Healthcare in America - Shooting Up in a Dollar General Parking Lot

Tucker301

Tucker301

Groundskeeper
Banned !
Feb 13, 2015
9,494
23,366
Southern VA
#1
I should have taken a picture or two, but I was injecting myself with medicine in a Dollar General parking lot this morning, thanks to our stellar healthcare system.

Back to the beginning.

I've been on the cholesterol drug Repatha since late February, and until last week it was going great.
Phone calls from the specialty pharmacy every two weeks insured that my medications always arrived a day or two in advance of when they were due to be administered.

June 23rd was no different. My next dose was due last Saturday, July 1st. So they set me up for delivery on Thursday, the 29th. Just like always, it sounded like this program was going well.

Thursday came and went... no delivery.
Friday... no delivery.

I called the pharmacy late Friday to see what was going on.
They told me I didn't have an updated "PA".
OK,... Let's pretend I know WTF a PA is. Where do I get one?

- Oh, we submitted the request to your doctor on the 23rd, but we haven't heard back from them. It's a "Prior Authorization" form that he has to complete for the insurance.

So did you check to make sure he got the request?
- Oh yes sir, we check every two days, but they haven't called us back. We even faxed it again.

Faxed? in 2017, in America, you're still faxing?
- Yes sir. We have to fax them over and he has to fax them back.

So am I supposed to do something at this point? I'm due to inject tomorrow, but obviously that's not going to happen, is it?
- No sir. A PA can take quite some time.

So why am I just hearing about it today? Nobody mentioned that I had to get re-approved every three months.
- Yes sir. We didn't know it was due until we tried to fill your proscription and it was rejected because the PA had expired. That's when we sent the request to your doctor.

So there was nothing in your system tracking that this needed to be done by a certain date?
- No sir. We don't know it's due until we submit a prescription and it's denied.

OK. I'm calling my doctor, before they close for the day.

__________________________________________________________________________________

- Oh hi, Mr. Tucker. The doctor and his nurse have all left for the day, but I'll see what I can do to help you.
Good. What can you tell me about the PA request from my specialty pharmacy? They said they faxed it over and called several times, but no one has called them back. They can't fill the prescription without the PA from the doc.
- Oh gosh! Those can take quite some time!
Well then perhaps it would be a good idea to start sooner, rather than having me run completely out of medicine? I mean I don't think I'm cured, and I'm not dead yet, so I guess I still need it?
- Yes sir. You do. I'll check with them Monday morning. We do have samples of Repatha here, so if we have to we can give you one of those to hold you over until they get your PA ironed out.
Well, I guess I'll see you Monday, after I drive over an hour to get there. Is there something I need to do here to make sure this doesn't happen again?
- No sir, it's all supposed to be taken care of between your provider, the doctor, and the pharmacy.

......

.....

- Mr. Tucker? Hello.

I had to mute the phone for few seconds while I screamed profanities. I'm back now.
- Oh... OK.
Yeah. Do you understand my frustration at all?
- Oh yes. I do. so, we'll see you Monday?
Yes. You will see me Monday.

So I go this morning, and when I get there the fabulously gay male nurse explains to me that they never received a PA request.
I look at him and shrug my shoulders and give him the standard what the fuck look.
He asks me if I know which fax number they sent the request to.
Another glare from me.
- OK. Do you have their number, Mr. Tucker?
Yes... I give him the number.
- We'll get it straight for you Mr. Tucker. Don't you worry.
You instill in me a confidence beyond anything I have previously experienced.

So now they hand me the injector. I had a hunch it was going to be like this so I took an alcohol swab with me.

- Now remember, Mr. Tucker. You have to keep that cool until you inject.
Yeah, it's 90 degrees outside, so I'm going to drive for a few minutes, let it warm to ambient temperature, pull off the road somewhere, and inject myself like a heroin addict, if that's OK with you.
- Oh. Um. OK sir. Have a good day!

____________________________________________________________________________________________

So that's what I did, because I knew that if they lifted another fucking finger my insurance would be billed for $400.

I am thankful for the wonders of modern medicine, and I am thankful for an insurance policy that pays for $14,000 worth of drugs a year, but there is room for improvement.
These people don't communicate well with each other, or with the patient.

I have to remind my cardiologist that we should get updated blood work BEFORE I see him every time. Otherwise, he'll order it when I'm there, and our conversation is about data from 6 months previous.

Why should I have to tell him this every time?
Why would an insurance company put someone on groundbreaking cholesterol medication and require a re-approval every 90 days? If I'm not dead, I need it. Period.
 
#2
My wife had her thyroid removed, she had Hashimoto's and her thyroid had become VERY enlarged.
Long story short, when they removed the thyroid, it damaged her para-thyroid glands. Now her body won't absorb the calcium levels needed without daily Forteo injections.
She'll be on Forteo for the rest of her life, but she has to go to the doctor every 90 days and have the refills ordered.
Of course, they always forget to send the prescription for the needles and the pharmacy has to call and request it.
 
#3
I'm been insulin-dependent for a number of years. You get used to the looks. One guy passed out on me and slid under his chair. Sometimes, for fun, I act like I'm nodding off after I shoot up. I guess since we look like heroin junkies to the outside world shame isn't really an issue.
 
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#8
Well, you can thank god you ain't getting it through the VA! There isn't enough room or time one here and it isn't worth me getting upset about. Trying to get a refill request through them is, well, like trying to get the VA to do their job. There is no metric, no comparison to incompetence of this magnitude. Doesn't exist on Earth, 3rd world medicine has it's shit together better because at least what they have is accessible. At the moment, they are lying to me insisting the Veteran's Choice Program has been suspended, which is bullshit, I watched Trump extend it myself, so now I can't see my dentist. They say it ran out of money but their budget has DOUBLED very recently. I have to go through their butcher shop and wait months because of this. Great. Also have another foot surgery to amputate part of a toe which they fucked up on a previous surgery. Letting them near me with a scalpel was the first mistake, but I was in a catch 22 at the moment, like I am now. Get it cut off, risk them fucking up, don't and risk getting admitted again and almost dying again from an infection. I may not be coherent enough next time to monitor their fuckups and make sure they follow procedure in the hospital, ie, doing their fucking job, washing hands, using clean shit, not picking up an IV line off the floor and plugging it back in, etc.

Yeah, talk about inspiring confidence when running a 102 degree temp connected to Zosyn and Vankomycin drip for three days with a second toe swollen the size of a hot dog, monitoring the nurses with scrutiny, making sure my IV was clean, programmed right, hands washed and new gloves, making sure the junky they apparently ignore and won't/can't fire isn't kifing so many of my pain meds I wind up in acute withdrawal, and then the doctor, an MD no less, telling me the pain in my groin isn't my lymph node swollen to a large marble, no, it's just a pulled muscle. WTF!? Don't see all the blood, seepage, dark swollen toe that happened within hours from an untreated infection (earlier that day their urgent care sent me home with oral antibiotics, I woke up four hours later on the way to the ER). So in front of all the student doctors he was trying to impress, and obviously these two smoking blondes, I grabbed his hand, put it down my pants and put his hand on my lymph node. He tried to pull away but I had him. "Feel it now?" Uh, oh, yeah, it seems I DO in fact have a slightly swollen lymph node. "Slightly? It's big enough and hard enough sepsis is a real problem no? Considering also the toe? Would you not 'concur.'" Yeah, he'd concur. That he was a tool and every one of those students saw it.

I'd give any fucking thing to have my health back to where it was when I was in my early 20's. Were it not for my mother being a nurse and me reading all of her medical manuals and books (she should have been a doctor) and having her to call, they'd have killed me long ago.

This "government" (I like to think of them more as fire sale auctioneers) in charge of health care is the worst thing. If it was bad before, wait until you add the federal government into your doctor-patient-insurance-pharmacy relationship, which is already 2 motherfuckers too many as it is. Yep, BP up, anxiety and getting pissed.

Oh, and FWIW, there are some good people at the VA, generally they have no power though. And some locations are better than others, and they also change over time, no consistency at all. The good people get stuck carrying water for blue fucking falcons, kinda like how good cops get stuck carrying water for the handful of shitbags that are defining them all. Not much different except at VA shitbags and incompetent people generally outweigh the good ones. And occasionally they do get things right, but often that's more accidental in and of itself, ie, even a blind squirrel gets a nut.

But as it is, I feel so fucking alone because I almost died and had to show the doctor where my lymph node was, and how difficult it was to do that, that it took public embarrassment, that just capped it all and completely deflated any trust in them I may have had left. How can I depend on them? And this is just the tip of the iceberg man, and I'm just one of millions stuck like this... But you all will feel it the more the federal government gets involved in your healthcare. Healthcare. It's gonna have as much meaning and merit as Drug War very soon. Yeah, gotta stop.

Good luck to the rest of you, rant over and out.
 
#9
EddieNFL said:
Seriously?
Click to expand...

Believe it or not, yeah. The guy was a very much out of Central Casting A.M.E. man of the cloth Charlie Rangel lookalike and his eyes literally went up in his head when I stuck myself. Damnedest thing I've ever seen at a Popeyes.
 
#10
Veer_G said:
Believe it or not, yeah. The guy was a very much out of Central Casting A.M.E. man of the cloth Charlie Rangel lookalike and his eyes literally went up in his head when I stuck myself. Damnedest thing I've ever seen at a Popeyes.
Click to expand...

WOW!. I always thought people were exaggerating.

Surprised he didn't blame it on the food and sue.
 
#12
On the fax machines... They still use them because they're HIPAA compliant while most other forms of comms are not. I know, stunning that a hard phone line and analog transmission is acceptable and considered, in the eyes of the law at least, more secure than end to end 256 bit encryption that is EASILY possible these days, but that's just another example of how far behind USG and federal law is from modern day tech. For an industry that pats itself on the back for staying at the cutting edge of medicine while introducing new forms of tech into treatments and patient care all the time, that they still rely heavily on fax machines and beepers is proof they're the dumbest smart people still in (government subsidized) business.
 
#14
Redmanss said:
On the fax machines... They still use them because they're HIPAA compliant while most other forms of comms are not. I know, stunning that a hard phone line and analog transmission is acceptable and considered, in the eyes of the law at least, more secure than end to end 256 bit encryption that is EASILY possible these days, but that's just another example of how far behind USG and federal law is from modern day tech. For an industry that pats itself on the back for staying at the cutting edge of medicine while introducing new forms of tech into treatments and patient care all the time, that they still rely heavily on fax machines and beepers is proof they're the dumbest smart people still in (government subsidized) business.
Click to expand...

I figured that's what it was about, but then you think about how many times someone fat-fingers a number and all your information goes to God knows where.
 
#15
Tucker301 said:
I figured that's what it was about, but then you think about how many times someone fat-fingers a number and all your information goes to God knows where.
Click to expand...

Glad ya made it, boy. Id hate to have to break in another mod. Dont know if Ive got it in me anymore.
emo30.gif
 
#16
I have a similar problem with ExpressScripts and my doctor. It occurs twice a year and I always end up with my doctor asking me to settle down. I remind her the medication is to settle me down so that I am not acting like an Italian watching soccer in the kitchen when shit like this happens. I work just like my doctor and the folks at ExpressScripts. I don't have time or patience to deal with the same shit twice a year. My employer would not put up with me doing the equivalent why should I have to put up with it? It is all about people paying attention and doing their fucking job right and not half ass.
 
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#18
All man nurses are gay, you dont have to make that distinction Tucker.

I had a similar issue with the desk help at my daughter pediatrician. I needed a copy of her immunizations for school and it took until the desk gal was sick and the nurse answered the phone to get it done. Great doctors and nurses and that desk jockey just pissed me off. The nurse, who has been there since our first check-up a few days after going home from the NICU (6 week preemie to a house at 8500 ft asl in 8 days) was pissed too and said it will be dealt with. Knowing them, they will have a new person there in no time.
A good friend now has a job as the head nurse in a busy ENT clinic and has horror stories about PA's with insurance companies. Long phone calls trying to explain medicine to a douche with a checklist that knows nothing of basic medicine, let alone a specialty area.

 
#20
Let me preface by saying that I have no idea of any details of your doctors' office.

However, in defense of the doctors around the country we get pretty fed up with it too. Some specialty pharmacies are good and go out of their way to help and others are trash. So how can a bad specialty pharmacy stay in business? Because the insurance company says that's the one we have to use. It's frustrating with our office staff as well - faxing PA's, prescriptions, and applications proving that other [should be read as CHEAPER] alternatives have already been tried, re-faxing PA's when the original was lost or "not received". Then the insurance companies change the rules every few months without really letting anyone know until something like the above situation happens. I could go on, but I get to be off the rest of the day and I'm not thinking about medicine!

Happy Independence Day!
 
#21
CypressJeff said:
Just out of curiosity. What did the Dr. do?
Click to expand...

It's more of what they didn't do, and don't do.
They didn't monitor the status of the prescription to insure uninterrupted service.
I also have to remind them to set me up for blood work before I go the office for scheduled checkups. Otherwise, and this has happened a couple of times now, we're sitting there discussing numbers that are months old and that were taken prior to changes in meds.

Typical for them, without being prompted, is to order blood work after each office visit. Then schedule another visit in 3 months.

 
#22
Tucker301 said:
It's more of what they didn't do, and don't do.
They didn't monitor the status of the prescription to insure uninterrupted service.
I also have to remind them to set me up for blood work before I go the office for scheduled checkups. Otherwise, and this has happened a couple of times now, we're sitting there discussing numbers that are months old and that were taken prior to changes in meds.

Typical for them, without being prompted, is to order blood work after each office visit. Then schedule another visit in 3 months.
Click to expand...

Sounds familiar, a guy would think he should be on the payroll after a while.

R
 
#23
Tucker301 said:
It's more of what they didn't do, and don't do.
They didn't monitor the status of the prescription to insure uninterrupted service.
I also have to remind them to set me up for blood work before I go the office for scheduled checkups. Otherwise, and this has happened a couple of times now, we're sitting there discussing numbers that are months old and that were taken prior to changes in meds.

Typical for them, without being prompted, is to order blood work after each office visit. Then schedule another visit in 3 months.
Click to expand...

Tucker, I feel your pain Buddy. Not just the shit I'm still dealing with, but the past also. Damn near every appointment is like reinventing the wheel. NOBODY talks to each other. NOBODY. Like Rthur just said, we should be on the damn payroll for all the shit we gotta do. Where's the common sense? It's not there. I told both my Dr's about each other and what each was doing continuously. Told them both that they were both wanting MRI's of different areas. Said why can't we just do one session of both areas. Oh, it doesn't work like that. No shit. You both don't get your own swipe of the Credit Card that way do ya? God damn shysters. Then they want to set it up on two different days!! What? I won that one. Meds? Ya, you said last time you were gonna send my scripts to the Union Center Pharmacy in Seattle so I can get 3 mos at a time instead of having to get ahold of you, have someone send it over to Safeway or some other shithole pharmacy, and wait around for an hour and a half to get my shit!!! WTF?

It's all getting worse, hands down. And people wonder why we're getting frustrated. Are you kidding me? Curb stomp indeed. :mad:
 
#24
EddieNFL said:
Seriously?
Click to expand...

I feel bad for that you have never witnessed someone pass out from either a needle or sight of blood. Saw a guy have a metal sliver in his hand. When he pulled it out a drop of blood came out. And i do mean a drop. His eyes rolled in to the back of his head and he hit the concrete floor so fast and so hard he cracked the back of his skull.

 
#25
2ndamendfan said:
I feel bad for that you have never witnessed someone pass out from either a needle or sight of blood. Saw a guy have a metal sliver in his hand. When he pulled it out a drop of blood came out. And i do mean a drop. His eyes rolled in to the back of his head and he hit the concrete floor so fast and so hard he cracked the back of his skull.
Click to expand...

A girl I went through school with had a real problem. Just talking about blood was enough. She did the downward slither n' floor plop out of a little wooden elementary desk chair in sixth grade general science class. And she was like that all the way through. Never did a single dissection, EVER.
 
#26
Tucker301 said:
It's more of what they didn't do, and don't do.
They didn't monitor the status of the prescription to insure uninterrupted service.
I also have to remind them to set me up for blood work before I go the office for scheduled checkups. Otherwise, and this has happened a couple of times now, we're sitting there discussing numbers that are months old and that were taken prior to changes in meds.

Typical for them, without being prompted, is to order blood work after each office visit. Then schedule another visit in 3 months.
Click to expand...



It's up to patients to monitor their own prescriptions / refills to insure uninterrupted service.

When you have bloodwork done, whether before or after your visit, your Dr. will see it and adjust your meds accordingly. Even if you don't have another appointment for 3/6/12 months. Your situation may be different. It's the insurance companies that are causing the Issues.

 
#27
Veer_G said:
A girl I went through school with had a real problem. Just talking about blood was enough. She did the downward slither n' floor plop out of a little wooden elementary desk chair in sixth grade general science class. And she was like that all the way through. Never did a single dissection, EVER.
Click to expand...

Wonder what happened when she got her period?
She must still be a virgin, or she might have gone into a full coma after having sex the first and possibly the only time...


My oldest daughter has a fit when she sees a needle. Thanks to her fucked up, whacked out mother making a big deal over shots when she was younger.

I don't get it. She can cut the shit out of herself in the kitchen and it doesn't bother her. The needle freaks her out.
 
#28
2ndamendfan said:
I feel bad for that you have never witnessed someone pass out from either a needle or sight of blood. Saw a guy have a metal sliver in his hand. When he pulled it out a drop of blood came out. And i do mean a drop. His eyes rolled in to the back of his head and he hit the concrete floor so fast and so hard he cracked the back of his skull.
Click to expand...

I guess we hang with different types. Seen everything from a nail shot though a hand to knife and bullet wounds, but never saw anyone pass out just by looking. When I was a kid a guy flipped his car right in front of me and my bud walking home from school. This was before seatbelts so he was ejected. Car rolled on him and flattened his skull. We were heroes at school the next day because we saw it.

I grew up around farm/country types. If you hadn't broken a bone or been stitched up by age six, you were considered an indoor type.

I
 
#30
All I learned new today was that when the pharmacy says "The PA is still on file", that means they don't have it yet.
Do they have meetings and come up with terms that they deem industry standard, but actually mean the fucking opposite to the rest to the normal world?
 
#32
EddieNFL said:
I guess we hang with different types. Seen everything from a nail shot though a hand to knife and bullet wounds, but never saw anyone pass out just by looking. When I was a kid a guy flipped his car right in front of me and my bud walking home from school. This was before seatbelts so he was ejected. Car rolled on him and flattened his skull. We were heroes at school the next day because we saw it.

I grew up around farm/country types. If you hadn't broken a bone or been stitched up by age six, you were considered an indoor type.

I
Click to expand...

Was a co-worker. I grew up simlair to you. I have had approximately 340 stitches in my life.
The wierd part about that story is that i know he had seen blood before from other's injuries. He was 22 at the time and after he came back to work a week later i asked him WTF. He claimed that he had never ever seen his OWN blood before.
 
#34
Hell I don't know. He swore he had never had a bloody nose, scraped knee, nothing. I will say he was ultra careful all the time. Wore safety glasses all the time (auto repair shop) and gloves with any chemical including loc-tite and RTV.
 
#36
2ndamendfan said:
Hell I don't know. He swore he had never had a bloody nose, scraped knee, nothing. I will say he was ultra careful all the time. Wore safety glasses all the time (auto repair shop) and gloves with any chemical including loc-tite and RTV.
Click to expand...

Oh that's right!! I forgot you are a mechanic. That makes it even more unbelievable. Heck, I rarely come home from working on tractors and equipment at the farm without some skin missing on a knuckle somewhere (and worse).
 
#37
vh20 said:
Oh that's right!! I forgot you are a mechanic. That makes it even more unbelievable. Heck, I rarely come home from working on tractors and equipment at the farm without some skin missing on a knuckle somewhere (and worse).
Click to expand...

He didn't last very long. And when I say he wore safety glass all the time, I mean all 8 hours everyday. Oh and the gloves where some chemical spill/hazmat type that went all the way to the shoulder.
 
#40
2ndamendfan said:
Was a co-worker. I grew up simlair to you. I have had approximately 340 stitches in my life.
The wierd part about that story is that i know he had seen blood before from other's injuries. He was 22 at the time and after he came back to work a week later i asked him WTF. He claimed that he had never ever seen his OWN blood before.
Click to expand...

How the fuck does a male grow up w/o getting cut or hurt. Goddamn I was lucky to have survived half the shit I did.

I probably would have had near that many but most got closed with duct tape and pine resin or something similar.
 
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