Saturday, March 21, 2009

This is Your Face on Medicare and Medicaid

Imagine that you have never seen a Dermatologist because finding one in the private sector who takes your insurance is like finding a needle in a haystack.

Carmella's Mange is doing better except for her persistently red snout (and paws which she keeps trying to lick).

I could call her Rudolf the red snout reindeer!

She made friends with the boxer next door and I took some very cute pictures of them playing through the fence.

I have been spending most of my time trying to find the specialists I need for my own health problems. One of my doctors stopped taking Medicare altogether and it was the best doctor of all of the ones I see.

That has been a fulltime job in and of itself, and now I also need to see a Dermatologist at Emory but the soonest appointment isn't until August. They are that backed-up! I have some dark areas on the right side of my face that may be melanoma, and a number of other complexion problems that have never been evaluated that have been brewing for a number of years.

It seems less and less doctors are accepting Medicare and even fewer accepting Medicaid as coinsurance. I am already forseeing that I will probably have to see at least two more in other specialties as well and am really afraid because I wonder with these forms of insurance whether I'll really get the level of care I need. The amount of work this is requiring is taking up all my time now when I'm not in bed resting.

Apparently the repairman who tore my brand new linoleum in the kitchen, bashed into my railing in the driveway, and made the crooked and uneven gate to my front porch entrance has decided to hone a crisp sense of entitlement, so he will not be asked back. People with that kind of attitude don't deserve repeat business, and I don't want him doing anymore damage to my house. The jerk really needs a lesson in humility. In this economy nobody can afford to give customers "the finger" like that. It looks as though it will have to be done over; at least one half of the room. I hope to hear something on Monday from Lowes (a real repairman) to set up an appointment for a price-quote. At the rate things have been going the entire floor would have eventually gotten peeled like a grape by Carmella if something is not done and soon because those edges stick up. I have tripped over it a number of times and stubbed my toe, especially just after the guy tore it moving my refrigerator. A family member is going to cover it, or I'd really be out of luck, as I don't have that kind of money.

My son gained a job briefly and has been laid off again. The town he lives in is very small and he's worked at a number of places already, so I don't know what he's going to do.

More fodder for letters to Barack Obama, I guess; all of these issues.

One hopeful possibility on the horizon is that when looking on Emory Clinic's website I came across a doctor who is doing research on a new stem cell technology to regenerate bone!

Those of you who have been diligently reading my blog will remember that I had rapid bone loss in my jaw several years ago when I almost died because of an acute flair-up of my Sarcoidosis. This bone loss was very aggressive and happened within only 5 days. I had some trouble getting help with it because one periodontist didn't want to bill it as medical because the area of the bone loss is in my mouth and billed it as dental which is not covered under either Medicare or Medicaid, so of course my insurance did not cover any of that visit. That was when NIH was just beginning to prove that bone loss around teeth can be caused by autoimmune disease, but that research was very early and they were just establishing the connection. That guy I saw as a consult did not believe bone loss like that could happen that fast and said that I must just not have noticed it until then and it must be regular gum disease, but I told him that it absolutely did not happen before that. I was and still am 100% sure of it because the onset of all my symptoms was sudden, my gums turned black overnight and each day (for five days in a row) my teeth were further and further apart. It was so shocking and scary that I made sure to document it. Antibiotics given to me by a GP turned my gums back to their normal pink color within about another week, way before I was referred to the Periodontist. He didn't get to see it as it was happening, and I'm sure his rather disdainful demeanor had something to do with my being on Medicare and Medicaid. He seemed to view me as some kind of derelict who didn't take good care of my body. You'd think doctors would not have that kind of bias but you'd be surprised at how many of them stereoptype people on Medicare and Medicaid. I then received a big bill and did not know where to go for treatment from there. I knew that at some point the research would bear out what I was saying and so in addition to brushing I washed with peroxide and just tried to keep the area clean until another option presented itself. My GP was as clueless as I was as to where to refer me next.

The research I found the other day involves some sort of patented material that is mixed with stem cells and used as filler in the recessed bone areas. From what I understand this material allows the stem cells to take hold and grow new bone onto existing bone (I guess the same way potting soil or fertilized fortified soil does in planting seeds.)

Well, I wrote the doctor in charge of the study and told him my situation and he thinks it would work for me! He said he has never worked with bone in that area but it should be no different than long bone.

I'm thinking that I may need to first confirm whether any current bone infection still exists and if so how far it extends beyond the jaw and address that. It occurred to me that if I have ongoing bone infection that could account for the way I've been feeling lately; the all over inflammation and fatigue. With technology having advanced confirming the connection between auoimmune disease and bone loss in the jaw since I last checked, it should not be considered dental this time around. This doctor asked if I'd seen an Oromaxilarfacial surgeon and/or ENT about it and asked what they said about my bone loss, and I had not seen these specialists for that yet. That gives me some direction as to what I should do. I sent an e-mail to my GP last night. He should receive it first thing Monday. I don't know if this research doctor will want me to have been seen by one or both other specialists before I start with him or whether he can call them in as part of the process as his consultants.

The local customer never ended up sending the money for those commissioned violet leaf earrings, so I have pretty much given up hope, as it's been several weeks since she told me she was sending it.

If it wasn't for $11.00 in my bank account I would not have been able to buy any groceries this weekend.

Carmella needed her fish oil and Pet tab vitamins refilled on Friday at the vet's. She is set for about another month or so with those. I am now really broke!

My Medicare part D claim for Benicar is still up in the air. If any of you are on Medicare or Medicaid, I urge you to write President Obama and encourage him to create a healthcare system that is more equal for those who have no other insurance option. If you have about as much chance winning the lottery as finding a quality specialist, then it's almost like being uninsured. Note that if you have Medicaid as coinsurance you cannot buy another coinsurance such as AARP that more providers accept. Such a system is intrinsically flawed and should be changed. The 20% co-payment to pick up what Medicare doesn't is often more than we can afford out of pocket. About a year and a half ago I had a surgery which took me a year to pay off the co-payment (and most doctors these days won't make that flexible a payment arrangement).


Kacey Anisa Stamats said...

These are some scary times you write about, and I have to say, from the moment you mentioned that hypothetical letter to Obama on, I couldn't help but see this in terms of big economic crisis. All the same, I wish you luck with the new treatment, and esty sales.

Giftbearer said...

Hi Kacey,

Yes, you're probably right. I do think it's gotten worse since the overal economic crisis. What's really ironic though is that more vets right now take Care Credit than doctors take Medicare and Medicaid. Although I had alot of difficulty finding a vet to do a rare treatment for Carmella, paying for it was less of a problem than it is for myself. Oddly enough, Care Credit also pays for humans to have elective plastic surgery like botox, face lifts, and liposuction but it will not cover regular doctor's visits.