[ Post a Response | ENDO SUPPORT FORUM ]
Now Playing: Beautiful Times
Posted by Kristy
on 12/1/2007, 4:00 pm
Hi all,
Just wanted to drop another line because it's been a few weeks and I've been thinking about all of you and hope all is doing well.
My mom is now 6 weeks post-op and I'm trying to get her to understand that even though she's 6 weeks post-op she still nees to be careful because her body can't handle some things yet. I'm afraid though that she's going to have to learn the hard way which means that after telling her some things today (after having been out so much today, knew she was going to be completely exhausted but I also know that if she's not careful she's going to have yet another setback) I won't be saying much more about this even though I know more than she does on the issue of recovering from surgery. Just hope and pray this won't be a situation of "I told you so" and me making sure I don't say that back and then have her think that I'm disrespectful. Unfortunately this is what I get for having so many surgeries for my endo even though I would rather not have any.
As for me, I'm hanging in there as well but my fibro has been giving me a hard time as of late and part of that is because of the weather the last few weeks not being able to make up its mind on what it wants to do. The other reason is because we have had some car troubles the last couple weeks, the first part of the work was very expensive and we had to get help to get the money to get the work done.
The other thing is that I've been having the pubic pain act up a lot over the past few weeks, and last week (on the 20th of Nov) I went to the gynecologist to see if it could mean an infection going on which is possible but don't have the results of the cultures back yet. I am hoping it will come back in on Mon or Tues. I also had a discussion with my doctor about the issue of the pubic pain and these nerves acting up. Told her about a conversation I had with a doctor in NH that knows about one of the nerve branches that relate to the pudenal nerve but I was asking him about it from the issue of endo and whether he had ever seen endo on this nerve branch in addition to the other nerves I am having problems with right now. So during the course of that conversation he mentioned about going on the Zoladex long term but of course that means having other medication to prevent problems with osteoporosis.
I asked her her thought (at the request of the Pain Management doctor after I ran this by her as well) about testing the pudenal nerve branch to see how much damage was there if any even though I'm more concerned about the genitofemoral and ilioinguinal (two other nerves that run to the vulvar area) nerves. She asked me what I'm going to do with that information and as I told her it's only to find out how much damage is there (if any of course).
The end result was no don't do it and so she asked me if I wanted to try the Zoladex for two months to see if it helps quiet these nerves down which would be wonderful. So she said that she would have the office manager check to see what my insurance benefits were like and we left it at that.
I got a call on Tues of this week saying that my prescription was ready. Funny thing is that this was from a mail order pharmacy I had never heard of before, and I thought I was getting a call from my usual mail order pharmacy who has a specialty section (under my insurance Zoladex is a specialty medication) and it wasn't. The nurse I talked to tried to tell me that all BCBS plans had contracted with their pharmacy for specialty medications so I checked with my usual mail order pharmacy and their specialty section. I am able to get the medication thru there. So I then had to call yesterday to ask for a provider number for this pharmacy from this nurse who said, "I don't have a provider number" and I told her that every doctor, pharmacy, etc has a provider number. So I got that info from the billing dept (which I don't know why she couldn't have found this out herself from them). I had to ask her for this because when I called again yesterday I said, "I'm aware of what you said about the contract with BCBS in general but I said, "does this include the federal BCBS PPO plan". She said, "I don't know". I felt like saying (but didn't) "but you should know this information because you are the one calling me".
So called my insurance company with that provider number who then looked it up and nothing came up. So now on Mon I need to call the pharmacy again (back to the billing section) to see if they have an additional provider number or a State ID number to see if we can pull it up that way. Because I need to make sure once and for all that this place has contracted with my plan which if they do they should have told us by letter that this is where specialty medications have gone.
That was the other thing the nurse said, "there are so many people they don't have time for something like this" and I told her that wasn't good enough (which it's not).
Also, on Mon I need to find out why my doctor's office manager faxed this prescription to this place instead of my regular mail order because I have a feeling this is a mistake.
And also need to find out on Mon if it's true that this medication is no longer considered formulary (which means that if it were I would only have to worry about a co-pay and not the co-insurance). If this medication is no longer formulary like it used to be that means this goes to my major medical coverage which means that the money I pay out is for my co-insurance which with my particular plan is a 90/10 plan. What that means is that my part out for payment is 10% which means that the figure is going to be $37.60 for the shots one by one unless I can push to get a 90 day supply for that $37.60 which is cheaper than paying that figure for each individual shot.
I will keep you posted on how this turns out and if once I get the medication again if it will help my vulvar area and quiet those nerves down.
I hope everyone has a good weekend and in to the next week and I will talk to you all later. Probably in another couple weeks if not sooner.
(((Hugs))) to all,
Kristy 
Message Thread:
« Back to thread
Becky's Gifs
Graphics to Decorate Your Posts
Becky's page will open in a new window
Forum visitors since 12/28/2006
Graphics by Ritva's Gallery Linkware