PI$$ED OFF

I want to apologize for the language, but to say it any other way would not do justice to the way I feel right now...my hands are shaking so much that it is almost impossible for me to type (sorry for any typos as well!)

I was looking forward to a 'down' morning. Drop the boys off at preschool and head to the gym for the first time in forever to get a workout and clear my mind. The longer I was on the cardio machine the clearer it became and the madder I got. I am so fed up with doctors looking at my mom and talking to my mom like she is dead already. I KNOW the diagnosis is bad - Stage IV lung cancer that has metastasized to the brain and other areas and the prognosis is bad - most people don't survive more than a few months. BUT, she is still ALIVE and breathing and feeling fairly well and as long as she is those things then there is HOPE...there are miracles and there are options...maybe not great ones...but they are there. I know it is their job to make us understand the severity...but I keep getting an overwhelming feeling that they are giving up on her (us!)...I feel like this is happening to all of us....I know we have the luxury of not having the cancer in our body or the prognosis that we might (will likely die), but I can't let this happen to mom alone, so I have internalized it....and it IS happening to us....it is our fight too...and if/when mom dies, then some of us (arguably the BEST of us) will die along with her. I don't want to imagine a world without her.

So, what now, get a third opinion? Pay out of pocket and go to a special treatment center in another state that isn't covered by her insurance but have worked miracles for others? I have to balance it all with the ticking clock we are dealing with and the physical limits of my mom and how she would prefer to spend her last months. I wish there was a clear path!

Then, on the way home from the gym (and this is what really got me so physically furious)...I get a call from the billing specialist from my dad's heart doctor. She had gotten a denial for my dad's coverage. If you remember, there were no cardiologists on my dad's plan, so Denise, my dad's case worker at BCBS had assured me that they would then make an exception and that we could go forward with tests, etc. So, based on that, my dad had his CT scans yesterday (in a covered facility, Wellstar, but it was referred by the heart dr)....the scans cost &7K+ but my dad's portion was $740. Then today, I get this call.....and am worried that they might not cover the tests!

As soon as I got home, I called Denise, and hopefully she is getting to the bottom of it all....alot of questions still and it may come down to semantics and definitions and things that the average person wouldn't know or couldn't know. Turns out my dad's heart dr (which we all use the term heart dr, cardiologist, etc interchangeably)...but his heart dr is Dr Zimmerman. Well, not sure what he 'officially' is - a cardiologist, cardiovascular specialist, etc. but when we made my dad's hospital follow-up he wasn't available soon enough (remember they had not given him discharge info on his blood thinners or bp meds so he didn't know what to take or not take and all are very serious meds especially when you just got out of the hospital with internal bleeding)....well, we saw Dr Guichard, who turns out, is a cardiovascular specialist (sure didn't think to ask him that question - who would!!)...well, there ARE other cardiovascular specialists on my dad's plan in the area. Not sure who would eventually do my dad's open heart surgery or where the other doctors in the practice or their titles/specialities/training play into the whole equation....what non-medical or non-insurance person would know to even ask....

The other thing that makes me furious, is that I could have asked my dad's other doctors who are all in plan and we have a long list of them (primary, pulmonologist, hematologist....) to order the tests...any of them would have been happy to do so! If Denise would have just told me that there might be an issue...all I know, is that someone better get it resolved because we ARE NOT paying that $7K bill - we can't...mom's bills alone are piling up. It is so pathetic, that your life depends on the amount of money that you can spend or what insurance you can afford...my mom is paying $260/month for her insurance and then has $50 copays every time we see a dr (and that is alot of times)....and then has to pay $5K out of pocket not including co-pays or meds before they will then pay 70%...then the numbers start over again next calendar year! It is better than nothing, but not much. We NEED health care reform in a major way -but a gov't run plan is not the answer...we would likely be still waiting on my mom's biopsy if we were in a gov't rationed (I mean run) plan...(sorry for any political implications that are perceived in that last statement).

Of course, I am not going to tell my parents about any of this...they don't need the stress....and I have just finally convinced my dad that his insurance is good and is picking up the bills that he sees coming in (his hospitilazatios were ~$32K and $26K alone)....he was so afraid they wouldn't pay or would drop him....I have been reassuring him for months....

Well, I really didn't mean to bore you with details...I just need to vent.

I need to get something done on my mom's ENT procedure today and get her a nutrition consult.