health insurance – My Good Wolf

Artistically altered photo of moon, clouds hanging low over New Mexican wetlands.

PROLOGUE:
While trying to stay afloat the summer heat waves, Doctor Rheumy #5 (number 6, if you count JustSeeANeurologist Guy) declared this here Lupine Lady an Anomaly of the Medical variety and referred Our Strangeness to the Mayo Clinic in Phoenix, Arizona. And I began composing the following. Eventually, the Good People of You Should Not Leave That Out in This Climate of All Places decided against our rendezvous. Nonetheless, change was afoot. (And is now a-neck!) Details on Turning the Corner coming soon, including Not a Miracle Healing by most standards, and Embracing Life after once again having a sudden sit-down with Death takes over a year, a ragtag village, fairy godmother’s wheelchair, and a very special dog named Draymond.

Z: Welcome to Better You Than Us!

A: Oh, hey — hello!

Z: How may we serve you? [Z hands menu to patron A]

A: Oh, um, okay. Yeah… [A speaks while perusing menu.] It’s just that I — Wow, you have that!? Sorry! I apologize. It’s just a really impressive menu! But, I think maybe an order was called in for me?

Z: No need for apologies! Everybody gets overwhelmed when they first step in here. They get confused. Grow lightheaded. Start crying. Faint. Or, some just get really angry. I am so glad you are not one of those angry ones. Uh … or are you?

A: No, not generally angry. Generation removed from free-floating rage. I’m more of a non-squeaky wheel type, trying in my Middle Ages to identify how and when to properly squeak.

Z: Excellent! My name is Zqwjj and I’ll be your waitstaff-helper-guide-person.

A: I’m Auuiy’o, person in need of wait-guidan— or, um, help. I need help. Obviously.

Z: All right! First things first. [Z checks electronic tablet.] We do have a third-party takeout order for you. Still needing insurance review and blood sacrifice, however.

A: Excuse me?!

Z: An Out of the Order (Nary) order of WhatIsWrongWithThisLadyPerson in a thick substrate of Gotta Be (Bloody) Rare was called in for you by Dr. TrulyGivesAShit.

A: I guess that’s what you call the pricey, intense, out-of-state, out-of-network, diagnostic work over— or, uh, workup, absent any and all guarantees for success?

Z: A week’s worth of poking, prodding, visualizing, repeating tests in all the ways, except this time with an air of self-righteousness and importance like you have never known and a very dry sense of … pretty much everything.

A: Surely, I’ll be granted the honor of paying for all that out of pocket, too — with my luck. While basking in the glory of the Sixth Circle of Hell!

Z: Oh … um …?! [Z worriedly checks tablet.] Says here your referral is to the Phoenix, Arizona clinic.

A: As I said, Sixth Circle; nicest one. You don’t offer a workup like that here, do you?

Z: Oh, no, no, no! However, we do cater the often long and soul-crushing waiting periods. You could start with our popular You Call That Accessible? crudités with I’m So Confused I Could Cry! dipping sauces.

A: That sounds … interesting.

Z: Are you being patronizing? The kind of patronizing a patron is not meant to be?

A: Sorry! It’s just … I, uh … I’m just not that excited about the whole Rising from the Ashes and Haboobs intensive deal right now. Not like I was.

Z: Ah. So, hold the Mayo?!

A: Yes, please.

Z: Sweet! Never had the opportunity to say that before! Professionally, I mean. [Z checks tablet.] Hmm… I see you have a long history of trauma and depression, and a complex medical profile, multiple autoimmune diseases (one rare), neurodivergent, lack of family support — lack of family, really —

A: Meaning?

Z: The Mayo may well hold itself.

A: What?!

Z: Even though there’s considerable evidence associating trauma, particularly ACEs (adverse childhood events), with autoimmune diseases — plus the fact that (worsening) depression is understandably common among those with autoimmune diseases — Mayo gets freaked out, if you will, by ongoing depression in cases like yours.

A: Anomalous rheumatology cases?

Z: Uh huh. Sure.

A: Rheumatological and apparently related conditions that overwhelmingly affect women and are therefore historically understudied, narrowly defined, and the sufferers maligned?

Z: As you said, “paternalistic.”

A: Did I? So … in cases of confusing, inconsistent test results and findings, blame the witches, oops, women as hysterical/borderline/whatever? Definitely do not find fault with the limits of current medical understanding?

Z: You’ve been misjudged before.

A: Last month I was told I was an entire medical practice’s one and only red flag. 1 out of 675. My occasional need for one particular type of legal medication is a stain on their otherwise spotless reputation.

Z: Ouch.

A: Been their patient for 9 years.

Z: Ah. May I suggest our Stir the Pot starter? Good for breaking out of stagnation.

A: No. Thanks. Actually, I think I’m ready to order my main course of action, now that Mayo’s off the table.

Z: Never good to leave the Mayo out on the table. [Z readies tablet for A’s order.] Now, what would you like?

A: [A reads from menu] Okay, I’d like an order of General Improvement, please, with greater ease of movement, no vertigo, clarity of mind, more stamina, normal digestive functioning, and significant reduction in pain.

Z: Well, I like the confidence, but …

A: Oh! And, an Abatement of Fear. On the side. [A closes menu.]

Z: [Tablet beeps and clicks briefly in Z’s hands.] Ah, yes, there are some, shall we say, compatibility issues with your current condition and that ask. Unless you want to start tithing? [Z looks at A who shows disapproval in no uncertain terms.] That’ll be a NO. Well, I’m sorry to say you’ve confused our General Improvement offering with our Full Remission special. But, from what I see here, I think an unassuming portion of General Improvement is a very good choice for you at this time.

A: Okay. What comes with that?

Z: You get your choice of greater ease of movement, reduced vertigo, and sporadic clarity of mind — OR — increased stamina, normal digestive function with rare, epic failures for no discernible reasons, and dizziness, no vertigo. Instead of reduction in pain, both choices come with better pain management. Served on a panorama of changing seasons or layered with an ever-evolving sense of peace with a series of devastating losses.

A: I see. Well, they’re both tempting, but I’ll go with the ease of movement/clarity of mind option with better pain management, layered with sense of peace stuff. And may I still have a side of Abatement of Fear?

Z: Yes, great choice! What flavor of Fear Abatement would you like? Milquetoast? Vague? Distinct? BlackWoman? HolyShit? Psychopath?

A: Distinct, please.

Z: Very nice. Now, how about a starter? OurPieInTheSkyHighHopes are popular.

A: No, thank you. Had it. That mix of sticky, sweet promise followed by enduring, bitter emptiness does not agree with me at all!

Z: Oh. [Z consults tablet.] Oh, right! My apologies! Of course, … That starter is not recommended for persons with Lupus.

A: Yup. Makes sense.

Z: For the Chronically Lupine, especially when ordering from our limited optimism menus, Hope Slivers and Cloud Linings, we usually recommend our Relativity Disclaimer starter, served with a delightful Cliché Blocker salsa.

A: Tell me about that.

Z: Our Relativity Disclaimer enhances the idiosyncratic nature of your main course, in this case, General Improvement. It’s all about how you feel now and not next week or last year. It’s not about you compared to someone else or somebody else’s idea of you.

A: Should I take that personally?

Z: Absolutely! It’s a bespoke savory starter. The Cliché Blocker salsa ranges from a mild, passive-aggressive, guess you mean well, to a hot, offensive, burn it all the fuck down. Medium is a spicy, assertive, be real or shut up.

A: Spicy, it is!

Z: Excellent! And for dessert? May I suggest a modest serving of our house specialty, Self-Acceptance, topped off with our renowned self-esteem boost, Is This Self-Love?

A: Oooh, I’ve always wanted to try that! But, I’ve heard it’s very rich.

Z: Oh, no, not really. You’ll be pleasantly surprised at how well Self-Acceptance complements General Improvement! Admittedly, Self-Acceptance can be difficult to digest, especially in combination with selections from our Stagnation and Decline menus. But for the disabled, especially the dynamically disabled like yourself, Self-Acceptance is often described as light and refreshing. Also fleeting, for many. You could probably indulge daily, if you wanted. Best part: Just save whatever you can’t finish for another time. It never goes bad.

A: Self-Acceptance never goes bad? No matter what?!

Z: Think about it.

A: What about the folks who claim it can have an enduring aftertaste?

Z: Consider the source.

A: Privileged, healthy, able-bodied people who perceive chronic illness and disability as threats to their worldview? Oh …

Z: So, that’s an unassuming order of General Improvement, with greater ease of movement, decreased vertigo, and sporadic clarity of mind, plus better pain management. For your side, a distinct Abatement of Fear. For starter, Relativity Disclaimer with spicy Cliché Blocker. And for dessert, Self-Acceptance, with a self-esteem boost of Is This Self-Love? Anything else?

A: Hold the Mayo.

Z: Done. Expires 6 months after issued. If properly stored, that is. Just FYI.

A: Noted.

Z: So, proceed?

A: Yes, let’s move on. Thank you!

Z: My pleasure! And soon, yours, too!

Hey! Shouldn’t you tell me where? ‘Cause I don’t know!

Preface: My former health insurance up and quit as of 31 December. My new insurance needs prior authorizations (PAs) with detailed histories (and possibly small animal sacrifices) before covering some of the meds I’ve been taking for years, including pain meds. (Yup, opioids. Ever controlled in a way that punishes legal users while not addressing the true source of the crisis, opioids.)

The need for a PA is only generated when one tries to fill the prescription. One can’t fill such a scrip early and is suspect if has more than a few leftover pills. But, one may get a 7-day “credit” of pills against the month’s supply, which then voids the prescription. So, when the PA goes through, one needs a new scrip for the remaining 3 weeks. And, if it takes more than 7 days for PA/approval? Well then, you is shit outta luck!*

The Steps, according to Underlying Conditions Lady:

1. Ration your remaining pain pills for maximum ineffectiveness.

2. Think hopeful and liver-affirming thoughts while swallowing extra-strength generic acetaminophen/paracetamol.

3. Try not to feel like a loser as “dat dumb drug dat was poisoned, ja?” — as your German aunt referred to Tylenol — does little more than reduce your lupus fever and aches a little.

4. Distract yourself with NBA basketball, podcasts, and passing thoughts of fire bombing FDA headquarters.

5. Play with the dog until everything hurts too much.

6. Go ahead and have an edible. Medical marijuana is legal in New Mexico and you have consumables. Lemon-lime-flavored, weedy gummies* and dark chocolate with a ganja aftertaste. Yum, right?

7. Try to enjoy being high for several hours. Stretch. Do bed yoga. Fall into a deep and dreamless sleep, which does, in fact, help.

8. Make a comprehensive list of all the drugs you’ve tried over the years for your multiple forms of chronic pain, and how they failed you — or you failed yourself — so that now you take opioids, because, of course, you are a loser.

9. Cuddle in bed with the dogs.

10. Play a game on your phone. Try to ignore the tinnitus. Fail at that, but win the game.

11. Nod off while playing a game or three on your tablet.

12. Toss and turn, while trying to not disturb the husband or, more importantly, the dogs, and wonder why the fuck your leg won’t stop jumping around.

13. Embrace your identity as a total loser as you take a low-dose gabapentin from your dog’s stash. Think: This should take the edge off the nerve pain. But just one pill, lest I lose my ever-loving mind. (Not an exaggeration.)

14. Do a guided meditation by way of an app on your phone. Observe your mind wander to thoughts of insurance — not very complimentary thoughts. And to the nurse who said you were “not a very squeaky wheel.” And to the fellow patient at your rheumatologist’s office who giddily declared his pain level was 0!

15. Zero? Zero! Schweine Hund! Arschloch! ¡Pendejo! You can not remember the last time your pain level was below 3! WTF?!

16. Breathe! Remember that you’re working on radical self-love, which means not using dehumanizing language, among other things. But … Fuck it! You hate the goddamn pain scale. And all this prior authorization shite. Also, reactionary and ineffective FDA policy. But mostly now not being able to sleep.

17. Eventually, you decide to make a gratitude entry in your journal and that helps a bit.

18. Next day you go ahead and take the nsaid meloxicam and cross your fingers that your stomach can take it. Maybe take one of your man’s omeprazoles. Or not really, as that’s illegal. And you don’t actually cross your fingers, but you do worry, because that’s just as useless.

19. Just go ahead and have another edible. Maybe you can read a short story or two before you nod off. (Current library loan, Ayiti by Roxane Gay!) Hey, maybe you’ll feel creative and write something. No pressure.

20. Realize you don’t have the strength to launch fireballs at the FDA; hence, you’d need to hire a catapult operator. Wonder what that might cost.

21. Recognize that you have taken a break from your loving-kindness practice, temporarily, in lieu of other meditation foci — and it shows! Give it a shot while stoned, because, why not? Direct it at yourself. It is possible that you may not, in fact, be a total loser.

Face of black dog with pointy ears, round forehead, and loving eyes. — The one of a kind presence that was Princess Holly Bollywood, she of many nicknames and much adorable ridiculousness.

*As opioids can be a little to very constipating, this may be literal for many patients.

*I still pronounce these rubbery treats as goo-mees, as did my German aunt for the 35 years I knew her, all in the USA. Never been a fan of anything gummy — worms, bears, etc. But I’ll readily take them over sweet-ass marzipan! I’m a freak!

Tag: health insurance

Hold the Mayo🚩🚩🚩🚩

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