the farmer's market. I see the nurse practitioner from my deceased doctor's office. I tell her I feel badly for her, she must be having a hard time. Well, she wants to know if I got a letter from the office letting me know what happened. I told her no, that I found out from the insurance co. She told me the family of the deceased doctor, through an intermediary, told her they didn't have any money to pay her a week after the doctor died. That she couldn't work there anymore, not even to contact patients to let them know what happened. The nurse, on her own, looked for (in the phone book) and was able to find 53 of the several hundred patients she knew, and in this way was able to let them know by letter, that the doctor had died and they needed to find a new doctor for their primary care.

So she is trying to find her own way and is working to get a new practice together. You see, a big reason I was a patient of the deceased doctor was because the nurse practitioner was on staff. I could get my physical examination with a woman. Now? Now I have to start all over again, with a  new doctor whose only recommendation is that he's so new he has room for me. Meanwhile, if the nurse practitioner starts a new practice I may or may not join her there, as she is a bit muddled in methods and communication. Fun all around.

But I can see even though this is a general pain in the ass, it is not so awful as it might be. I am in good health. I am not dependent on the deceased doctor for any prescriptions, treatments or diagnosees. As frustrating as this situation is, it could be so much more so. I'm grateful for that. My heart goes out to the patients who actually have to find their way through this morass, not just checking in around the edges like I am doing. 

Hopefully everything will go smoothly with the transfer of records and I won't have anything new to report until next year. I'll let you know.

the skinny on cholesterol

Oh yeah, I said I was going to post on the test results for cholesterol and vitamin D, didn't I?

Strangely, although I gave up some purported cholesterol producing foodstuffs and started eating more purported cholesterol reducing foodstuffs, my overall cholesterol went up between Jan. and April by a sizable chunk. Especially the "bad" kind (LDL). Ftischhhh.

My vitamin D, however, is up in the normal range. Yay!

The result? I'm less likely to be depressed about my health being endangered by the plaque building up in my arteries. Ha, ha, ha.

Seriously, though, I'm gonna try taking Omega-3 fatty acids as a supplement, and see if that helps. But, the thing is, until April my cholesterol has been pretty much the same for the past four or five years. So my feeling is the stress of worrying over the health of my arteries has created more damage than anything else I might be doing. So I've decided to put thoughts of cholesterol back where they belong: in the world of the bean counters.

I'll go outside and "walk briskly", (although I prefer strolling) for half an hour. A half hour is the recommended time frame for this excellent {although frankly silly looking} low maintenance high benefit exercize. Or maybe bicycle down to the co-op or up to the Peace Park (east and west stretches of the bike path, respectively).   

And I'm gonna find another doctor. Somebody who knows how to read their own forms (and send test results to the correct address), tells patients all the tests being performed for them and why, and can remember in a timely manner to give cogent recommendations on the type and amounts of efficatious supplements.

Seems reasonable, I think.

See you later - time to get outside.

short visit to say hi and some recommendations

Hey-ho (as Kermit the Frog would say),

I've been mulling over this and that the last few weeks, plus I still have a cold, which was really hellacious at first, ten days ago, and now just irritating. I tried breaking up with it earlier today (imagine me yelling at it: "It's OVER! Get out of my body, NOW, and take all your snot rags with you!", kicking the waste paper basket across the room for emphasis). We'll see if that has the desired affect.

Meanwhile, I've been visiting some more web sites.

Here's a few I particularly like:

TED: Ideas Worth Spreading

Bizarroblog

Byron Katie's "The Work"

Have fun with these. I'll be back after I change the locks (if I can ever get this darn cold to leave the house).

Curiosity is keeping this cat alive

I called the doctor's office to find out what would happen to my blood once it was drawn (see previous post on tests below), and how much it would cost.

My blood will be tested for vitamin D levels, and for cholesteral (the good and the bad kinds). It will cost $76.88. $25 for drawing the blood, $51.88 for the lab work.

Stay tuned. I'll let you know how it all turns out.

Tests I didn't know I was taking and other health related costs

So I got my statement from BlueCross BlueShield this morning. Turns out the information I posted recently about the cost of a mammogram is more than twice as high at $312 than the higher end of $150.

Insurance only covers $249.23 of it, but unlike other statements I've received recently the difference is not passed on to me. I guess the radiologist and my doctor eat the difference. Or maybe the $249.23 is how much it really costs and the $312 is what they ask for just in case the insurance company is feeling generous???

Meanwhile, I got a bill from my doctor's office for $14.27, for the lab work on a pregnancy test. (Clearing my throat) I didn't ask for or need a pregnancy test, and this is what I told the doctor, after speaking with the receptionist, who told me to call the insurance company to find out why this wasn't covered with all the other lab work, and the insurance company told me to call the doctor to discuss the (apparent) need for the test by the doctor. Following me so far?

I got a physical examination in January from the nurse practitioner. She included the pregnancy test with all the other lab work, but didn't mention it at the time of the examination.

So I was really surprised when it came up on the bill. I was just lucky when the doctor answered the phone the second time I called the office, after speaking with the insurance company. He said he didn't know why it had been included, and said he could do one of two things; speak with the nurse practitioner about it's inclusion or take the $14.27 off my bill. I said it would be great if he could do both, and he said he would.

Hopefully, case closed. Although I have more lab work scheduled for later this month, with this doctor's office. They want to find out if the vitamin D3 I'm taking is showing up in my blood. Apparently when they tested for this in January my D levels were at 9 (parts per million?). "Normal" is 25-50, so I guess I needed some assistance in the vitamin D department. I've been taking 2000 iu (international units) of Vit. D3 every day since mid January, and made an appointment back then for mid April to find out how things were going.

Now I'm going to call the doctor's office and find out if there's anything else they're going to test for while they're drawing blood. Just, you know, out of curiosity.

Crazy

Last Saturday evening I went to a production (one woman play) called "Crazy" by Gail Marlene Schwartz up at the Vermont College Chapel. Third Story Window is the name of Gail's community based art/performance company. Very Cool. VSA Arts of Vermont was the producer for the 5 performances in Vermont, the one in Montpelier being the last of them.

I'm so glad I went! Gail's story, which is autobiographical, centers on her experience of the 18 therapists she's seen since she was 5 1/2 years old. It's a great story and afterwards there was a panel discussion with local providers, consumers, advocates and some combination of all three and the audience, and Gail, the actor/writer. It was a great experience, and instead of re-writing all about it I'm going to re-print the evaluation/testimonial here.

Initially I scribbled some notes to myself and wasn't sure if I was going to send Gail or the producers my feedback, but after a couple of encouraging e-mails from Gail I decided to go ahead.

Although I've never been diagnosed as "clinically" one thing or another I've never felt "normal" either. Not coincidentally this was also my mother's approach to being pinned down mental-health wise, in large part because once one is diagnosed it is on one's permanent health record...or something like that.

So seeing someone explore their life-long relationship with the therapeutic process with humor and panashe and so fearlessly, despite interruptions indicating the contrary (see answer #2 below), well, it was just great! At some point I will post a response to the questions of Jewish and Crazy that Gail posted about recently. In the meantime, I think this is plenty to read about right here.


1. If you were telling a friend what you appreciated about this presentation (show), what would you say?

I liked the story, the method of story telling (not linear!) and detail choices, the set, props and three dimensionality of the stage (riding bike onto stage, using props handed up and thrown back from front row, etc) and the intelligence and wit.

2.What moment/s stood out for you and why?

The "interruptions" of neurotic cleaning during particularly tense or tender moments of the performance, the video of the actor's younger self riding her bicycle near the end of the performance, and the stills of the actor's recent self crying. The cleaning interruptions were so funny and real. The actor used the bike with the banana seat through the whole performance, and spoke beautifully about her experience of learning to ride her bike. As an audience member, when I got to see real footage of her riding her bike, I found it quite moving and saw it as a statement about the actor's resiliency and innate sturdiness in the face of 18 versions of interpreting her "craziness". I was very surprised by the stills of the actor crying, as this is, usually, as emotionally vulnerable as a person can get. I appreciated the actor's inclusion of these stills, but didn't fully appreciate their value until I read the materials afterward and discovered the actor had been photographing herself in high states of emotion to include in future performance pieces.

3. What did not work/what would you change about the presentation and why?

The "Rorschach" test images were invisible from where I was sitting. I felt I was being shown a blank (or almost blank) screen and being asked to interpret nothing; that it was a joke, which was frustrating. At the end of the performance I saw that the images were shown in their original size and shape and were actually out of focus close ups of objects, and the actor's face. I wish the test images were just a little less out of focus, maybe because Rorschach test images are so graphically stark.

4. Were your views about mental health/illness impacted by the presentation? How?

Yes. I felt a surge of positive associations with being on the "crazy" end of the mental health continuum. That is, I identified with the intelligence, wit and vulnerability portrayed by the actor. I'm not crazy about being considered "crazy", but this performance displaced a chunk of the shame associated with it, and I also felt less isolated. Thanks.

5. Would you recommend this program for other communities? Why or why not?

Yes! What's not to like??? Seriously, because it takes issues that might be seen as "mental health" issues and turns them into human issues, which is something everyone can benefit from.

6. Any other comments?

Thanks to the actor for baring her soul, and VSA Vermont for producing the performance, and the Vermont Community Foundation for funding the project! This is important work and should certainly be supported in the future.

7. May we use your comments in future projects?

Yes.

downtown on a Saturday afternoon

After chores and lunch I went downtown on foot, on the way to a brisk walk. I've been diagnosed with high cholesteral, so I'll be doing a lot of brisk walking from now on, although I enjoy meandering a lot more. But that's not what I wanted to write about. On my way downtown I saw the blue lights of a police car and realized a street march was starting from the City Hall parking lot. When I got paralell on the street with the marchers I could see their placards. It was an anti-abortion rally. It happened that the marchers and I were walking the same route, although any similarity between myself and them stopped there. I looked at the marchers as I walked along. I realized after a few minutes that I didn't recognize anyone. At the time I thought the marchers were from out of town, that they had been imported for the event, which is entirely possible. But it's also possible the couple hundred people were local and I just didn't recognize any of the faces on the street because their lives and mine just don't intersect.

There was something else I noticed as I was walking down the street. It was very quiet. The marchers weren't chanting, they were mostly just talking among themselves. There was hardly anyone on the sidewalks that lined the marcher's route, and the car traffic was thin. It wasn't until I had almost reached the Post Office when drivers started honking their approval. One car honked all the way down the block. It wasn't much, though.

I'm thinking about the pro-choice rally I attended back in 1992 (I think that was the year) here in Montpelier. 5,000 people were estimated to have attended. I somehow ended up at the head of the parade (there was a percussion band keeping time and I banged on a drum for awhile) and got my picture in the paper the next day (if I can find a copy of the picture I'll post it). I remember one picture that was taken during the rally. It showed the blocks from the State House up through the corner of State and Main literally filled with people. That's five city blocks of people who felt strongly about the right of women to choose their reproductive lives.