She’s Lucky I Don’t Have A Weapon…

So, my husband’s insurance has changed–we have a new prescription provider, CVS Caremark. I thought I hated Express Scripts THE MOST, but now Caremark has taken over the #1 spot. I went to get my Delzicol (extremely vital med I take for my Ulcerative Colitis), with my new prescription card in-tow, naively thinking that I would shell out $75 and walk out with a 30 day supply. WRONG. Never, ever assume anything when it comes to attaining your medical care. Turns out, Caremark (the irony that “care” is included in this name…ha) will require an appeal by the prescribing doctor, stating why Delzicol is used and not some other prescription. Now, I get it–Delzicol is an expensive, patented brand-name drug with no generic substitute, and if it’s not necessary to pay these inflated prices then Caremark doesn’t want to pay them. But I was told it will take a minimum of 72 hours for the appeal to be processed, and I can’t even begin this process until I get a hold of my doctor on Monday (it’s after 5pm Friday). I NEED MY DRUGS NOW. I can’t go all weekend without them, I can’t even skip a dose or my ass starts bleeding. So…I realized I had a prescription on file for another (less effective but supposedly equivalent) drug, called Asacol HD. And guess what?! Asacol HD is also a patented brand-name drug that requires an appeal from my doctor in order to get coverage. So I’m left with: pay out-of-pocket for a weekend’s worth of meds OR go without meds. Of course we paid out-of-pocket…EIGHTY TWO DOLLARS…$82 mother*cking dollars for 2.5 days worth of Delzicol. OMFG. If you ever feel sorry for yourselves, just please be glad that you don’t have a chronic life-long disease that is sucking the life out of your body and your pocket book–just please count that among your blessings.

Oh, but it gets better. Today I had to call my GI to see about 1. getting some samples of something to tide me over until I can get a prescription of Delzicol and 2. Getting them to appeal the Delzicol. You see, it was actually prescribed by my former GI in Las Vegas, so Walgreens sent his office the notice to appeal for the Delzicol, but it’s really not his job at this point. So I called up my current GI’s office (which is small and full of old ladies) and the first lady asked me what I needed, so I started to explain and she cut me off and forwarded me to a woman who I assume must be either and RN or an MA (most likely an RN, because oddly most of the Dr.’s offices in this town still rely on RN’s and haven’t switched to MA’s). We’ll call her OB (short for ‘old b*tch’). I begin to tell OB about my medication drama and she keeps f*ing cutting me off–very rudely. I’m not being long-winded either. I try to tell her about the Delzicol and she says “So then we must have gotten the paperwork sent to us by the pharmacy already”…NO, b*tch, you DIDN’T because it wasn’t prescribed by you, it was prescribed by my former GI and new GI approved me to continue. Then she says “Wait a minute, I have here that the doc prescribed you Asacol HD, so why are you taking Delzicol”….well B*TCH, that is because I wanted to switch to Asacol HD because it’s easier to swallow than the Delzicol, but unfortunately I had blood and mucus coming out of my ass so obviously it wasn’t working, and I switched back to Delzicol, which immediately stopped the blood/mucus–the doc already knows this. Then OB says “Ok, so we’ll just send the appeal to them and you should be able to get your meds” and I said No, that the Caremark people told me the quickest way to submit an appeal is over the phone, and they had given me a phone number, to which she replies “Well I DON’T UNDERSTAND, I do this EVERY day and it always works so I don’t understand, blah blah rant rant…”…and I cut her off to say “Well I don’t understand either, all I know is what they told me. But if you’ve worked with Caremark before then I trust you know how to get it handled”. And then, I asked her if she has any samples of anything I can use until the appeal goes through, and she named off a couple, including Lialda–which I’ve taken before with success. I mention to OB that I’d like to try the Lialda, and I also mention that it’s actually covered by Caremark without an appeal, to which she replies “Well then why don’t you just take that if your insurance covers it, because it’s ALL THE SAME THING, it’s all Mesalamine”…OMFG why are nurses SO STUPID?! These meds are NOT all the same, they are in different preparations and release differently in the body–most recently I have not done well with the extended release meds (such as Asacol HD), and Lialda is an extended release med. Just because I took it 2 years ago and it worked doesn’t mean it will work NOW. And NO THEY ARE NOT ALL THE SAME, you stupid stupid ignorant *&^%$#!–if they were truly all the same, then we’d all just take the motherf*cking generic and not bother ourselves with calling your sorry ass to make an appeal. Right?! Right. Geezus. So, after I made it VERY clear that I still wanted her to appeal for the Delzicol, she said “Oh by the way, the hospital called to say that you didn’t show up for your most recent Remicade infusion, so I assume you’re going to call and do that this week”…well, no actually, I’m NOT, because I just talked to the doc on the phone the other day to discuss pushing out or possibly permanently suspending the Remicade, because I’m currently under control and trying to get pregnant. And he approved. And THIS is why I so urgently need to get my meds–so I can maintain remission WITHOUT the Remicade. Do. You. Understand. Me.? She said she’ll leave the Lialda samples at the front desk. Click.

There’s more. I called Caremark yesterday because it occurred to me that they may not give me the sweet ass deal on Bravelle that Express Scripts was giving me ($75 all-you-can-eat, first time Dr. Angel ordered 10 viles but this last time he ordered 20 viles and either way it only cost me $75 dollars, whoop whoop!) I got a really nice guy named…Bobby? I think. So anyways, first Bobby looked up Bravelle and found that it’s not covered. And I said “Ok, well do you have a biological equivalent that is approved?” And Bobby asked me what kind of med it is, so I explained is a reproductive medication, called Follicle Stimulating Hormone, or FSH. Bobby put me on hold for a few while he looked it up, and came back with: Pregnyl and Human Chorionic Gonadatropin (he couldn’t say the words so I asked him to spell them)…well, those are both HCG shots, not FSH. So Bobby put me on hold some more and dug deeper. What he found was that Bravelle IS covered WITHOUT an appeal required, and I could hypothetically get 20 viles from a retail or specialty pharmacy for $300–for two refills–and then I’d have to go through the CVS mail order pharmacy. And I said “God willing Bobby, I won’t need more than two refills”. It’s more expensive than Express Scripts, BUT $300 for $3000 worth of meds is nothing to complain about. So, at least there’s that–BUT it’s only hearsay at this point.

Mr. MLACS will joke sometimes when someone pisses him off (usually while driving) that if he had “one bullet a day” that person would’ve gotten it. So I do it too now, when people piss me off I’ll turn to Mr. MLACS and say “one bullet a day” and he giggles. So I leave you with this: Today, OB is lucky that this is just a joke, and I don’t even know how to shoot a gun. I’ma go pick up my damn samples and she best hope I don’t see her sorry ass when I do. *spits on the ground, mean mugging*

Will Work For…?

Hey ladies, what’s happenin’?! Well here, I’ll go first:

I was 100% correct with that BFN on 12dpo, and I started AF on Monday, as scheduled. IT WAS SO F*ING PAINFUL. Omg, I was popping the ibuprofen gel caps (fyi they work way better than the tablets) 400mg every 2 hours and it still hurt like a mofo–like I was grinding my teeth and holding my breath. Which was just icing on the cake because I started my new job at the medical office on Monday! Oh yeah, it was an 11 hour shift and guess what: they don’t take lunch breaks! I expected an hour lunch break, but nope, they don’t take ANY lunch break and instead they take turns making infrequent trips to get food or coffee (there is NO Starbucks nearby either *hurumph*) and they freakin’ expect us to eat quickly in the back room or bring it up front to the front desk–which seems SO unprofessional to me. If you are a sick person do you really want to walk in to a room that smells overwhelmingly of chili? Me neither. Yes, I am aware that this practice of no official break/lunch is totally illegal. Um, we also don’t clock in. You record your hours in a log book. Freaking weird huh? But everyone is really nice, including the docs that own the clinic. Supposedly the profit sharing and bonuses make up for the BS (snacking for lunch). And they are compensating me for 3 new pairs of scrubs–nobody does that. I’m so torn about this situation. And you know what makes it more awkward? I’m a horrible liar, and I’m keeping stuff from them. I don’t want to tell them I’m taking Remicade for my Ulcerative Colitis. I don’t want to see the look of shock and dismay on their faces when they realize that I am a “sick person”–don’t want the stigma. This clinic treats a lot of contagious sick people and I am taking a risk by being on an immunosuppressant drug and exposing myself to whatever might walk through the door. I wonder if maybe I am stupid for even considering taking this job, but I’ve been on Prednisone (a steroid/immunosuppressant) and worked in the same type of clinic and I never got sick–save for a typical winter cold. I had to “dance around” telling my new employers/coworkers about the Remicade though, because I needed a flu vaccination and I can ONLY take the flu shot (non-live vaccine) and NOT the flu mist (live vaccine)–and they asked me “Do you have asthma or something?” and I simply said “Yes”…which is partially true because I do keep an inhaler around for occasional exercise-induced asthma…but I felt like such a liar! I know it’s none of their business but still…these people treat each other as friends, and God forbid if something should arise (I get super duper sick) and I have to tell them…and what if they think I’m just a big fat truth-concealing liar???

In Procreational news, I had to put the smack-down on Freedom Pharmacy, but my Bravelle should arrive tomorrow–and it only cost me a $75 copay!!! How sweet is that?! How lucky am I?! I am so very grateful, because that’s really all we can afford right now (since the IRS is taking their sweet time returning the money they wrongfully took from us). Freedom Pharmacy just pisses me off–they couldn’t tell me my mf*ing copay, and I kept having to call them back, and finally I said “get me a manager because I don’t have another 24 hours to play phone tag and I WANT TO KNOW WHY this is so difficult, if you are indeed a legitimate pharmacy.” And manager got on the phone, apologized for the two other phone reps who had given me conflicting information and no answer as to what my copay would be, and she went and ‘fetched’ that information herself–when she told me it was only $75 I did a little dance and thanked her and hung up the phone. But cheese ‘n rice they are such a pain to deal with.

I worked 1/2 the day today and called my OBGYN ‘Dr. Angel’ as soon as I got home, so that I could figure out the protocol for this cycle and arrange a time to come in this Friday to learn how to do my Bravelle shots. Here is my protocol:

1. Begin 2.5mg Letrozole CD3 (today)

2. Begin 75iu Bravelle daily on CD7 (Sunday)

3. Come in for monitoring daily until follicles mature

4. Do the trigger shot and IUI

This is such a circus…first of all, Mr. MLACS doesn’t arrive home until next Friday the 22nd, so I’m just slightly concerned that we time everything so that he’s around to “do his part”. The other thing is, I just started this new job and I DON’T GET A LUNCH BREAK, which I was counting on to be able to rush over to Dr. Angel’s office and do my ultrasounds/monitoring without having to take time off or give an explanation. FML. What am I supposed to tell my work? They said they will be flexible about my schedule for the first couple weeks while I’m training, because I wasn’t supposed to start until December, but still…they will expect me to give some explanation or else they will think I am weird and shady. Any suggestions? I’m at a loss. And there’s more….

I got this job for several reasons; I’d like to save up and pay cash for nursing school (I have enough student loans for one lifetime, thanks); I’d like to travel with Mr. MLACS; I’m glad to have the experience since I plan to become a nurse; I need something to keep me busy while Mr. MLACS is gone; etc. We don’t particularly need the money, especially because Mr. MLACS just got a promotion and pay increase–his pay increase is more than I will make in a year at this job. There’s pro’s and con’s to this job, and I’m not sure if I should even let them waste time training me if I’m not going to stay…can you guys take a look at this and tell me what you would do if you were me?

Pros:

  • Money–you can never have too much money
  • Experience–my nursing school resume will look ‘beefy’ with the variety of clinics I’ve worked at
  • Purpose–it’s great to know that you’re helping people; it’s great to have a reason to wake up in the morning
  • Social–it’s great to interact with people, instead of being a “homebody” and sitting around until everybody else gets off work
  • Schedule–it’s full time but I only work 3.5 days per week (Three 11hr shifts + One 5.5hr shift)

Cons:

  • Health Risks–I’m on Remicade, which suppresses my immune system. I may not get any more sick than a “normal” person. Or, I may end up with a raging infection that threatens my life. WHAT IF I GET PREGNANT?! Could I live with myself if my brazen job choice put my long-awaited child’s life at risk?
  • Time Apart–Mr. MLACS is typically going to be gone 1/2 the month. How am I going to tear myself away from him?! This first trip is actually more than 3 weeks and when he gets back next week I just want to glue myself to him. Work-Schmerk. Blah.
  • No Lunch–seriously, this is sort of a deal-breaker for me. I live 5 minutes away from the clinic, and when you’re working 11 hour shifts sometimes you just need to get away during your lunch break (hence the word ‘break’). I’m not a doctor or a nurse and I sure as hell don’t get paid like one (um, some of you wouldn’t get out of bed for $11.50 per hour, right?) So I want my mf*ing lunch break.
  • Privacy–I have doctors appointments more than most people, and I’m sure there will be times when I need to go to the doctor and these people are going to roll their eyes and look at me funny. I mean, these peeps don’t take lunch. And when people who work there need a doctor, they see our doctors. So how am I going to keep my medical information/history private??? FML.
  • Travel–Mr. MLACS finally has a schedule where he gets time off! For the first time in our relationship! I want to go places with him. This clinic works with a skeleton crew and the only way people get time off is if other people are working overtime for them.
  • Socio-economic status–Ok, this is a tough one but I’m just gonna put it out there. I have nothing in-common with my immediate coworkers. They work at this job because they need the money, because they are an integral part of providing for their households. I have to downplay my situation in order to “fit in” with the other office staff (it’s always this way in every medical office I’ve worked in). It’s a conscious effort I make not to mention certain things so I “blend”. I’m proud of the fact that I work because I want to–I think that says something about my character–but it would be arrogant for me to share this with my coworkers. I don’t get any satisfaction from having more than someone else and I take care not to gloat–I despise people who parade their good fortune (and most of the time people who act like that are full of sh*t anyways). I can’t wait until I’m in a position (such as a nurse) where I mingle with coworkers who are in similar situations as myself so I don’t have to feel like such a schmuck.

My choices as I see them:

  1. Quit this job immediately so they don’t waste any time training me and I don’t miss any time with Mr. MLACS when he’s home for the next 2 weeks (not my fav option because I’d like to make a couple paychecks at least).
  2. Wait until I find another job (go find another job!) and then quit this job
  3. Wait until I’ve reached a pregnancy milestone, such as a positive HPT or graduation from first trimester, then quit so I can just rest and focus on my health/safety (staying away from sick people).
  4. Quit and just do charity work to stay busy (until I return to school) and don’t worry about making an income.

Any other options that you suggest I am willing to entertain, if you feel like putting yourself in my shoes and dishing advice. There’s just SO MUCH to consider and I’m overwhelmed and not prepared to make a decision. I don’t want to ‘screw over’ the clinic and work just long enough to entertain myself and line my pockets, but on the other hand a friend pointed out to me that the clinic wouldn’t think twice about acting upon it’s own interests, so I shouldn’t feel guilty about acting in my own interests. I am perplexed.

How My Blog Saved My Marriage

Ok, this is me being melodramatic but it got your attention didn’t it?

Soooooo….where to begin. I was sitting next to Mr. MLACS on the couch the other night, hacking away on the laptop, composing my “Dream Doctor” post. Mr. MLACS seemed curious so I asked if he wanted to read it. He already knew about my blog so he can see it whenever he wants–I could never keep it from him and if I felt I had to then I couldn’t be married to him.

However, I was a little apprehensive because I knew he hadn’t read the “Medical Marriage Problems” post where I candidly recounted how he has previously reacted to my medical bills and how I cringe at the thought of talking to him about them (you guys all read that post, right? Ok good). I was not at all sure how he would react. But you know me (you don’t but I’ll tell you)…I don’t look for adversity but I ain’t no chicken neither–bring it.

Well, I think he was offended by a few things, even though he didn’t say so specifically–he did not appreciate feeling like a villain. What’s more though, I think reading my words allowed him to actually process them and take my thoughts and feelings into consideration. I don’t think he realized how strong my feelings are about his fighting style or my medical issues or my miscarriages. I mean, I’m pretty solemn when it comes to expressing my grief and loss–it’s hard for me to express those feelings even under the most nurturing conditions, and Mr. MLACS is a real “dude” (I don’t know how else to say it, he’s a manly man who would not be scared by a pack of terrorists but FEELINGS make him panicked and defensive).

But Mr. MLACS is far from being a neanderthal–he is quite brilliant (an engineer) and perfectly capable of both understanding and articulating feelings–he just has to choose to exercise his abilities. To paint a more accurate picture, he is loving and sentimental (likes to cuddle, likes to use our “pet names” for each other, pretends to disdain the cat but will come home with new toys for him, opens doors for women, loves/is loved by children, etc. etc.) He is a caring and compassionate person. He is not just a big ‘ole bully.

I think when Mr. MLACS read my blog diplomatically, he saw my points. I think because he is an intellectual man, a man of great integrity, and a man who loves his wife immeasurably…I think that he decided he didn’t want to be the guy I was talking about in my blog post. I think he instantly felt bad for any pain he caused me (although he can’t say this I know it).

So guess what?!

He calmly and rationally initiated a conversation about our medical bills (mine and his). HE brought up the conversation (instead of me) and he proposed that we would pay all the smaller bills and save the biggest 3 or 4 for later (per my suggestion). I was flabbergasted.

To say I’m happy is an understatement…I’m SO happy…I’m SO relieved…I’m SO impressed with my husband for rising to the occasion. I’m SO encouraged about our future together, seeing that he is willing and able to control his anger/reactions to things (ex: bills) that upset him, and work with me to SOLVE the problems (and spare us both the time and energy wasted on fighting).

Also, while Mr. MLACS is always quick to compliment my looks, he is quite stingy with more substantial compliments. So I was shocked when he told me tonight that he thinks I’m a very talented writer! That totally made me smile and blush. He thinks my blog is good. Bonus.

So there you go, by virtue of my husband reading this blog, I feel that my marriage has become stronger and our connection has deepened. I feel that I made myself quite vulnerable by exposing all these thoughts and feelings, and Mr. MLACS could’ve been combative, but instead he has been gentle and kind and supportive. He has deepened my respect and my trust in him.

Today I spent the afternoon paying $1500 worth of our medical bills. Hated to part with the money, but it feels good to be checking these off the list and putting them behind us. I feel like a huge weight has been lifted and I just love my Mr. MLACS to pieces! As my Mom used to say about my Dad, Mr. MLACS is my “diamond in the rough“.

My Medical Bills (and their direct impact on my marriage and my sanity)

Oooooooo, I’m so fuming mad! And I don’t know exactly whom to direct my anger towards. I’m definitely going to “have it out” with my insurance company. I was just sitting here adding up my stack of medical bills, intending to pay a big chunk of it before we move–do my best to wipe the slate of this tumultuous last year clean, both physically and financially. My husband doesn’t know that the weight of all these bills keeps me up at night. Because I can’t talk to him about it without a fight. He will say sh*tty things to me like “you didn’t even need any of that stuff you just don’t care about wasting money”–do you know how furious that makes me? Do you know how that makes me want to divorce him??? I cannot believe how ignorant he acts when he’s angry (about money).

I didn’t ask for any of this:

1. To move to a place where I cannot find a decent job that treats me with respect and is willing to pay me $12+ per hour (when they can underpay underqualified people $10). We moved here for HIS CAREER and he makes six figures. I found a job and suffered until we were on our feet (we were broke from paying for our wedding) and then I quit (to go back to school). He supports that….until things like my medical bills come up and then he is mean and disrespectful. Predictably.

2. I didn’t ask to get pregnant. I don’t regret it and I’m thankful it happened even though it ended sadly, but at the time it happened our marriage was shaky and I intended to wait until it was stronger, plus I had plans to start nursing school and get most of the way through before we started ttc. Technically, he is responsible for ALL of this, because he didn’t pull out (during sex), which is why I got pregnant, and the pregnancy is what caused me to get so sick (necessitating all these bills). This is how my husband fights–with finger-pointing and shaming/blaming. So he can chew on this (yes I do sink to his level, can’t beat ’em join ’em).

3. I didn’t ask to have my doctors scare the sh*t out of me when I got my post-partum diagnostic tests back…I had NO idea what was happening to me and I was scared for myself and scared for a future pregnancy (as I desperately wanted to be pregnant again). So of course I let them take the 30 viles of blood for that autoimmune panel. And then I got a bill for $857 that I hadn’t bargained for.

4. I didn’t ask to be referred from doctor to doctor to doctor, but that’s what kept happening…I was bounced around like a pinball, and I didn’t know until afterwards how USELESS some of these doctors and some of the tests they ordered were. I’m not psychic.

If I knew then what I know now, I would’ve avoided some of those doctors and tests–I have regrets. But at the time, I decided to be proactive and pursue all testing in the name of answers. In the name of not having a second (or more) miscarriage–which ended up happening anyway.

Yeah, so, I didn’t ASK for my immune system to go berzerk and then require all kinds of diagnostic testing to pinpoint WTF was going wrong. I surely didn’t ASK for my miscarriages–they broke my heart.

But now I have to ASK my husband for the money to pay these $2200 of bills that have accumulated (on top of at least $2000 we’ve already paid). And really, since I’ve probably racked up closer to…well I’d say closer to $50,000 worth of medical bills, maybe more, just in the last 12 months…I think we need to count our blessings instead of our bills–that I’m ok, that we only have $2k instead of $50k hanging over our heads.
But my husband will only see the $2200. He will accuse me of squandering his money like I’m buying a fur coat. He will not even consider that NOT ONLY have I had to go through the wringer of chronic illness and miscarriage, and NOT ONLY do I feel horribly stressed and pained to part with the money, but yes, he fails to see how sh*tty and futile it is for him to take it out on me.

And then the next day, he will be like “so tell me how much money you need in the account”, no apology. Why does he have to make me scream and cry and shout and say mean sh*t back to him? Why can’t we just skip that part of his repertoire and go straight to “lets deal with this”??? WHY DOES HE HAVE TO MAKE THIS SO HARD?

I’m going to show him his medical bills FIRST, because his total about $1000, so maybe that will curb the finger-pointing “you racked up these bills because you just love going to doctors” lunatic bullsh*t that he pulls. He “squandered” plenty himself.

Hey, and I am NOT looking for sympathy here–believe me I stick up for myself and say what’s on my mind (and if I’m really pissed, I break his beer mugs). I guess what I’m looking for is…well…does anybody else’s husband try to guilt and shame them about their medical bills? Or am I the only one? And, have any of you argued with your insurance over diagnostic tests? Any advice on arguing with insurance companies is appreciated, cuz I’m not sure where to start. The lady on the phone was no help at all–suggested I write a letter of appeal. Thanks in advance ladies. XO

**UPDATE** I just talked to Mr. MLACS on the phone, and just came right out and told him that I had been sifting through our medical bills but that I don’t have the energy to fight. He asked how much, and I told him his and then mine, and told him we don’t need to pay the 2 or 3 most expensive bills now, but it would be best to get rid of many smaller ones that have added up. Shockingly, he just said…”OK”. I don’t know if this indicates that we are growing as a couple or that he read my blog (he probly didn’t read it) or what…but that’s a relief. Now we’ll see what happens when he sees the bills and it’s time to write the checks…