Medical Care Decisions

Arthritis Care...

Recently I've had to make a few decisions about my medical care. The first being with my rheumatologist. I was diagnosed with psoriatic arthritis when I was 17, and since then I've seen several doctors that have helped control the pain. When we moved here to BR I had to find another rheumatologist, and that task was pretty much tainted by the wonderful doc I had in Houston, Dr. W. It was very hard to leave him because he "got" me. He had a very cynical personality, but great bedside manner. We got along great, and I trusted him completely. And he knew me very well. I'm not a complainer when it comes to my arthritis pain. Over the years I've learned to live with the pain associated with arthritis. I was able to find a level of pain that I was able to live with on a daily basis because I knew that there would never be a completely pain-free day. And when I had a flare-up I would call Dr. W and tell him, and without making me come in, he would prescribe meds to get me over the hump and back to "my normal".

When I found out we were moving I researched rheumatologists here in BR, and found out about a doctor, Dr. M, that was very knowledgeable, but most people said he didn't have much bedside manner. And I found that to be completely true at my first appointment 2.5 years ago. But, according to everything I had read, I was seeing the best doctor in BR. So I decided I would just stick with him because for what he lacked in bedside manner, he made up for in his knowledge of rheumatology.

Since my LAP a month ago I have been in the middle of a HORRIBLE flare-up, and so when it first started I did what I had always done and called Dr. M's office and told them the situation. The nurse just kind of sat there, and so I asked, "Is there anything that Dr. M can prescribe to get me through the flare, like a Med.rol dose pack (what Dr. W had always prescribed for me)? She said, "Well, let me talk to Dr. M and I'll get back with you." By the next day I was miserable, and I hadn't heard back from her so I called my pharmacy, and sure enough, he had called it in, but the nurse failed to call me back to let me know. So basically I went though an extra day of pain thanks to her. Can't fault Dr. M for that, but I was livid with his unfriendly nurse.

A week later I called back because the dose pack hadn't given me any relief, and Unfriendly Nurse told me to make an appointment to see Dr. M. I went in that day, and was furious when I left because I had been completely dismissed. He told me I had carpel tunnel syndrome (CTS) and there was nothing I could do but wear a brace and take pain pills at night to get me through the night. Now, I'm no doctor, but I KNOW arthritis pain, and what I was feeling was 100% arthritis pain. What I couldn't believe was that I was hurting ALL OVER, as in EVERY joint in my body ached, and he had the nerve to tell me it was CTS. I left with the Rx for Lo.rtab, but I was furious!!!

Another week later I was still in LOTS Of pain and taking WAY more Al.eve than I was supposed to take, so I called back to ask if Dr. M would move up my Rem.icade infusion. Get this...She said, "He'll let you move it up one week, but you can't go in this week." WTHeck???? I had to go through ANOTHER week of pain before I could have my infusion!!! I was fuming, but honestly, there wasn't anything I could do at that point. So I continued taking more Al.eve than I should have been just to get me through the day, and I was taking the pain pills just to sleep. I somehow, by the grace of God, made it to my new Rem.icade appointment, and when the nurse in the infusion lab asked me what my pain scale was I told her a 9 out of 10. She was floored!! I had NEVER in 2.5 years EVER felt this bad! She asked me if I had told Dr. M, and I started to cry. I told her the story, and she said, "Girl, you gotta get you another doctor."

Sadly, the Rem.icade infusion didn't help either so SOMETHING was going on. So I called Dr. M back to tell him, and he had me come in again. That was a COMPLETE waste of time! He did give me an anti-inflammatory and another pain pill RX this time, but I still felt like he wasn't hearing me, and he didn't believe me when I told him how much pain I was in. Dr. W would have ordered all kinds of labs and x-rays to view my joints, but Dr. M did NOTHING of the sort! When I left I decided I had given him enough chances to help me, and it was time to see someone else.

Yesterday I met with Dr. C (another doctor in the BR Clinic), and told her everything that had happened with Dr. M. After talking with me and examing me for almost 30 minutes she said she wanted to keep my meds where they were at this point, BUT she ordered labs and x-rays of my joints. FINALLY!!! So when my labs and x-rays come back she said she would call and we would discuss what to do to get me out of this horrible nightmare.

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Infertility care...

I called the doctor's office that I am being referred to in January, and asked them what their prices were for office visits, IUI's, u/s, blood work, etc...I told her that the doctor would be added to my insurance once the Network Adequacy Hardship had gone through, and she said, "Well, once you come here, your insurance will quit paying anything because you are now diagnosed with a problem." Huh??? Then what good is having an RE on your insurance??? She said I would pay them $150-220 at the first visit, and then they would submit it to my insurance company and if they paid anything they would give me credit for future services or send me a refund.

I don't know that I want to go through the hassle of getting the hardship if in the end nothing will be covered. So I think we've just about come to the decision that we'll just give the Clomid/Met 6 months with my OB, and if nothing happens then we'll throw in the towel. At that point we will have been ttc for 2.5 years. I think that's plenty long enough for this gal to make the decision to give up and move on.

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Accu Care...

The last appointment I had with my accupuncturist (for arthritis care, not infertility) was the day before we left for Jamaica. When he asked me when I could come back in the next week I told him we were going to be in Jamaica the following week so I would have to come back in the week we get back in town.

I go through the appointment, and after making my next appointment Mr. C was trying to get me to buy $100 worth of herbs and a $50 tube of cream to rub on my joints. While I'm sure they work fine, I told him that we just couldn't afford to spend $150 for 2 sessions a week, plus another $150 for herbs and cream. To which his reply was, "You can take a trip to Jamaica and you can't afford this? I'm just trying to help you here." I was floored!!!! Did I really just hear that? I grabbed my purse and headed out the door. Needless to say I WILL NOT be going back for my appointment this afternoon.