Monday, August 2, 2010
Conversation with my Insurance Company
Jolyn> Welcome to TriWest Healthcare Alliance Contact Center, this is Jolyn, Customer Service Representative. How can I assist you?
Sarah26> I have questions regarding referral # 0000000000. There is a car icon on the referral, are my travel expenses covered? If so, does it cover everything, ie food, gas, hotel?
Jolyn> Please wait while I check your eligibility and review your question. This should just take a moment.
Jolyn> TRICARE allows reimbursement of reasonable travel expenses related to health care, for Prime beneficiaries referred to a specialty provider more than 100 miles from the assigned PCM’s office.
Jolyn> Reasonable travel expenses are the actual costs incurred when traveling such as meals, gas/oil, tolls, parking, and tickets for public transportation (i.e., airplane, train, bus, etc.). You must submit receipts for expenses above $75. You are expected to use the least costly mode of transportation, and government rates will be used to estimate the reasonable cost. The actual cost of lodging (including taxes and tips) and the actual cost of meals (including taxes and tips, but excluding alcoholic beverages) may be reimbursed up to the government rate for the area concerned.
Sarah26> Ok. Thank you! Another question, I show that the referral reads as "Point of Service", will I have to pay a deductible or a percentage of the cost to see the doctor and any tests that are done?
Jolyn> Yes it it states Point of service it is a $300.00 deductible and you will be responsible for 50% of charges.
Jolyn> Is there anything else I can help you with?
Sarah26> I am seeing the Doctors at Mayo because they are the only neurologist that really know about my condition, Devic's Disease. My neuro in my area is excellent but I was given the referral to Mayo from that neuro so I can confirm my rare diagnosis. I was told that TriWest prefers I go to the closest provider in order to be covered and when I venture out of network, that's when I have to pay. Even with the Mayo Clinic in Arizona being the closest facility to properly diagnose my condition, the visit will not be covered?
Jolyn> Correct I am showing it was approved as Point of Service.
Sarah26> I don't intend to keep going to Mayo, I just need to confirm what my neuro in my area thinks I have. And with it being quite serious, I want the best. I'm just trying to see if there's anyway to get it covered.
Sarah26> So are you telling me that it's Point of Service and there's no way that's going to change?
Jolyn> Your doctor can write a letter stating there is no one else that you can be referred to in your area concerning this.
Sarah26> Ok. Thank you.
Jolyn> If there is no one else that takes care of this it may get overturned.
Sarah26> Got it!
Jolyn> Is there anything else I can help you with?
Sarah26> One last question, if my neuro writes the letter stating that there is no one else he can refer me to in my area, can that letter be sent to me and I forward it to you guys or does it need to come directly from him?
Sarah26> I know it needs to be on his letter head and all that, I'm just thinking it'll get to you guys quicker if I go up there and have him do it in front of me and then send myself.
Jolyn> I would have them fax it to us. along with referencing the referral number that is already in the system.
Sarah26> Got it!
Sarah26> Thank you for your time.
So there you have it. I have already contacted my neuros nurse and left a message for her regarding my new dilemma. Now I get to wait on them again. Great! They're going to need to perform this duty a bit more swiftly than the last. If they shoot the shit for too long, I'm going to end up needing an updated referral. I hope that doesn't happen.
Saturday, July 31, 2010
Finally!!! My Referral to the Mayo Clinic is IN!
I'm hoping that if I have to see her, at least he'll be there to assist or available for her to run test results by. You can guarantee, I'll be requesting him to view everything. I've read and have been told that he is the best at the Mayo Clinic in Arizona and you already know, I want the best.
Unfortunately, it looks like my visit will not be completely covered by my insurance company. We're military so our insurance usually covers everything, no co-pay. But since the Mayo Clinic of Arizona is out of my network, there's going to be a hefty deductible and other fees. With all the tests they'll have to run to confirm my NMO, it's not gonna be pretty.
I'm going to call my case manager on Monday and get some facts about everything but, I feel a fundraiser coming on. =)
Friday, July 30, 2010
Referral to Mayo Clinic Update
I called my GP's office again today and asked them if they have received anything from my neuro with the words, "Mayo Clinic" on them. Whether it be a referral or just some sort of correspondent requesting that they (my GP) create a referral for me to the Mayo Clinic and send it to my insurance company.
Wednesday, July 28, 2010
Decisions. Decisions.
I've also been slacking on my doctor stalking. Or referral stalking. Whatever. But I've liked it. Now tomorrow when I call my GP, they better have the damn referral (and the right one!) from my neuro or I'm gonna go ape shit on their asses! LOL! Kidding. Kind of.
So on to my decisions.
On August 24th, I have my first Neuro Ophthamologist appointment. On August 24th, I also have the opportunity to appear as an extra in a movie. Not a big deal, but the experience would be nice and I get to look like crap in the movie so no need for beauty products. YES!!!
I haven't made up my mind yet. I know my health is important and this appointment is very important to my health, so I'm sort of stuck. However, if my appointment were pushed back a week, or even a month, will it hurt me? Probably not. I'm going to call the Neuro Ophthamologist office tomorrow and see if they have any availabilities on any other day in August. Maybe I can get lucky and push it back by a few days or even a week. Not likely though.
BTW... Things have been going well for me lately. I'll update on diet, exercise, and everything in between very soon.
Saturday, July 24, 2010
Chasing A Dream
I live close to one of the biggest cities in the industry so just this week I decided, I'm gonna dive right in and see how long I can swim before getting spit out. Well, as it turns out, I was spit out pretty quickly.
(Quick note: Modeling has always been in the back of my mind and it's always been something I wanted to do. For a while, I was not satisifed with my size and I was probably even too large to be considered a 'Plus Size' model in the industry. Even though I think their idea of plus size (a 10) is ridiculous, it is what it is. So I've been working really hard to get in shape not only for my disease and to make myself feel better, but I've also been doing it for the hopes of one day being in front of the camera.)
Sometimes, dreams do come true. Other times, you have to make them come true.
Tuesday, July 20, 2010
Keeping Track
Here we go...
Carol (Office Manager at my Neuro's) - Left message to confirm Doctors email address since no one else in the office was allowed to do it. I was going to send my request directly to him.
8:37am - Monday, 6/28 - Message Left
9:19am - Tuesday, 6/29 - Message Left
Gave up on her quickly and decided to go with...
Jamie (Referral Coordinator)
11:15am - Wednesday, 6/30 - Message Left
12:12pm - Thursday, 7/1 - Message Left
9:41am - Friday, 7/2 - Message Left
SURPRISE!!!
Jamie called me back on Friday, 7/2. She told me I needed to talk to Mary (fantastic!), my neuro's assistant. She will be able to request the referral from him and get it submitted. Jamie did tell me that she would speak with Mary about it but if I didn't hear back from her in a week, to give her a call and check the status. That's always comforting, isn't it? It's like they're saying, "I'll most likely forget about you, so call me back and leave a detailed message. That way, I can hurry up and do it before I return your call."
So I waited a week and of course, I heard nothing.
Mary (Neuro's Assistant)
10:03am - Monday, 7/12 - Message Left
12:37pm - Wednesday, 7/14 - Message Left
Morning of 7/19 - I finally spoke with Mary. Each message I left was letting her know that I was checking status to see if my neuro has written the referral. I explained the whole situation when I spoke to her and she said, "Oh yeah, he's written it and I have sent it over to Jamie to send it to your General Practitioner". Why couldn't she just call me and tell me that? So I then tell her that I will check with my GP's office and confirm receipt. Thank you and goodbye!
Secretary of General Practitioner's Office:
Me: I'm checking to see if you received a referral for me to go to the Mayo Clinic in Arizona from my Neuro.
Sec: Let me check...... Oh yes, I see it here. Let me call them and see if this is what they actually want me to send to your insurance for the referral to be approved or if there's something else.
Me: Great! Will you call me back or should I call back and check status?
Sec: Call me back this afternoon.
Me: (Great....) Ok. Will do!
Monday afternoon I call her back...
Me: Hi! I spoke with you earlier regarding my referral from my neuro's office. You were going to call them and confirm that's what you were supposed to send.
Sec: One second please.....
Me: (This hold music sucks!)
Sec: Yes. All I have here is a consult from your June 22nd appointment detailing the conversation you had with your neuro and your recent diagnosis.
Me: Uhh... You told me earlier you had something mentioning the Mayo Clinic in AZ.
Sec: No, we don't have it.
Me: O...K.... I'll call my neuro's office and get them to resend. Thanks!
Sec: Ok. Thank you!
Jamie (Referral Coordinator)
9:38am - Tuesday, 7/20 - Message left.
Tomorrow I'll call my GP again and see if they have anything. If not, Jamie is getting another call from me. I don't know about you but to me, this is bullshit!
Sunday, July 18, 2010
Saying Goodbye
And right now, it feels right to not inject myself anymore.
Thursday, July 15, 2010
Progress Report - Take One
I started eating healthy and exercising after my misdiagnosis in October of 2009. Then I was off-again for a few months and I think I was on-again sometime in March or April. Then off, and finally back on (hardcore) 10 or so days ago.
You're probably looking at the picture above and thinking, "What the hell does she mean by "She's on her way", looks to me like she's already there". My reply to that, I have fat in places that I prefer it not be, and I'm sparing you those pictures. And I'm not doing this for anyone else but myself. And maybe a little bit for the Hubs. =)
My Goals:
1. Drop 12 pounds.
2. Tone. Tone. Tone.
3. Have Superwoman muscles to go with my Superwoman attitude.
4. Be 100% confident in my body.
5. Win an Olympic Gold Metal.
Just kidding about number five. So far I have lost 3 pounds and the muscles are on the way. My birthday is in late August and although I know I won't have Superwomans body by then, I do hope to be down the 12lbs.
I'll definitely keep you updated and if you have any advice or want any (limited) advice from me, I'm here.
(Now that I've killed maybe 20 minutes typing this, I must find something else to keep my mind off those delicious turkey burgers I made for dinner tonight.)
Wednesday, July 14, 2010
2010 NMO Patient Day
Tuesday, July 13, 2010
50 BEST Low Calorie Snacks 115-125 Calories (August 2010 Issue of Good Housekeeping)
SWEET
1. 11 M&M Pretzel Chocolate Candies
2. 1 pkg. Q.bel Dark Chocolate Wafer Rolls
3. 1 Deep Chocolate VitaTop VitaMuffin + ¼ cup raspberries
4. 1 Van’s Natural Food Lite Totally Natural Waffle + 1 ½ tsp. Nutella
5. 2 scoops Ciao Bella Orange Sorbet
6. 14 Quaker True Delights Multigrain Fiber Crisps Wild Blueberry
7. 1 Breyers Smooth & Dreamy Chocolate Covered Strawberry Bar
8. 1 pack Kellogg’s Special K Fruit Crisps + Iced chai tea + ¼ cup fat-free milk
9. ½ cup Edy’s/Dreyer’s Slow Churned Yogurt Blends In Tart Mango + ¼ cup blackberries
10. 4 oz. light yogurt + ½ cup Nature’s Path Crunchy Vanilla Sunrise cereal
11. 1 Breyers Inspirations Natural Vanilla Bean Low fat Yogurt + 1 Mini Nilla Wafer
12. 1 Jell-O Caramel Crème Mousses Temptations + ½ large apple, sliced for dipping
13. 1 pkg. Nabisco 100 Cal Fudge + 1 cup iced coffee with ¼ cup fat-free milk
14. 1 Kashi TLC Fruit & Grain Bar in Dark Chocolate Coconut
15. 1 pkg. Peeled Snacks Much-Ado-About-Mango
16. ½ cup Yogi Granola Crisps (Fresh Strawberry Crunch or Baked Cinnamon Raisin)
17. 10 Barbara’s Snackimals Chocolate Chip Animal Cookies
18. 15 Shale Snacks Cranberry Pecan Biscotti Crisps
19. One 100 Calorie Pack Emerald Cocoa Roast Almonds + 1 Tbsp. Ocean Spray Craisins
20. 1 Kozy Shack Chocolate Hazelnut Pudding + 3 raspberries and 3 strawberries
21. 7 Nabisco Nilla Wafers
22. 1 Starbucks Grande Iced Caffé Latte with Soy Milk
23. 42 Pepperidge Farm Vanilla Grahams Goldfish
24. One 1-oz. pkg. Smartfood Cranberry Almond Popcorn Clusters
25. ½ Cup Blue Bunny Caramel Praline Crunch All-Natural Frozen Yogurt
SAVORY
26. 22 Original Popchips
27. 20 Kettle Brand Baked Potato Chips in Salt & Fresh Ground Pepper
28. 6 oz. Low Sodium V8 Juice + 1 Large hard-boiled egg
29. 1 cup Campbell’s V8 Garden Vegetable Blend Soup
30. 2 Blue Horizon Organic Indian-Style Vegetable Spring Rolls + ¼ cup edamame
31. 3 Daella’s Biscuits for cheese, Hazelnut with Figs + 1 Tbsp Chavrie Original Fresh Goat Cheese
32. 2 Tbsp. Wholly Guacamole Classic + 5 Food Should Taste Good Cheddar Chips
33. 2 John Wm Macy’s WheatSticks in Garlic Romano + 1 wedge The Laughing Cow Light Swiss Cheese
34. 5 Multigrain Food Should Taste Good Chips + 1 low-fat cheese stick
35. 13 Terra Sweet Potato Chips
36. 11 McCain Sweet Potato Crinkle Cut Fries
37. 1 cup McDougall’s Black Bean Soup
38. 7 Beanitos Pinto Bean & Flax Chips + 3 Tbsp salsa
39. 3 Kitchen Tables Bakers Sesame Parmesan Crisps + 1.5 oz. deli ham
40. 7 Snyder’s of Hanover Multigrain Sticks
41. 1 Mini Babybel Light + 3 Ak-Mak Whole Wheat Stone Ground Sesame Crackers
42. ½ Thomas’ 100% Whole Wheat Bagel Thins + 2 tsp. peanut butter
43. 3 Tbsp. Alouette Light Garlic & Herb Cheese + 6 endive leaves and 2 tsp. pine nuts
44. Jolly Time Healthy Pop Butter 100 Calorie Mini bag + 1 Tbsp. grated parmesan cheese
45. 1 small pear + 1 wedge The Laughing Cow Light Blue Cheese
46. 14 SunChips Original Flavor Multigrain Snacks
47. 1 Cabot 50% Light Cheddar Snack Pack + 20 red grapes
48. 3 Tbsp. Sabra Peppadew Hummus + 10 baby carrot
49. 16 Quaker Rice Snacks Cheddar Cheese Quakes
50. 19 Garden of Eatin’ Baked Yellow Chips
Monday, July 12, 2010
ENT Confirmed
Thursday, July 8, 2010
Before Devic's - EEG and VEP
So all my tests are done, now I just wait. I wasn't able to get my Radiologist Report today. You have to mail/fax/email a request, they then have 14 days to respond. I'll send the request tomorrow but I'm sure I'll see my Neuro before they get here.
My appointment to go over all tests results is next Thursday, the 29th. Between now and then, I'm just going to chill. These may be my last 8 days of being 'free' of an incurable disease.
Once I get the results, either way they go, I'll share with you after all family members have been told.
Thank you for your support. :)
Wednesday, July 7, 2010
Before Devic's - Spinal MRI
Yesterday was my MRI of the Cervical and Thoracic (sounds like a dinosaur) Spine. It was at a different place then my last MRI because of the Doc change of course. I didn't think it was possible for this MRI to be any louder then the first one but surprise, surprise, this one was.
I went in a 7:30pm with a slight headache. I finished at 9pm with the sound of fog horns ringing in both ears and a massive headache. She gave me ear phones that were playing classical music but really, what's the point? I heard maybe one song throughout the entire hour and a half.
I don't know if I've mentioned this before but I don't handle IV's or getting my blood drawn very well, or in this case the contrast.* For me, it's not the prick or even the feel of the stuff going in that bothers me, it's the thought. I think about a needle hanging out of my arm and blood and....yuck! Anyway, I'm known for passing out.
So the radiologist asks me before I even go in, "How are your veins?" And luckily, they're great! So I tell her that but I also inform her that I don't handle that kind of stuff well and so on. When the time came for the contrast, all was fine until I see what looks like water flying towards my face. I close my eyes and then she quickly asks if I'm alright. "Yes," I say. She then tells me to NOT move my arm no matter what and that she has to go and get some more contrast. Great!
So I'm sitting there, thinking about a needle hanging out of my arm, wondering if I'm bleeding or what's happeneing. Of course I can't see because I have all this padding crap around my head and a metal bridge-looking thing going over my neck. In my mind I'm thinking, "Come on Lady! Hurry it up!" I keep looking at the beautiful (artifical) scenary that's postered on the ceiling panels and trying to think of something else. Anything else.
Finally, what felt like 10 minutes but was probably only 2, she came back. She finished up the contrast, taped the "wound", and sent me back into the tomb of (noisy) death. I hate it when I'm in there. I've only done it twice but with both times, I've been ready to scream right at the moment before they pull me out.
I received a copy of my scans (obviously) and have shared a couple of the clearest pics with you. I'm no doctor but I have a pretty good idea of what I'm looking at. If I'm right, I'm screwed!
* Contrast - Contrast dye is a solution that is used to accentuate specific structures when looking at an image. Injected into your blood vessels. Fun! Fun!
Tuesday, July 6, 2010
Before Devic's - EEG: In Progress
I am officially "wired" for my 72 hour EEG test. It took about an hour and a half to get all 21 wires placed in the proper place on my head. No hair was removed and each wire is taped and glued to insure that it stay's in place. The other end of the wires are attached to a recorder which I have to carry around until they're removed.
Here's the educational portion of this post: An electroencephalogram (EEG) is a test that measures and records the electrical activity of your brain. Special sensors electrodes are attached to your head and hooked by wires to a computer. The computer records your brain's electrical activity on the screen or on paper as wavy lines. Certain conditions, such as seizures, can be seen by the changes in the normal pattern of the brain's electrical activity.
Thank you WebMD for that excellent description. The purpose of this test for me, my Neurologist's wants to review my brain activity, particularly when experiencing headaches, migraines, dizziness and a few other symptoms. Luckily, the wires will come off one day before my daughter's 2nd birthday party. Whew!
So above is my before picture. Most of you know what I look like but that is for my newbie's. And also for myself. Just a little reminder that this is only temporary and my lovely locks will soon be flowing again. And below, well, it's obviously the after photo.
It's kind of annoying having people look at you like you're crazy. Rather then crawling into a corner and crying, I'll just stare back at them and maybe make a crazy face and throw my arms in the air. LMAO! In all realness, I have to be pretty chill during this test. It's very sensitive and even a blink is seen on the screen.
Update: Still waiting on my MRI results but once I find something out, I will certainly share.
Monday, July 5, 2010
Before Devic's - Fast Forward
Wednesday, June 30, 2010
How it Came to Devic's
This blog will be a compilation of my journey with Devic's. Below is a very brief version of how I found myself with a Devic's diagnosis.
I was originally diagnosed with Multiple Sclerosis (MS) on October 29, 2009. I started Copaxone on November 7, 2009 to help slow the progression of MS.
I've been having vision issues for about a year now and it's progressively getting worse. I have blurry vision in both eyes that is off and on all day, I also have occasional double vision. I voiced these concerns at a routine appointment in my neuro's office where a second Brain MRI was suggested. Unfortunately, I was dealing with the NP at the time and she dropped the ball with getting the referral to my insurance company.
For two weeks I waited for her to put in my referral for an MRI. My patients ran dry and I ended up going to my hospital ER and getting the MRI done myself. Two doctor's from the neurology team at the hospital asked me why I thought I had MS? I told them, "because an MS Specialist diagnosed me and I've been on Copaxone since November. Why wouldn't I think I have MS?" This understandably put a lot of questions in my head.
A week later I saw the NP in my neuro's office to go over the results. I mentioned that I am now questioning my diagnosis and I would like an appointment with me neuro ASAP! I got an appointment less than a week later. (Let me just say, my current neuro is THE BEST! (in my area at least) But he's not the neuro who diagnosed me. I was seeing another MS Specialist within the practice but he left shortly after my diagnosis to volunteer overseas.) Once I got in the room with my neuro, he immediately pulled up my spinal MRI from back in October 2009. My previous neuro had said that the lesion on my spine was a typical MS lesion. But as it turns out, that's not right at all.
I believe my current neuro screwed up by taking his partners word for it as far as my MS diagnosis goes. I don't believe he really went over any of my tests until he heard I was questioning my diagnosis. The lesion on my spine is in my spinal cord, it is also "long and stringy" according to my neuro and spans the length of 6-7 vetebrae. How the heck my diagnosing neuro could think that was a typical MS lesion is beyond me. Even I know it's not typical for MS. He then told me that the lesions in my brain, I have 2-3, are not typical of MS either. From what I've learned, having NMO means no lesions on the brain but after that statement it always say's, "but that's not always the case".
Back in November 2009 I had the blood test for the NMO IgG antibody which came back negative. My neuro said that I am extra, extra special in the sense that A. I have NMO and B. I tested negative for the antibody. Judging from his statement, he doesn't have many, if any, other patients with this disease.
At the moment, I'm trying to see if my insurance will approve a visit to the Mayo Clinic in Arizona. I want to go through all their testing and just further confirm my diagnosis or put it in question. They seem to be at the top of all the research happening with NMO and I want the best!