Wednesday, March 28, 2012

Persistence for the Partner

It seems as if every day presents a new challenge for my partner. His health condition remains difficult, but let me assure you, he is fairing as best as he can. He is working part-time, resting and eating well. However, his medical condition remains fragile, and messes with his head. Literally. He can't think logically and easily gets overwhelmed, which results in confusion, agitation, and bouts of emotion.

We are in it for the long-haul. I am as committed to him as ever....

He has no worries that he will be left to sort out the combination of challenges in doctor's scientific jargon, insurance company legal-ese, or contradictory information from various books and websites.

This is what I do -- I listen, read, comprehend, and continue to keep "the big picture" in mind. I advocate. Anyone and everyone who is involved deals not only with my partner (in a physical sense), but with me as his personal healthcare advocate.

My partner will get well. He will. It will take time, but he will improve. I have faith. I exude that faith in every interaction with my partner so he feels better -- mentally anyway. A positive attitude goes a long, long way to helping improve his outlook. It would be easy for him to wallow in doubt, self-pity, and anger. I continue to make him laugh, and to smile whenever I am around him.

The most recent update -- more tests have confirmed beyond a doubt that he is demonstrating the symptoms of a lingering, long-term chronic illness that is hard to beat. The bug that is causing it has crossed the blood-brain barrier. Few drugs taken orally pass that barrier.

Treatment with antibiotics administered intravenously is the next step. IV antibiotics cross the blood-brain barrier more readily.

And now we also have a physical complication due to a hernia that he developed just a few days ago. Sheesh!

Through six hours of patient persistence with his health insurance company, three doctors, and probably a couple turtle doves and a partridge in a pear tree, I have orchestrated the least invasive treatment so he will get his hernia repaired and I.V. antibiotic treatment at the same time, and done as an in-patient (that is, in a hospital instead of some doc-in-the-box outpatient facility.) I swear, health insurance companies only support the cheapest route, even if it is not the best choice for the patient's care based on his overall condition.

A hernia repair is a quick procedure. Provided all goes well, he should be in and out of the hospital in one day. The I.V. antibiotic treatment will continue for 30 more days after I bring him home. I will do whatever he needs. Thank goodness for training as an EMT a long time ago. I think I can handle a PICC line. No biggie.

I fought, patiently argued, made my points, used the insurance company's paperwork against them (that is, I pointed out their own contradictions and errors) and forced them to consider the "big picture" of why an in-patient procedure is required in his case.

If I had not done that, his insurance company would have "won" by filling our mailbox with tons of legal mumbo-jumbo and caused my partner to throw up his hands (and probably his lunch) in disgust. Sorta like what they set out to do -- wear him down to the point of not fighting it any more.

But that won't happen on my watch. Not at all. I am fierce when it comes to protecting "my own." I fought for my uncle, I fought for my aunt, and I have fought for some senior pals. I guess I have a long history of taking on the "big guys" to make things right; to make them see the whole picture and understand the entire story; and to lay out a course of treatment that makes sense for the patient's care as well as would work for the insurance company.

I'm not out to take advantage of the insurance company or rip it off. However, I will not, under any circumstances, let an insurance company's "protocols" dictate a course of action that is inappropriate but based on rule-bound bureaucratic narrow-minded rules.

I broke through all that on Monday. My partner will receive coordinated care for both his hernia repair and disease treatment.

My partner's primary care physician was so impressed that he phoned me to say that I am the first one that he was aware of who ever got that insurance company to back down and grant an exception to their standard protocols.

A good friend in the local fire department (former paramedic) commented that I should change my profession to becoming a consumer advocate.

Ha! The insurance company didn't know who they were dealing with. Most insurance companies treat people as if they are complete idiots, so they don't know what to do when an advocate steps in and converses in a calm, persistent, scientifically accurate, and legal level. It throws them for a loop. (giggle.)

The new initials after my name have changed from "PhD" to "KMD" -- K for "Kvetch", a Yiddish term for someone who persistently complains until he gets what he demands, and "MD" for the obvious, "medical doctor." Well, I am not a medical doctor, but I tell 'ya, after the past few months, I feel as if I have earned that degree in spirit.

Life is short: fight for those you love, and show them how you love them each and every minute of every day.


Anonymous said...

You do amazing advocacy work. I think it is your calling. Congratulations on the breakthrough with the insurance company, and go get my brother-in-law well.

Ore e sempre,


Anonymous said...

They're right. Advocacy is your calling. I've never been more convinced of anything. You fight for those you consider your own, yet I see there are not many that you exclude from that definition. We've all witnesses this through your blog and I'm sure your close family and friends would agree that you make us all want to be advocates for those we love...for what we believe in...and for the various causes we champion. Your partner is blessed to have you in his corner. Keep fighting the good fight.