Louisiana Medicaid Hell

Study Finds Stents Effective in Preventing Strokes

2010-02-26T12:14:00.000-06:00

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

Current Medical Situation

2010-02-22T13:04:00.000-06:00

Currently receiving treatment for:

----------------------------

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

----------------------------

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]

----------------------------
AWAITING TREATMENT for:

fibromyalgia
spondylosis

rheumatologist

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

----------------------------
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.

----------------------------

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.

----------------------------

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.

----------------------------

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

2010-02-22T13:02:00.001-06:00

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

2010-02-14T22:49:00.000-06:00

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!

2009-11-17T11:16:00.011-06:00

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

2009-11-07T17:03:00.001-06:00

Until January. THANKS MR. LEVINE!

People Trying to Help

2009-11-03T20:58:00.000-06:00

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...

Unfortunate Needs

2009-10-24T14:34:00.003-05:00

Each day is proving to be different, with some more difficult than others. Some days I awake more fatigued than I was when I went to bed. Others, I have mobility problems just getting from room to room, and I've adapted to using 2 canes to get around the house. Jaden's mom gave me these when her grandmother passed:

They have proven very helpful and have prevented me from falling many times, so if I've fallen 3 times this week, these have prevented maybe 10 times that number. The base of the quad cane is quite heavy for me, and I have difficulty using it but for short periods, and inside the house only. The walker is also cumbersome for outdoor use, and not much help if I'm traveling more than a block. A good friend gave me an offset aluminum cane like this [in all black], which I use for out of the house mobility:

I have what I call 'Unfortunate Needs'. There being more than one way to skin an animal, there are also more than one way to achieve outside the house mobility. I am desperate for something better than canes or a walker for getting to and from medical appointments, the grocery, local errands and such. The options are:

The adult tricycle. Allows me to not have to worry about my balance as I ride. Least expensive of the options. Unfortunately, even at $249.00, it is way out of my price range. I had ordered one of these just before The Thing in 2005. After The Thing, all UPS deliveries were cut off for some months and I have never had the $ to order another. I don't believe this would be a perfect solution because my strength gets sapped when I'm out in the sun. I'd have to see if I could ride to the grocery on the other side of the causeway. Regardless, it would allow me a real sense of freedom from this disease.

Next then are these, which would give me the power and the range to accomplish everything I needed to do. The chair is bus-friendly, the adult tricycle and the scooter are not. All are cost restrictive, but it is nice to think of the mobility either would offer.

I already have safe and secure storage here at the house. Kind of like a tiny garage. Unfortunately there is/will be no money for such a thing, thus, 'Unfortunate Needs'.

Nothing + Nothing = Nothing

2009-10-23T13:25:00.003-05:00

So now we've seen what these past 3 months of effort brings to a Medicaid patient. Nothing.

It does not matter that a Neurosurgeon orders a test, that the patient then begins the process at a learned man's direction. Many, many phone calls. Excruciating pain. Doctor visits. More pain. Faxes. More phone calls. If it involves Louisiana Medicaid, it amounts to NOTHING AT ALL.

I am no closer to a diagnosis and treatment after 3 months of effort than I was 4 years ago, AND I must wait 3 more months, according to Medicaid, before I can see a doctor and we can start the dance all over again.

One must ask, Why Bother?

Fill in the blank, check the box. Move to the right...

Telephone Operator

2009-10-22T16:31:00.001-05:00

So often during this trek I have felt like the overwhelmed old-time telephone operator during a national crisis, managing all these telephone wires, connecting the right Medicaid person with the right medical person so they can work things and I get the treatment I need for my medical conditions. It has been this way since I became a Medicaid 'enrollee' in January 2008. Here is just the latest:

The Neurosurgeon on July 27th, told me to go back to the Urologist and have a Urodynamics test, so,

1] I called my PCP to get another referral to the Urologist.

2] I called the Urologist to set up the appt for the test.

3] was required to be seen by the Urologist prior to the test, scheduled regular appt.

4] seen by the Urologist and test was scheduled for 10/20.

5] 10/12 - Urologist's office calls to cancel Urodynamics because Medicaid has informed them that I have exceeded my visits and am told to have my PCP obtain the extension from Medicaid.

6] call my PCP with the info I'd been given.

7] PCP calls back and explains that the Urologist has to request the extension.

8] call Urologist's office back and pass along this latest information. Informed that the appointment then has been canceled and will be rescheduled if/when Medicaid gives approval. Does not sound hopeful as they make the observation that, 'Medicaid won't pay for it'.

9] out of total frustration, I declare war on the Medicaid Bureaucracy 10/13 and begin this blog.

10] seeing the need to review medical events from May when I last saw my PCP, I make an appintment to see him for 10/15.

11] I see PCP and review all with him on 10/15. He prescribes medications I require but have not been able to to obtain mostly due to transportation difficulties.

12] 10/15 [i presume following my visit] PCP writes letter to me, withdrawing as my PCP because, 'I believe that I am no longer able to meet your need[sic].' Informs me that he 'will continue to provide care for [me] for 15 days'. So, I've got a PCP through October 30th.

13] 10/21 - I receive telephone call from a lady who identifies herself as with Medicaid. She is kind enough to confirm or enlighten me on the issues before me:

               A.] Case Manager. Apparently, it is presumed that either the enrollee [me], or family/friends/support group[s], or whomever... is seeing to the overall management of things. I do need help in that area, because I appear to be wholly confused by all the data I am trying to deal with. Attempting to find my way around Medicaid's system is an advanced college course all in itself, and I am less able to absorb and navigate. Is my brain affected by this? It can be terrifying. One would think that Medicaid's organization would be much more humane. They call it 'intuitive' on the interwebs.

There have been occasions where, while trying to find my way through some other issue, I have stumbled across a valued nugget. Such was the case during a period while I was falling more than 3 times a month [still] and was looking at the different Medical Alert Systems out there. Totally by accident I learned that I am eligible to receive a system, with the monthly fee paid by Medicaid. Thank whatever god in which you have faith, because I could find the little around-your-neck systems easily enough, I just couldn't afford the recurring fee. I still don't have the thing. I can't find where I wrote the information down. Saves Mecicaid a couple of dollars a month, though.

The thing is that, no, Medicaid does NOT provide a Case Manager to ensure those kind of things get done.

               B.] It was my belief that I was eligible for 12 PCP visits a year. In reality my eligibility is limited to 12 visits per calendar year with ANY doctor, PCP or specialist[s]. Only took 2 years to learn this, and the need for more visits developed only because we are trying to determine what is wrong with me. This, my friends, is Louisiana Medicaid. Thanks, Mr. Levine!

               C.] Transportation. Medicaid has not a clue. For this past year I have attempted to arrange Medicaid provided transportation on 3 occasions. Two of those I have shared with you in Let's Talk Transportation. I think we all will find this third of interest as well.

There came a time this past summer, where it became almost impossible for me to take the local bus system, with or without a companion. Within the first block, most especially in the sun and heat, the strength is sapped from my legs. It's as if a drain-plug is pulled, the strength rushes out of me, I am light-headed and as useless as a rag-doll. I have greatly limited my outdoor activities to medically related excursions only.

You may recall dear reader, that by my second intercourse with Medicaid transportation, I had found and spoken with a Medicaid approved transportation firm. With a much better idea of how things work, I called with confidence. Oops... I forgot rule one; 'never, ever expect ANYTHING to work correctly where Medicaid is involved'

I get all the facts, call Medicaid to make the transportation appointment and am told, "That account is full.' Excuse me, I don't understand. What does that mean? 'It means the account is full.'

The bottom line is that this company's account was full. I presumed, correctly it turned out, that meant Medicaid wouldn't be transporting me that day.

               D.] It is up to me to get the train back on the tracks. The Medicaid lady who called yesterday explained that it will be up to me to get the train up & running again toward diagnosis and treatment.

That was last evening, right before I received the letter from my PCP saying he could not meet my need. I presume he meant 'needs'.

So, anybody here think I am losing my mind? Is it me or is it Medicaid? Is the system itself designed to massively bungle and discourage proper medical care? Methinks so. Mr. Levine?

All of this effort over 3 months by Health Care Professionals and lay-people, accomplished NOTHING AT ALL, and in fact, lays out the roadwork for more months of navigation that will go nowhere. It is my opinion, and I believe that it will be the decision of the courts, that this kind of burden placed on the shoulders of Medicaid enrollees, constitutes TOTURE.

NOW, is it any wonder costs are so high, with no end in sight?

Fill in the blank, check the box. Move to the right...

.

Never say...

2009-10-21T23:42:00.003-05:00

... because no sooner than you say it, whatever you are saying comes to pass. You see when I asked earlier today, rhetorically I might add, 'Did you ever just want to crawl into a hole and die', I truly did not expect to receive a letter from my PCP afterward telling me that he quits. He 'can no longer see to my need' [sic]. Letter was written on the 15th, postmarked on the 20th, giving me 15 days [til the 30th] to find another PCP.

NOW Fill in the blank, check the box. Move to the right...

.

So Much For Humanity... but, Thanks for the Call

2009-10-21T17:35:00.006-05:00

Guess what, folks? Medicaid has called back, and we had a very frank discussion. Unfortunately, I have no such thing as a Case Manager; doctor visits ARE limited to 12, including your PCP PLUS any specialists you are referred to, thus I HAVE used all 12 of my doctor visits in this calendar year; they have no clue what's up with their own transportation setup; and it is up to me to get the train back on the track. Have you ever wanted to just crawl into a hole & die?

Fill in the blank, check the box. Move to the right...

.

Let's Talk Transportation

2009-10-20T20:28:00.006-05:00

This is a pretty good area for me to live. Within 3 blocks there are a small family run grocery [the best!], a major Drugstore, a Post Office, three bus stops, and I'm eligible for Medicaid subsidized transportation for medical appointments. Not bad, I thought.

Today, after several attempts over the past year, I have yet to be successful arranging Medicaid transportation to/from a single medical appointment.

The way it works down here in the swamps, is that you contact the [Medicaid] dispatcher only AFTER you have contacted an approved transportation firm that serves your parish, 48 hours before your appointment. Back in November, I did that. 20 minutes before I was supposed to be at my new PCP's, the firm calls and tells me they cannot help me as they don't serve this area. No, they do not know who does. Thanks, so MUCH Medicaid!

Took me a few days but I found a PCP whose office is on one of my 3 bus lines. Because I switched PCP's when I did, It wasn't until 3 months later in February that I could get an appointment. I have really had to practice patience. I apologize to those with whom I have not been perfect.

As was bound to happen, I was referred to a Specialist whose office was not on one of the 3 bus lines. I was forced to turn to the Medicaid [never has] provided transportation. I call one of the approved companies, then Medicaid's dispatch office and we're good to go. Or so I thought..

At 6:00 pm the night before the big appointment I had waited 3 months for, Medicaid dispatch calls to tell me that my appointment time [4:00pm] is outside the transportation firm's hours of operation. Fill in the blank, check the box. Move to the right...

I wanted to cry.

The Doctor Versus The Bureaucracy

2009-10-19T13:21:00.001-05:00

I do not believe that I am an ignorant man. In many things, yes, of course. One can't know all about all, so I am ignorant in many things. But I can read, and I can generally comprehend an issue that affects my life as profoundly as my own health.

It just seems to me that if the government determines that you are disabled, and connects you with a Primary Care Physician that you select from a list of participating doctors [Approved to accept Medicaid], and you start the trek to discover what is wrong with you, evaluate treatment options, and establish a pro-active medically designed treatment plan... well, shouldn't Medicaid then support those efforts? One would THINK so, eh? Mr. Levine, any thoughts you'd care to share?

So let us review this trek and see, if we can; Why, in the middle of the doctors and tests necessary to determine a diagnosis, treatment plan, and prognosis, Medicaid cancels tests ordered by one of their own approved Neurosurgeons. The train gets knocked right off the tracks. I'm bewildered to be honest.

This little exercise begs the question: 'Is this the way to run an operation'? Because what Medicaid is saying to me is that I and the doctors I have been seeing at the direction of a Board Certified, Medicaid Approved Internal Medicine Specialist, AKA [Also Known As] my PCP [Primary Care Physician]... well, Medicaid says that we don't know what we are talking about. Wow.

I have no choice but to conclude that this entire exercise is futile. I am not going to get better learning what is wrong and treating it, according to Mr. Levine and his brainless bureaucracy.

I have no doubt whatsoever that Mr. Alan Levine is a much qualified administrator of large government operations: Alan Levine's Professional Summary

So why have we spent so much trying to discover what needs to be discovered on my case, yet Medicaid has not approved a single request from either myself or from health care professionals for any treatment other than medication?

I NEED something to transport me to the three bus stops within walking distance. Unfortunately I can no longer walk to these stops without major difficulty, plus the recovery time of a couple of days after each trip. Something like this would be fine, and I have a prescription for one written by my PCP at the time, but, like everything else they have denied, I expect this to be denied as well, and I believe I would have to present a prescription written by my current PCP:

The relief and benefits my life would experience would be life-changing. I would no longer be a shut-in, having transportation to reach the grocery store across the causeway, the three bus that can transport me anywhere. It would be a good move by medicaid. Mr. Levine?

Who's Who

2009-10-19T12:46:00.006-05:00

Alan Levine

Secretary

Louisiana Department of Health & Hospitals
628 N. 4th Street
P.O. Box 629 (Zip 70821-0629)
Baton Rouge, LA 70802 Phone: (225)342-9500
Fax: (225)342-5568 dhhwebadmin@la.gov

Long Term Care
1-877-456-1146

WoW Deuce

2009-10-19T12:14:00.002-05:00

We first notice that something is wrong on the way to the store 2 blocks away. The moment I begin to walk on any slanted surface, my strength is sapped from the waist down, and my back goes berserk. Driveway, slanted cement corners, handicap ramps, whatever.

Fulfilled our shopping needs quickly, walked home and by the time I reached home, I needed to sit, but went to the floor instead.

I was helpless on the floor writhing in pain. As bad as that pain was, it was brutal because of its overwhelming intensity. As I felt it coming on it took my legs from me first. Overwhelming weakness, pretzel legs. I lie down where i am at. No arguing there.

It seems that mostly the spine is affected , but I notice the weakness in the feet & legs first, must lie down whereever I am or whatever I'm doing. Then the back pain. Whoa! I still can't describe what happens to my head. I had 2 of these 'spells' in a 12 hour period. I guess I'm not going to die from them, so that's why they are not important to medicaid. They just destroy my life.

Real time NOW - ATTACK!!! I'll get through it, but WOW

2009-10-18T02:42:00.002-05:00

That WAS the headline I could not post Saturday as the attack was happening, then continues below: It was not good:

REAL TIME UPDATE - THE ATTACK CONTINUES

OUTSIDE TEMP 63.9 DEGREES FAHRENHEIT - medium drizzle

30 MINUTES

THIS IS THE WORST ONE THAT I'VE HAD.

Turns out I had that one big one that lasted 45 minutes, then a shorter, less intense one later that night.

It really was WOW. Roommate's family were here. saw it. first people to actually be here when one of these things happen. They described it to me today and I have already forgotten what they said. I'll have them write their descriptions up here tomorrow.

Slept 6 hours on couch in my den and was told I snored very loudly. LOL That is a good sign that I got a great 6 hrs. I don't normally sleep for more than a couple hours at a time, rarely get to REM sleep, so the snoring was good. I apologized to them of course. We've made some changes to the way things are done. Because it started on the walk TO to the drug store with them, I will no longer leave the grounds without an adult with me who's been briefed on what may happen. That includes someone going with me to medical appointments.

I am exhausted and going to bed.We'll have an update for you later today.

All of the Time, Every Time with Medicaid

2009-10-15T14:48:00.146-05:00

Monday 10/12 - 8 hours on medicaid related meetings, phone calls, and forms. Progress = ZERO

Tuesday 10/13 - 6 hours on medicaid related meetings, phone calls, and forms. Progress = 1 form mailed.

Wednesday 10/14 - 2 hours.
Progress = Medicaid canceled Urodynamics test. Ordered by Neurosurgeon. Scheduled July 27, 2000 for test date of October 20th. Have waited 2 months for this test and Medicaid canceled it a week out. Shame on you, Mr. Levine. Shame.

Thursday 10/14 - 7 hours.
Progress = 1 Board Certified Internist Appointment as directed by Neurosurgeon @ 11am
bus to and from hospital
blazing sun
90+ degrees F
strength sapped while waiting for bus [10 minutes @ 1 end and 55 minutes on the return].
serious difficulty walking - Pretzel Legs.
major pain
very frank and honest discussion with Primary Care Physician, who wrote 6 Rx's.

Note: Pharmacy could not fill 1 of these because I currently have an 11 day supply. The number of treatment days provided by the prescription, generally 30 days, must pass before medicaid will pick up the cost of a refill. Generally makes sense.

NOTE II -

Pharmacy could not fill a 2nd because medicaid "is requiring pre-approval." Pharmacy will manage faxes and other requirements, then notify me when prescription is ready for pickup.

PROBLEM =This means a second bus trip on another day, just to pick up 1 prescription for medicine I have been taking monthly since late 2007, and has never needed Medicaid's 'pre-approval' before now. Second non-budgeted round trip cost $2.20. Won't be able to get there now until Sunday at the earliest because, as is usual, I am experiencing volatile lower bowel distress and will be a shut-in for 2 days while recovering from today's activities. Bear in mind also, that this 2nd trip for an issue that should have been resolved by today's series of events will result in more bodily distress and a 2 day layup because of that activity. 6 days of T-O-R-T-U-R-E accomplishing what should have been accomplished today. Thank you Mr. Levine. I wonder what the total cost of that prescription ends up being after tying up all these professionals because of bureaucratic nonsense? Wasting [stealing] the taxpayers $$$, Mr. Levine. Any thoughts you'd like to share?

This is representative of most days on Medicaid. The incentive to remove myself from the dole is great. My goal is to get well enough to say thanks to Medicaid, and move on, providing for myself once again.

Mr. Levine and this bureaucratic nonsense is not helping. Shame, shame, shame...

Fill in the blank, check the box. Move to the right...

All I Want For Christmas

2009-10-15T01:59:00.002-05:00

When I fell into the steps and broke my teeth in May 2007, I thought maybe all I'd want is some teeth. Unfortunately, Medicaid can't provide medical related transportation. At least all of my attempts in the past two years have been fruitless. Plus, it takes 2 years to be seen by a dentist.

So, how about we shoot for something reasonable this year - RELIEF.

Whaddaya say, Mr. Levine?

Are ya up to it, or should I just hurry up and die?

PS - are you any relation to Dick Cheney? You both seem to favor torture.

Pain Management

2009-10-15T01:38:00.001-05:00

NOT covered by Louisiana Medicaid. Anyone surprised by that? Can you spell T-O-R-T-U-R-E, Mr. Levine?

The ankle bone's connected to the what?

2009-10-15T00:39:00.001-05:00

With genetics popping up all over the place in this medical exercise, this is the picture before me today:

Multiple Sclerosis is not fatal [but it sure is disabling], so I guess Mr. Levine wants me to hurry up and die. Can't let me cost Medicaid much money, ya know.

The Tethered Cord

2009-10-14T23:52:00.003-05:00

Have you ever heard of an Obese Filum? Okay, the technical term is Fatty Filum, also known as Tethered Cord. Obese Filum just sounds cooler.

I had never heard of any of them until the Neurosurgeon told me that that was part of my problem.

Seems we all have this thing very similar to a rubber band in our spine that stretches when we bend in any direction. When you straighten back up, it pulls back into shape and helps to align your spinal cord. Another genetic thing, I understand.

Mine doesn't work. Knowing what it is now, I realize that mine hasn't worked in many years, if ever. I have ALWAYS had problems reaching down to tie my shoes, could NEVER do jumping jacks, certainly could not bend from side to side. Explains all those 'D's in gym class, why I couldn't play football, and why I never owned a Frisbee or climbed a ladder, eh?

There is a great rundown here: Tethered Spinal Cord

Again, the Neurosurgeon's request to do something about it was just DENIED by Mr. Levine's Medicaid.

Oh, and here I am. Essentially unable to move from where I sit and no relief from Medicaid. Does it help to say, 'Help, Mr. Levine. Help'?? Sorry, I forgot. I won't die from this, so It's benign.

Would it be fair to observe that you would like for me to hurry up and die Mr. Levine?

Oh, and I wet the bed until I was 14. I know why, now.

Bowel Incontinence, Diarrhea or Constipation are common. Urinary Incontinence, Frequency or retention are also common. Imagine that?

Thanks for all of your help, Medicaid.

The Baby & The Bathwater

2009-10-14T22:50:00.001-05:00

No one ever wants to throw out the baby with the bathwater. So why are there essential ingredients being thrown out when the world is experiencing a global natural and financial upheaval? In other words, where did we throw our HUMANITY?

Is it gone forever? Or will we have another opportunity to rethink just what it is that we are doing? If we do get that opportunity, I am not certain it will be deserved.

Did you hear about the 6 y/o boy in Delaware who got tossed into a 45 day suspension and reform school? He had brought one of those 3 in 1 camping fork, spoon and knife gizmos to school. Brought it out at lunch, and Whammo - ZERO TOLERANCE!!

Wow. I had a ball reading the many hundred comments following that article around the world. To their credit, the school board injected a little humanity into this terrifying situation and the little cub scout is now a bit more intelligent rather than hardened. And it took us until 2009 to get here. I do indeed, fear for our species.

In this day of financial distress, can we not inject a little bit of humanity into everything we do? I do believe that is indeed the missing ingredient in what we have become.

I believe that we are being taught lessons, but we are not learning from them. The system failure of 2005 should never have happened in this country, and men knew that it very well would. 1700 of our loved ones are gone too soon. Many, many thousands of people have had their lives touched by The Thing.

Can we not Mr. Levine, inject some humanity into your Medicaid program? I suspect there would be substantial financial savings if you were to do so.

Be a hero, and be the right man at the right job at the right time.

It's The Economy Stoopid!

2009-10-14T22:00:00.001-05:00

Chronic low back pain disability is the most expensive benign condition that is medically treated in industrial countries. It is also the number one cause of disability in persons under age 45. After 45, it is the third leading cause of disability. Disc disease costs the health care system more than $50 billion a year.

Did ya catch that? BENIGN. It means it is not going to kill me. Louisiana Medicaid has forced me to submit to torture for almost 4 years because my condition is not fatal. Should I equate Mr. Levine with Dick Cheney? They do seem to both favor torture.

To be fair... The Neurosurgeon ordered physical therapy. I am still working on finding one that takes Medicaid and that I can get to by bus. Oh, I forgot... I can't take the bus anymore, and not once in 2 years has Medicaid been able to provide transportation to and from medical appointments for me. Everyone that I knew that had transportation, moved to other states after The Thing. Lack of transportation is a serious issue down here.

Hmmm... wonder what it costs us in GDP? Bet that's a lot more than $50 billion a year.

June 20, 2009

2009-10-14T21:34:00.000-05:00

10 days after I fell out of bed [Which now has railings. Also known as Durable Medical Equipment. With NO thanks to Louisiana Medicaid, who DENIED my request]. That fall was the third time I had fallen out of bed since the stroke. The first requiring a hospital visit. Not that THAT did any good.

10 days out and the more active I am, the more I lose control of my bladder and my bowels. I have made messes for days and a person should not have to live like this, so friends took me to the Emergency room. They took a blood test, some radiology, told me I had gastroenteritis and sent me home with some anti diarrhea medicine.

The Neurosurgeon ordered up a Urodynamic [Urologist], and referred me to a Gastroenterologist. Finally, I thought, we shall get some answers. My mistake. Thought and Medicaid are like oil and water. At least here in Louisiana and under Secretary Levine's watch. Oh, and Medicaid does not seem inclined to give answers either.

Yesterday Medicaid canceled the urodynamics exam, which had been scheduled since 10 days after I fell out of bed. Medicaid told me that I have reached the limit for doctor visits. I've not yet determined if they mean ANY/ALL doctor visits, until when, or whether that includes other ordered and scheduled tests already on the books. Mr. Levine, care to answer, sir?

Fill in the blank, check the box. Move to the right...

Fall Out of Bed - June 10, 2009

2009-10-14T21:07:00.000-05:00

I remember the feeling that I was falling quite rapidly from a height. I was whirling my arms in that way we have when we're off balance and falling forward. I was dead asleep so I can't say whether hitting my head on the edge of the door woke me, or if I was knocked out when I hit. I remember the pain. I've been conditioned. The blood on the floor didn't phase me. I did upchuck a few times, but made sure I did not fall asleep. Been there, done that. Gave those details to Medicaid already though. Fill in the blank, check the box. Move to the right...

I should not have gone to the emergency room that day. I thought the pain wracking through my body was up there; It was NOTHING compared to the next week. But, test results that I have never been shown indicate no new damage I'm told. okay.

Let's see now... I had had to buy a new laptop while in exile following The Thing. I fell over with it and on to it so many times that my falling destroyed it. You will have to forgive me if I do not recall how many times I have fallen since the stroke. Nine times in the month of October 2008 I know.

I do remember kidney stone #27 passed later the same October day I fell on the outdoor steps and ripped off half the house on the way down. Hey, passing a kidney stone is a major event; ya take the benefits where ya can. No pain help there either. Do we sense a trend? Mr. Levine, can ya help us out here?? Are people that really need intelligent pain management being discriminated against here in New Orleans? Because of The Thing??

I apologize. I forgot that intelligent doesn't quite fit into the Medicaid lexicon.

Ten days later and I was in another Emergency room...

Back Story II - No Pun Intended

2009-10-14T18:54:00.024-05:00

Going back to the blizzard of March 17, 1973 and pushing many cars out of snowbound ditches that week, I have had back problems. Anyone knowing me much of these past 36 years knows that my back has not been one of my strong points for many years, and in-fact, has been through more than a couple violent traumas.

Neurosurgeon ordered Durable Hardware to operate, but was DENIED by Louisiana Medicaid.

My thinking is that I put far more faith in what any Neurosurgeon says about a brain or spine over the bureaucratic nightmare named MEDICAID, eh?

MRI May 8, 2009:

Should I only be told to, 'Take Aleve' for this? That's what Louisiana Medicaid says. You tell me...

I'm working on an index of medical definitions for you. In the meantime:

Annular Bulge:

But you know, it wasn't until just this past May that turning to put that fork or spoon into the drawer that the sciatic nerve went bonkers [and hasn't stopped since]:

Spondylosis: (spinal osteoarthritis) is a degenerative disorder that may cause loss of normal spinal structure and function. Although aging is the primary cause, the location and rate of degeneration is individual. The degenerative process of spondylosis may affect the cervical (neck), thoracic (mid-back), or lumbar (low back) regions of the spine.

A month after the MRI, I fell out of bed.

Just Following Orders

2009-10-14T18:04:00.000-05:00

Now there are those who say, 'Why don't you sue them?', and the easy answer is, 'Why?'. They have immunity when they are doing their jobs. That's the easy answer.

And, 'I was just following orders', is something we all are quite familiar with since Nuremberg. I was just following orders...

Fill in the blank, check the box. Move to the right...

And finally of course, there are monetary damages. Get rich.

We live in a global world my friends, and if we do not change, if we do not reshape our thinking on every issue starting at the top and following it through to the very bottom, we are jeopardizing the future that we MUST shape better than that that exists today.

Fill in the blank, check the box. Move to the right..

The Back Story

2009-10-14T14:42:00.001-05:00

This sequence of events really starts with a series of heart attacks just before Christmas 2002. Over a 5 day period I suffered 7 heart attacks that I mistook [from past experience] as kidney stone attacks. The good people at University Hospital in New Orleans took their blood test and rushed me into two angioplasties over two days. Unfortunately there was a complication during the second procedure, and after a code blue in ICU which afforded me another near-death experience, I held on for the next week. After a month of recovery from the bleed-out, I was able to function well enough to return to part-time work. [Thank you, Leigh.] For the next 3 years I was actively involved in developing and managing a successful business operation. Life was good.

The morning of Monday, August 29, 2005 brought Katrina. The following days exposed the complete system failure of our own local, state, and federal governments. I returned to New Orleans 5 weeks later, and learned that I had lost my home.

Though I had plenty of the various medication I needed on hand for the duration, I was unable to obtain refills of my prescriptions in November anywhere in New Orleans, because not a single pharmacy had reopened. This, I realize now, was the beginning of the end of anything related to my own good health. On November 19th, I suffered a stroke while sleeping on the floor of my business.

The good people of The Spirit of Charity Hospital, operating out of tents in the now infamous Convention Center, brought in a mobile cat-scan and later transported me to Touro Infirmary. There, the medical staff of the destroyed Charity Hospital and the decimated LSU HealthCare Network, working in unfamiliar surroundings, guided me to improved functionality and gave me direction for follow-up care at a health clinic they were reopening some distance from my own location.

One was forced to do EVERYTHING differently than we have ever been taught or learned how to do on our own. The good folks at Touro evidently did not realize that patients could not get prescriptions filled ANYWHERE in the city. Due to the pharmacies being looted by the city's addicts during and following Katrina, we had no pharmacies. When eventually some did reopen, New Orleans' patients had to follow far more involved and strict procedures than ever before to simply get a prescription filled. Most of these rules have now been adopted nationwide, and I am certain many of you are now dealing with many of the same aggravations that we here in New Orleans have had to deal with since The Thing. If you are unfortunate enough to require pain management, that in itself is a whole new ballgame entirely.

Declaration of War

2009-10-14T14:05:00.003-05:00