Thursday, May 15, 2008

And Today Was a "Good" Day!

Today was errand day with my grandmother, and as errand days go, this was a "good" one. Last Thursday, she had given me a letter from Human (her Medicare Part D prescription drug insurer) suggesting we ask her doctor to try a cheaper drug in place of her Aciphex and Avapro. Several options were recommended. Some of them she has tried already unsuccessfully. The confusing thing was that in February, I had spoken with a Humana rep about Aciphex, and she had told me that Mam-ma has a waiver on that drug "for the life of her policy." So why, now, were they recommending substitutes?

I wanted to find out if they were about to refuse coverage on these drugs, so I phoned the Humana help line. I was told that no information could be given to me because I was not on "the list," and I would have to have my grandmother give permission for info to be released to me. I explained that I have Durable Power of Attorney, and my grandmother was at HER home, and I was at mine. The girl said, "Well maybe you could go to your grandmother's house and call us back - we are here until 8 p.m." I told her that was not happening that day, but that I WOULD be calling back. So today, I went early to Mam-ma's. I got on the phone to Humana and had her sit by her other phone to give the authorization when asked, so that I could get answers to my questions. It never happened. The rep - Spencer - answered all of my questions without hesitation and never asked to speak to anyone else. He never mentioned authorization or any such thing, and he assured me that Mam-ma's drugs are covered, and I am not to worry! I made good notes of the conversation and thanked him!

Meanwhile, Mam-ma had a bill from the hospital for her stay in February. The bill was for $135.50. Since she has Medicare and Medicaid, I figured maybe this was the remainder that Medicaid would cover, and it just had not been filed yet. But I told her I would call the hospital and find out. Medicare and Medicaid have both paid all they will on her $10,000+ bill - she does indeed owe the hospital $135.50. For what, exactly, I am not sure, but I wrote the check. I figured on the overall bill, that was not that much, but so much for "full coverage."

On to the optometrist's office to pay $24 for protective coating on Mam-ma's new glasses. That, too is a story - she was told that her glasses were covered by Medicaid, and the Medicaid lab made them, but when my mother took my grandmother to get her glasses yesterday, the lady in the lab said that Medicaid had refused payment. After some finagling (and I suspect "absorption" by the optometrist), it was determined that Mam-ma would not owe anything for the glasses, but the coating would be $24. That was how it was the last time we got glasses for her, so I was okay with that. I wrote the check!

Finally, Mam-ma had a letter from her primary care physician's office with a print-out of lab work from blood drawn two weeks or so ago when we visited. The note at the bottom said she needs to take potassium, and we needed to call the clinic and speak with the lab tech and get a prescription ordered. It also said we needed to visit the doctor on May 22nd for a six-month check-up, and again on June 12th for a 6-week follow-up on her most recent visit. I didn't recognize the May 22nd date, but I told Mam-ma, "We're not going on May 22nd."

I called the clinic and asked the doctor's wife (who is a receptionist there) about the appointments and the letter from the lab. She had already cancelled the May 22 appointment. She put me through to Toni, the lab tech (I thought) who said, "I will order the potassium, but we need to draw blood on your grandmother - you need to bring her in." I told her we were coming June 12th, and she said, "Yes, but this needs to be done now - her B12 and something else (I didn't understand her) are low - she may be anemic." I tried to be nice, but I told her it seemed funny to me that we were there 2 or 3 weeks ago for blood work, and we were just now learning that she had a problem. AND... she got a B-12 shot from her Home Health nurse today. I asked, "If this was so urgent, why didn't someone call us?" She quickly shot back, "Oh, we DID call, on April 21st and again on the 29th and May 5th, and on the 8th of May I sent the letter." I asked why nobody called ME, and she said, "You're not on the records." Now how on earth am I not on my grandmother's records at the clinic after all this time? I guess the same way they still had her chart showing she was taking Lisinopril that was discontinued after a month in 2006 because she couldn't tolerate it!

So, I told the girl on the phone we would come after Mam-ma got her hair done at the beauty shop. I hurriedly did our grocery shopping at Wal-Mart - both hers and mine. I swung by the pharmacy and picked up Mam-ma's prescriptions, then went to get her at the beauty salon. I realized our cold groceries would never last in the humidity while we sat at the clinic, so we drove to my house and I put away my cold things while Mam-ma visited with Greg and looked at the view out our windows. She hugged Greg and said, "I don't know why you don't come to see me!" Greg was caught off guard and mumbled, "I don't know either!" Welcome to my world!!!

Then we headed to Mam-ma's house to put away HER milk and frozen food. On the way, we passed a produce stand that has opened near my house. Mam-ma said, "Sometime I would like to go there." I said, "Let's do it now." She said, "No, we don't have time." I told her we did have time, and she said, "then let's go!" We turned around and went back, and she bought a quart of strawberries and a cantaloupe to share with her friend Ruby. I bought fresh okra, tomatoes and strawberries. Mam-ma said she would like to go there often. I told her maybe we could go there some on Thursdays. She said, "That would be great!"

We took Mam-ma's groceries home, and THEN we went to the clinic to give them some blood! The receptionist called us pretty quickly to the lab, where the technician was frowning and visibly irritated. She said, "I wish they had let me talk with you... I am so sorry. I can draw blood today, but now that she is starting on potassium, she will have to return next week for a follow-up blood test to see how it's doing, and we can do it all at once." I said, "I thought I talked to Toni - are you Toni?" She said yes, but that they had connected me to Rae, a nurse. I said, "She insisted this was urgent and we had to come right away! She also said she didn't have my phone number and that you had called several times." The lab tech said that they did not have my number on the records in the lab, but now they do, and she was very apologetic, and that the test for anemia was not urgent. I told her if it was not necessary to stick Mam-ma today, then we had no problem with waiting a week. I asked Mam-ma if that was okay with her, and she said, "ABSOLUTELY!" So the girl apologized again, and we left, and we will swing by there next Thursday after the hair appointment.

Now the thing that gets me is... they KNOW my grandmother. She lives a few blocks from their clinic. They know she is 95 and hard of hearing and might not always hear her phone. If you feel a person is anemic and needs potassium, would you really only call 2-3 times in 3 weeks and then MAIL A LETTER? It's not rocket science! In this little town of 6000 people, those folks at the clinic know me - they know they can call me if they can't reach my grandmother. Some of the people in that office attend my church and many attend Mam-ma's church! They KNOW us! What if this had been even more dire than low potassium and/or possible anemia? Would they have just sent a letter and waited for us to respond? As we were leaving the clinic, Mam-ma saw Dr. Bivins, and he spoke and asked us how we were, and she told him, "If y'all don't stop taking my blood, I'm going to start charging you for it!" Dr. B said that would be okay if they figured out a use for it! Greg had told Mam-ma that it was a shame that THEY charge HER for giving them the blood, so she was all geared up to share that little anecdote about charging the clinic. I was just thankful that was all she told him. She started her sentence with "I tell ye what..." and that can be a landmine... especially with Dr. B... he is the one she told that her friend was "almost as big as you are" (and she was not being complimentary!)

Driving home, Mam-ma said, "Sometime, I want you to drive me down to the lake so I can see the flooding. People keep telling me how bad it is, and I haven't seen it." I just turned the corner and headed for the lake. She said, "But you don't have time today." I told her today was as good as any, and we toured three neighborhoods - Sandy Beach, Ausley Circle and Anderson Circle. She was amazed and satisfied, and home we went. She said she had "work to do" - putting away her groceries, putting potassium tablets in her daily medicine boxes, and fixing cantaloupe and leftovers for Ruby to eat supper with her. She thanked me for all of my help and even said, "I don't know what I would do if I didn't have you to do these things for me."

All in all, today was a "good" day! I'll take what I can get!

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