Wednesday, July 28, 2010

Medicare Part D and other unfair practices.

 I guess you now know by the title I'm in a not so good place with the coverage the seniors and disabled are forced to accept. I received that wonderful notification that I was $120 away from "THE BLACK HOLE"  coverage gap-purchasing only my daily meds required for survival.  I've been extremely careful, trying to not tread those waters. After all, I'm still paying off all those wonderful meds from 2008!
     As luck would have it, I started coughing again. This past Saturday it got a new complication. I was coughing up blood. Now this is a MAJOR red flag for me, since this was one of my original symptoms. So to say I was scared is an understatement. After calling my transplant coordinator, some cough suppressant with codeine was called into  my local pharmacy. Imaging my surprise when I was told the cost was $125.00-because my Part D Provider  CVS Caremark Silverscript does not cover cough suppressants. The pharmacist suggested a lesser expensive one and I was caught in the hurdle of ruining my coordinators day off. I called CVS Caremark when I got home and got the usual song and dance.. "Well if it were a Monday, we could push through an authorization/" BUT that takes 72 hrs- "Well yes".  Completely unfair since they regularly change the formulary forcing all participants to switch meds-bother Doctors- JUST every other month or so. I've actually had to stop updating my formulary book I have received so many.
       My luck ran true to form once again and I began a light temperature. The decision was made to call in the Big Guns... I was getting Levacquin 750 mg for 5 days. As I inwardly gritted my teeth ( remember the tooth incident?) thinking of how exorbitant the cost was going to be.  Was I ever wrong... IT WAS WORSE!!!  Five tablets cost me $140.23! Do you realize that is $28.05 per tablet.  Oh and CVS well they saved me a whopping $38.76.. 
       I know you'll say well you'll get a $250 rebate from the gov't when you hit the gap. So what! Look how much I have to spend to get out of the gap.
     When things like this happen, I have to wonder is there anyone minding the raises our elected officials get?  Is anyone up there controlling the cost of these meds? NOPE.  Are they trying to cut physician payouts -forcing us to pay more- YEP. Are they not giving out that cost of living raise? NOPE
Are they helping other countries while we have scores of unemployed? Are they rebuilding other countries while Americans can't afford food?How they in good conscience send billions to help others and not help their own?
     I mentioned to the lovely CSR from CVS who answered my call that I intended to climb back on my soapbox, and let others know what they are doing to their members. I have.
By the way, I also sent a letter to President Barack Obama- wonder if he'll answer...?

Saturday, July 3, 2010

Happy Birthday Daddy! I Miss You

05/15/05Daddy-The Positive foundation






As I’ve grown older, I’ve learned many things. Most of them were instilled in me from my parents. We always remember the good times with fondness, however I recall that the bad ones made us stronger and closer as a family. We had a happy life but each of us kids knew we didn’t dare cross daddy. Retribution was swift and the punishment fit the offense. He wasn’t the type to “beat us” as kids say nowadays, oh no not our daddy. He knew that restriction was the worst thing you could do to a teen or child. I think it was the disappointment on his face that was the real punishment for me. I’d live with the thought that I’d let him down and it ate at me for days.

Memories are like a warm sunny day. We wrap ourselves in them, close our eyes and are transported back to that wonderful time. I can still remember being in a boat in the middle of the river with daddy, fishing and talking. He had me fishing from the age of 3 and our quiet time I remember the best. We would go on to have many quiet times in the future, but fishing together was the beginning of our foundation. I’m talking back in the 1960’s, the early years, and we had a small johnboat, so when it rained we held up an umbrella, laughed and waited for the rain to stop. Now that’s a warm, fuzzy picture I carry with me all the time. I remember a few years’ later mom & dad bought a real boat. When dad & me went fishing and I got tired, he always had life jackets set out like a mini cot in the bow of the boat for me. Even now I fall asleep when I hear the water lapping the sides of a boat. No matter what kind of day I have in a boat, thanks to dad it’s always a great one.

My mother was always the sensitive one, worrying like a mother hen over her children. When I got sick, and they thought I needed to go to the doctor or hospital it was daddywho came to talk to me. I knew it was from the two of them, but this is when I turned to daddy, when there was something medical I needed to talk about. As I got older I would talk to them both, but daddy I remember always holding my hand and calmly talking me through. Mom was the clean up crew. She’d hold me on her lap, rub my arm and calm me until I fell asleep. Another fond memory. One instance in particular, I remember, I had to miss Vacation Bible School because I started coughing up blood. At the time we had no idea what the cause was and wouldn’t find out until many years later. I was lying on the couch; everyone was keeping an eye on the baby of the family! Daddy came up to me, held me and started talking about going to the doctor. He thought it might be appendicitis. Even though I was maybe 5 or 6 he talked to me as if I were an adult and had a say in my care. This is a positive foundation that has stayed with me. He helped me see, calmly that something needed to be done and off we went to the doctor. He knew from my earlier years I had what could be called “white coat syndrome” and did all possible to avoid anyone in the medical field. As long as daddy was there I knew subconsciously I’d be ok. Now that he has so recently left us, I find myself wondering how I’m going to make it through the next procedure. I know in my heart he’s with me, he’s already let me know, but I really miss his presence, his smile, and his positive outlook. I draw on the strengths he instilled in me and the confidence he made sure I had in myself as a person when I feel I need him close.

My teen years were uneventful medically. I decided in the 11th grade I wanted to go into the medical field and started classes to decide which part. I enjoyed working at the hospital helping patients, it was so rewarding. It was in my senior year of school that I took the AFEES test for the armed forces, and signed up for Junior college. I graduated on June 3rd and was in college on the 8th. No need to waste time, I loved school and learning. In August of this same year I spoke to a recruiter. I had accumulated enough college credits and my score was high enough to go into the armed forces as a commissioned officer. Of course it would be the Navy that is the branch daddy was in during WWII. I wanted to go into Intelligence or Air Traffic control. In the late 70’s they didn’t allow females onboard ship, so that was out of the question, even if I decided to be a nurse. The more I considered it, the more appealing Intelligence seemed. I imagined myself in a long trench coat, sunglasses, secretly strolling around Europe. The hit show “Alias” had nothing on me. The show was probably written from my thoughts alone. I remember the day I went in for my entrance physical. As they say, “ It was a day that will live in infamy” My entire world came crumbling down in one simple step.

I made it through the physical until the chest x-ray. A problem was discovered with the pulmonary artery. Since my Afees scores were so high, they were sending me to a cardiologist for verification I could continue on to boot camp. I was concerned, but was taught not to worry unduly on things I can’t change. So I waited to hear the results before I came apart. My mom was with me for the visit. The cardiologist told us it was serious, and wouldn’t know more until a cardiac catheterization was done. Of course, I would not be able to join the Navy or have children. That is the exact way he told me, cold and seemingly uncaring. At 17, my entire world came apart. I was taken back to where my initial physical was done, they told me if there was anyway they could get me out of boot camp they would, but there was no way. So, through the clouds of gloom I walked out, and wondered what in the world I’d do next.

Through the next 13 years my parents were the rock I clung to when life’s obstacles got in the way. It was a time of trial, error, wheelchairs and oxygen, but they were with me through it all. They smiled, encouraged and kept me going. I don’t know how they did it. I never saw them worry, though now I know they did. How could they not, they were told I had a rare disease and probably wouldn’t live to see 20. Daddy always had a smile and a hug and always knew when I needed it most. They watched as I attempted college, moved out on my own, even moved away from the state. They let me experience it all and for that I am so thankful. I know they wanted to shelter me, and protect me from harm, they knew I was dying, but they found the strength to let me live my life no matter what. That is the best thing you can do for your children. Let them have their life, but be there to help pick up the pieces. No advice, no yelling, just positive reinforcement. There were a lot of pieces to pick up. I had the everyday obstacles to overcome as well as the medical ones too. Thank you mom and dad, if I had children I don’t know if I could be half the parents you’ve been.

When the doctor told me I had twelve months to live and needed to go on a transplant list I was living in Ft Lauderdale. My first phone call was to my oldest sister Beverly. I didn’t want to tell mom & dad over the phone and wanted to let someone in the family know for when I drove up to Jacksonville. Shortly after the phone call, she called back. She and another sister Frances were driving down the next day (Friday) to drive me back to Jax. My parents were not to be told I was coming up, they would wonder why I (the gypsy of the family) was not driving myself. They arrived and we had a lighthearted evening overshadowed with what I had to do, and started out the next day. To say we surprised my parents was an understatement. As soon as they saw me they knew I had news.

After the shock we began to plan. They knew my records were sent to University of Pittsburgh for consideration. I had to make arrangements with work, my apartment, etc. I would be moving back home at the age of 29. Not something I thought should happen, I always felt that being the last child they deserved their time alone when I turned 18 and made sure they got it. It was the least I could do for all they did for me over the years. Since daddy was close to retiring, he decided to take early retirement when my call came through and stay with me in Pittsburgh. The hospital recommended that one family member stay through the entire ordeal so the recipient would have someone they could talk to about it later if needed. Looking back on it now, I don’t know how Mom stayed behind and handled it all. She worked, came home and returned numerous phone calls, played receptionist to a constantly ringing phone and worried. She & daddy drove up for the initial surgery, but she flew back home, after I was out of intensive care. How she found the strength to leave amazes me to this day. She is one of the strongest women I know. Daddy had a different job. He watched me fight to make it. When I was in and out of a rejection coma and the doctor told him prayers were all that was keeping me here, he prayed, and stressed whether to tell mom. He decided not to tell her, and wait. His unshakable faith in God saw him through. In three days I was awake and my new lungs were functioning at 100%.

Even though I spent the time in the hospital, I remember the time fondly. The first time I had a bronch and was craving decent food daddy brought me the biggest order of pancakes and sausage I’d ever seen. Each day he brought me an orange-which we shared and some popcorn. During my second lung transplant, both parents stayed with me at transplant housing in Gainesville and the tradition of sharing an orange carried over. Dad would slice it and we’d all watch TV and eat it. The five weeks in Pittsburgh helped me see just how unshakable daddy’s faith really was. He was always positive no matter what and did all he could to make sure I stayed that way too. The nurses put 2 recliners in my room, one for me and one for daddy. Sometimes I think they liked him being there the best. They would laugh when they saw both of us, our feet propped up, sleeping in our chairs with the TV on. When I was released to come home, we decided to drive instead of fly. I was concerned since we were in the middle of flu season and I was immuno-compromised. The doctor said ok so long as we stopped regularly and I walked. They didn’t want any blood clots forming from inactivity. Mom flew up and it was like one of our vacations we took together all over again. Except with the extra stops for walking.

The next 8 years passed quickly. I had as much of a normal life as a transplant recipient can. Trips to UPMC, took early out from the airline, moved to Orlando to be on the opening team of Disney Cruise Line, things were moving right along. Unfortunately so was chronic rejection. I noticed I was having trouble walking and talking at the same time, a warning sign. What followed was a nightmare. The last thing a recipient wants to hear is those two little words –chronic rejection. It feels like a death sentence all over again. The wind is crushed from your sail in seconds. I had to plan again, and tell my parents again. I’d bought a house in Lakeland, so the next 3 years I remember vividly. Not so nice, but I held onto the positive foundation from daddy and read the book of Job a lot during this time. Bell South loved my long distance calls to my parents. I called just to hear their voice and lift me up. I needed to piggy back my emotions from them to keep me positive. They obliged and even made many trips to see me.

Much of this time they didn’t see what I had to endure to survive. I felt I’d hurt them enough and tried to keep as much of the horror as possible from them. I’d tell them about it after everything was ok. I endured iv’s, hospital visits, still trying to work full-time and go to college full-time as well as a pulmonary rehabilitation exercise program. I lost 60 pounds through it all, was diagnosed as steroid induced diabetic and wondered if I’d make it to another transplant. It was at this time I was listed with Gainesville. No other center wanted to do another transplant for me. This was the emotional chasm that almost destroyed me. Hearing all these centers tell me no, when they are supposed to save lives. My thesis in college reflected all my anger during this time and was directed to these centers. This was the only way I knew to release the negative emotion building up  inside me. Shands at Gainesville restored my faith in the medical field and gave me a comfort zone stronger than any other hospital I’d been to.

I finally had to call my parents when I was rushed to the hospital and the doctor told me I needed to decide on whether to go on a respirator or die comfortably on morphine. I didn’t think it was that bad, but then again I wasn’t at Shands either. Mom and daddy were volunteering at the Lions Club making a spaghetti dinner, so I called a sister and asked if she’d let them know I needed to talk to them. The next day my room was filled with family. I needed to know they were all right with my decision, after so many years of fighting the thought of dying comfortably was so appealing. However, I couldn’t let daddy down. I heard him mention to mom that he still saw a spark of the fighter in me, and knew they were holding out for a miracle. I decided to go for the respirator, was moved to ICU and waited through the night. His miracle happened, I didn’t need the respirator and was sent home 2 days later. I immediately made a trip to Shands to discuss what I needed to put in an advanced directive. That night at 3:00 am they got another miracle. We were home and my call came through. We drove back to Gainesville and I got my single left lung transplant.

It was about seven months after this that dad began to show signs of Alzheimer’s. The thought that this man, who has given so much, should have to endure this was unthinkable. I’ve always called him “Mr. Volunteer” and credit my helping others like I do from watching him all my life. We watched him deteriorate for two years; it was so rapid we barely had time to adjust. It hit my mother the hardest. She had to watch each day as he struggled to walk, form sentences and the final days in the nursing home. She just couldn’t lift him anymore, being a small petite woman herself. I still saw the daddy I’ve always known. Living my life disabled taught me a lot, the first was that daddy was still a person and would be treated as such. It was my turn to give something back to him on my visits. I called regularly to keep mom upbeat, but the visits were for dad. In the last 6 months of his life, I had a few obstacles of my own. I was treated for rejection and was waiting for a kidney transplant, hoping for living donor. I was told the wait could be five years.

I couldn’t talk to dad about all this anymore, so I drew on what he’d given me all these years. I didn’t want to burden mom, she was under enough pressure. I did want her to know that I understood, and they were here with me even if not physically. I visited them for a week, what was to be my last precious moments with daddy. After I got home, two days later I got a call from the kidney transplant program, they had a kidney for me! I couldn’t believe it, it was only six months of waiting. I called mom, hoping she could find time to let everyone know. I got out of the hospital one week later on Thursday and daddy went in on that Friday. From the hospital he went to a nursing home. I got daily reports from my sisters and stressed if I’d be able to see him again. I was so freshly out of a transplant I couldn’t go visit him in a nursing home yet. I finally got the ok at 3 weeks out with a few restrictions and we drove up. We got there late Wednesday and he passed away 12 AM on Friday June 3,2005. I got to see him, but he was semi-comatose so I’ll never know if he knew I was there. I know I was and I still drew strength from the man that is my daddy.

I had to leave early on Friday for an appointment a shands. My kidney wasn’t functioning they way they hoped and they wanted to admit me. It was then that the loss of daddy hit me. He wasn’t here to tell me, it was going to be ok. If I were admitted how would I go to his funeral and say goodbye? The loss was so great I cannot describe it. I had to be strong so mom wouldn’t hear all this over the phone. I was also scared to death of having a kidney biopsy and the thought was more than I could endure. Mom knew this too. At the last minute, they discovered they couldn’t do the biopsy and I could go home. I called mom and we both said at the same time “thanks dad”, he was still watching out for me.

Even though my daddy has only been gone a little more than a week, I’ve learned that the best tribute I can give to this man for all he’s taught me is to keep him forever in my heart. When something bad happens I touch my heart and remember him, his strengths and when something good happens I touch my heart and say “thank you daddy”.  I have a large jar of "pennies from heaven" too, and know that silver lining behind the clouds is Daddy telling me he's still there watching over me.

I miss him and need him more with each passing year.

I am posting this today July 3,2010 because today my daddy would have been 85 years old. We now believe it was not Alzheimers.

Through a breaking heart and tear filled eyes this is for the most wonderful daddy in the world.
I love you daddy... Happy Birthday..