Friday, September 12, 2014

How We Do It: Part XLVIII




It gets better.

Me


Sophie was scheduled for an ambulatory EEG this afternoon at 3:00. It's been on the books for about a month, but I haven't been thinking about it because I hate the whole process. The ambulatory part is a godsend -- no hospital! -- but there are all the leads, the stinking glue, Sophie's curly, curly hair, the clean-up, the smell and, of course, the significance. Sophie has always had an abysmal EEG -- the kind of EEG that is, frankly, pretty hopeless. She's probably had at least ten in the last nineteen years, most of them in-hospital. Every single one is wildly abnormal. I won't give you the jargon. She hasn't had one in three years, though, and we thought it was time, particularly given the dramatic reduction in her clinical seizures since we started giving her cannabis oil. Yesterday afternoon the lab called to say that the insurance company claimed Sophie wasn't a member, so I went into my clipped and efficient mode and got that ironed out (our id number was transcribed wrong). This morning, I got a call from the EEG lab with the news that they are Out-of-Network for HealthNet and that we would be subject to the 50/50 rule after the insurance company pays the usual and customary rate. How much is that?, I asked. The financial person told me that, historically, insurance companies have determined the cost to be around $120, so I would be reimbursed for 1/2 that or $60. How much is the EEG? I asked. She said, Around $1700 or so. There is no other ambulatory EEG facility in the area, and MediCal is not contracted with them either. My options at this point are to admit Sophie to the hospital for an overnight EEG (out of the question), pony up and pay (the usual choice that has strained our finances for nearly twenty years), or appeal to HealthNet and request that they pay the in-network rate (throw my head back and laugh maniacally). Reader, if you're still here, please scroll up to the video that I posted at the top and forward to :23 seconds, maybe one of my favorite scenes in the movie, when Benjamin tells his parents that he's getting married, and Mrs. Braddock throws her head back and screams the most fantastic laugh you'll ever see on film. I am Mrs. Braddock, and that's what I do in my mind whenever I have situations like this EEG one. I no longer feel stressed, to tell you the truth. What might have caused me to weep copious tears, to tear at my hair, literally, to feel the poison of anger and adrenaline coursing through my veins, has disappeared. Mrs. Braddock enters my mind, and I throw back my head and let out a screaming laugh. After nineteen years, I'm here to tell you that it gets better. That's how I do it.

13 comments:

  1. I am hoping the EEG shows some significant change for the positive in Sophie's results. It never ends, does it? I am glad you are able to throw back your head and laugh, even if it is a aching thing.

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  2. I have no words or wisdom other than I'm glad you're not letting the bastards get you down. (I hope). (Though nobody could blame you)

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  3. Ah. So perfect- that reaction.
    What else can you do? Yeah, yeah. Tear your hair out, weep copious tears. Sure. I know you've been there, done that. I am so glad you don't do it now.
    I'm going to remember that laugh. I'm going to try it out.

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  4. One of the greatest movies of all time. "No, it's completely baked" - that's one of my favorite movie lines of all time.
    It sounds as if the thinking at the insurance company is half-baked - or maybe not baked at all.
    My heart goes out to you, and my mind is spinning into fantasies of professional medical advocates, funded by the Gates Foundation (or Robert Wood Johnson or something like it) to go to bat for you and others who are constantly dealing with complex medical issues. You should not have to fight for every.single.thing that Sophie needs. If the doctor deems it necessary/in Sophie's best interest, who are the bean counters to argue?
    {insert maniacal laughter here}

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  5. "No, it's completely baked," is one of my favorite lines also. I know you are not close to Pasadena and I know Huntington Hospital has an Ambulatory Care Center which might do EEGs and it might be worth asking. My son is seen there for his cardiomyopathy. Shrieking laughter does seem to help. xo

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  6. Goddamn, but they make life hard! Much harder than it oughtta be. Love the scream and I can see you doing it - in your head of course. I used to actually scream into a pillow when the mood struck. Very cleansing.

    Oh, and I love the toast popping up to punctuate the ending. Priceless.

    Good luck with f*king HealthNet. You have a full time job on your hands just dealing with bureaucracy!

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  7. Well you may not be tearing your hair out but reading this made me madder than hell. Our medical and insurance systems are so fucked up. It's almost ALWAYS -----NEVER about the patient!! And of course the charges are ludicrous! So sorry you have to deal with the idiocy of it all.

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  8. Medical insurance seems to be specifically designed to fuck people over. The American Dream apparently.

    Hope it works out.

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  9. The insurance co needs an EEG. With lots of glue. Damn it.

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  10. I love your blog. I've been doing this for 5 years and I so look forward to the day when I can just let out a laugh like that instead of being so wound up and stressed. I can relate to your journey.

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  11. The glue, the smell, the significance...and then to have to fight to make it happen. I know this incomprehensible pain soldier sister and am with you in support and solidarity. xo I admire your ability to laugh. I still reach for my sword and resist a powerful urge to lop a few heads off.

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  12. Good grief. Letting out a screaming laugh is a wonderful response to that insanity. (And I love that scene too, BTW.)

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  13. i need to watch that movie again, and get myself an american style toaster. :)
    hope everything turns out fine.

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