Medical Problems - suggestions appreciated

[BirdbyBird]

Following up on the related subject of insurance. I feel much better having upgraded my coverage from the standard Ohio State Teacher Retirement System group plan that is offered here in Ohio. Having travel with several of you guys or listened to your stories over the years of getting ill while out on the road. (I always think back to the time that Sharon got so ill in LA but know that her California insurance wouldn't cover her outside the state of CA??? I think I got that memory sort of right.)

I have occasionally had that shock of getting a bill from an "outside provider" that I didn't know was an outside provider. Especially after being seen in an ER and getting some test read or completed. If you do want to travel around the country it is something to think about. And like JB shared a couple years ago, I would rather budget a little more $$ out a month and know that I don't have to hesitate or stress financially to get something looked at because of unexpected co-pays screwing me up, than suddenly look at a huge bill for some hospital test or even a short stay. I also notice that the providers seem to smile when I hand them my AARP United Health card. It is as if they understand that they will get paid. I am not one to run out for medical help at the drop of the hat but I have also lived long enough and observed the results of the decisions of others that I would rather be embarrassed by jumping the gun to check out a "Nothing" than to get yelled at for ignoring an big OMG thing. Life can go downhill too quickly.

Good Luck and stay strong in your health care adventures!

Tina

[monik7]

Regarding Kaiser: I realize it’s not close to you, but at least you could most likely get an appointment. Kaiser Senior Advantage would become your Medicare supplement, but I think you’d have to make the change from your current supplement soon as there are only a few days left in the open enrollment period. Could you try it for a year?
Sandi

[Acadianmom]

I was just thinking of a promise I once made myself after having dental surgery to remove a cyst at the root of a tooth. They went through a root canal and it got infected. Had a huge lump in my cheek. Called the dentist and the young thing answering the phone kept insisting it was normal swelling and I did not need to come in. Well, of course, in the middle of the night, it burst, and I had a mouthful of pus. Rinsed it out as best as I could, but not pleasant.

Judy, I had a filling done and was in pain to the point of crying the next day. I called the office a couple of times and was told that it was a big filling and it would be uncomfortable. A friend got me in to see his dentist and I had an abscess. Ended up having to have a root canal after being on antibiotics. That dentist lost all our business. I should have quit him when my mother had lost a filling and he was on vacation. The dentist that was seeing his emergency patients put a temporary filling so the first dentist could fill it so we had to pay twice.

Martha

[havingfunnow]

I was part of a local practice where a) I never saw my primary physician and b) the PA -- and the support staff -- tried to bully me into an outdated and unnecessary treatment protocol. I was furious!

I talked to the system based out of the local (good) hospital, and eventually found a new physician in one of their clinics (they serve a tri-county area). She was just out of residency, and I gave her my lecture on proper doctor-patient partnerships the first time we met. It's worked out well -- I can see her when I need to, and she listens when I speak!

Sometimes I wish it were possible to request tests on my own, darn it!

All of which leads me to believe you'd be better off with a different doctor from a different system!

[Redetotry]

So sorry you are having these problems with doctors Anne. It is the same here, hard to get an appointment and if you press, they just say go to Urgent Care. The Urgent Care is only staffed by PA"s. It is also hard to find a doctor who has a degree from a good school. I can barely understand my primary physician and she has been in this country at least 30 years. I do have a doctor in St Louis that I can consult with or see but with the general scarcity of doctors it is now difficult to get an appointment. You can look up doctors credentials and where they went to school online.
I'm like Karen, I refuse to take certain medications. I think my chart has NON COMPLIANT written in bold letters across the top. I also refuse the bone density test as I refuse to take the drug. This is a small area and if a really good doctor is hired they don't stay long.
I think most doctors tend to over medicate because they are paid by the pharmaceutical companies to prescribe certain drugs. You can go online and find out how much your doctor receives each year from big Pharm.

[OregonLuvr]

I am so thankful I have a great Medicare supplement plan. I can go to any Urgent care/Hospital or doctor in any state if needed and know I am 100% covered. I dont need a referral to a specialist. I have the AARP United healthcare plan. And like Tina said they dont even bat an eye. My infusions every 6 months are $13,000 not counting the specialist doctor visit or the lab work also 100% covered. I justify my $190 monthly premium as if I had to pay what was left over from just Medicare I would be broke by now.

[Bethers]

I actually would only want the supplement plan good nationwide and it's what I selected last year. I did take the United health care plan through AARP, but am changing to the same plan through Aetna starting in January. They have as good a rating, coverage is identical and instead of my rate going up, it's going down. I needed to talk to someone with the United Health Care plan/AARP and spent over 20 minutes selecting phone options and on hold. With the Aetna plan I have an agent to call. I've called twice and he's actually answered the calls. That helped me make my decision to change. But we all have to do what we feel is best for us.

I'm not at all against seeing pa's . Often I think they are more up to date than the doctors. Same with nurses assistants.

[JudyJB]

I also have United Heathcare plan that plays 100% of everything, and allows me to see any specialist without a referral.

BUT, this reminded me that somewhere in my policy there is a nurse advocate or something similar that you can call. I think a lot of plans have these, so you might want to check the back of your card and see if there is a number you can call. I remember someone calling me when I had seen a couple of doctors a couple of years ago when they thought I had had a lump in my breast and it turned out to be "inflammation."

Nurses are like good librarians when you are going to college, they can save your life, literally. And they are ALWAYS on your side, so maybe a call to such a person would be a good idea.

[Shirlv]

Just wanted to add that I also have United Health Care and am very satisfied.

[Rufflesgurl]

I have Medicare with Blue Shield supplement and have had excellent coverage - no referrals ever required. For the very first time, I was charged an additional $47 for an eye exam I had recently. Have heard "they" are going to start sneaking charges like this through to us. Will see. Scripts thru Humana which I might be
changing.

Linda

[Cudedog]

Good morning, everyone.

Though I would post an update on my medical situation, since so many of you were so kind to respond to my thread. I sincerely thank you. Particular thanks to those who suggested that they had had good results when being seen by a Nurse Practitioner. I would not have consented to be seen by an NP without your good thoughts.

Update:

Had tried to schedule an appointment online this past Monday morning with my doctor, the only appointment I could get was nearly six weeks out. So phoned the office, seeking an appointment, and was told that my doctor would be in the office on Thursday, and would I like to see him then. I happily said "yes", was told that someone would phone me back with an appointment time later that day (again, this was Monday).

I waited all day Monday, and all day Tuesday, for a call-back that never came. Wednesday morning I telephoned to find out what time my appointment was scheduled for the following day (Thursday). After a lot of hemming and hawing (and about ten minutes "on hold") the scheduler came back on the phone and said that in order to get me in on Thursday, would mean that my doctor would be double-booked, so my appointment had been declined by my doctor (!). I was then asked if I would like to see an NP instead, and agreed to see the NP - which I never would have done without reading your positive experiences about your own visits with an NP.

The appointment with the NP was very positive. She really did ask me a lot of questions, spent a considerable amount of time with me (especially since I insisted that I did not want to take any drugs for this pain, that my main interest at the moment was just trying to find out the cause of this pain) and we talked a bit about my options and possible reasons for my symptoms. Since I had never had this done before (she asked if I had or had not) a blood test was run to see if I had any kind of auto-immune disease (such as arthritis or Lupus, both of which could cause the joint pain I have been having).

She also said that if I am negative for this, I might just need to face the fact that my discomfort is due to the aging process. I laughed, and agreed this might be the case - but, again, I spent a week in Yellowstone last May, where I walked for many pain-free miles. Just now I have joint pain just walking across the room. So I do have my doubts. Could, of course, still be age-related, but since this pain has come on, and slowly worsened, only since my Yellowstone trip (where I was attacked by clouds of mosquitoes while hitching up my trailer), I do have my doubts. I doubt that age-related joint pain could have come on relatively suddenly.

I just pulled up the test results online, and the test for auto-immune disease was totally negative. A very good thing, really. The results didn't even show a number, it was just totally negative. A relief there, for sure.

But it doesn't go anywhere to find out why I am having pain. At the time of my cellulitis last summer (I also had a respiratory infection along with, and at the same time, as the cellulitis), as I said before I was extremely ill and debilitated for about four weeks, six weeks before I began to again feel like myself. I was on heavy-duty doses of two different antibiotics during this time, neither seemed to have much effect the course of my infection.

Near the end of the six weeks, I was finally able to get in to see my regular doctor, and his thought was that my infection (both cellulitis and respiratory) were virus, since the antibiotics seemed to have little effect. We discussed the fact that there are many different pathogens that exist in mosquitoes in the Rocky Mountains (where Yellowstone is located), he didn't really know which of these to test for, and (in any case) it was more than likely that the virus had now cleared from my system, so any test would likely prove negative.

Still waiting for the test result for Lyme disease. I was not tested for West Nile Virus (or for any other virus) at the end of my cellulitis infection when I was finally able to see my own doctor due to the time delay. When I first became ill, when I explained that I thought my cellulitis was the result of a mosquito bite that I received in Yellowstone, all they heard was "mosquito bite". No one heard the "Yellowstone" part. Mosquitoes are a big problem in my area as well.

I even had one call screener, when I first became ill, tell me (sounding incredulous): "You want to come in to be seen only because you have a mosquito bite?!?"

So there you have it. At least for now, I am not ready to accept that I am having pain on walking is solely age-related. I did some searching online, and joint pain does not appear to be one of the lingering effects of West Nile Virus. Something called Chikungunya virus does attack the joints. I will need to research where it occurs in the U.S. - although it is rare here, it has appeared in some places. It is a virus spread by mosquitoes. If anyone has had it, or has heard about it, please let me know.

I guess it is up to me to find out what is going on with me. Which is, of course, always the bottom line in such things.

I don't have the circumstances of limited medical options. I have used a Nurse Practitioner for the past 8 years maybe. After my MD left the practice to join a boutique practice which was much better for her family life.

. . . A week later I turn up calling with the Bells Palsey issue. Again after talking to their nurse in reception they got me in.

. . . I am thinking that your idea to move can't come quick enough, except that you are having difficulty moving.

Thank you, Tina, for your thoughts. Very helpful to read that you had a good experience with an NP. Thought I would mention that in researching my own problems, that Bell's Palsy came up as a possible side effect of Lyme Disease. As for moving - I still want to move, but can't at the moment face the thought of moving until I can resolve the pain issue. I can barely do usual housework. Packing for a move pretty much out of the question.

Lymes disease can be very serious if not treated right away. I have a friend who died from it because he was misdiagnosed until it was too late.

Thanks for your comment, Barbie. Scary thought. Keeps me motivated to keep doing my research on this.

Are you being a "good" and polite patient? Maybe you should not be. Have you told them that you are having more and more pain and difficulty walking? Tell them you think you might have

Thanks, Judy. Yes, I am generally a "good" and "polite" patient. When I have tried to be otherwise, tried to be forceful and more of a self-advocate, it has seemed to just make getting an appointment to be made more difficult. It has seemed that they listen to me less, not more.

Regarding Kaiser: I realize it’s not close to you, but at least you could most likely get an appointment. Kaiser Senior Advantage would become your Medicare supplement, but I think you’d have to make the change from your current supplement soon as there are only a few days left in the open enrollment period. Could you try it for a year?
Sandi

Thanks, Sandi. After reading your post, I did try to find out if I could switch to Kaiser. My zip code is not listed in the areas covered by Kaiser, thus I am not eligible to be covered by Kaiser (careful - this link will not open in my browser, it just automatically downloads the .pdf to my computer): https://medicare.kaiserpermanente.org/medicare/pdfs/2019/ca_ncal_SB_PBP1351.pdf

The walk-in clinics are just about useless unless you have a cold or want a flu shot. Martha

Thanks, Martha. I agree 100%

. . . All of which leads me to believe you'd be better off with a different doctor from a different system!

Thanks, Louise. A different system is, unfortunately, out of the question. Sutter North basically has a lock on medical care in my area. My recent experience with the NP was a good one, though, so perhaps I will stick with her. Certainly easier to get an appointment than with my regular doctor.

So sorry you are having these problems with doctors Anne. It is the same here, hard to get an appointment and if you press, they just say go to Urgent Care. The Urgent Care is only staffed by PA"s. . . .I can barely understand my primary physician and she has been in this country at least 30 years.

. . . I think most doctors tend to over medicate because they are paid by the pharmaceutical companies to prescribe certain drugs. You can go online and find out how much your doctor receives each year from big Pharm.

Thanks for your comments. I agree with what you say here, including the difficulty understanding some care providers. As for being referred to Urgent Care - this just brings me back to the feeling of age-discrimination. Plus, Urgent Care can charge insurers at a higher rate, because your problem is "urgent" and not just a "regularly scheduled" appointment. $$$

Just thought I would mention that I also have (as many of you do) AARP United Healthcare as my Medicare Supplement. I have had them about two years now, and have been very happy with them. All of my bills not paid by Medicare have been paid by United Healthcare, no questions asked.

Thanks again to all who have responded to this thread, apologies to you if I may have missed replying to you directly. All of your comments are valuable to me, so thank you very much.

Best wishes,

Anne

[SoCalGalcas]

Hi Annie, I have been following this thread with some interest. I myself would prefer a NP or PA to an MD. Although I do like my primary care MD. I am with KAiser as is Sandi. When I am in pain (like with my ankle) I could not get an appointment with my primary, so they gave me an appointment with another MD. What an ass. He would not listen to me about having this pain on and off for years, so I knew what is was. After I wrote to my primary that I was never returning to this ass again, they offered me PT, which I gratefully took. He helped me tremendously.
Many years ago a Kaiser MD was just too busy to take off a squamous cell carcinoma from my leg. They gave me a PA to do it. He did a fantastic job!
bottom line, go ahead and take NP/ PA whenever offered. I am happy with Kaiser, but, think all health care systems are just too busy. Watch out here in CA when we have single care! You think care is bad now, we are in for a rocky road when we are ill.
Lyn

[Acadianmom]

Anne, it looks like they could at least refer you to an orthopedic doctor for an MRI. That would at least tell you that the pain is age related and not something else going on. I don't want to scare you but my brother had an infection set up in his hip joint and he ended up having a hip replacement in his 50's.

Martha

[retiredhappy]

I prefer a NP and have one as my primary and have for many years. I never have a problem getting an appointment and they actually listen to you. Altho mine referred me to specialists when I had pneumonia and cancer last year but she still acted as my primary. I'm not a good patient as I actually read all my labs and research stuff on line. My NP is actually good with this = never had a doctor who wanted their patient to have an opinion.

[JudyJB]

When I had my first urology appointment a couple of weeks ago, it was with a PA. He was a young man who did a much better job of explaining to me why the emergency room doctors in August had told me my kidney function was normal while I clearly had a kidney that was not functioning well. I had been very irritated because I felt I had been misled. He explained that they were basing it on blood tests, which were influenced by my right kidney having taken up some of the slack. And it was only due to a cat scan (with dye and contrast) done by someone else a month before that showed how bad things were. (That doctor was horrified at what he saw in the cat scan and pushed me to see this urologist.)

Anyway, my experience with PAs is that they really do understand things and do a much better job of explaining stuff than a busy doctor does. Admittedly, he had access to the better cat scan. He also gave me a prescription for pain meds and ordered the pre-surgery tests.

And this PA, by the way, got me scheduled for surgery within a very few days, and passed information on to the urologist, who I saw for the first time only a few minutes before my surgery. However, since he had been recommended by my other doctor (the horrified one), I was OK with that.