Archive for August, 2013
World gonna be so cruel to you, world gonna be so mean. I’ll catch you when you’re fallin’ through. I’m gonna throw on you, like a trampoline.
That song made me feel better today, so I wanted to share it.
I got back from an awesome, but non-budgeted vacation only to be greeted by an unexpected $600 medical bill. Yippee!
After rounds of phone calls with nurses, insurance agents and billing people, I found out that the reason for the bill is because my in-network specialists billed insurance as “outpatient hospital visit” rather than “in office visit.”
The problem is that my in-network specialist rate of a $50 copay apparently only applies under certain codes. And this particular hospital didn’t know the magic words. That leaves it as being charged against my deductible, a way higher amount. My insurance claimed they can’t do anything about (United Healthcare BTW).
So, I went back to billing at the hospital, who told me that it was state law that they bill it that way. I called bullshit – the other rheumatologist that I see also has an office in a hospital, and I’ve never been charged more than my copay (they’re in the same state, in case you’re wondering). Billing claimed there was nothing they could do except offer me a payment plan.
So that leaves me hounding the nurses to resubmit the bills. I feel bad about this. Nurses already have a million things on their plate, but should I really be penalized $600 because they chose to use one code over another, equally applicable code? I haven’t heard back from them yet.
The whole mess is frustrating. I went to this doctor because they were in-network. I triple checked the UHC website to make sure of it, so that I wouldn’t be charged out-of-network rates.
A system that requires you to jump through hoops, call and clarify every little visit, procedure and test before it’s done, speak to insurance about which codes to use, and then hound nurses to make sure they’re filing bills under the codes that work for your particular insurance policy is broken. And bureaucratic BS.
Now don’t get me wrong, I’m not ungrateful. My insurance allows me to be on medication for less than $500 per year, when it would otherwise be costing me about $32,000 per year (Enbrel and methotrexate), and therefore is something I couldn’t live without. But that doesn’t mean the system’s not rife with inexplicable inconsistencies, nonsensical loopholes and traps, and a whole lot of incomprehensible coding and rules.
I don’t have answers for you, I only know Obamacare won’t solve it. Do you have advice or insurance horror stories? I’d love to hear them!
Yes, that’s right. Quinoa. The miracle superfood. The gluten free wonder. The spotlight food of the moment. IT MAKES ME SICK.
I used to eat quinoa all the time. And this is before I was gluten free. I just thought it was a tastier option to rice. And healthy.
Then, one fateful dinner about four years ago, my boyfriend and I made quinoa. About twenty minutes later we were both writhing around the floor of our living room in complete gut-wrenching agony.
I’ve experimented with quinoa since then, both on accident and on purpose, all with the same result.
The latest experiment happened last night. I made a really nice dinner for my boyfriend and me.
Last night’s menu:
My take on the “African Delight” salad from Happy Herbivore Abroad: line a large pot with water and coconut oil, heat and add sweet or red onions with a bit of berbere spice (a mix of cayenne, paprika, fenugreek, cardamom, coriander, cumin, nutmeg, ginger, cinnamon, allspice, turmeric, and cloves), cook onions until translucent, add yams or sweet potatoes and cook until soft, add fresh ginger and kale and set to simmer.
Zucchini and summer squash fresh from the garden, cooked in olive oil with sweet onion, parsley and basil. Served over gluten free pasta with parmasean.
Paired with yummy white wine from Sicily.
Anyway, I digress. Dinner was good up until the sudden urge to puke my guts out. My boyfriend wasn’t feeling the effects yet, so we went through every spice, wondering what I was sensitive to. Finally we looked at the pasta box. There in the ingredient list was the culprit: quinoa.
My bf started feeling the effects about twenty minutes later and we both spent the next four hours in agony, trying to distract ourselves with Archer, The Daily Show, and The Colbert Report.
I’m feeling better today, but am going to be much, much more diligent about checking the ingredient list!
More on quinoa sensitivity: http://sopranointherealworld.blogspot.com/2011/12/quinoa-psa-and-seven-foods-you-should.html
Has anyone else developed a quinoa sensitivity?
This one may be for the ladies, but I think you’ll understand when I say that shoes can be so much more than shoes. They reflect your style, they help define us to the world, and they can change how you walk, strut, and feel about yourself. So where does that leave you when you can’t wear the shoes you want? When you’re stuck with shoes that don’t reflect who you are?
Alright, the shoe story actually starts with my wisdom teeth extraction. I got my wisdom teeth – all four, all impacted – removed back in mid-June. To say healing didn’t go smoothly is to put it lightly.
First off, the initial swelling lasted about two weeks before going down (with one mild dry socket). When it finally did go down, I was ecstatic. The only problem was that the left side of my chin was still pins and needles numb, which is uncomfortable and distracting. Of course, there’s apparently not a whole lot they can do about numbness except wait.
With the swelling down, I jumped back into working out because I’d made a goal to do a sprint triathlon (.5 mile swim, 12-17 mile bike, 3-4 mile run) by the end of the summer, and I was woefully out of shape.
Then fast forward to right before the Fourth of July and suddenly the right side of my jaw was in a lot of pain again. I went to visit my dentist, who at this point was pretty sick of me. He told me to wait it out.
Finally my jaw was so painful and swollen that I made an appointment to see my dentist and a new oral surgeon in the same day. My dentist again told me to wait. So I went to the oral surgeon, who told me that the extraction was so complex, my dentist should have referred me out and never should have attempted it in office. He also said the X-rays that my dentist had been working off of were abysmal.
Well, great. Of course I felt like an idiot, because I had a similar incident with an impacted tooth in high school. My dentist at the time thought that he could do a procedure to reveal and attach a brace to an impacted tooth. Mid-procedure, he leaves me sitting in the dentist chair, awake and bloody with a mouth full on cotton. Turns out he can’t do it, so they cart me away to an oral surgeon to knock me out and finish the operation. I may just have shit luck with dentists.
I ended up switching my care to the oral surgeon, if only because my dentist and I were getting pretty tired of my frequent visits.
Anywho, the new guy was worried my jaw had been fractured during surgery, which turned out to not be the case. He sent me away saying that probably my muscle ligaments had been severed and were having difficulty reattaching because the bone they had been attached to was no longer there. So I went on my less-than-merry way, being told again to just be patient.
But then it got even worse, so I went back to the oral surgeon (bless his soul, aside from the initial consolation fee and the cost of new, more sufficient X-rays, he hasn’t charged me a dime). The OS decided to do a biopsy of my jaw and found out that I had a blood tumor (super gross word meaning that blood has been collecting in my jaw where it shouldn’t have been – also called a hematoma). So… That was really f#*king gross. He had to poke me in a bunch of places inside my cheek with large needles and drain the blood. He also found and extracted two bone spurs, pieces of bone that didn’t get removed during surgery and were trying to work their way out of my jaw. My OS put me on five days of antibiotics.
And here’s where the shoes come in: to cheer myself up, I went shopping. I found myself the cutest shoes and bought them despite not really being able to wear heels because of my RA and their uncomfortably high price. At any rate, in the store I convinced myself that I could wear heels if I wanted.
Maybe heels are a state of mind? Like if they’re cute enough, and well-made (read expensive and Italian), I could wear them. Right? They made me feel feminine and pretty, and I really needed to feel that.
Wrong. Every time I went to wear them, my feet were more swollen than they’d been in the store and it was a blow to my ego. Each time I decided sore feet on top of a swollen jaw wouldn’t make me feel better, but not being able to wear the shoes I wanted to was making me feel worse.
After that I was STILL in pain and swollen, but I guess it was more because of all the needle pokes. A couple days post operation I started getting better and I was seriously soooooooo happy. I danced around my living room beaming.
I went back to some lighter workouts, thinking that maybe I still had a chance at a triathlon in August.
Then, a week later, wham. I found myself back at the oral surgeon’s office, getting a new hematoma drained from my right jaw. Painful, time-consuming grossness. This meant another couple days of recovery and another seven days of antibiotics. Which also meant another week of not taking my RA drugs since fighting infection and restricting your immune system don’t exactly go hand in hand.
It’s been a week and a half of not going anywhere near the gym or my running shoes, trying to keep my blood pressure low, sleeping on my left side only, and trying to keep my head elevated. I’m happy to report that, today, I feel mostly fine and look normal. Yay!
As for the shoes, they met a not-so-happy end. Yesterday, I made the heart-breaking choice to return them, unworn. In the end, I decided that no shoes were better than having pretty shoes mock me from inside my closet. Begging me to choose fashion over comfort.
More than giving up my shoe dream, I had to give up my goal of doing a sprint triathlon this summer. All of these teeth complications have just made it too hard to train. Making the call to choose to give my body a break and room to heal has been hard.
Giving up on goals and dreams is not usually my style. But there’s two ways to look at it: defeat or wisdom. I’m trying to go with wisdom. (Hey, if I can’t feel pretty, at least I can feel smart!)