Health

There is so much to discuss in healthcare in this country
but there
are individual questins to be asked and answered also.

2. msgreer - 8/20/1999 2:41:56 AM

Do you have specific healthcare questions you need answered?

Do you
want to know where the lastest research is being done on a specific
healthcare issue?

Or do you just want to share your personal
experiences with the healthcare and or insurance system?

3. msgreer - 8/20/1999 2:44:17 AM

what about those nasty codes that appear on your insurance papers? Are
you curious in learning how to break those codes and empower yourself
with your individual carrier?

Let's get started.

4. Slackjaw - 8/20/1999 2:44:58 AM

actually, I have this mole...

5. msgreer - 8/20/1999 2:45:41 AM

Stick with me. I am learning TheMote system of posting.

6. msgreer - 8/20/1999 2:47:25 AM

Slackjaw

Cute very cute.

Dare I ask where this "mole" appears on your body?

7. Slackjaw - 8/20/1999 2:50:18 AM

yikes! Well, this is confidential, right?

8. msgreer - 8/20/1999 2:54:14 AM

And yes I am ready to discuss how our country delivers heathcare.

It is always a lively debate to have
but I am off to the shower as
I have client in the hospital and need to get there before the doctor
makes her rounds.

9. msgreer - 8/20/1999 2:55:51 AM

Slackjaw

Your mole is a confidential matter?

Get thee to a
urologist immediately!

10. msgreer - 8/20/1999 4:36:47 AM

Slackjaw

or do you need to take this question to the PENIS THREAD

heehee

11. Slackjaw - 8/20/1999 4:37:26 AM

wouldn't you like to know.

Tramp.

12. msgreer - 8/20/1999 4:42:14 AM

Slackjaw

Yes Yescall me a tramp.

Get the whips and leather out.

13. Slackjaw - 8/20/1999 4:56:57 AM

I'm sorry, this must be the wrong bordello. I asked for a nurse motif.

14. Slackjaw - 8/20/1999 4:57:19 AM

15. msgreer - 8/20/1999 5:15:00 AM

Slackjaw

Who says nurses don't have needs?
We are human!

Now
back to your mole problem.

The nurse is in.

16. msgreer - 8/20/1999 5:42:08 AM

From JAMA

Doctors say profit-starved Humana is targeting them for more saanings, but the insurer insists its claims reviewprograms aims to pay fairly for office-based services.

17. msgreer - 8/20/1999 5:42:49 AM

sannings=savings

18. msgreer - 8/20/1999 5:48:27 AM

Since Humana Inc., began reviewing office visit claims last month, Remigio G. Lacsamana,MD, has submitted 166 claims for review.

Each claim was downcoded from Level 4 t a Level 3.

Dr. Lacsamana charged that Humana,or the company it contracts with to perform these reviewa, is making these decisions automatically -- and unfairly.

"That tell you that they never reviewed them," said the Daytona Beach, Fl. internist.

But Michael McCallister, Humana's senior vice president of health systems management, see Dr. Lacsamana's experience differently.

His billling is not consistent with his treatement," McCallister said.

19. msgreer - 8/20/1999 5:52:05 AM

That disparity underscores a brewing conflict between physicians and submitting claims for payment for the two highest codes (Levels 4 and 5) and Humana's new claims review program targeting these codes for closer scrunity.

According to doctors Humana's policy is swamping them with paperwork and is a strtegy to squeeze more savings in the wake of the insurer's shrinking profits.

20. msgreer - 8/20/1999 6:01:38 AM

But McCallister aid Humana is simply responding to what it sees as a gradual "creeping up" of claim submitted by physicians.

"In what other industry would you write a check for a service where the only thing you had (to document the service) was a bill?" he asked.

"We are obligated to make sure that we are paying premium dollars out in an appropriate fashion. If we don't do that, we end up in a spiraling pattern downward," McCallister added.

Humana launched the program on July 1 in Florida, Kentucky and Texas and expanded it nationally in early August for both commercial and Medicare plans. Claims submitted by some 40,000 doctors are being reviewed by Aztec Medical Systems, Miami.

Doctors in the state where the program started said they suddenly began receiving letter from Humana elling them to submit copies of patient CHARTS for claims coded at either Level 5 or 4. Such claims would automatically be downloaded one level if physicians did not submit tht documentation within 14 days, Humana said.

21. msgreer - 8/20/1999 6:11:18 AM

But even after providing the additional documentation, Jeffrey Frank, MD, a neurologist in Louisville, Ky., said Humana still downloaded about 75% of his claims, resulting in a loss of about $20 for every adjusted claim.

Other insurers and the Health Care Financing Administration have audited his practice. "No one has ever found problems with our coding, and here Humana is downcoding 75% of our claims," he said.

Texas neurologist Sara Austin,MD, is annoyed that Humana is questioning her claims when the nature of her specialty requires intensive patient visits.

"I could see if they wanted to audit the outliers...but to do it to a neurologist is harassment. If a patient has a numb hand, it could be carpal tunnel syndrome, multiple sclerosis or a brain tumor. In 15 minutes, I can't decide one or the other," she continued.

Mary Self,MD, an endocrinilogist is in a four-doctor practice in Louisville, is worried that shipping patient claims to Florida for review will compromise patients' privacy.
downloading=downcoding.

22. msgreer - 8/20/1999 6:21:21 AM

She also said doctors should receive interest on their claims while they are undergoing the extra level of review. "It allows humana to keep our money for a few more weeks," said Dr. Self, whose group is terminating its Humanaa contact over the new review program.

Doctors also said Aztec only filed its state incorporation application on May 11, creating about its expertise. Physicians have voiced fears that Aztec receives financial incentives to downcode, a charge Humana officials denied. McCallister said Aztec receives a flat fee for each claim it reviews.

Humana spokeswoman Mary Sellers declined to give more information about Aztec's contract with Humana but said it performs claim review for other insurers. Aztec officials did not return phone calls seeking comment.

The new claims review program also has triggered an aangry response from state and local medical societies and large physician groups.

Both the Florida and Texas state medical societies have scheduled meeting with local Humana official. A large physicians' group in Austin filed a complaint with the Texas Dept. of Insurance over the issue.

Earlier this month, the Jefferson County (Ky.) Medical Society organized a meeting between Humana's medical director and area physicians. Despite a discussion doctors describe as "heated," nothing was resolved.

23. msgreer - 8/20/1999 6:53:08 AM

It is difficult to determine whether physicians are inappropriately upcodong or if insurers are trying to wring more savings from doctors, said an analyst wit William M Mercer Inc.
Many times, it's mixture of both.

Mercer's studies of physicians claims patterns have revealed that doctors sometimes skew their office visit codes toward the highest payment level instead of following the typical bell-shaped curve. But it is unclear whether that is due to inappropriately upcoding or billing for the additional time spent with patients.

In fact, confusion among Louisville physicians abut proper coding procedures prompted the Jefferson County Medical Society to organize educational sessions on the subject.

But with pressure on health insurers to cut costs, payment for physicians office visits is becoming a more visable target, especially since may doctors are refusing to accept contracts that include fee schedule cut.

"When companies can't push down the fee schedule anymore, they then scrutinize the heck out of claims.

24. msgreer - 8/20/1999 6:56:49 AM

NOW THIS IS NOT AS DRY A SUBJECT AS YOU MAY THINK.

Who do you want making medical decisions for you? You and your physician or some claim adjuster who is not only NOT in the examinating room with you and your physician but is more than likely sitting in a cubicle stamping "claim denied" before your claim has even been looked at by a physician?

25. msgreer - 8/20/1999 7:11:18 AM

CONSIDER THIS

If your doctor feels you need Level 4 or 5 care on an office visit and it will take more time for them to give you this care don't you want hope your doctor will take his/her time and be appropriately reimbursed for their efforts?

We are back to who makes the decisions.Is it between you as an educated consumer and your doctor or is there always to be a third party in that examining room with you?

26. msgreer - 8/20/1999 7:27:35 AM

DAMN

DOWNLOADING= DOWNCODING

my apologies

27. msgreer - 8/20/1999 7:29:37 AM

want help= help

please this is not the play pen. no comments are needed on my typing this morning.

28. ChristiPeters - 8/20/1999 9:24:42 AM

msgreer -

It would be easier to follow this if you could give a brief explanation of what is Level 5 care and what is Level 4 care.

29. msgreer - 8/20/1999 9:54:10 AM

ChristiPeters
There are 5 levels of care. On a routine office visit Level 3 is usually the code.

However if your doctor needs to do addtional testing which is avalilable to him/her in the office you maybe at Level 4.

Level 5 is the most intense. It usually means you have come in with an acute emergency ie numbness in an extremity or trouble with balance or vision and your doctor will need to spend more time with you. Decisions will have to be made if more testing outside the office is needed.

Does that help?

30. ChristiPeters - 8/20/1999 10:27:11 AM

Yes, thanks. That helps a lot.

31. theDiva - 8/20/1999 10:28:21 AM

ms g

32. ranheim - 8/20/1999 1:32:33 PM

I imagine that I am one of the few M.D.s here. My wife has been doing my paper-work for years. It helps that she was a MedTech (the old fashioned kind that did a blood sugar with a test tube and a Bunsen burner).

She does not want fights with either Medicare or Medicaide (which in LA is handled out of Arkansas). So she codes very conservatively -i.e. lower, probably, than that visit called for. But, since 1972 I can recall no question as to the skill level or time involved in a patient visit. For Humana's paper work company to challenge 75% of a doctors claims is unheard of!

Humana owned the hospital 4 miles away from me at one time. I did my best not to refer patients to that facility. I thought that they cut corners back them (15 years ago?).

33. ranheim - 8/20/1999 1:33:24 PM

I imagine that I am one of the few M.D.s here. My wife has been doing my paper-work for years. It helps that she was a MedTech (the old fashioned kind that did a blood sugar with a test tube and a Bunsen burner).

She does not want fights with either Medicare or Medicaide (which in LA is handled out of Arkansas). So she codes very conservatively -i.e. lower, probably, than that visit called for. But, since 1972 I can recall no question as to the skill level or time involved in a patient visit. For Humana's paper work company to challenge 75% of a doctors claims is unheard of!

Humana owned the hospital 4 miles away from me at one time. I did my best not to refer patients to that facility. I thought that they cut corners back them (15 years ago?).

34. ranheim - 8/20/1999 1:43:21 PM

#31

Training can run the gamut. But, in the huge % of cases, those people who would question a decision of mine would be minimum wage - or just above.

Isn't that a comforting thought.

My brother is a retired Cardiologist. Hassles like this are why he retired in his late 50s; unless a Cardiologist loses his hearing some of his most productive years are during his 60s. EXPERIENCE COUNTS WHEN IT IS YOUR HEART. But, arguing with in-house clerk-types (he was a member of a very large clinic in the suburbs of Minneapolis) who were bugging him because some insurance company had pulled the in-house personnel's chain over a quibbling matter added so much to his frustration that he retired rather than face more of same in the coming years.

He now goes in part-time and not a quibble is to be heard. And although paid at a lessor amount, he is much happier.

35. Thoughtful - 8/20/1999 7:23:38 PM

If I may ask a more personal question of the medical professionals here, my Mom (early 70s) has had a big problem with insomnia for years. She will feel tired and be able to sleep about 1 1/2 hrs and then wake up and be up for hours before she's able to get back to sleep. She now considers 5 hrs of unbroken sleep an excellent night and gets that maybe one night a week at best.

She asked about going to a sleep clinic, but I thought those would just track your sleep patterns and you need someone to interpret the results and treat you accordingly. Is there such a speciality as sleep doctors? Or is there some other specialty that covers this problem?

Thanks in advance.

36. Ranheim - 8/20/1999 7:32:32 PM

Thoughtful

Possibly msgreer will know more than I. Duke used to maintain one of the best sleep labs in the USA. But, that was 10+ years ago.

I know that there are so-called "Sleep Clinics" out there. There are none in my area of central Louisiana that I am aware of.

I can only give you anecdotes from my own practice; but, you mother's sleep habits don't sound too bad. The important thing to find out is "Is she satisfied?" Sometimes this age group will amaze you with what they consider NORMAL.

37. msgreer - 8/20/1999 7:39:28 PM

thoughtful

As we age our body requires less sleep
but sleeping is often a problem for the elderly.

From your post is sounds like your mother has had sleep "problems" for sometime.

My suggestion is your mother sees her primary care giver first. You want to make sure there is no underlying physical reasons for what you describe as her difficulty with sleeping. You will want to rule out not only possible physical ailemts which may be keeping her up but also depression.

This is the most undiagnosised problem for the older client.

And your mother's primary care giver can establish what medication she is on, whether she drinks caffeine or alcohol before bedtime
...there is alot to look into before a sleep clinic.

38. msgreer - 8/20/1999 7:49:10 PM

cont.

Does your mother follow a regular regime for bedtime each night? Some people who have trouble with falling asleep make sure they follow a certain ritual everynight. A warm bath, a glass of milk if her diet allows
whatever makes her comfortable.

Our resident physician is correct in that your mom's sleep problem you describe maybe annoying but does she feel rested after sleep regardless of the amount of hours she gets each night?

I am curious to know what she does when she awakes after the hour and a half of sleep and can't fall back to sleep.

Does she get up and start doing chores? Does she rest in her bed? Does she read a book?

Another thing I find to be of help is to remember the bedroom is for sleep and sex. If your mom can rest but not necessarily sleep this is helping her body.

Amd remember each person's requirements for sleep are different.

About sleeping clinics.. there are many. I don't know what part of the country you live in so I can give no suggestions. ranheim is correct in that Duke has a fantastic sleep clinic.

This maybe a question for
your mother's primary care giver.

I am certainly willing to research
sleep clinics in your area but that would mean letting me know the bigger cities your mother is close to.

Does this
help at all?

39. Thoughtful - 8/20/1999 7:51:59 PM

Thanks for the input. She's been to her primary doctor and discussed this with him many times. He just wants her to go on elavil, but she doesn't want to use that drug. (I can't blame her -- I was on it and hated it.) She has no caffeine, she's tried altering when she takes her premarin. She has ambien now, but knowing it's addictive will only take it at most once a week...usually less. She has tried melatonin, but finds that while she sleeps real well with it, after about a week, she starts getting "dopey" or "brain fog" where words and thoughts have more difficulty coming to her. She exercises regularly (treadmill, weightlifting) and is otherwise in very good health. She's active and social and doesn't fit anything that I would think of as depressed. I've also read where the ability to fall asleep with early wake up is more indicative of a physical problem rather than emotional. She's also tried the usual remedies like making sure she goes to bed at the same time, avoids exercising late at night, etc. Her doctor asked her if she feels ok, and she says yes, but to her that means she is able to get through the next day. She notices a distinct difference when she sleeps better in her performance and how she looks.

I post all this not because I'm looking for a diagnosis, but to try to respond to the points you've made. I think she's ready for something more than what her primary care physician is giving. That's why I ask about the sleep clinic. Hubby went to one for his snoring/sleep apnea, but he had an ENT who sent him and went over the results. So again I ask, is there a specialist she should see who handles these kinds of things?

40. Thoughtful - 8/20/1999 7:55:13 PM

Sorry, msG. cross post. I hadn't read your part two. I know of a sleep clinic, but can you just walk in and say I have a sleep problem...help me. I mean what kind of a doctor does someone with narcolepsy go to? Hubby's ENT was kind of obvious...but I'm at a loss here.

41. ranheim - 8/20/1999 8:45:49 PM

Thoughtful

If your mother's mind is made up that Ambien is habit forming/addicting - that is the last word. Unless you can convince her (always assuming that Ambien is working) that there is no such thing as an addicting drug in a 70 year old patient. Assume she takes it, safely and effectively, for the next 15 years. Has that "addiction" harmed her?

42. Thoughtful - 8/20/1999 8:53:18 PM

We are very reluctant to follow that line of thinking. They put my grandfather on percodan for his sore legs when he was 75 saying how long could he be addicted? Well 25 years later, he finally died from kidney failure associated with long term use of the drug and making life nearly impossible for everyone including accusing everyone of hiding his pills on him, his never getting them, etc. This went on in its severest form for 4 years -- to the point where even the visiting nurses declared him by far the worst patient they have ever seen. (Mom's mother made it to 96.)

43. Thoughtful - 8/20/1999 8:58:11 PM

So I guess the answer is that there is no "sleep specialist" category other than perhaps calling the sleep center itself and asking for a recommendation -- or convincing her to see a psychiatrist.

44. ranheim - 8/20/1999 9:06:19 PM

Thoughtful

What state do you live in?

I may have an M.D. friend nearby that could give me a name.

45. Thoughtful - 8/20/1999 9:25:30 PM

ranheim, I will send you an e-mail. Thanks for the offer.

46. ChristiPeters - 8/20/1999 9:25:56 PM

thoughtful -

I just got off the phone with msgreer. She wanted me to post to you that her WebTV has been giving her fits and she can't get online right now. She had another long post all ready for you, but couldn't get on to post it. She is calling her Service Provider now. If they can't get her back up and running, she is going to call me again tomorrow and dictate the post to me so I can put it up for her.

All -

msgreer also wanted to let y'all know that she is very committed to the Health thread and will be back as soon as she can.

47. Thoughtful - 8/20/1999 9:31:15 PM

Christip, that's great. Thank you both for your help. Sorry she's having difficulty -- been there, done that. I appreciate all your efforts. Thanks.

48. Thoughtful - 8/20/1999 9:34:27 PM

To continue with sleep problems, I thought most recently I read of a study that said it was assumed the elderly needed less sleep, because they slept less when in fact even older people should be getting 6-7 hrs each night. If not, there's something wrong -- be it medications, depression, etc.

49. ChristiPeters - 8/20/1999 9:37:04 PM

I also want to add a little of my own experience re: elavil. While it was originally developed for depression it has the side effects of nerve pain relief and making/helping you sleep. It is now prescribed almost as often for these side effects as for it's original purpose. So a physician prescribing elavil as a sleeping aid does not necessarily mean the Dr thinks the patient has any problems with depression or other emotional problems.

I was put on elavil for pain and it worked very well for that. I was not depressed. I don't know what your experience with elavilis, but mine has been bad for only one reason. I have experienced runaway weight gain on elavil. I have gained 100 pounds in spite of averaging 950 calories/day and eating a low fat, low cholesterol, low salt diet. The weight gain has caused high blood pressure and now borderline diabetes. Talk about the cure almost being worse than the disease!

I say almost, because when I started the elavil I was on so much pain I couldn't function. Now, thanks to five hospital procedures (and maybe a lot of meditation helped too.) My pain level has been reduced enough for me to get off elavil. I'm losing an average of 10 lbs a month with no other change in my lifestyle than the med change.

So, I guess what I am saying is that I totally understand any reluctance you or your Mother may have in regards to going on elavil, but that the doctor is not necessarily saying your Mom is depressed when suggesting it.

50. Thoughtful - 8/20/1999 9:45:23 PM

christip -- glad to hear you are off the stuff. I know it's not just for depression and know it's powerful effects as a sleep aid. But I've also seen it listed as one of the drugs that should be avoided by the elderly. Also, Mom is like me. I don't like drugs and avoid them if at all possible. I especially don't like playing guinea pig, having drugs thrown at me to see if they work and if they don't try something else. I would much rather know what's wrong first, then fix it.

I have no doubt that there is a large psychological component to her sleep troubles, though not necessarily depression. Rather, like the studies show that we learn to anticipate pain and suffer more for it, she's probably grown to expect that she won't sleep and then proves herself right more often than not. Me, I found a lot of my sleep problems went away with the TV. I turn it on to a dull show (no sirens). I listen enough to keep my mind from spinning over the things that happened today or I have yet to do tomorrow, but not enough to keep me awake. The TV shuts itself off after 1/2 hour, and I'm all set. About twice a week I will wake up early -- 2 or 3 am -- and it usually takes me a couple of hours before I can go back to sleep. Of course, by then, it's time to get up anyway. Even here, though the TV helps me doze off.

51. Bubbaette - 8/20/1999 9:51:17 PM

I have insomnia off and on. Some of the suggestions that
help me are:

Only spend time in your bedroom for sleeping -- not for reading or watching tv.
If you're tossing and turning, get up and go in another room til you get sleepy.

Exercise during the afternoon can help use up any excess energy, but I don't
know if this is suitable for your mom.

A warm bath before bed helps because it raises your body temp. Drowsyness
is a natural reaction as you cool down again.

I take ambien when it starts to affect my work.

52. Thoughtful - 8/20/1999 9:55:51 PM

All good suggestions -- Mom has used the hot bath thing with some success. I didn't know the cooling down was what did it. Interesting as she is a Reynaud's sufferer and tends to like to keep things hot. I know for myself that being too hot makes for poor sleep. Hmmm.

53. msgreer - 8/20/1999 11:07:21 PM

thoughtful

I am back. Some wonderful tech support young man in Redwood,California lead me through a host of exercies and here I am.

It appears you are getting alot of good information.I wanted to add melatonin should not be taken for more than 7 days in a row..10 days tops.

What your mother described as her side effects with melatonin are well recorded.

If ranheim can give you a recommmendation of where to go for further help with your mom I would surely contact him/her.

I am able to research where sleep disorder clinics or specialist in sleep disorder are located but I need to know where your mother lives.

See if ranheim can help
if not you can always contact me on this thread.

Good luck and please let us know what you find out and if your mother gets help.

54. theDiva - 8/20/1999 11:10:21 PM

Ms G

Please e-mail with an update on your previous missive. I'm anxious;y awaiting news.

55. msgreer - 8/20/1999 11:31:24 PM

Diva

check your email.

56. ChristiPeters - 8/20/1999 11:38:35 PM

Glad it's fixed, msgreer!

57. msgreer - 8/20/1999 11:48:41 PM

ChristiPeters

check your email.

58. ChristiPeters - 8/20/1999 11:51:47 PM

Got it!

Speaking of sleep - I just chased the hooligans into the bedroom. How much you want to bet that no sleeping occurs.

59. msgreer - 8/20/1999 11:52:28 PM

Another topic which is too close to my heart at the moment but could be an interesting topic is children taking care of their parents.

How is impacting your own life? How do you feel about it? If you have other brothers and sisters are they helping?

How does it feel down deep in your gut to take care of your parent and/or parents?

60. theDiva - 8/20/1999 11:54:01 PM

Ms. G

Check your e-mail.

61. msgreer - 8/21/1999 12:01:17 AM

Diva

email received.

one coming back to ya so give a check.

62. ranheim - 8/21/1999 7:46:41 AM

Thoughtful

Keep in mind that I'm a dunce when it comes to computers.

I tried your e-mail and the message was returned to me as un-deliverable. Which, in all likliehood, means I screwed up.

I have an M.D. brother-in-law on Cape Cod. But it will take some time for me to get to him. He owns a small yacht and lives to sail. I will have to catch him between sails.

I'll try to get back to you this weekend. Its 8:00 AM central daylight here.

63. msgreer - 8/21/1999 9:05:31 AM

ranheim

If thoughtful's mother is anywhere close to Boston there are several good sleep disorder clinics as well as doctors who specialize in this area.

I hope you will be able to give thoughtful a reference. If not please let me know as I am familiar with the Boston medical "establishment."

You're a good man, Charlie Brown.

64. msgreer - 8/21/1999 4:41:49 PM

I was called in on a case about a month ago. I took it pro bono.

The gentleman I was working with was a kind soul who just had been
through too much tragedy and sadness for one person.

I worked with
the Veteran's Administration and other health care facilities to get
this gentle sould the help he needed.

We became good friends. We spent
many hours together just talking. He often told me how much I was
giving him but let me say it was mutual.

Get to know an older citizen
in your community and you will be pleasantly surprised with the
pleasure of hearing old stories and tales only someone with many years
on them could tell.

Afew days ago I picked up the newspaper to read
he had called 911 as his despair had gotten too much for him. He
called for help. Why he didn't call me I never will know.

The police
came to his home to find he had a pointed tool in his hand. They
immediately treated it as a threatening situation for THEM.

What
follows is a letter to the editor I wrote and got published. The
local paper had been carrying his story from the beginning which I
am proud to say had to do with the fact I went to them and said we
need your help. This is what is going on with this man. Write about
it. Help us put abit of pressure on the medical establishment.

The letter reads

"Once again, a 911 call intended to avert tragedy has resulted in a
needless death, an "assisted suicide" as it were. Isn't it time for
police officers called to such a scene to be routinely armed with a
tranqulizer gun, spray pepper or Mace>To be trained to disable rather
than to kill a person armed only with a sharp object, be ita tool or
a kitchen knife?

Or does the fact that we have become a fear-ridden
culture encourgage officers of the law to "shoot first" and then
plead(with odds of seven to one) self-defense?

65. msgreer - 8/21/1999 4:47:07 PM

cont.A footnote to this sad affair: It is clear that "Steve", who had "slipped throught the cracks" of both the Veterans Administration and our so-called health care system, lost all hope due to chronic pain which threatened his livelihood and by lingering sadness and loneliness after the theft of his dog.

What a pity that this despair was extinguished rather than repair, that those cries for help triggered such an unnecessary, deadly outcome">

66. msgreer - 8/21/1999 4:50:03 PM

So my question is do we have it "right" with our health care system?

The answer is a very loud no.

I don't believe this is an isolated incident. It probably happens in some town everyday.

The question is what do we do to change or "fix" our own health care system so another "Steve" in not shot merely because the health care system failed him.

67. msgreer - 8/21/1999 4:53:30 PM

ALISTAIR

THE EDIT BUTTON...PLEASE.

I am getting embarrassed with how some of my posts look.

68. msgreer - 8/21/1999 6:25:22 PM

ranhein

you can reach me msgreer@home.com

69. msgreer - 8/21/1999 6:26:21 PM

ranheim

sorry about mispelling your name.

70. SpenceMirrlees - 8/22/1999 2:15:36 AM

msgreer:

It is counterproductive to search for a system with no cracks for people to fall through. They all have cracks; the goal is to find the one with the most acceptable cracks. Anecdotes do not help demonstrate that we are very far away.

71. msgreer - 8/22/1999 4:50:51 AM

Spencer

I did not have to "search" for a health care system that is full of "cracks">I live in one.

It is all around me.

I work in "our" medical system everyday.

This was just a story, a true one at that, that I happen to be apart of.

As we get to know each other you will find I have a hundred and one stories I could tell in regards to the "cracks" in our system.

I am not foolish enough to think it is only our medical health care delivery that needs "fixing".

I have yet to find a health care system which does not put some of its citizens at risk.

72. SpenceMirrlees - 8/22/1999 4:54:02 AM

I have yet to find a health care system which does not put some of its citizens at risk.

My point exactly. So what does it accomplish to point out that our current system places people at risk?

I do not doubt the veracity of your anecdote. My point is not that it's invalid but irrelevant.

73. msgreer - 8/22/1999 4:57:32 AM

cont.

I don't think it is necessarily a bad thing to tell a "story" when attempting to illustrate an aspect of our health care system that needs attention.

I find as a medical advocate the more I am willing to speak out the better results I get. Now it maybe one person or one issue at a time but atleast it is a beginning.

I like to discuss the reasons why we or another country fails its citizens so often but I have found in 10 years of business it oftentimes is these personal stories I relate that gets the faster action.

I also admit I have to know the laws regarding health care in this country or all the stories in the world will not be effective.

So I am up for any type of discussion.

I am sorry to hear you felt my relating a story was counterproductive.

74. SpenceMirrlees - 8/22/1999 4:59:39 AM

I am sorry to hear you felt my relating a story was counterproductive.

But I didn't say that.

75. msgreer - 8/22/1999 5:03:25 AM

Spencer

It is very important to tell stories which illustrate how our system fails. It begins a dialolgue between folks. And we have to start talking in order for these situations not to happen again.

In this particular case I am still working with the VA and several health care facilities not to speak of the police to find out where we all went wrong.

I know it is one small incident at a time but through discussion I hope this particular incident will not happen again.

This is what I do for a living. And I do it anyway I can to get people's attention and a dialogue started.

76. alistairconnor - 8/22/1999 5:05:45 AM

Yes you did Spence.

Obviously, it is important to characterise the flaws in any given system with respect to what happens to individuals. That gives the flavour of the system.

77. alistairconnor - 8/22/1999 5:06:51 AM

No edit button, MsG. Use the Preview box.

78. SpenceMirrlees - 8/22/1999 5:07:53 AM

It can also be very misleading to tell stories and only stories. It is not clear from your story, or from the doubtless hundreds like it that occur all the time, that this particular failiing of our system (still not sure what it was, actually--just a nondescript failing) is a matter of general concern.

79. SpenceMirrlees - 8/22/1999 5:08:28 AM

MsGreer: please show me where I said your relating a story was counterproductive.

80. SpenceMirrlees - 8/22/1999 5:13:17 AM

oh, 79 was to AlistairConnor, not MsGreer.

81. msgreer - 8/22/1999 5:21:28 AM

Spencer

It is "matter of general concern" to all consumers to know what is out there for them while weaving their way through the health care system.

It is my belief an educated consumer will get what they need. It is the other 98% of our citizens who out of frustration or not knowing their rights that throw up their hands and give in. And the results can be deadly.

What I am saying is in order to fix something you have to be willing to look at the "cracks". You have to be willing to stand up and say to the establishment this is not working. We need to found out why not and DO something about it.

You are not sure why my story "is a matter of general concern".

You would be if this man was your father. You would find yourself very concerned. And you might even be angry enough to find out why it had to happen.

Re relating my story as "counterproductive"... you didn't understand what I said before. It is oftentimes necessary to tell stories of such failings to get a dialogue going. Most people can relate to stories as opposed to dry discussion.

The specifics of our health care system and the laws that govern it are of great importance to me but I'll tell you when I am asked to speak as a guest say concerning caregivers for the Alzheimer's patient telling stories people can relate to helps get the crowd in a mood to act. Then comes the task of going through the laws that govern these injustices.

It is a place to start.

82. alistairconnor - 8/22/1999 5:23:29 AM

Site is Going offline now folks... see you in about 20 minutes?

83. msgreer - 8/22/1999 5:23:48 AM

found=find

84. alistairconnor - 8/22/1999 5:24:27 AM

Last Posts Please...

85. alistairconnor - 8/22/1999 5:51:44 AM

Welcome to New York everyone!

86. SpenceMirrlees - 8/22/1999 5:58:10 AM

what the...what happened? Oh, looks great. Love the new digs.

Now then. MsGreer, if your story is building to something more substantive, I will anxiously await that date. But, once again, I did not say your story was counterproductive. Nor did I misunderstand it. But you're not writing a novel; if you want a dialogue, start talking. We have all seen Dateline NBC and know people get screwed. What do you want to do about it?

You are not sure why my story "is a matter of general concern". You would be if this man was your father. You would find yourself very concerned. And you might even be angry enough to find out why it had to happen.

You know, I've always thought "what if it happened to you?" a lame argument when it comes to public policy. Yes, if it was my father, I would be very concerned. I would not necessarily expect you to be. So no, if it was my father, though I would be distraught, I would still not be sure why this is a matter for public policy to handle.

It is "matter of general concern" to all consumers to know what is out there for them while weaving their way through the health care system.

I completely agree. And after reading your story, or dozens like it you could tell, what have I learned about what is likely to be "out there"? I don't even know what crack this one man slipped through.

I'm not saying this person is not important to people. But should be base public policy on his particular experience?

87. alistairconnor - 8/22/1999 5:59:18 AM

If a million people all slip through the same cracks, then papering over them isn't good enough.

88. alistairconnor - 8/22/1999 5:59:50 AM

Spence needs some statistics. Sorry, haven't got any.

89. SpenceMirrlees - 8/22/1999 6:00:38 AM

87--

Yes alistair, I completely agree.

90. msgreer - 8/21/1999 2:17:29 PM

Spencer

I was posting when all of asudden the big change took place. Sorry for the interuption. But it does look good, doesn't it?

I was about to say when I finish investigating this particular incident I will get back to you and report what "cracks" I found.

As for statistics you are correct. I shall do my best to bring you statistics while discussing a specific issue.

Right now I have another project. Medicare fraud.

I see that everyday too. Did you know if you report Medicare fraud whether it be an individual doctor or clinic/hospital and the government investigates and finds there was fraud.. you the consumer who did something about it will get a check from our government for 25% of all monies collected by that fraud.

91. msgreer - 8/21/1999 2:24:51 PM

Spencer

You asked why I should be concerned when it comes to the failings of our health care system.

I get paid to be concerned. That is what a medical advocate/consultant does.

When a client comes to me for help they are paying me to stand up for them. They are paying me to ask the tough questions.

When dealing with health care issues folks are scared and vulnerable. They want someone who is not afraid to speak up and question what the hell is going on here?

I watch Dateline too so I know what you are saying. But oftentimes their consumer advocate tells a story to make their point when it comes to a failing in the health care system or the auto insurance business. They don't always give us the answers but by their reporting they make us wiser consumers with the hopes the information will enpower each of us to do something about a problem.

92. SpenceMirrlees - 8/21/1999 2:29:09 PM

You asked why I should be concerned when it comes to the failings of our health care system.

Actually, I don't recall asking you that about general failings...but I'm glad you are concerned anyway. I have no doubt that the people you work with are delighted and relieved to have someone on their side who can speak up.

What I want to know is, to what extent is that solution workable in general? If we clone several thousand msgreers and distribute them around the country, free for the asking to individuals, paid for by care providers, how much would that help?

93. msgreer - 8/21/1999 2:36:40 PM

Spencer

It is a good question. There are alot of advocacy organizations already in existence working of "cracks" and changing laws everyday.

I don't have an answer to how many msgreer medical advocates it would take to turn the system around.

What I do know is getting the message out helps educate the consumer and perhaps take some of the mystic the health care system thrives on out of the equation.

I do it one case at a time. I work with local, state and federal officials.

Am I changing the world? Probably not. But someone has to be willing to take the health care system on.

We are a very wealthy country. We have the resources to implement a better system. First we have to define each "crack" and start writing some new laws.

And I find it pretty scary when Congress can not even act on a Patients' Bill of Rights. You would think that would be a good starting place.

94. SpenceMirrlees - 8/21/1999 2:49:53 PM

Well, yes, we have the resources. The question is what you want to give up to make it happen, and limo rides to work for DC bureaucrats won't do the trick.

So, how many more plane crashes do you want to have?

95. msgreer - 8/21/1999 3:05:41 PM

Spence

I don't know we have to give up anything to make the health care system a viable one. If the laws already on the book were carried out some of these "crack" would fill in for themselves.

However when we are dealing with the special interest folks or lobbyists who have all the money in the world to buy a Congressperson's vote on a certain health care issue that IS something that needs to be changed.

Our system makes it very difficult for the average citizen to get what they need when they don't have the ability to write a big check to the folks who make the laws.

Thus it is back to a grass root effort to start making the changes.

I believe most Americans want changes in the health care system. They just don't feel they have the strength or know how to go about doing it.

96. SpenceMirrlees - 8/21/1999 3:10:01 PM

Naturally that depends on what you mean by viable. But if you want more than 4 in 5 Americans to have decent (and I use the term loosely) coverage, that will require more resources than are presently used on health care. That will require fewer resources elsewhere, presumably even accounting for any productivity enhancing benefits of better coverage.

97. msgreer - 8/21/1999 3:14:00 PM

A friend of ours once wrote me "I find it politically intolerable that
any nation with the means to look after its own should voluntarily
refrain from doing so".

I have an idea. Instead of the Congressmen and women going on those junkets the HMO's provide why don't they take 100 msgreer's aka medical advocates. I bet we could tell them about what is happening out there in the real world.

I am not holding my breath for an invitation. It is merely a suggestion.

98. SpenceMirrlees - 8/21/1999 3:19:21 PM

For that sort of political activity to work requires a much more fundamental change. One can't just ask people in the present political system to change their behavior--presumably they are already acting to their own best advantage. Asking them to contravene their incentives is futile.

What is needed if we don't like the way the policy process works is a new set of incentives.

99. msgreer - 8/21/1999 3:20:44 PM

Spence

There are millions and millions of dollars which could be saved by collecting on Medicare fraud alone. That is one financial resource which would put more money into improving the system.

Then there is the profit-greed motive which roles most of our HMO's and other insurance companies. I don't believe for-profit health care insurance companies need to give their CEO's 7 million dollar bonuses at the end of the year because they did their job so damn well it "saved" millions of bucks for them.

How about looking at our health care system of one not dominated by the mighty buck and one that concentrates on serving the people.

It can be done.

100. msgreer - 8/21/1999 3:22:21 PM

How is that for an incentive?

101. SpenceMirrlees - 8/21/1999 3:24:44 PM

frankly, not necessarily so good. If collecting on medicare fraud is such a great incentive, why isn't it presently being done?

102. SpenceMirrlees - 8/21/1999 3:25:43 PM

Best bet for incentives: make it so that "serving the people" results in more of the almighty buck.

103. msgreer - 8/21/1999 3:28:42 PM

Spence

Certainly you are correct when you say folk in the business are acting to their best advantage. It does not mean what they do goes to addressing the needs of the "4 out of 5" people you mentioned.

Of course changing behavior is a mighty big challenge. But in the case of the health care system it is long overdue. But is it right to sit back and watch millions of dollars being given to our political leaders for a vote when even that money could go to better use.

I always like to see the names of Congressmen/women who take money from lobbyists. I like to know how much it takes to buy their vote.

104. msgreer - 8/21/1999 3:33:22 PM

Spence

I think we are reaching that point where I bring up the one payer system.

If what we have now can only be patched up with financial incentives to those giving the care it is time to think about everyone gaining access to the same high quality of health care many of our citizens get.

Please...I am not against people making money. It is a matter of how much one needs to make when delivering a basic need.

105. SpenceMirrlees - 8/21/1999 3:34:22 PM

It does not mean what they do goes to addressing the needs of the "4 out of 5" people you mentioned.

Obviously. That's why we're having this conversation.

The point is, people will always use any system to their best advantage. So, best to make the sum total, if you will, of best advantages work out to a socially desirable outcome. That requires system level change.

106. msgreer - 8/21/1999 3:39:10 PM

BTW, collection on Medicare fraud is being done at this very moment. There are just not enough workers to catch it all. There are not enough workers to go from place to place and read the financial books of every doctor/clinic/hospital.

But little by little people are getting caught. It is such a huge problem and like the health care system it will take more people willing to work harder at finding these frauds and acting on them.

Remember there is a financial incentive to turn a doctor/clinic/hospital in for Medicare fraud. As I posted earlier if the government investigates a fraud you have brought to their attention and they collect any money they will send you a check for 25% of what they collected.

There is a financial incentive for anyone willing to stand up and call it as they see it.

107. ranheim - 8/21/1999 3:39:41 PM

I must be doing something wrong.

Should I preview prior to posting, the post gets lost in the "ether" when I hit the "post this message" button.

108. SpenceMirrlees - 8/21/1999 3:40:57 PM

test

109. SpenceMirrlees - 8/21/1999 3:41:47 PM

ranheim: once you preview, and you actually get to the "preview" screen, if you haven't made any changes to your post after looking at it, unclick the little box at the bottom of the preview screen.

110. SpenceMirrlees - 8/21/1999 3:42:10 PM

then click the "post" button.

111. msgreer - 8/21/1999 3:43:36 PM

Spence

"that requires system level change".

YES YES YES.

That is what I am saying. And I think I have made some suggestions re money given to Congressmen/women to buy their vote on a health care or insurance law.

Cut that out of the system and let our leaders vote what is best for their folks back home.

I wonder what the votes would look like if the people in Congress were not allowed to take any money from special interest.

112. SpenceMirrlees - 8/21/1999 3:45:38 PM

msgreer:

BTW, collection on Medicare fraud is being done at this very moment. There are just not enough workers to catch it all. There are not enough workers to go from place to place and read the financial books of every doctor/clinic/hospital. But little by little people are getting caught.

Obviously at any moment there is some fraud detection. But which do you think is accumulating faster, cases of medicare fraud or discoveries of medicare fraud?

Why are there too few workers to do the job? Maybe because it's not a good enough job? If the incentive is so strong, why isn't it happening.

Don't get me wrong, that line of reasoning isn't definitive. But it is suggestive. If the incentive is so great, why isn't it working?

113. SpenceMirrlees - 8/21/1999 3:46:58 PM

And herein lies the rub: a political system in which contributions cannot be made from so-called special interests is not on the horizon.

114. ranheim - 8/21/1999 3:49:37 PM

I would assume that there are PhD thesis by the gross on this subject. All one doctor can have are anecdotes; anecdotes are not statistics.

What is frustrating to me is that for the poorest of the poor here in Loouisiana :
1) my services are free
2) lab testing is free
3) x-rays are free
4) Rx medication is free
5) hospital stays are free (they aren't free : 1 - 5 cents on the dollar).

The problem lies in the fact that those eligible for these free services, don't know how the system works.

I'm sure that msgreer will tell you that she can usually steer this category of patient into the proper loop. However, it takes an inordinate amount of her time for this category of patient.

So another area where it comes down to education and is everyone educable. These people frustrate me.

I get pissed at the ones that claim helplessness!

115. msgreer - 8/21/1999 3:55:00 PM

ranheim

You are right. It takes me alot of time when working with the indigent consumer. But as you said it can be done.

Don't throw up your hands at the folks who say they can't deal with it all. Some of those people have been put on hold so often and for so long they know not what to do.

Education. That is what I stress. Let us educate the consumer so they can advocate for themselves.

116. msgreer - 8/21/1999 4:16:24 PM

Spence

Sorry for the interuption. I am at the hospital with a client now and will be most of the day.

Plus the pc I am working with keeps going into sleep mode.

Now you say contributions made from special interest groups are not about to change.

Why can't that change? Why can't our elected representatives... those jolly folks we vote into office to take care of our needs decide it is NOT in the best interest of our citizens to be making policy according to who gives you the most money.

There is something very wrong with the special interest groups and their tactics.

Money makes the world go round

the world go round

the world go round.

I can hear Joel Grey singing that out loud and clear in Cabaret.

Now to your other questions. Medicare fraud is accumulating faster than discovery.

You asked about the workers who daily look into such fraud... where are their incentives. They aren't in their paycheck that is for sure. This is another issue to visit at a different time. Alot of the incentive has to come from within as anyone who has been involved in a grass root effort will tell you. There have to be some people willing to fight for their principles knowing they better keep their day job while fighting.

I am in private practice and bill as I choose. I also work on a sliding scale when it is necessary for the client.
And I do pro bono.

117. msgreer - 8/21/1999 4:27:06 PM

Now it is time to get some f I will count the drops in both IV's hooked up to my client..

Part of my job. If the order is for 12 drops per minute and it is going at 21 it has to be dealt with.

I will be back.

118. msgreer - 8/21/1999 4:28:01 PM

f=food

119. msgreer - 8/21/1999 5:30:33 PM

I'm backkkkk.

120. msgreer - 8/21/1999 5:57:44 PM

test

121. msgreer - 8/21/1999 6:16:47 PM

www.test.com\

122. msgreer - 8/21/1999 6:17:41 PM

mailto:j@p.com
link="www.t.com"

123. msgreer - 8/21/1999 6:26:30 PM

test

124. msgreer - 8/21/1999 7:02:54 PM

To post a webpage link, you must...

1) type the title youn want people to read and finish with
Example: The Infoseek Search

To post an e-mail, add mailto: to the prior formula:
Marcy's

Another example:
To go and find out about html go to www.html.com or click on the link below Html Page

125. msgreer - 8/21/1999 7:07:03 PM

please disregard my testing.

126. msgreer - 8/22/1999 1:44:17 AM

HTLM made easy

127. msgreer - 8/22/1999 1:48:11 AM

arky

after you get in scroll all the way down and click on to the right of "show me".

I am not feeling so smart right now.

128. msgreer - 8/22/1999 1:49:24 AM

arky
obviously click HTLM first.

129. arkymalarky - 8/22/1999 1:54:05 AM

Thanks, Msgreer. I bookmarked it.

130. Thoughtful - 8/23/1999 4:19:19 AM

Well, my medical coverage is starting to pinch. I went to get a refill on my Celebrex this weekend and the pharm said, "That'll be $120." I said, "What happened to my $12 copay?" He checked and said I need some kind of authorization to use this medicine. I contacted the insurance people today and they tell me it'll take 24 hours to get approval/denial from them. I've only 3 pills left. AARRRGGGHH!

131. msgreer - 8/23/1999 6:23:27 PM

thoughtful

I have heard of this problem before.

It could be one of several problems.

Your insurance company gives the doctors a list of what medications they are allowed to write a prescription for. Yes, the doctor follows that list. Unless of course he/she feels strongly you need a specific medication not on that list.

If that is the case the physician has to get on the phone to your insurance company and plead your case and his.

Another possibility is your insurance company has changed some policy and you have not been notified yet.Obviously when you took it to be filled the pharmacist knew enough to say we need to get authorization.

If you want an immediate answer I would call the pharmacist. They know more than the doctors and insurance companies. They are kept upto date re changes faster than anyone. It is worth a try.

Excuse me I have to deal with an issue in the hospital where I am working today. I will get back to you.

Do you have anyother questions.

BTW, since you have been taking this medication and all of asudden you need authorization I can tell you one of the scenarios I have mentioned maybe taking place.

132. theDiva - 8/23/1999 6:26:53 PM

Ms. G

133. msgreer - 8/23/1999 6:30:33 PM

thiughtful

I must say it takes up so much time for a doctor to have to call an insurance/ HMO to ask for an okay on a certain medication or ask for authorization to send a patient to a specialist that they no longer have the time.

Some doctors actually hire someone to sit in their office and do nothing else but make these costs. And it ends up costing them a bundle.

You have to remember with most insurance/HMO's there is a FINNCIAL incentive for the doctor to not send their patients to specialist. Some insurance companies actually when contracting with a doctor write in a clause saying you are not allowed to discuss all the health care options open to your patient for certain diseases or other health care issues.

It's a dandy system.

And as Spence and I were discussing afew days ago we can't even get a Patients' Bill of Rights passed in Congress. Many of all our healthcare daily problems with the insurance companies would be solved to a great extent if the Democractic Patients' Bill of Rights got passed.

I will be back. I really have to sign off for abit.

134. msgreer - 8/23/1999 6:40:21 PM

Diva

I will yahoo you right away.

135. Thoughtful - 8/23/1999 7:48:15 PM

Thanks for your input MsG. Dr. must've said the magic words as I got a call back -- finally -- saying I've been approved for 12 mos. Thank goodness. After spending 2 years looking for a med that would ease my pain, I finally found one -- and then the insurance pain started! Sheesh!

136. ranheim - 8/23/1999 8:12:54 PM

As an M.D. I am somewhat ashamed to admit this - but, I am rural. Many of you are urban.

Do you/your family ACTUALLY save money in an HMO? May sound strange coming from an M.D. but I have no idea what your answer/s will be.

137. ChristiPeters - 8/23/1999 8:16:26 PM

msgreer -

I know you are busy, so take your time answering this.

I have an elderly aunt who has just undergone heart valve replacement surgery. It's been a week since the surgery, which supposedly "went well", but she is still in ICU. Is this typical?

This "Aunt" is really my Dad's double-cousin and was very close to my Dad and, hence, myself and my brothers. She and my Dad's much younger step-sister are the only ones left of that generation of the family. I am very worried about her.

(I'd welcome input from anyone else who knows anything about this, too)

138. msgreer - 8/23/1999 8:54:49 PM

ChristiPeters

i hesitate giving an answer only because i am not looking at the chart.

however i can say oftentimes people are in ICU for a week.

at this point do you know if there were ANY complications or did your aunt have other cardiac problems?

a valve replacement is major surgery. it maybe she is just not ready to go to the second level yet.

didn't you mention she had another health issue to me? a stroke if i remember.

all i do know is this the decision to keep her in icu is made by her doctor and cardiac surgeon.

i can understand your concern. is there anyone in your family that can get in touch with her doctor and ask your question?

139. msgreer - 8/23/1999 9:02:14 PM

thoughtful

glad to hear you were approved but why just for 1 year?

perhaps your insurance company wants to make sure you need this specific medication.

if you have to go through getting authorization every year don't you want to find out why this happen in the first place?

i keep saying call the pharmacist. she/he knows more about authorization questions than anyone. atleast i have found them to be very helpful to me in my business.

i am often the person on the line to HMO's/insurance co. trying to get authorization for a medication or a procedure. it has taken me along time to break their codes but i have done it. it helps when talking to them if you know their lingo. it is all such garble if you don't know the secret codes.

if i may ask are you with a HMO?

140. DocBrown - 8/23/1999 9:03:13 PM

Christi, you should also know that sometimes non-medical factors contribute to a person staying in an ICU for an extended period. All the stepdown units may be full or short staffed. A unit might be closed for cleaning or remodeling. A doctor with a lot of clout may be holding a block of rooms for his own purposes. These things happen all the time.

Is your Aunt awake and alert? As you probably know by now an ICU is an unpleasant place for patients and families. For this reason hospitals usually try to expedite awake and alert patients away from ICUs if possible.

141. ChristiPeters - 8/23/1999 9:09:06 PM

Oh, my poor Aunt is one of those walking miracles. Her heart was damaged by rhumatic fever as a child and she has had a pacemaker so long she's on her third one. No problems with them, they just wear out after 7-10 years or so.

She was in a major major car wreck when I was a toddler and had a stroke then.

Recently, she had an post-surgery infection (the pacemaker replacement) which kept her hospitalized on IV antibiotics for a couple of months.

She was scheduled for this valve replacement surgery awhile ago, but fell and hit her head and got a blood clot on the brain in the same area as her previous stroke. She had to recover from that before they could do this surgery.

She's 20 months younger than my Dad, so she's about 75 now. She is listed in "critical" condition in ICU.

For all the pain and trouble she has had in her life, she is unfailingly cheerful, deeply devout, and so sweet diabetics should stay away from her!

142. ChristiPeters - 8/23/1999 9:12:09 PM

Doc Brown - I think that my aunt is not awake. I only have my news second hand from my Uncle as passed on by my Mom. Mom is in Southern Michigan. My Aunt and Uncle are in Northern Michigan. I am in Texas. I want to go up there sooo bad, but can neither afford the airfare nor the time off work right now. It is driving me crazy.

143. msgreer - 8/23/1999 9:19:17 PM

ChristiPeters

I would expect the term "critical" to be used. What I would like to know is your Aunt "critical and stable.

stable in most medical settings means they have a blood pressure and pulse.

Have you thought of calling the doctor yourself?

He/she would need to know who you were before he/she would give out information but perhaps a family member in Michigan can make that call first.

It helps to talk directly to the doc.

And the nurses in ICU are usually helpful. But they will give information only to family members.

Let me know what's happening.

144. ChristiPeters - 8/23/1999 11:03:32 PM

I will. Thanks for the info that "critical" is "normal" in this kind of situation. I will call someone tonight.

145. Thoughtful - 8/24/1999 12:59:05 AM

MsG, I am with an HMO and I don't mind approval once a year for the drug, especially since it seems to be less effective over time for me. Besides, I've decided that my pain will be gone in Oct 99 -- 2 years after onset. I'm tired of it, so it'll be outta here!

Ranheim, yes I do save money with the HMO over the traditional health insurance -- provided I stay healthy. }:-) No deductible; OV=$15 co-pay; Rx=$12 co-pay; mail order Rx $11 for 3 month supply; no lab fees. This includes specialists provided I get a referral from Dr. first. Traditional plan was $250 deductible per person then 20% of all costs. But the HMO does put the screws to you if you want them to pay for something significant.

146. Thoughtful - 8/24/1999 1:00:11 AM

ChristiP, sorry to hear about your aunt -- sounds like she's really had a rough time of it. My thoughts are with you.

147. ranheim - 8/24/1999 1:02:23 AM

I just realized something! Dumb me!

Do most of you who belong to an HMO receive it as a perquisite?

I really shouldn't be posting as I'll be in Cape Cod for a week.

148. Thoughtful - 8/24/1999 1:07:05 AM

For me, the health care is provided by the company and it includes dental and some limited eyecare coverage. Funny, the company offers scads of life insurance -- are they trying to tell me something?!?

149. msgreer - 8/24/1999 2:31:36 AM

FOOD FOR THOUGHT

ABC Evening News reports the countries largest HMO, Kaiser Permanete, has a new plan in action in Colorado. If you belong to their HMO program and think you have an emergency and want to call 911 for an ambulance you have to call them first.

And who will answer the phone for Kaiser and make the decision whether you are having an emergency. Noneotherthan their technicians.

Training you ask? Most of the technicians you will reach have taken a 4 week training course.

Is this who you want making emergency decisions for you?

Paramedics in Colorado say the time it will take to make this call could be a life and death situation. They say certain emergencies can't wait while these Kaiser technicians decide whether you can ride in an ambulance. They contiunue to say it will cause great confusion among alot of people especially the elderly.

And this is going to all 50 states in 9 months

150. msgreer - 8/24/1999 2:41:13 AM

ranheim/thoughtful

the key words in thoughful's post on his HMO is "as long as I stay healthy".Good luck thoughtful. I fear where your HMO will be if you get very sick151. Dusty - 8/24/1999 3:16:42 AM

test test test test test

152. Dusty - 8/24/1999 3:17:16 AM

153. Dusty - 8/24/1999 3:17:34 AM

test

154. Dusty - 8/24/1999 3:18:01 AM

test

155. msgreer - 8/24/1999 3:19:35 AM

Dusty

Okay you all are testing the new format. I see this thread is back to the old look.

Someone stop me from saying "you all".

156. Dusty - 8/24/1999 3:19:51 AM

better but not yet fixed?

157. Dusty - 8/24/1999 3:20:52 AM

I fixed the width, but I can't seem to correct the italics

158. msgreer - 8/24/1999 3:22:45 AM

Dusty

I think it looks good this way. It is difficult to follow someone's post when it is so compact.

And why the arrows in the thread itself as opposed to at the end of the page?

I am sure there are reasons you are looking at new formats.

Test away.

159. Dusty - 8/24/1999 3:24:03 AM

You used a (em) tag, not normally used. I tried ending it but got an error, I'll try again.

160. Dusty - 8/24/1999 3:24:24 AM

There!!!

161. msgreer - 8/24/1999 3:27:51 AM

oops.

162. Thoughtful - 8/24/1999 4:07:08 AM

I know. Kaiser pulled out of our area awhile ago saying they couldn't make money.

A buddy of mine and his neighbor belonged to a local HMO that was started by area doctors. It ended up in bankruptcy and stopped paying bills. Fortunately, my friend only had a Dr. visit outstanding and only had to pay about $100. But his neighbor was receiving chemo and suddenly found out he was responsible for all those bills and bingo --over $100,000 in debt. Nice. Of course, the Drs who founded the HMO are untouchable, but you know they made money on the deal.

163. ChristiPeters - 8/24/1999 4:34:57 AM

I don't have an HMO, but rather a Network. If I go to a Network doctor, my health insurance pays 90%. If I live/work somewhere they have no Network or I need to see a specialist they don't have in the Network, they pay 80%. They pay 100% for cancer screening, annual exams, annual Superchem.

I can choose to go to a non-Network doctor/hospital, but then they only pay 50%. In an emergency, I can go to whatever facility is closest and I don't have to call them first. They pay 80% the cost of any meds, but if there is a generic and I (or the doctor) choose the name brand, they only pay 50%. There is no deductible to meet before they pay for the screenings and the meds, but there is for the rest of it.

I don't think I would work for a company whose only health coverage was through an HMO. I wouldn't join an HMO if I had any other choice.

164. msgreer - 8/24/1999 1:43:05 PM

Good morning friends

I continue to come to you from the hospital.

I got here at 5AM Eastern.

You have to get here early if you want to catch those doctors doing their rounds.

When you come to a hospital at 5AM it is a very quiet place. I should say the hallways are quiet as most nurses are doing charting and it is not time to go into a patient's room and wake them with the lovely light above their bed.

But it soon starts making all the unfamiliar sounds by 6AM. I say unfamiliar because any noise or movement to a person lying in bed can be a scary one. They don't know the routine of the hospital day and oftentimes a client will say "what is that noise, are they coming for me, is that the doctor in the hall?".

A hospital can be a frigtening place to be. I don't like hospitals myself and I know what is going on.

There must be a better way to help each patient feel more at ease while they deal with the health issue that put them in the hospital to begin with.

I feel posts coming from me on the politics of the hospital coming on.

Anyone have a hospital story of their own to share?

165. msgreer - 8/24/1999 1:51:50 PM

trike "coming on".

Excuse my grammar or lack thereof.

I hope to wake up any moment.

I might add the experience in a specialized unit as ICU or CCU is abit different than the Medical-Surgical Units.

166. msgreer - 8/24/1999 1:54:48 PM

cont.

In these units a nurse usually is assigned one patient. Of course this depends on staffing and the number of patients in the unit.

But is gives the patient one on one care and a true bonding experience begins between patient/family and the nurse.

167. alistairconnor - 8/24/1999 2:01:13 PM

I have never been hospitalised myself. The last time I was in a hospital was four years ago, before my father died (I am proud to say, he didn't die in hospital). It was rather eerie, because I used to spend a fair bit of time in that same hospital during the school holidays when I was a kid, annoying/helping the office staff - my father, a radiologist, used to work there in the sixties.

168. msgreer - 8/24/1999 2:46:40 PM

alistair

I agree with you on one thing. I would not allow any relative of mine to die in a hospital.

169. alistairconnor - 8/24/1999 2:56:04 PM

It's not easy, MsG. Once a dying person gets into hospital, it's not easy to get them out. Even for us, a medical family. My elder sister is a doctor, and I could see her being conservative about it, doing what doctors will do, wanting to be sure that everything was tried to keep him alive. When he instructed his doctors to stop giving him antibiotics, she had to admit, like them, that there was no point in him staying there. But even then, I had to do some moving and shaking to get him home, in time for it to make a difference for him.

Damn, I haven't thought about him much recently. I love him, and I miss him.

170. msgreer - 8/24/1999 3:11:03 PM

alistair

I know how difficult it is to get a doctor or even a family member willing to fight to get their loved one out of the hospital to go home to die. I am all to aware of what it takes. I have done it for so many of my clients over the past 10 years.

I have found it has gotten abit easier with Hospice becoming so well known and understood by families and doctors.

Living Wills also help when one wants to get the hell out of the hospital.

The medical establishment doesn't make it easy.

It makes you wonder about our system. When it comes down to it whose choice is it anyway?

If the medical establishment didn't look at death as a failure and realized it is going to happen to all of us it might help.

It is a natural event. And the wishes of the patient should always come first.

I didn't mean to bring up sad memories for you. I imagine you miss your father very much.

171. alistairconnor - 8/24/1999 3:16:57 PM

It's OK. I like thinking about him, and I enjoy the sadness too, if you know what I mean.

172. msgreer - 8/24/1999 3:22:38 PM

Alistair

Yes I do understand.

It may sound silly but whenever I watch a University of Michigan football game I think of my father and the years we watched UM football together. We had such fun.

And when UM fight song was being sung well we were up on our feet and singing.

And we were watching the game on television.

Wonderful memories.

173. ProfEmeritus - 8/25/1999 2:07:38 AM

Alistair and Ms Greer

I sure sympathize with your efforts, Alistair, and I am happy that they were successful. Your love for your father came through very clearly, and I am sure he appreciated what you did.

I have a son who is a doctor (internist), and he works out of a university hospital where he also teaches. He has written a text on internal medicine, and I proofed it. He made a special effort to induce doctors to be empathetic and take family feelings into account. He also practises what he preaches. He has told me of many cases (no names, ever) where he has encouraged the family to do what you did, Alistair. He is known as a doctor who has much feeling for patients and family. I feel certain that his patients would never need Ms Greer's services. I admire what you do, Ms Greer.

174. ProfEmeritus - 8/25/1999 3:03:25 AM

In the economics thread Thoughtful said that medical costs are falling because HMOs are becoming more popular. Popular is hard to believe. They have increased their senior patients because the cards are stacked in their favor. Medicare covers more for the HMO patients than for the independent patient. I would never choose an HMO after the many complaints I have heard from my senior friends who are forced to use them. Doctors are also very unhappy with HMOs because of their penchant for overruling medical decisions and the excessive red tape they require for patient treatment.

Ms Greer, these assertions are made by one who is only an interested observer, but no student of health care policy.

175. Thoughtful - 8/25/1999 4:53:36 AM

ProfE -- I didn't say with whom they were becoming more popular -- why those who foot the bill for medical insurance, of course...corporations and such. Earlier in this thread I posted the relative costs for us of the two insurance options my co. offers and the HMO version is cheaper --provided you stay healthy or provided you need care that is cheap, e.g., generic drugs, no unusual treatments. So the economic incentives are there. However, when they are hooking you into the HMO, they never tell you about the stumbling blocks they will throw in your way to make you pay more and them pay less.

176. ProfEmeritus - 8/25/1999 5:10:51 AM

Thoughtful

I figured that that was what you meant, and it is right. I just wanted to look at it from the user's viewpoint.

177. ChristiPeters - 8/25/1999 5:24:40 AM

I do not ever want to have to deal with health care for myself seriously ill. I hope and pray that I am healthy up until about two years past retirement, then I get hit by a truck or something and die instantly.I will thereby not only stave off lingering illness, but the prospect of being a homeless baglady all in one fell swoop.

178. ProfEmeritus - 8/25/1999 5:46:50 AM

Christi

At what age do you plan to retire? 99? At 65 your life expectancy with good health is probably about 15-20 years.

179. Thoughtful - 8/25/1999 8:05:36 PM

Yeah, a lot fewer of us end up in nursing homes than is commonly thought. I still am seriously considering buying nursing home insurance for hubby though as his mother, aunt, uncle, and grandmother all ended up there -- and he's so like them in so many ways. Considering I'm significantly younger than he, I suspect it would be good protection for myself...especially considering that without children, there will be no one to care for me in my dotage.

180. msgreer - 8/25/1999 8:23:00 PM

thoughtful

run don't walk in getting insurance for a nursing home as well as at home care.

you don't even want to know what nursing homes look like inside.,p>the abuse and neglect to our greatest resource .. the elderly... is widespread throughout the entire system.

a good nursing home costs anywhere from $3700-$4500 per month. anything else will buy you zero. and if you saw what it bought you you would never be able to place a loved one in such a facility.

it is important to get this kind of coverage BEFORE there is any diagnosis of dementia/Alzheimer's.

from years of experience i ask you to trust me on this one. should your loved one have any of the neurological degenerative disease diagnosis before you purchase this type of insurance you will not get it.

i will give you an example. i had a client who was showing the signs of alzheimer's. at that time she had no nursing home or at home insurance. i spoke to her children and said get her the insurance. right now. this is what is happening and if i take her to a doctor first

181. ChristiPeters - 8/25/1999 8:25:11 PM

ProfE -

Another 15-20 years!? Geeez, I hope not. Life isn't really all it's cracked up to be, y'know.

182. msgreer - 8/25/1999 8:26:38 PM

and get a dx. she will never get the insurance.

they did got her the insurance right away and within 6 months she was placed.

the insurance companies may not like my tactics but i don't live for their approval.

183. msgreer - 8/25/1999 8:27:30 PM

got=get

184. ChristiPeters - 8/25/1999 8:28:48 PM

msgreer -

...and your clients are darn lucky for it, too

185. msgreer - 8/25/1999 8:36:29 PM

ChristiPeters

thanks.

i just know what is out there.

i have no guilt whatsoever when i give suggestions like these to my clients/friends.

186. msgreer - 8/25/1999 8:39:12 PM

what happen to the rest of that post??

as i was so rudely interupted i was making the point it is not like the insurance business is one that makes it leaders live in poverty. and you can be sure they are getting good health care.

i could care less what they may think of my tactics. i don't much like theirs.

187. Thoughtful - 8/25/1999 9:37:21 PM

MsG., my mom-in-law is in a nursing home now. We paid down her assets at about $72,000 per year and now there are none. She's on medicaid. Of course, it didn't take long to go through it all, but fortunately her husband died a long time ago and her assets were just used to support her. It's a much bigger problem if there's a surviving spouse. My experience with nursing homes for the most part have been quite favorable. The places we've been are expensive, but clean, neat, careful and the people are caring. I've never seen any signs of abuse or neglect -- at least on the part of the workers. On the part of the families may be another story.

188. Judithathome - 8/25/1999 9:43:55 PM

msgreer:

Have you any suggestions of good policies to get (re:nursing home/home care) or companies to check out? What are the companies that give you fewest hassles in that regard?

If you would rather not answer me on-line, could you send me an e-mail? I have concerns because of family history on both my side and my husbands, too. JudithAtHome@mailcity.com

Thanks!

189. Thoughtful - 8/25/1999 9:50:31 PM

My company offers nursing home insurance and the open enrollment is in November so I think I'll check it out then -- they also just lowered the rates.

190. msgreer - 8/25/1999 10:29:32 PM

I want to add there are alot of dedicated CNA's and nurses that work in nursing homes. it is a VERY difficult job.,p.but there are many who feel the important of what they are doing.

i just wanted to give the recognition they have earned.

and there dedication to their clients and their families in never reflected in their paycheck.

i have made a list of 53 questions I ask when looking at any nursing home. afterall i have been doing it for 10 years. i also have a book with over 1400 pages which goes state by state and lists the best nursing homes in each county of each state. it also tells one when they were last visited for inspection, what was found and if corrections had to made they give them sometime to make the corrections.,p>anyone looking into a nursing home has the right to see these reports.,p>someone stop me. i could go on and on. i maybe giving more information that was asked for.

191. joezan - 8/26/1999 2:43:33 PM

My Managed Care Horror Story:

My sister is an RN, but hates working in hospitals. She raises and shows Irish Setters, and needs the freedom to be able to just take off on short notice for shows, etc. Quite often, she takes work through agencies which don't pay as much as she could get in a hospital, and offer little or no insurance benefits, just so she can have that freedom. Thank God she's always been healthy.

But about six months ago her asthma - which has not flared up in over 20 years - got bad enough that she had to go to the ER, and now has to have treatments. After that it wasn't that hard for my other sisters and myself to talk her into getting a "real" job, with benefits. So, she took a job in a doctor's office, whose employees belong to a HMO, and she's absolutely loved it.

Three days ago, she had a trainer over to her farm, attempting to break one of her horses, an Arab she's owned for a couple of years. After awhile she attempted to ride, and the horse took off like a shot, throwing her over the fence. When the trainer got to her she was still out cold, and remained that way till the ambulance arrived about 5 minutes later.

She woke up en-route to the ER not knowing who she was, and in great pain. At the hospital they checked her over and concluded she had a concussion, so she was sent for head x-rays. She had told the ER doc that she was having trouble breathing, and that she's asthmatic. So he listened to her chest and had the nurse administer albuterol. There was no skull fracture, so she was sent home with my other sister. Over the next 2 days her breathing was getting increasingly labored and the asthma treatments weren't helping, so she went back to the ER yesterday afternoon.

This time they sent her for chest x-rays, and found 3 broken ribs and a collapsed lung. They immediately inserted a chest tube...

...and sent her HOME!

Home...with a chest tube!

192. Thoughtful - 8/26/1999 3:31:46 PM

JoeZ, most interesting -- especially since my HMO requires you to pay for the ER visit if they don't admit you. Do they expect her to remove the chest tube herself? Or will they let a Dr. do that? Man! Maybe before too long, if you need surgery, they'll just issue a "do it yourself" kit, eh?

193. joezan - 8/26/1999 3:44:19 PM

Thoughtful:

Her plan requires a co-pay for ER care, whether she's admitted or not. And, if they determine the visit wasn't an actual emergency, she's gotta pay the entire bill.

When I was 18 I had a collapsed lung, with no other injuries (except for the hole where the knife went in) and had to stay in the hospital for 7 days! And the first 2 days were in intensive care! With all the trauma my sister suffered (she absolutely cannot move -everything hurts), you'd think they'd keep her at LEAST a couple of days...

When I found out she'd gone back to the hospital yesterday, and what they'd found, I called our pastoral care minister (an RN herself) who left work immediately to visit my sister. She was stunned when she arrived and found out they had discharged her.

194. msgreer - 8/26/1999 4:26:02 PM

joezan

what kind of hospital did your sister go to? it sounds like they have people walking around acting as if they were doctors.

I am sitting here trying to understand how they could miss a collapsed lung. the symptons she presented were enough for anyone working in ER that has a pea for a brain would be able to figure out.

has she spoken to her HMO to find out what their restrictions are on ER visits?

the hospital would know and if she had to give her HMO information to them perhaps that had something to do with it.

otherwise i have only one thing to add... everyone working on her that night are totally incompetent.

thank god she made it through.

a true horror story.

195. joezan - 8/26/1999 4:39:10 PM

msgreer:

Believe it or not, she used to work at this hospital - one of 2 big community hospitals in her county. She joked that perhaps that was why she received such crappy care. I don't know all the details of her coverage, but it was definitely a managed care decision.

I haven't said anything yet, but when I see her today I am going to suggest that she see a lawyer.

196. msgreer - 8/26/1999 5:02:43 PM

joezan

sounds like a good plan to me.

but remember we are not allowed to sue our HMOs just yet.

at time of service if she wanted to make a complaint she could have called her HMO and it would have gone through a review board which cantake weeks.

if you have been following the Patients' Bill of Rights discussions in the Senate you would see the Democrats want a clause put in allowing one to sue their HMO's. the Repubs do not. i say they DO NOT want the ability to sue in any Patients' Bill of Rights.

they say it would increase rates for all its members and price people out of getting coverage.

i don't know if the HMO's continue to treat life and death situations as they already do enough of thier folks will die and then new people can sign up for membership.

the HMO lobbyists have given the Repubs an enormous amount of money. and yes the have given the Democrats money too but about a third of what the Repubs have gotten.

197. msgreer - 8/26/1999 5:04:41 PM

thier=their

198. Judithathome - 8/26/1999 7:18:32 PM

msgreer:

I received your letter and thank you for responding in such a timely manner. I will look into this company first thing next week.

I hadn't really thought much about this until I read your remarks yesterday and it dawned on me, hey...this is not a bad idea at all and I really should check into it. Thanks again.

199. msgreer - 8/26/1999 7:23:02 PM

Judithathome

I hope it works for you.

Now I am off to the hospital again where I have been posting for the last week. I don't see I will have anytime to post until this evening but I will be back.

Carry on.

200. Thoughtful - 8/26/1999 7:27:38 PM

What's really interesting is reading about JoeZ's sister and how little care she's received vs. my Grandmother on Medicare who they couldn't do enough for. Man.

201. Judithathome - 8/26/1999 8:25:55 PM

To anyone who's been waiting with bated breath, as have I, for the bill to come in from my husbands visit to the ER last month: today was the day and I have the vapors over it.

$20.00......TWENTY BUCKS!!!!!!! I thought I had read it wrong. I am faint with relief.

202. ChristiPeters - 8/26/1999 9:14:38 PM

WHEW!

I'm happy for you!

He's all healed up now, right?

203. Judithathome - 8/26/1999 9:30:19 PM

ChristiP:

Yes, he's back in the "swing" of things, meaning he's already played golf twice and bought 2 new pair of shoes. I call him Imelda...he can not pass up a good sale on expensive shoes. (Thank god he refuses to pay full price for them!)

I was shocked that our insurance paid for everything. I guess I'd heard so many horror stories lately, I was just primed to be another one added to the pile. I suppose you can tell we rarely use our insurance...

204. ChristiPeters - 8/26/1999 11:16:04 PM

Well, that's the kind of shock that's nice to have.

205. msgreer - 8/27/1999 7:00:36 AM

judithathome

That is one good story about your insurance.

Please please enlighten us. What insurance company are you with?

Is it a HMO or private insurance?

If you choose not to share the name just say whether it is a HMP or private insurance.

Thanks

206. msgreer - 8/27/1999 7:01:23 AM

HMP=HMO

207. msgreer - 8/27/1999 4:03:24 PM

Thoughtful

CELEBREX ALERT

Trying to avoid errors and te need to re mane their wildly popular arthritis drug, Monsanto Co. and Pfizer In. have launched a campaign to make sure doctors and pharmacists don't confuse Celebrex with similar-sounding drugs. Celebrex sounds alot like Celexa, a depression treatment and Cerebyx, an anti seizure drug.

Since Celebrex was released in January, federal regulators have received 95 reports of dispensing errors blamed on health professionals confusing the pain killer with similarly named drugs.None of the cases involve serious injury of death...yet.

At the urging of the FDA, the companies have paid for advertisements in major medical journals to make sure doctors and pharmacists understand the difference between the soundalike drugs and the need to make sure they are writing out the right pill.

Marketing representatives are reinforcing the message during visits with doctors.

If the problem does not improve, the FDA could make the companies change the drug's name, which could threaten sales.

208. msgreer - 8/27/1999 4:11:41 PM

cont.

And you know anything that threatens a companies income will make them act quickly...atleast we can hope.

Monstanto already has changed the drug name fro Celebra, which federal regulators said sounded too much like other medications.

Of the 95 mix up cases, 22 involved a patient actually taking the wrong drug. With the rest someone caught the error in time.

"This is an accident waiting to happen" says Hedy Cohen, Vice President of nursing at the Institute fr Safe Medication Practices, a non profit group that tracks medication errors"."It's a matter of time until a person that is already sick gets the wrong drug and the chance for a erious injury can occur."

Celebrex has become the fastest selling new drug ever, with about 9.3 million prescriptions written since it debut. Sales of $1 Billion are expected this year, with upward of $4 Billion by 2002.

209. msgreer - 8/27/1999 4:16:42 PM

MORAL OF THE STORY

If your doctor hands you a prescription check it and make sure it is correct.

When you pick the medication up take a look at the name of the medication on the label. Make sure that is correct. Make sure your name is correct.

Once you pay for the medication and take one step out the door you own that medication. Even if you find a mistake after leaving the pharmacy you do not get your money back.

They will refill it correctly but you maybe out alot of money.

And make sure you have the pharmacist take the medication given in error off your records. Your insurance company knows everytime you get a medication filled.

From personal experience I have found if my damn records are going to be public I sure want them to be accurate.

210. msgreer - 8/27/1999 4:19:22 PM

HELPFUL HINT

If you are with your doctor and he/she recommends a medication for you ask him/her to CALL it into your pharmacy. They have all the phone numbers to call.

If you do that the medication will be ready for you when you get there. You won't have to wait while they fill it!

211. Judithathome - 8/27/1999 6:03:12 PM

212. Judithathome - 8/27/1999 6:04:51 PM

Toys, msgreer...toys. don't forget! Put 'em away.

213. Judithathome - 8/27/1999 6:05:57 PM

By the way, our insurance is Tri-Care, the coverage available to retired military.

214. msgreer - 8/27/1999 6:27:20 PM

judithathome

When I posted I had no idea it would come up in italics. I did nothing to try to post in italics.

So why did it happen?

I understand to put tags away but I am stumped as how the post went to italicas.

Any input up can give me I would appreciate.

It appears I need to go back and read the helpful tips CalGal has posted.

BTW, I am waiting for information on the second company I mentioned to you. I should have it today and will email you with all the information.

215. msgreer - 8/27/1999 6:28:56 PM

So why did the post above not come out in italics.

It is back to the books for me.

216. Judithathome - 8/27/1999 6:37:23 PM

msgreer:

Now all the italics are gone! Maybe the Mote doesn't like working on Saturdays. :-)

217. bloodnfire - 8/28/1999 2:24:05 PM

Missy, I didn't realize you were hosting a thread !, and here you have been so actively participating in Spiritual Issues. Anyway, forgive me. I have read half the posts in the Health Policy thread, and will catch up when I get back from work this afternoon.

Our cuddling is just great. Breasts are wonderful, (none more so than yours dear Missy), but brains are even more erotic ! My sincere compliments. :-)

218. bloodnfire - 8/28/1999 10:17:48 PM

Caught your post in the Spiritual Issues thread. Go ahead and explain what you do. It sounds most rewarding. Are you R.N. ? L.P.N.? Own your own business? WHAT? WHAT? WHAT? (You have already learned I am impatient :-). Whereabouts in Florida do you live? I just got back from a 1200 mile round trip down to Fort Lauderdale. I'm halfway between Tallahassee and Pensacola. Blessings on you. I really enjoy the weekends !! :-)

219. bloodnfire - 8/28/1999 10:27:40 PM

When you post, if you go over the 2,000 limit, highlight the excess in the 'Check for Dust' box. Put your cursor on 'Edit' and then 'copy'. Delete the highlighted part. Cast your mote with the remainder, then come back to the empty posting box, and after putting your cursor on 'Edit', 'paste' to the blinking cursor. Hope this helps?

220. msgreer - 8/28/1999 10:32:25 PM

bloodnfire

It certainly does help.

It was nice you took so much time to help me.

221. Thoughtful - 8/30/1999 1:19:20 AM

MsG. Thanks for the warning about the Celebrex -- I'll be sure to make sure I'm getting the right stuff.

You gotta wonder why/how they are allowed to name things so similarly.

222. msgreer - 8/30/1999 2:23:06 AM

thoghtful

I am so glad you saw the Celebrex post.

i have not been home lately. when i did come home i was always looking for you to tell you about my post.

It certainly does make one wonder about the need for similiarly-sounding medication.

You don't think it could have anything to do with MONEY do you?

I hope you are well.

223. bloodnfire - 8/30/1999 6:09:48 AM

Missy, you've got mail.

224. msgreer - 8/30/1999 8:53:44 AM

It is about 1am Eastern.

I got home from the hospital and as I usually do I threw my things down and headed for a hot bath.

I had spent another full day with my client.

Up until now I have choosen not to speak about this client. I am ready to post now.

The client is my mother.

I have been trying to get ahold of my own emotions and felt I could not talk about my mother until I felt abit more at ease.

I don't know how "at ease" I feel but I need to talk about my mother's medical issues.

Her problems started lasts April when she placed her companion of 8 years in a facility for the Alzheimer's patient. This is not a new experience for me or my mother because the two of us took care of my father for 8 years as he too had Alzheimer's Disease.

My mother went inot a deep depression after her companion was placed.

225. msgreer - 8/30/1999 9:01:23 AM

This fall was a serious one. And many of the symptons she presented with became worse.

At some point she suffered a second stroke. Her first one was in March '98. It was a very minor one and she was left with few problems.

But things began to change rapidly for her after this fall. Her headaches which were dull but round the clock became unbearable and she was put on a potent narcotic. She lost all gait/balance. She also lost her will to live.

I basically moved in with her. After watching what she was going through I decided she needed several medical evaluations.

My mother was checked by her internist, neurologist and a cardiologist.

The only concrete diagnosis was major depression. All her doctors felt her physical symptons were just apart of this depression.

As I said before she had sufferend another stroke.

To make along story short she ended up in ICU as an emergency case.

A CT showed she had a tumor in her brain as well as the fact she was bleeding in her brain.

She underwent immediate surgery to remove the tumor (which was benigh) and stop all the bleeders.

226. msgreer - 8/30/1999 9:06:13 AM

I was told she was critical and I should prepare for her death.

I was not ready to lose my mother and I just did not get into dealing with the possibilit she might die.

Post op complications set in and her brain began to swell. She was rushed back to surgery in order for a shunt to be put in to add in reducing the swelling. This is not an unusally complication of neurosurgery.

But I could tell I was losing her. And everyday when I was with her I could see this woman slipping further and further away from me.

I would like to add because I still have anger over this...I have 4 sisters. I called all of them and they were aware of the situation. I voiced a need for help. NO ONE came down to be with mom or me.

Now last Saturday I am home getting some down time when I get a call from some biggy at the hospital.

227. msgreer - 8/30/1999 9:13:32 AM

I was told my mother had taken a fall. I immediately said what are you saying were her guardrails down and she fell out of bed. She is still in ICU at this time.

No was the answer. 2 ICU nurses had gotten mom up for the first time to take afew steps to a chair so she could get out of bed and hopefully start healing.

These 2 highly trained ICU nurses DROPPED her.

Dont' even ask how that could happen.

We are taught in Nursing 101 how to break a fall.

In all my glory... I had pj's one, wet hair and no shoes I got to the hospital in record time.

When I got there my mother was still on the floor and screaming from pain. She had fractured her right hip.

After screaming at enough people she was given a large shot of pain medication.

I will leave out what I had to say to all the people who were huddled around her. I do know the President and CEO of the hospital was there and this is on a Saturday.

So now she is trying to recover from 2 neurosurgeries and she has a fractured hip too.

By the end of the day she was on the ortho unit in traction.

228. msgreer - 8/30/1999 9:19:06 AM

I got ahold of the only orthopedic surgeon I trust in this town. He came immediately.

But if all of this was not enough my mother was taking coumadin... a blood thiner given to her after her first stroke.

She could not be operated on until she was weaned off this medication and she had received enough Vitamin K so there would be no risk of her bleeding out while they gave her a total hip replacement.

Still no one from my family has shown up.

When it became crystal clear mom was critical and if any of my sisters wanted to see her alive again they would have to come before todays surgery.

Yes her hip replacement is set for late afternoon today.

2 of my sisters are coming but will not arrive before the surgery.

Did I mention I am named on her Living Will so all this time I have been making all the medical decisions. I still am.

My mother is still critical. And watching her die abit each day has been the most painful experience of my life.

As I have shared with some I am not ready to lose her.

229. msgreer - 8/30/1999 9:28:18 AM

It has been a nightmare from the very beginning.

I have advocated for her everyday.

I have watched every procedure and every medication she has received.

And I am listening to her telling me please leave me alone. I do not want to live. And I sure don't want to live this way.

I am totally exhausted. I do not remember when I got a good night's sleep.

My own doctor sent me home yesterday with medication and said get out of here and go to bed.

I ache. My heart aches. Sadness has taken over.

So now I have posted. I ask only for your prayers for my mother.

She is not out of the woods by any means.

There is no guarantee she will make it through her surgery today.

She just has so many complications to be going in for surgery again.

I don't know what else to say.

I don't know anymore words to describe how I feel or don't feel I should add.

I am hurting but in order to deal with this all part of me is numb.

I will keep in touch. I have asked ChristiPeters to post for me from now on and she has agreed to help.

I want to thank everyone who has had my mother and me in their prayers. It means alot to me.

I have to be at the hospital at 5am and it is close to 2:30am now.

I will see you again when there is time.

Thanks for giving me this forum to share my story.

230. bloodnfire - 8/30/1999 9:46:22 AM

We'll be thinking of you, and praying God to guide the surgeons' hands this afternoon Missy. Let us know how things go, and try to get some rest.

231. alistairconnor - 8/30/1999 9:47:34 AM

A big hug from me, MsG... I am listening, I am with you.

232. msgreer - 8/30/1999 9:52:44 AM

bloodnfire/alistair

thank you so much. i will take all the hugs i can get.

i did not even read what i posted. i just wrote it down.

i will make sure i get back to this thread and let you know how the surgery went.. i will be spending the night with mom so christipeters may post for me.

i have to be at the hospital so early because i have not signed the consent form yet. i have question for the surgeon.

i will take you hugs and prayers with me.

233. msgreer - 8/30/1999 9:54:32 AM

you=your

and how did those italics get in there alistair? i really did not post it that way.

234. SnowOwl - 8/30/1999 10:00:01 AM

My good thoughts are with you and your mother, msgreer. Please take good care of yourself as well as of your mother.

235. msgreer - 8/30/1999 10:22:27 AM

SnowOwl

I better start taking care of myself or I will find myself in the bed next to mom.

Thanks for your kind words.

236. ChristiPeters - 8/30/1999 4:13:44 PM

msgreer will, of course, be at the hospital all day today. However, she does have access to a PC and may get a chance to check in The Mote if you have any thoughts for her. If you don't have her email address and want to send her any messages, send them to me at christipeters@hotmail.com and I will pass them on.

I am praying for msgreer and her mother and any and all prayers and kind thoughts are welcome.

237. msgreer - 8/30/1999 5:17:07 PM

ChristiPeters

thanks so much for all your help.

i think everyone knows my emailaddress by now as i have posted it many times...

msgreer@home.com

They are taking mom down at 12Noon.

238. ProfEmeritus - 8/30/1999 6:01:21 PM

ms greer

I will be thinking of you and your Mom. I went through all that six years ago so I know how difficult it is on the family. We will pray for your Mom and put her in my wife's prayer chain.

I came over here to mention that I see my cardiologist in an hour to find out if my pacemaker and several medications are doing me any good, as shown by a recent echo-cardiogram. My wife is more uptight about it than I am.

239. PsychProf - 8/30/1999 8:14:51 PM

My best to MsG...

240. Thoughtful - 8/30/1999 8:42:51 PM

Oh, MsG, my heart aches for you. Your Mom is so unbelievably fortunate to have you in there fighting for her when she is unable to fight for herself. I know you have the strength to see this through, even though at times it may seem as though you don't.

Try not to think about your sisters -- they will have to deal with themselves. They are not your problem. Instead it's so important for you to focus on yourself and your Mom ... do what is necessary to see that you both come through this.

If it comes that you will have to say goodbye to your Mom, you will be able to do it with your heart open and your mind clear, knowing that you've done everything you can for her, knowing that you've been there for her, and knowing that no one can ever take away from you the things you both have shared...

Try not to borrow trouble -- take it as it comes. Deal with what you have to deal with as you have to. Don't try to take on any more than that.now that my thoughts are with you as you face this very trying ordeal, and know that I hope for the very best for your Mom.

241. Thoughtful - 8/30/1999 8:44:48 PM

That's "Know" my thoughts are with you....

242. Thoughtful - 8/30/1999 8:46:15 PM

ProfE, good luck with the cardiologist & the pace maker -- remember, you gotta have heart!

243. ChristinO - 8/30/1999 8:47:56 PM

MsG and ProfE,

My thougths are with you and your loved ones for successful procedures and speedy recoveries.

244. ChristiPeters - 8/30/1999 8:59:15 PM

ProfE - My Aunt has been on a pacemaker that she's worn out two of them (7+ years on each) and is on her third one. So they can be a real blessing and are tried and true technology.

Good Luck with yours!

245. ChristiPeters - 8/30/1999 9:00:27 PM

Hmmmm.....

I should have checked my dust

That should be "on a pacemaker so long that..."

246. ranheim - 8/30/1999 9:15:17 PM

I, too, feel for msgreer; I hope your prayers are answered.

Getting back a few posts to confusion arising because of similar names for Rx medication : I always write on my Rx what the medication is for; e.g. Take 1 tablet at bedtime to lower cholesterol. If your Rx bottles do not have the purpose on the label, ask your pharmacist if he/she would include that also.

Going way back : stays in a hospital when you can't see why or, actively, disagree with the medical establishment : sign out ama (against medical advice). This is not the Soviet Union! No hospital can DETAIN you against your will. I am not a lawyer; but, believe that signing out ama can be done even is every penny of the bill has not be accounted for.

247. DocBrown - 8/30/1999 10:05:09 PM

Msgreer, you and your family will be in my thoughts all this day.

Obviously you have a strong empathy for the experiences that medical and surgical patients go through in hospitals. You are concerned that your mother's complex condition will lead to a bad outcome.

Do not worry about that. The surgery is out of your hands and worrying about it only makes it worse.

FWFW, my Previous Employer was a major tertiary care hospital. I saw hundreds of complex "train wreck" cases, where the patient had multiple serious conditions at the same time. I know they have methods and treatments to deal with cases like your mother's, and the surgeons and MDs will do their best for her. Let them deal with it.

While they care for your mother you need to take care of yourself. Your mother's pain can be controlled with medication. Your pain is different. It can only be controlled by your own mind.

Be strong, msgreer.

248. theDiva - 8/30/1999 10:30:05 PM

Ms. G

Please tell me you've finally gotten some sleep. We'll continue to pray for you.

249. Thoughtful - 8/30/1999 10:52:50 PM

Re Rx, remember that with the internet, there's lot of Rx info available. For example, drugstore lists all the warnings, side effects, etc. for all the drugs they sell. I've also found useful info here.

250. ProfEmeritus - 8/30/1999 11:59:37 PM

You have been in my thoughts all day, even during my own long appointment with my cardiologist. I will email you about what was going on after everything is settled for you.

Thanks Thoughtful, Christin and Christi for the good wishes. The news couldn't have been better. A heart problem that could have been life-threatening has been reversed. The cardiologist was very pleased and said he didn't know if it was the result of the pacemaker (which he reset today), the medications I have been on since June or my life style. My wife volunteered that she thought is was a miracle.

251. ProfEmeritus - 8/31/1999 12:00:52 AM

The first paragraph was addressed to ms greer.

252. PsychProf - 8/31/1999 12:05:32 AM

ProfE...how do you plan to celebrate...how about "dance like noone's watching"...

253. ProfEmeritus - 8/31/1999 12:08:21 AM

PsychProf

254. ProfEmeritus - 8/31/1999 12:13:16 AM

PsychProf: My wife and I have already celebrated. We got on our bikes and biked to the Red Hook Brewery where I had my first beer in many moons and then a delicious lunch. I was told to be off alcohol until today; I had been a two glasses of wine consumer until that prohibition a couple months ago.

255. PsychProf - 8/31/1999 12:13:18 AM

Ha...ProfE...a concise post(253) w/o unnecessary rhetoric or verbosity.

256. ChristiPeters - 8/31/1999 12:17:03 AM

ProfE -

HOOOOOOORRRAAAAAAAAYYY!

I'm SO glad to hear your good news!



(now let's hope msgreer has good news, too)

256. PsychProf - 8/31/1999 12:17:03 AM

ProfE...let the good times roll.

257. ChristinO - 8/31/1999 12:19:44 AM

Wonderful news ProfE! Congratulations!

258. ChristiPeters - 8/31/1999 3:22:38 AM

More Good News!!!!

I just heard from msgreer. Her Mother's surgery was completely successful! Her mother came out of the surgery with flying colors, has been alert and coherent, and has expressed her great relief at the tremendous reduction in pain she has as a result of the surgery.

Msgreer is now home for a much needed sleep.

259. dusty - 8/31/1999 3:24:48 AM

Thats Great!!!! I'm glad to hear it!!!

260. bloodnfire - 8/31/1999 3:33:07 AM

Hallelujah!! Please God continue to bless MsGreer and her Mom. Help them both get some much needed rest.

261. arkymalarky - 8/31/1999 4:46:24 AM

I'm so sorry you and your mother have been having such a difficult time, Msgreer. Maybe today's good news of the surgery will be the beginning of a trend. You and your mother have my thoughts and prayers.

262. Thoughtful - 8/31/1999 11:58:18 AM

So glad to get the good news for MsG., MsGMom, and ProfE. I hope this is just the start of a serious run of good news for all.

263. ProfEmeritus - 8/31/1999 6:05:35 PM

Thanks all for helping me celebrate my good news. There was even more good news yesterday. My son found out from his neurologist that he wouldn't need an operation for a herniated disk.

264. vonKreedon - 8/31/1999 6:32:39 PM

I am so relieved to hear the abundance of good news from MsGreer and PE. As Thoughtful says, lets hope that this is the beginning of a run of good news for us all.

265. vonKreedon - 8/31/1999 6:50:27 PM

On the Health Policy front I offer the following for your consideration:

Science News
August 14, 1999
Vol. 156, No. 7

Modern Hygiene's Dirty Tricks
The clean life may throw off a delicate balance in the immune system
By Siri Carpenter

Sweeping along 14th-century trade routes, an infectious agent left a trail of incomparable devastation throughout Asia and Europe. In China, this plague slashed the population from 125 million to 90 million by the century's end. In Cairo, the Black Death, so called because of the dark, swollen lymph nodes that characterize the disease, claimed 7,000 lives a day at its height. Before it subsided, the plague had wiped out one-third of Europe's population.

In most of the world today, the plague has receded to a distant, if gruesome, memory. So, too, at least in developed countries, have smallpox, typhoid fever, cholera, diphtheria, and polio declined. One by one, infectious diseases that once ravaged society and preyed especially on children have been quelled by better sanitation, antibiotics, and vaccinations.

While raising barricades against deadly scourges, however, the industrialized world has also shielded people from the microbes and parasites that do no harm. Does it matter?

(Cont.)

266. vonKreedon - 8/31/1999 6:51:36 PM

A growing number of scientists now suspect that stamping out these innocuous organisms is weakening some parts of children's immune systems, allowing other parts to grow unchecked. Such an imbalance, they theorize, triggers a host of illnesses, including asthma, allergies, and even such autoimmune diseases as rheumatoid arthritis and the most severe type of diabetes.

This notion, called the hygiene hypothesis, arose from scientists' inability to explain the rising prevalence of asthma and allergies in many developed nations. The National Heart, Lung, and Blood Institute estimates that in the United States, for ex