Study Finds Stents Effective in Preventing Strokes

http://www.nytimes.com/2010/02/27/health/27stroke.html

Current Medical Situation

Currently receiving treatment for:

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coronary artery disease
carotid artery disease

Cardiovascular Specialist

*** require new referral - next appt march 2010

-awaiting referral in order to schedule delayed blood test; carotids ultrasound; Dr. appt

Dr. has seen that I continue to be prescribed necessary cardiovascular rx's as a courtesy during search and linkage of new pcp.

AMLODIPINE BESYLATE [NORVASC] 10MG 1xDAY
CRESTOR 20MG 1@BEDTIME
METOPROLOL TARTER 25MG 3TAB 2xDAILY
HYDROCHLOROTHIAZIDE [HCTZ] 25MG TQUA 1xDAY

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kidney stones
nephrolythiasis

Urologist

*** require new referral - next regular appt may 3, 2010

FLOMAX 0.4MG 2xDAY
POTASSIUM CITRATE FR 10MEQUPS 2@BEDTIME
HYDROMORPHONE 2MG ev6hrs PRN [10 day supply / no refill]



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AWAITING TREATMENT for:


fibromyalgia
spondylosis

rheumatologist

*** require new referral - new pt appt april 7, 2010



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The following need to be addressed:

am experiencing extreme, sudden falls in blood pressure.

82/48 2/11
71/45 2/13
83/41 2/22

unknown trigger, though i have been experiencing 'spells' where i am overcome with weakness and feel almost like an 'electrical charge' throughout my body. these 'spells' have peaks and valleys, but the low bloood pressure readings are not always at the peaks, the middles, or the lows. i am quite puzzled. and concerned for that matter.

blood pressure generally runs around 100/60.

the 'spells' only started in late 2007. i've only recognized the bp falling since 2/11/10.

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vertigo - falling quite regularly since stroke. formerly prescribed MECLIZINE 25MG 3xDay 1978-1996. unable to maintain as drs have been concentrating on more serious issues these past years. it is now, however, causing further medical problems.

- seriously aggravating back problems. Most recent fall february 20. Scatia pain is severe. can barely walk from room to room. have become almost completely shut-in.

- have also been experiencing 'pretzel legs', where my feet and legs don't seem to function the way i ask them to, and i cannot coordinate my arm controlling the cane and my legs. i get all twisted and fall to the ground. several times a week.
 
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myalgia - have been referred to a neurologist more than once but have been unable to find a medicaid provider.

pain management - for years i have been complaining about pain similar to that i'd expect from an alligator taking a bite out of my left side.

for these same years i have thought these pains to be related to kidney stone problems, which upon testing proves to be not always the case. more than half the time, not.

i now know that this is all related to:

- spondylosis [rheumatologist?]
- tethered cord
- annular bulge L3-L4
- scatia

osteopath? please help...

i can no longer leave the house without assistance. used to enjoy walks, but now cannot even walk to the drugstore 5 blocks away to get my prescriptions.

I bought an adult tricycle, but cannot ride it because of the vertigo. I need a new prescription for an electric wheelchair or scooter.

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i continue to battle depression & ptsd.

have not been able to obtain treatment at the edenborn facility due to lack of transportation.

have not been able to maintain medications since november 2009.

 

Medication Pre-Approval

After my last blood test, the cardiologist called and told me to stop taking Prevastatin and start taking Crestor, which he had just called in to the pharmacy. Unknown to me, Crestor required pre-approval from Medicaid. this pre-approval has expired; my PCP withdrew as my doctor in October when MS reared its ugly head; Community Care [the group that manages Louisiana Medicaid] didn't answer their phones from November 15, 2009 through January 19, 2010 so that i could change my PCP; I am unable to take Crestor as prescribed because I will not be linked with my new PCP until March 1; Cardiologist requires a new referral, which of course he cannot get until after the new PCP sees me some time after March 1.

Today I called Medicaid Pharmacy and was informed that the dr's office had to call to arrange the pre-approval.

So I have a question for Mr. Levine... Will you please let me know how I can continue on the medications prescribed according to your rules when I appear to be in Medicaid Limbo?

I guess I'll just have to go without until I am in conformance with Louisiana's medicaid rules, eh?

Note: This morning's bp: 83-41... not good...

Medical Danger - Bureaucratic Bozos

I have been having Blood Pressure problems since the stroke in November 2005. An ultrasound at Touro Infirmary at the time showed 90%+ occlusion of both carotid arteries. An ultrasound at Oschner Hospital in April 2006 showed the same. An ultrasound at Tulane University Hospital in May 2007 showed the same on the right side and 100% blockage on the left side. I was unable to get medicaid help until January 2008. An ultrasound at East Jefferson General shortly after getting Medicaid approval showed occlusion at less than 50% on both sides which amazed both the cardiologist and myself.

Yesterday I had a very bad day. My blood pressure measured 71/45.

Because Community Care [the people that run Louisiana's Medicaid program] did not answer the phone one single time from November 15 through January 19, I cannot see a Cardiologist until after March 1.

I have to wonder if I'll be alive to see him.

Thanks, Mr. Levine.

BINGO!

The CATO Institute has published an opinion written by Michael F. Cannon that states, in part, "In fact, a body of literature suggests that the program exacerbates the problems of poverty and high health-care costs and points to a counterintuitive solution." *

And to that I say, BINGO! He wins the prize.

Listen, I am just one lowly Medicaid patient whose greatest wish is TO GET OFF MEDICAID. Why, you ask? Because of the very reasons above. On Medicaid I truly feel like an unwashed person. Doctors order tests that their office managers know Medicaid will not pay, so they are the ones who have to tell the patient. Office managers are not known for their tact [nor should they be], and to a Medicaid patient on the other end of the phone when the doctor's office calls to cancel an appointment they have had on the books for some months because Medicaid will not pay for the test, it is abundantly clear that the Medicaid patient is not equal to other patients.

Also, I truly feel Medicaid plays me for a fool. Allow me to share a personal experience:

Oct 15th I see my PCP. He writes 5 prescriptions for meds I have been taking for months & years. I take the prescriptions to the Pharmacy located just outside the hospital. They are able to fill all but one, which they advise, "This medication must be Pre-Approved by Medicaid". They will make all the calls and I can pick up the Rx tomorrow. Okay, great. Except I do not have transportation and it is unlikely that I will be able to pick up that prescription. And that is exactly what happened. They called and I was unable to arrange transportation to pick up the medication, so I was forced to go without it for an entire month.Thank you, very much Medicaid.

Now it is a month later. I've had time to arrange transportation and I call in the refills. Go to pick them up and they are sorry, but "one of the prescriptions requires pre-approval from Medicaid". It wasn't filled and I would have to go back to pick it up. Shades of a month ago, Medicaid! Now here's the rub; The Rx that required pre-approval in November did NOT require pre-approval in October, and the Rx that required pre-approval in October did NOT require pre-approval in November. Once again, thank you, Medicaid.

Again I must go without a medically necessary medication for 30 days. Not a wanted circumstance. That, I know, can not be Mr. Levine's mission. 

Each month a different Rx, or a different doctor's appointment, or a different test that everybody has known about for months, gets slammed by Medicaid. Each month the number of phone calls to try to get something done is staggering. The amount of time wasted is fiscally irresponsible.

Several months ago I realized that the only way I am going to get anywhere near healthy would be to GET OFF MEDICAID. I concluded that Medicaid is designed deliberately to short-change and confuse both patients & providers, with the bottom line being patient health getting no better, and, in fact, possibly worse.

Now I must find a new PCP because the one I had been seeing, can 'no longer meet [my] needs'. Quite a dilemma for a guy who has limited mobility.

Thanks, Mr. Levine! Have a nice Thanksgiving.

*  CATO Institute Article

Medicaid Hibernation

Until January. THANKS MR. LEVINE!

People Trying to Help

It is a shame when the first time you know anything about being cut off on the number of times a year you are allowed to be seen by a doctor, is when they cut you off without notice and embarrass you in front of the people trying to help you.

Of course I read every piece of material with regard to medicaid that came before me. I read about 12 visits. I interpreted that to be 12 visits to my Primary Care Physician [PCP]. My PCP makes referrals to specialists as he deems necessary. I was just following the road ahead.

I have an appointment next week with a Rheumatologist that's been on the books for 3 months. It's a shame I'm going to have to cancel it...