The Holy Spirit's Gift of Complication
I write that in the title because I have that gift. No, I own that gift. I possess that gift. Me and that gift are at one with each other. Basically this blog has been a testimony to that fact. So let's carry it on out and I'll fill you in on the latest and greatest. First off, if I seem a little gruffy it's because I don't feel good. I've been horking up green all day, even though I've been on an antibiotic for a week and a half. I've also had to be back on prednisone which makes me puke like an Aggie in a rowboat. I got to come off of the vile stuff a couple of days ago but the damage was done. Evil medicine.
So, I got word from the health insurance folks last Wednesday (that would be February 18) at 4PM that they would cover the recombinant hgh therapy. Here's how they told me it played out. The folks from the pharmacy side and the folks from the medical insurance side had a meeting to determine if it was covered and if it was, who was supposed to cover it. During that conversation an early decision was made that gene therapy was excluded in the plan. So they faxed my endocrinologist and said, "denied. Gene therapy is not a covered item." Evidently about that time the D.Pharm for the pharmacy side wandered up to the table. One of the people there asked him what he knew about it. Come to find out, he knew plenty. Seems our Pharmacy doctor has him a pituitary adenoma that requires both testosterone injections and recombinant gene therapy using the same stuff my endocrinologist was prescribing. And he said it was most definitely medically necessary. That it was pretty medically impossible to live without it. And just like that, it was covered. The guy with the tumor stumbles in on the conversation and the result is this medication, which normally runs a couple grand a month is only going to cost me about $150 a month.
Now, here is where it gets good. I am given the assignment of going to the doctors office to pick up the prescription and take it to CVS. When I get to the doctors office the nurse Juanita, asked me how I was going to pay for the medicine. I told her I had just gotten a call from the insurance folks telling me they were going to cover it. She told me they had just gotten a fax from the insurance company saying they wouldn't cover it. I assured her I had spoken to them and they said we were good to go. She said, "well, let me give you the ding letter we got from them, as well as the letter we sent them saying the medication was necessary and the prescription." I said, "that will be just peachy." She dutifully handed me an envelope with my name on it. I waited until I got in the car to read through it. The letter from the doctors office to the insurance company was priceless. Not because of the content. But because of the spelling. It was atrocious. It was hilariously atrocious. I have three diagnoses. One that is the cause and two that are the effect. The cause is
1. Pituitary Adenoma.
The tumor on the pituitary then causes the second two diagnosis points which are:
2. Hypogonadism
3. Human Growth Hormone deficiency.
The length of the treatment was listed as "lifetime."
What was written to the insurance company was as follows:
1. Pituitay Ademona
followed by
2. Hydrogonadism
3. Human Growth Hormone deficiency.
The lenght of treatment: Lifetime.
No wonder it took two weeks. Every time the folks at headquarters took a look they'd laugh until tears ran down their legs. I mean, just think about it. It's hard to take a medical specialist serious whose office can spell neither pituitary nor adenoma correctly.
As for the hypo vs. hydro, I'm sure they wondered why I needed HGH, when I had water on the gonads. Had it been me who received this letter I would have written back and told them that their patient needed to get out of the hot tub to remedy that particular situation. The shame of it all.
But it gets better in a strange sort of way.
So I took the prescription to CVS and the pharmacist told me they didn't carry it but that it would be in Thursday. I also made them run it through the insurance and it came back as covered with a hundred dollar copay. Thursday I dutifully showed up at the pharmacy and they told me it was there and they all wanted to be there when I opened it so they could get a look at it. I was their first pharmacy client who had ever had this particular prescription. So with baited breath we opened the box.
And it wasn't the right medicine.
I'm not joking. It wasn't the right medicine. Then we took a look at the box and it wasn't the right medicine on the box as well. Ms. Zafar, the pharmacist who is as good as gold got very embarrassed. She took the medicine back to where she sits and opened a big book and started calling folks. A few minutes later she came back and said, "we'll have it for you by this time tomorrow. I am so sorry but we ordered the wrong thing. I hope you aren't too mad at us." I can assure you I wasn't. There have been a lot more hurdles than ordering the wrong medicine.
While we were having this conversation amongst ourselves that Dido song, the one about white flags and ships came on. I've only ever been one other place when that song came on. It was a supermarket called Central Market. Here's what I noticed then AND what I noticed yesterday at CVS. Every woman who has ever been done wrong by a man knows every word to that song. I just surmised that at Central Market. It was the way the estrogen descended on the granola section like a fog and all the woman tried to run me over with their carts. It was one sweaty heaving pack of humanity all joined arms singing about no surrender and no white flags and men who were bastards for merely breathing. So when the song came on at CVS and every other woman put down their shopping baskets and started swaying and singing that I did a little survey. I asked all the singers, "have you ever been done wrong by a man?" To a one they all said, "I have and if you don't get back down there with the kitty litter, I'll cut you deep Mister Dog, don't push me." Undaunted I continued my survey with the women who didn't sing. To a one they said, "I've never really been done wrong by a man, I have no idea what this song is about." Granted, the three who didn't sing and who told me that were all of the Indo/Pakistani variety and they don't date. Their parents decide who they will marry and they are fine with that.
Look, for the record I wouldn't have been interested in my parents choosing who I was going to marry. I saw a BBC Documentary called "All Good Marriages Begin In Tears" that was about arranged marriages. The idea is that it's a scary thought meeting the person your parents arranged you to marry and marrying them all within the same afternoon. On the other hand, there is no Pakistani equivalent of Dido. No ships, no flags, no fear being struck in the hearts of innocent shoppers just wanting to buy some granola for breakfast.
Take care of yourselves. I'll write back in a few days when I've had a chance to quit horking green and when the hgh makes anything grow.
I am hydrogonadically yours
WaterMan Yasko
www.bpdfamily.com
So, I got word from the health insurance folks last Wednesday (that would be February 18) at 4PM that they would cover the recombinant hgh therapy. Here's how they told me it played out. The folks from the pharmacy side and the folks from the medical insurance side had a meeting to determine if it was covered and if it was, who was supposed to cover it. During that conversation an early decision was made that gene therapy was excluded in the plan. So they faxed my endocrinologist and said, "denied. Gene therapy is not a covered item." Evidently about that time the D.Pharm for the pharmacy side wandered up to the table. One of the people there asked him what he knew about it. Come to find out, he knew plenty. Seems our Pharmacy doctor has him a pituitary adenoma that requires both testosterone injections and recombinant gene therapy using the same stuff my endocrinologist was prescribing. And he said it was most definitely medically necessary. That it was pretty medically impossible to live without it. And just like that, it was covered. The guy with the tumor stumbles in on the conversation and the result is this medication, which normally runs a couple grand a month is only going to cost me about $150 a month.
Now, here is where it gets good. I am given the assignment of going to the doctors office to pick up the prescription and take it to CVS. When I get to the doctors office the nurse Juanita, asked me how I was going to pay for the medicine. I told her I had just gotten a call from the insurance folks telling me they were going to cover it. She told me they had just gotten a fax from the insurance company saying they wouldn't cover it. I assured her I had spoken to them and they said we were good to go. She said, "well, let me give you the ding letter we got from them, as well as the letter we sent them saying the medication was necessary and the prescription." I said, "that will be just peachy." She dutifully handed me an envelope with my name on it. I waited until I got in the car to read through it. The letter from the doctors office to the insurance company was priceless. Not because of the content. But because of the spelling. It was atrocious. It was hilariously atrocious. I have three diagnoses. One that is the cause and two that are the effect. The cause is
1. Pituitary Adenoma.
The tumor on the pituitary then causes the second two diagnosis points which are:
2. Hypogonadism
3. Human Growth Hormone deficiency.
The length of the treatment was listed as "lifetime."
What was written to the insurance company was as follows:
1. Pituitay Ademona
followed by
2. Hydrogonadism
3. Human Growth Hormone deficiency.
The lenght of treatment: Lifetime.
No wonder it took two weeks. Every time the folks at headquarters took a look they'd laugh until tears ran down their legs. I mean, just think about it. It's hard to take a medical specialist serious whose office can spell neither pituitary nor adenoma correctly.
As for the hypo vs. hydro, I'm sure they wondered why I needed HGH, when I had water on the gonads. Had it been me who received this letter I would have written back and told them that their patient needed to get out of the hot tub to remedy that particular situation. The shame of it all.
But it gets better in a strange sort of way.
So I took the prescription to CVS and the pharmacist told me they didn't carry it but that it would be in Thursday. I also made them run it through the insurance and it came back as covered with a hundred dollar copay. Thursday I dutifully showed up at the pharmacy and they told me it was there and they all wanted to be there when I opened it so they could get a look at it. I was their first pharmacy client who had ever had this particular prescription. So with baited breath we opened the box.
And it wasn't the right medicine.
I'm not joking. It wasn't the right medicine. Then we took a look at the box and it wasn't the right medicine on the box as well. Ms. Zafar, the pharmacist who is as good as gold got very embarrassed. She took the medicine back to where she sits and opened a big book and started calling folks. A few minutes later she came back and said, "we'll have it for you by this time tomorrow. I am so sorry but we ordered the wrong thing. I hope you aren't too mad at us." I can assure you I wasn't. There have been a lot more hurdles than ordering the wrong medicine.
While we were having this conversation amongst ourselves that Dido song, the one about white flags and ships came on. I've only ever been one other place when that song came on. It was a supermarket called Central Market. Here's what I noticed then AND what I noticed yesterday at CVS. Every woman who has ever been done wrong by a man knows every word to that song. I just surmised that at Central Market. It was the way the estrogen descended on the granola section like a fog and all the woman tried to run me over with their carts. It was one sweaty heaving pack of humanity all joined arms singing about no surrender and no white flags and men who were bastards for merely breathing. So when the song came on at CVS and every other woman put down their shopping baskets and started swaying and singing that I did a little survey. I asked all the singers, "have you ever been done wrong by a man?" To a one they all said, "I have and if you don't get back down there with the kitty litter, I'll cut you deep Mister Dog, don't push me." Undaunted I continued my survey with the women who didn't sing. To a one they said, "I've never really been done wrong by a man, I have no idea what this song is about." Granted, the three who didn't sing and who told me that were all of the Indo/Pakistani variety and they don't date. Their parents decide who they will marry and they are fine with that.
Look, for the record I wouldn't have been interested in my parents choosing who I was going to marry. I saw a BBC Documentary called "All Good Marriages Begin In Tears" that was about arranged marriages. The idea is that it's a scary thought meeting the person your parents arranged you to marry and marrying them all within the same afternoon. On the other hand, there is no Pakistani equivalent of Dido. No ships, no flags, no fear being struck in the hearts of innocent shoppers just wanting to buy some granola for breakfast.
Take care of yourselves. I'll write back in a few days when I've had a chance to quit horking green and when the hgh makes anything grow.
I am hydrogonadically yours
WaterMan Yasko
www.bpdfamily.com
It's true - I know every word to that song - though you would never find me singing it in Central Market or CVS...however, I believe SHE is the one who did him wrong. I know, strange, huh?
Hang in there Dave - you're amazing!
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