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“It doesn’t matter what your card says. We’re not taking patients.” Or the Joys of Obamacare, Part 320,349
Today, I finally decided I was low enough on my standard medications for my chronic illnesses that I would finally contact that new doctor I signed up for in August. It didn’t take effect until September 1st. See, I had to fire my last internist. After a (literal) 5 minute appointment with the man for my yearly evaluation, I was told that he was very busy, one of my other specialists could do my labs and investigate any further issues (that being every issue, since he did nothing). That was the extent of the appointment. After he rushed out, I was nearly in tears which does take quite a lot for me these days.
I fired him when I got home.
Today, I called the new office to make an appointment and was told that New! Improved! Not Crappy! Doctor could not see me as she was no longer taking patients. I said this had to be in error since she was still listed on the insurance website as taking patients. We’re in open enrollment, so surely this was a miscommunication. Even if she was no longer taking patients, I had her assigned as PCP in starting in September. I’m not “new” exactly, I’ve just yet to see her.
I was told after a long hold that it didn’t matter what my card said. She’s not taking patients. After a dead silence and absolute shock, I mentioned that this sucked and she murmured something resembling a non-committal sound of questionable agreement with the sentiment. I asked if any other doctors in the office were taking patients. One. One that I know for a fact has gone “boutique”, which is to say, requiring a yearly down payment prior to any appointments. That same doctor (who is excellent, I might add), is booked up through February.
I hung up, completely flattened.
I’m now on the phone with my insurance discussing complaint filing, but basically being told to just look through their catalogue and pick. I have a migraine. I’m about to run out of medicine and my only recourse since the advent of Obamacare is an urgent care or the ER. I am in tears because it is not going to get better. I finally hung up because the front staff of the Place I Wanted to Go has switched phones to voicemail over an hour early and cannot be contacted by my insurance carrier. All medical offices will be closing soon and there’s no point in picking people from a list and then calling them one by one to ensure they will take new patients (which is the only consolation my insurance has offered me). Come January 1st, my insurance goes from HMO to even crappier HMO.
I have chronic illnesses that are already impacting my life. It is hard not to embrace California’s Right to Die law while sitting here knowing that my quality of life will be stolen from me, not by the disease process; but by sheer incompetence, reduced access to timely care, and legislated medical malpractice.
Published in Healthcare
Please don’t take this wrong way—I know you are a highly educated nurse and you most likely know all this. I’m not trying to tell you what to do or insult your intelligence in any way. I’m only saying this in case there’s something here that might help you in your battle.
I suffered from migraines until I was 45 years old. I did not have the classic aura-inducing migraines but rather the common migraine that arises in the back of my neck.
At one point my primary care doctor, after sending me for a neurological workup and an MRI, put me on Fiorinal. Fiorinal is a barbituate, which means that the more of it the patient takes, the more the patient needs to achieve the same effect.
I had to see the doctor every six months for a refill prescription–which was not a problem financially because I had great health insurance at that time. In terms of my personal time, it was irritating to have to go every six months.
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The Fiurinal was a blessing. My daughter was about just about three years old, and one day we were crossing a busy street. I said to her, “OK,” meaning “Take my hand,” and instead she bolted out into the street. I saw oncoming cars, I screamed and waved my arms, the cars stopped, and she was fine. But the blood vessels in the back of my neck tightened up into a horrific migraine pretzel that would not quit. After three days of terrible pain, the doctor prescribed Fiurinal, and that’s how the prescription started. He said the pressure through the constricted vessels in my neck had actually bruised those blood vessels.
I was told by the doctor that the Fiurinal would not work well if I waited too long. Once the headache became full blown, it would take 24 hours for the Fiurinal to work. So, as many patients on barbiturates do, I started taking it as soon as I thought a migraine was starting. That meant I was taking a lot more than I had been, and the more I took, the more I needed to take.
I took it for about three years, and then we moved. I had to change doctors. The new doctor obtained my records from my former doctor, and he prescribed the Fiurinal I had been taking.
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A year later with my new doctor, he suddenly turned to me and said, “You are addicted to these drugs.” He said it in a very damning way. I felt threatened. I could see where this was going.
So I started investigating Fiurinal. I asked my druggist about it, and he looked at the prescription and found out that it contained codeine. What?!? He looked at my old records and compared them. My new doctor had, in his haste, written my prescriptions for the wrong Fiurinal—one contained codeine, and one did not. My former doctor had me on just the plain Fiurinal. So, after this new doctor was so horrible to me, he had made a terrible mistake.
But nevertheless, I decided I had to get off these things because I didn’t want to be depending on doctors anymore. I didn’t want to be jerked around by them this way.
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So I started looking into the many triggers for migraines, and I changed a great many things about my daily life that together have helped me avoid them. I always wear a hat when I am outside–sunlight downward on my eyes causes migraines for me. No red wine or aged cheese—actually, as it turns out, I can have some of both. Just not too much. Same with chocolate.
Most important, I have to have the same sleep-wake-up routine every single day, seven days a week. I cannot vary this.
I’ve never relayed this story to anyone because I assume everyone has the same information I do. But the part of your situation that jumped out at me was the crazy hours you are keeping.
It doesn’t matter what part of the day you are asleep or awake. What matters in migraine prevention is that those hours be the same and that your wake-up routine is the same. For me, that’s three cups of strong coffee. Which makes sense since caffeine was a major ingredient Cafergot, the migraine treatment of years ago.
I also take two aspirin—aspirin thins the blood.
I also found out that my grandparents had always taken Excedrin, which contains caffeine, so probably my headaches are genetic, and they knew about aspirin and caffeine way ahead of me.
I hope, I pray, I haven’t ticked you off here by giving you unsolicited advice.
I work for a US government hospice(VA Hospital), and we have NEVER had that conversation.
I remember when I started at VA Mental Health just doing Advocacy and Case Management and one client was getting oxycontin for Anxiety from a Psychiatrist. Luckily he wanted to reduce his med load, so I was able to tear into that Psychiatrist, who honestly thought that was a safe FIRST treatment for Anxiety Disorder.
Of course it is never that explicit. Well, I would hope it wouldn’t be!
That’s not even a legitimate indication for that drug! What the Hell? !
Nope. I feel for you on your end of things. I’ve been very lucky that my whole family has migraines and I’ve had mine since I was 12. I’ve known the ins and outs and triggers. Lately, it’s just straight up stress and muscle spasms. The sleep issue is something else altogether, but I’d be surprised if it wasn’t a component!
Anything can be a migraine trigger.
Good grief Kay and Right Nurse! Where is the vestibular nerve located? I just looked it up – I hope they come up with a good treatment – glad there is treatment! God bless you two
Just the other day my sis was lamenting about insurance and some vote in CO about a plan.
Part of the exchange included me quipping, “There’s always hemlock.”
Every fiber of my being is opposed to suicide but Obamacare tests my mettle, and I’m a healthy person.
I’m so sorry you’re facing this.
To both of you and everyone – also try food elimination for allergies- I am allergic to wheat, dairy and soy – all have different symptoms, but they are miserable. These include bad headaches and neck pain, joint pain, irregular heartbeat, gastrointestinal distress, drowsiness, shortness of breath, and in some cases fainting. I didn’t even realize these food allergies were the causes until in my 40’s. Very tiny amounts are ok, but I get bold and cheat, and start the misery. It can takes days for symptoms to resolve. Also, chiropractic can adjust what may be pinching nerves, head and neck issues etc. I use a chiropractor that is trained with the manipulator pen – she doesn’t adjust me manually – this may work for you or anyone –
Right.
It took years to figure out what caused my headaches. Even changes in air pressure, such as happens when a storm is moving in, can do it.
I know you are trying to think of solutions but man, this is what its come to? Go to WalMart for healthcare? Please folks – don’t vote for HRC….
I work in Neuro. Neck manipulation is baaaad, mmkay? ;) As for allergies, I have a currently undiagnosed autoimmune..thing. They don’t know what to do with me. Migraines are really the least of my concern. The problem there is that I have no doctor to refill my rescue meds. That’s it. Once I got on Inderal for prophylaxis, everything got better.
As for allergies, I have them all. I am both skin reactive and serum reactive to the following: avocado, peaches, legumes, melons, citrus, chicken egg whites, tomato, corn, wheat, soy, shellfish, clams, peanuts, chestnuts, carrots, peas, banana, mango, multiple types of weeds, dog and cat dander, multiple types of grass, multiple types of trees….
Believe me, I’ve been on top of that. Hence autoimmune.
I didn’t read all the comments, so this may have been covered. But I have two suggestions, one “informal”…
Important! Do you have a copy of your medical records, so a new doctor could verify your situation?
if yes, are you a member of a religious organization? (Church, synagogue, mosque, etc) if so, there are likely doctors who are members, and the priest/ whatever knows who they are. One such person could look at your stuff, and do the scrips, maybe recommend someone who could take you on.
Do you live near a university with a medical school with an associated practice of some sort? It is easier to get specialized care from within a family practice unit who refers you to someone two corridors over…
these may be unrealistic, and/or someone else may have made them, but just possibilities… we are all going to have to do more workarounds– the administrative state is inflexible & incompetent.
MBF’s suggestion of getting more to spend on boutique care by scrimping as much as possible on routine, uncomplicated problems does work for some people. I’ve done it. Some complicated medical conditions do require that even routine stuff be done differently, but not all do. TRN has so many allergies that maybe that strategy wouldn’t work for her, but I understand why MBF suggested it.
Even without disastrous healthcare policies, there’s much to be said for making really cheap low-level urgent care commercially available. It’s a royal pain, actually, to be sent to the emergency room when all you’ve got is a low-level but urgent problem. Basic urgent care is a good thing.
TheRightNurse Ever been stabbed? Last person I know who went got stabbed while crossing the border. Admittedly, this has been a while. Also, medical tourism scares me.
No, but it goes without saying that you stop at the black ops office before crossing and hire a couple of guys to escort you for the day. Generally you won’t have too much trouble then.
Re. med. tourism; I would have preferred to just go to the dentist a block from my store but he gave me an estimate of $12,000. When I said I just didn’t have that kind of money, he said put on my credit card. That still does not pay for it! My wife’s sister had gone to this dentist down there so gave her a try, cost under $2000. A crown costs $250 there and $2000 here. Latest procedures and equipment like implants and digital x-ray! The vast majority of people using the Mex dentists there are retired US and Canadian with no dental insurance and have limited income. I’m just putting this out FYI it’s not for everyone but someone might benefit.
The longer Obomacare goes on more and more of the doctors here will be foreign trained and it will them coming here
Election migrane? xxoo
I have a bipolar 1 relative who is very sensitive to certain meds – they get incredibly ill on the most commonly prescribed ones, and last year they finally got on one that worked, only the FDA has not “approved” it for bipolar 1, only bipolar 2.
New year, new carrier because the old one jacked rates 20% last year, and the new carrier refuses to approve this med because they don’t have any record that my relative tried all the others. Appeals denied. Phone calls to carrier about appealing the appeal led to a 3-hour telephone circle about whom to speak to, only to get lied to about the entire process.
3 months later, still no resolution. Paperwork from the physician rejected for being on obsolete forms (that were provided by the carrier), more lies, more obfuscations.
To a certain extent, this always been true of claims submitted to insurance companies. I had BC/BS when my second child came along thirty years ago. My husband was running his own business, and we moved, and we didn’t get the bill in time. I have forgotten all the details, but it was lapsed for only thirty days, but it came in the mail (and I think they were supposed to send it by registered mail, return receipt requested) when I was in hospital with a C-section (very expensive). I called the insurance company to plead my case (we had a good defense, but I can’t remember what it was), and the woman on the phone finally said, “Look, you’re right. But you must understand it is my job to find ways to deny claims.” I’ve never forgotten that. Geesh. Even after they agreed, they sat on the money for almost a year.
What kills me when I hear this stuff is that people have paid billions of dollars to these companies. When people get cancelled, the companies keep all those past premiums. What a racket!
testing emoji explosion. ignore my comment.
@michaeljohnson what browser do you use? I’m trying to figure out why that emoji blew up for you.
@max, I use Firefox and emojis explode for me
test from firefox
Test from firefox on a Mac product not yet running Sierra.
In other non-emoji news, I’m working on my complaints to both Cigna and the Czar of Managed Care. It appears that the doctor may not know that the front office staff is not updating Cigna. It may also be that everyone involved is horrible and trying to manipulate the system.
I took advice from a previous comment and am being assigned a Care Manager to do the legwork to find me a doctor. Unfortunately, I have little faith that I will end up with more than an available and local doctor.
Omg.
My friend had a case manager find her a neurologist in network. Probably the worst neurologist in the state. Not one positive feedback on the individual.
The best person, most experienced person for the job is out of network, and does not take insurance.
And there we have it: we’ll be thankful for rationed care because at least we’ll know we are getting crap. ?