Thinking Cap$ on Please. (I Need Your Help).

Good Evening...
I am (almost) lost for words.
(I owe you BIGTIME if you can even get through the whole sordid mess)!

I know a lady that goes to the same pain center that Casey and I do.
She is a very nice lady. Well, unless you cross her. hehehe
(I really HAD to include that- As a show of deep respect and admiration).

She went in yesterday to get her prescriptions renewed for another month.

* Note:
If you have never gone to a pain management specialist doctor, you must go in every 30 days to have your pain meds refilled.
Upon your arrival to the clinic, they have a questionnaire for you to fill out, about 5 pages of different stuff.
You MUST fill every page completely.
I respect that they have you do this- Not for their own culpability, but to refresh the patients mind also.

One of the pages states something to the effect of, "I know it is harmful & dangerous to abruptly discontinue the use of these medications without doctor recommendation, supervision and guidance." 

You must check each box that you have read it each time. 
You must sign every page etc etc etc.

Thus begins her visit... Normal so far. hehehe

* Another Note:
She does not see her regular NP, rather an extra they have. New perhaps?

She indicates how much pain she has still been having- She is on extended~release morphine, in addition to something else for her breakthrough pain. I believe it is either oxycodone or vicoden.

This NP "ups" the morphine claiming that it "is less addictive" than her other pill that she takes for breakthrough pain; that when she hurts more, she should take an extra morphine pill instead of the other.

I really am at a loss to explain that to her. Hearing this makes no sense to me... But surely they know better than I do?
SO I remain mute. hehehe Really I do.
(Know that I will look it up for her- there has to be something online).
 
Since she had enough medications to last for exactly 30 days, she has none left. Keep in mind that going off either of these narcotics "cold turkey" as they say, will be dangerous to do.

She takes her 30 day refills prescriptions with her, and off to her pharmacy.
She has gotten these same meds refilled for a long time already, and at the same pharmacy.
They know her on sight, by name, and tell her the meds will be ready for pickup in about 20 minutes.

When she returns, she is told that her insurance will not pay for these medications. 
One is $319.+. Another is $250.+, the third is $112.+

She asks, "Why not"
Stating, "They have always done so in the past?"

The pharmacy explains she must contact her doctor and her insurance company, and straighten this out. That they have no idea.

She contacts both places; leaving a message at the doctors office, and being put on hold at the insurance company 3 times for an extended period of time. So the insurance company is basically unreachable. (She was on hold 20 minutes at one point).
The doctors office calls her back. They agree to do any/all interceding on her behalf.

Later, the doctors office calls again, saying that it is all handled and that she will have her meds by that night.

She calls the pharmacy.
Nothing was ready. Nor had it even been approved with the insurance! 
She tells them to "please run it again" because she already knows it is approved.

Thinking that she will be fine until morning, she calls back the next day.
Her prescriptions have not been processed, approved, or filled.

Many "pass-the-buck" phone calls later, this is what she knows"

1. The doctor tells her that it is in the pharmacy's hands.
2. The pharmacy tells her it is in the insurance company's hands.
3. The insurance company now tells her it is not a covered drug. (She will not be put through to a supervisor either).
   
   • She has received these same meds many times and they were ALWAYS covered.
     
     
   wtf!, Right?
   

Wow.
Again, I am at a loss for words.

She has been going to this pharmacy for her entire life. The pharmacy knows her. They have always gotten their money from her and/or her insurance.
This is a medicare advantage policy by the way.
Medicare Advantage policies are NOT Medicare. They are only a supplemental policy TO Medicare, and have nothing to do with the government.
This insurance company is on the east coast. With another phone call she learns that they apparently have not processed anything for 3 days, and are trying to catch up- The snowstorm put everything back, and they had been closed for those 3 days.

She cannot wait 3 days for her medications! To do so would jeopardize not only her pain, and her well being, but would add some very physical and nasty withdrawals to it.

She asks the pharmacy to please give her enough meds to cover those 3 business days, that she would pay for them herself.
No can do. It's all or nothing.
WHAT?!?

So... Who the hell is lying, and why?

Please know this is not Casey; although she has had her own problems with this clinic- Not ever with the doctor himself, but more specifically with the NP's (Nurse Practitioners). Lord knows the damned doctor doesn't have any time to spend with his patients to be able to piss them off in the 1st place.

Is your mind boggled yet?

This lady is also Native American- Choosing to use CVS instead of the clinic pharmacy because it is much closer to her home.

She calls the tribal pharmacy- Do they have these meds in stock?
Yes.
She calls CVS and asks for her written and signed scripts back, telling them when she would be there to pick them up.

She picks them up- One is written on, (the one she is already sick from withdrawing from), but they have attached a note for the Native Pharmacy to call them.

All is well.
She has her medications. (With a big smile from the pharmacist too)!

• CVS has lost a very loyal customer. Her monthly medications are over $8800.00 annually. Now add in a sickness, or stitches, or a broken bone to that.
  
  • In addition to herself, lose her parents, her children, and grandchildren to add that lo$$ for CVS.
    
    
• My guess is that the pain clinic will lose her also.
  
  • They lied to each other, one telling the other that it was all taken care of and covered.
    
    

• She will also change her secondary insurance at the end of the year.

Do these insurance companys actually make people withdraw from their meds? Is that even legal?
Or like the one gal said to her, "well lady, we are not doctors!"

Somethings not right!

What's YOUR take?
Whose mess is this?
Is that NP correct about morphine being less addictive than the others?

Know that you are not permitted to be at a loss for words since I already am.
~<;-)

XOXO
Me

Life goes on...
I should not have said "all is well." But she DOES at least have her prescriptions, and that is a relief to her.
It will take some time for these drugs to actually help her again.

"Hint, Hint"

Good Morning All;
We are home. Have been since late Tuesday. And it was an awful drive through "Snowstorm Doug"...

Our 'trip', (and what a road trip it was!), began nice enough-
And I was quite happy to see this sign.
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Oh yeah, Baby!
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I-94 was not bad at all; especially given the fact that Minneapolis had been under a storm warning for 2 days already- We were quite effectively snowed in, in that hotel.

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Smooth sailing on I-94 eastbound
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Almost as soon as I'd thought "well this isn't so bad" the road became downright crappy.
Worse than anything were the underpasses.
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Each and every one of them on our way home had this splotch of ice underneath. 
I slid the 1st few times thinking wth? I have put many, many, miles on driving in winter weather, and have never, ever, seen this phenomenon before.

Every time we went under the overpass, the car/truck slid a bit. Just enough to throw Casey's and my blood pressure up a few notches, and live on adrenalin.
I remain unimpressed.
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Of a sudden, our 4 lane highway turned to 2 lanes...
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Kinda...
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The 2 lane road came and went. When worst comes to worst, you can always drive on the graveled shoulder of the road. (If you can find it without going in the ditch). hehehe

For some reason, with God as our witness, ALL of the darn snowplows were heading west.
Had they been eastbound, then sooner or later one would catch up to them. It didn't happen.
Oh and yes, our road would have been plowed! duh.
Casey and I remarked on their absence more than once.

In some counties there was salt on the shoulders. In others, there was sand spread around between the lanes.
I hadn't wanted to stop.  Drives like this leave me with a very bad case of tunnel vision. I know I want to be home. I know the roads are very bad, and deteriorating with each mile, and no matter how much pain I am in.
I go slow, like the turtle, and thus far it has always paid off. Reasonable speed being the only practical way to drive, adding many silent prayers.
Casey's insides, and Punks bladder (and my own), would not allow for me to drive straight through.

We stopped to feed the girl, and to get gas twice- (That gasoline, just to keep as much weight in the car as was possible). It makes no never mind to me if I have 4~wheel drive. 
* I see LOTS of 4~wheel drives in the ditch and in the snowbanks in Winter. They simply cannot function on ice either.

Put snow over that ice, and you have problems.

Then add more snow...

And finally, a county snowplow in front of us!

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Add lots of wind, and a snowplow in the left lane...
Whenever he hit those drifts it was a complete whiteout in front of me for about 10 precious seconds. We were completely blinded, even staying back the requisite 200 feet.
Since there was NO passing him safely, he remained in front of me until he used an exit lane...
So much for asking for a snowplow.

Highway 29 became this 2 tracking road. I knew the 2nd lane was there, somewhere, I had some room for error..
Some cars passed me. Many 18 wheelers too, yet most remained happily behind me.
Why is it that the smaller the vehicle the faster they go? I will never understand that one.
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The closer we got to home, the more disappearing acts the road did...
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Finally going through Pulaski, and we were on County B.
Say Yay!
Only two nasty hills to deal with. These hills do not bother me overmuch- Maybe because I am close to home; and maybe because as long as the other cars know how to drive then all is well.
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Joy! The snowplow on this county road had gone our way! hehehe
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But that same snowplow, and the snow, had also obscured my driveways.
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Oops, but never mind- (Please refer to the fact that I have 4 wheel drive).
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A little extra push on the gas pedal, and little swing at the end of that driveway, and we were HOME!
And SAFE!
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The tire tracks were from Miss Kelli stopping by earlier to make sure the house was warm for our arrival.
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We weren't home for an hour and a half and Jim pulled in with his snowplow. Thank God for Jim!
I hadn't planned on calling him until Wednesday, but his wife Sarah had driven by on her way home from work and had seen the lights on.
And it was a godsend that he did come because then at least we could get in/out if we needed to.
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I swear my hands are STILL deep red and bruised from holding that steering wheel.

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Casey stayed here until Wednesday evening- Too risky for Greg to have driven out that night.

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Miss Punk, and a very noisy (and indignant) Mr. Sputnik were reunited.
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I have just checked the weather forecast:

"A WINTER STORM WARNING REMAINS IN EFFECT UNTIL 6 PM CST THIS
EVENING.
THE SNOW WILL QUICKLY SPREAD EASTWARD FRIDAY MORNING...
AND IS EXPECTED TO TAPER OFF FROM WEST TO EAST LATE FRIDAY
AFTERNOON. AT THIS TIME...IT APPEARS THAT SNOW ACCUMULATION OF
THREE TO FIVE INCHES WILL BE POSSIBLE IN THE WARNED AREA."

Oh wait! ~That's the forecast for Prattville, Alabama! hehehe

I sure hope William sends me more pictures, (like this one from last year).
Hint, Hint, William...
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That's my Lawrence! (March/2009).
He will be 10 on the 17th. Time flies.
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Texas already received their snow.
I have zero pictures of Isaiah or Wyatt in the snow.
Hint, Hint, Jenne.

"Hint, Hint" for Chuck, (and Katie, and Kristen, as well) !  hehehe

Uncle Chum called two days ago- He said he is doing well! (Sault Ste Marie, MI) and was going to be calling my Aunt Marlene that night.
She lives in Philadelphia, PA. They have gotten so much snow in the past ten days that it seems to be never ending. Breaking all records...

I'd better close for now, and get on with my day.

Hope you all have heat, electricity and are safe. (And once those things are taken care of then please get out and play in it)! I would love to see you take a picture of your own snow angel.

My love to all

XOXO
Me