Thursday, November 16, 2006

k Has a Difficult Day, and Requests Assistance

I sat here this morning looking at the skin peeling off my left leg.

When you have an infection, it gets warm. When you have a very serious infection, it gets hot. This one got so hot it melted the cream antibiotic I was slathering on it. Melted it like butter in a hot fry pan.

An infection that hot burns the outer skin just like a sunburn, but from within.

Now the skin is peeling off - just like a sunburn. Since the entire leg was infected from mid-thigh down, a lot of skin is coming off.

It's a sign of healing. A good thing.

But still a little disconcerting to see.

The infection started 3 1/2 weeks ago, Friday, October 20, 2006. Almost a month has passed.

I'm trying to walk a little bit again. Carefully - it's quite literally dangerous. The now-dormant germs lying around the internal scars would just love a chance to get multiplying again, and that's exactly what too much walking will do. It'll make that perfect environment for them to wake up and multiply and reinfect the foot and leg.

A few days ago, I made my way outside - slowly, agonizingly - from the front porch to the back porch. It was the first time I'd seen the side of my house, or the back yard, since the day the infection set in. Almost a month.

I saw plants I love that died because I couldn't get out and water them once the rains stopped. Other than that?

Everything was exactly as I'd left it when the ID doc's office called me back on my cell phone that Friday and said, Come in, NOW.

My wheelbarrow had some things in it and there were filled yard bags, stacked here and there, just where I'd left them. Tools outside. They'd gotten rained on.

It was like returning to the deserted scene of a tornado or car crash or something, weeks later, when no one's been there or touched anything or cleaned up the mess. Chilling. Traumatizing. The shock and the memory and the fear hit me like a kick in the gut. I couldn't breathe.

I went back inside and went to sleep again. That tiny venture left me drained and exhausted for three days.

I hardly ever get the fever and chills any more. But I'm still sleeping around 18 hours a day, partly from allergies. The pain in the foot is still intense. The shin bone is tender, and the ankle too. But the foot itself, internally scarred from the abscess in 2004, is by far the most affected by pain.

If I walk just a few steps, the pain ramps up, and lasts for hours or days.

And I still don't have a working scooter, even for home use. All I can do is sit around with my feet elevated, letting the things I need done go undone, letting my life slowly fall apart around me.

Yesterday, for the very first time, a certain realization hit me full force: If I'd had a working scooter - instead of the defective one delivered in July and never replaced - the infection would probably not have happened. The incompetence of the equipment company and the HMO is the primary cause of this terrible new infection, more permanent damage and permanently increased pain, and almost the loss of my leg.

After the infection, with a working transportable scooter, I wouldn't have been stuck here for a month, unable to go anywhere or do anything. I would not have fainted at the pain doctor's office from the strain of walking 150 feet. I would not have felt the intense pain I do every time I walk from my office chair to the kitchen or bathroom or front door.

My written complaint to the Medicare HMO about the scooter issue was finally addressed, over a week after submission. The person calling me from the complaint department had no idea I was complaining about the durable medical equipment company as well, including allegations of fraud. Even though this was included in the complaint she was supposedly reading, right in front of her.

I told her, very specifically, the name of the *good* company I wanted to provide a working scooter. They even have a provider number for BCBS. They don't have one for the particular BCBS plan I'm on.

This is because the incompetent frauds my plan uses? Well, it's the only equipment company they use.

So going *out of network* takes an act of Congress.

The complaint lady now says my primary doctors' office needs to do yet another authorization request for the scooter, specifically naming the *Good Scooter Company.* Now, she says, it's out of her hands, and in the Authorization Department. She seems to think the chances of approval are quite poor.

All right. I can't say yet that I've been turned down. But I also no longer want to wait, and was hoping to get some muscle to call that authorization department, to just encourage them to do the Right Thing.

So today, I embarked upon a series of telephone calls that left me feeling so depressed and victimized I broke down and cried.

I called the Medicare Fraud Line. Not interested. WHAT? See, the frauds billed through a Medicare HMO so Medicare itself doesn't care. I said, Could you please check to see if they're a direct Medicare supplier? (Because then Medicare maybe would care.)

But she cut me off in the middle of my sentence and hung up the phone on me.

Next, I called various agencies off a list left with me by a social worker who'd come to visit. I called one after the other: agencies to help disabled people, agencies for poor people, legal aid, the State of Florida. A whole page of phone numbers.

I did leave a couple messages. So I can't say that every single one was of no help. Not yet.

Just every single one I talked to.

The ones I did speak with?: --Not our jurisdiction...we only do spina bifida...we only appeal denial of services...that's federal not state...

You see, I fall through the cracks because it's a Medicare HMO. The state HMO helpers say it's federal. But the feds, Medicare, won't help because it's an HMO instead of direct Medicare.

Two of our local TV stations have these *help* programs. One, WSVN-TV (Fox), you can call and complain about a company or so forth screwing you, and they'll maybe pick your case out of all the many others and try to get it resolved. *Help Me Howard,* it's called. Ol' Howard's a lawyer. I left a message.

The other one is *Magnum's Force.* Diane Magnum is one of the news anchors, married to some famous race car driver. She and WPLG-TV (ABC) started this charity-type program where they help poor people who just need a decent wheelchair, or the roof fixed, so forth. They put you on the news, all public and - please excuse me, but it's true - syrupy and sappy.

The thought of either calling attention to my situation in public in any way, or even talking to any charity for something like this - a truly necessary medical service for which I paid years and years and years of both Medicare and insurance premiums - makes me cringe with humiliation. I left a message.

I also called a malpractice attorney. They referred me on to the Biggest Baddest Nastiest Malpractice Lawyers in Broward County. Why? Because one particular doctor's screwups in 2004 meant the foot scarred far more than it ever needed to. The result has been years of pain and fear and new infections and permanent inability to walk the way I could have without the screwups. I will not walk much, or be free of intense pain, ever again till the day I die.

In 2004, I let it slide. I was far too sick for far too long to want to do anything, and frankly, I really dislike fights. People make mistakes; we aren't perfect. Even the string of serious and stupid mistakes this particular doctor made...well, he's human too.

But in the back of my mind has always been the knowledge that if someone doesn't blow the whistle on this doctor, he may well kill an innocent child at some point. Not filing against him has left me with a burden of guilt. Put that together with his direct contribution to me almost losing the entire leg this time? No more. No more. I won't let him go any more.

I'll call those lawyers when I'm calmed down. Maybe the meter has run and the statute of limitations has passed. Maybe not. They can tell me if there's anything we can do.

And if I can't find anyone at the federal level who cares about those incompetent medical equipment frauds? I bet I can at some of these: the Better Business Bureau, the State of Florida Consumer Help Line, Florida Department of Professional Regulation...

The State of Florida has famously terrible DCF and Medicaid services, but their *regular* consumer-type help is excellent. In fact, it was a Florida HMO complaint taker who - after explaining she couldn't help, it was Federal - actually put me on hold to research some things for me. She was even fast. She said that even before I'm actually denied the *good* scooter company by my HMO, I have this right: if my health is endangered by the problem forming the basis of my complaint, they must respond in 72 hours. It's already been 10 days. Got 'em.

Now that is consumer service. Nothing actually *required* her to do that. She did it because it was the right thing to do.

She also asked what Medicare said about the fraud. I told her: not interested, because it was a Medicare HMO, not a direct supplier to Medicare. Ah. Jurisdiction, she understands. So. Did I tell the HMO about the fraud? --Sure, many times. I even verified the supplier was fraudulently billing for a working scooter. --Good! What did the HMO say? --Nothing. Not interested. They just don't care at all. In fact they seem to wish I wouldn't mention it.

I'll get back to *work* on all this after I go to Sam's and Penn Dutch and Walmart. I'm sure my tiny amount of shopping will do me in for the day. So what. I'll sleep and wake up and start again.

It helps that this time kmom will drive me. We are very independent people, and asking my mother for this help was an emotionally awful thing to do. She'll drop me at the doors of the stores so I don't have to walk from the parking lot to the store scooter and kill my foot again.

Because doing that is what led to this most recent infection in the first place. Walking when it's not safe to do so. Walking, because I've never had a wheelchair or scooter for my car, and the scooter at home has been broken for a year, and they incorrectly said I'd have to pay $500 to fix it. And then did nothing to replace the defective one delivered this July, despite hours of calls and two formal telephone complaints with the HMO.

My complicity in this was in not standing up for myself better. But I think you can see, I did try. Oh, I tried and tried. Now I have to tap into my own vein of ruthlessness and not stop until this is completed. They aren't just hurting me here, they're hurting others too, that's how it works. Then they make it so hard to remedy, the vast majority of people truly damaged by these incompetent HMO's and fraudulent suppliers just give up. They break down in tears and depression like I did today and simply can't face it any more.

I have it in me to take it to the wall. I used to do this sort of thing as part of my profession. I can do it for myself today. I'm exhausted and weak but I'm not entirely bedridden. I can talk on the phone and surf and email and write complaints.

The name of the incompetent HMO is Blue Cross Blue Shield Health Options Medicare and More. The name of the incompetent frauds, the equipment company, is Central Medical Equipment Rentals. I'll be surfing up any info I can on Central Medical. If anyone out there knows anything about either of these outfits that might help me, or has any suggestions where else I might turn for redress and to stop the frauds, let me know. Those people need to be put out of business.

Will my primary doctor back me up on any of this? I don't know. I was supposed to see him this Friday, and wanted to talk about it then. I had to call to cancel, though. I have no way to get from the parking lot to his office, way down a long outdoor corridor on the second floor.

20 comments:

Cindi said...

I am nearly speechless after reading this, k. It really pisses me off how anyone could turn a deaf ear to your plight. I am hopeful and think you are going in the right direction re. the malpractice attorney.

I don't know what kind of relationship you have with your mother but I hope that your apprehension about asking her for help is misguided. I am glad she will be able to take you to the store. I wish I lived near you because I would be there in a heartbeat to help you.

Just curious, but how much does a scooter cost?

Mickysolo said...

I'm more than concerned about your leg. I thought it was in better shape before I read this post. Your anger toward Blue Cross and Medicare is warranted, but your greatest efforts and thought should be directed at your health. I wish you were closer so we could help out. Has your doctor considered IV antibiotics? When my leg gets really hot, IV is the only treatment that works.

Last Friday the last scab fell off my leg, and I was cleared for swimming. That was also the day I took my last antibiotic pill. Monday was my first time back to water aerobics. I came home and put my leg up. I'm frightened of re-occurrence. Your post also frightens me about Medicare. I go on in January. I'm told Medicare will be my Primary and my wife's insurance, a good plan through Georgia, will be my Secondary.

Livey said...

I should be home by 5 (my time) tonight. If I forget to call you by 6 (my time) call me. Together we will get this shit straightened out first thing tomorrow morning. I promise!

For today, rest. Love ya!

prettylady said...

Now I have to tap into my own vein of ruthlessness and not stop until this is completed.

Rah. Rah. Rah. Rah.

Michael, at this point, I believe siccing the dogs of war on the HMO, the scooter company, and the doctor IS directing effort toward k's health. This situation is shameful. Nobody should have to go through this. The entire health system in Florida is a disgraceful racket; the system has evolved to prey upon elderly persons with health insurance, not help them.

A friend of a friend was grievously wounded in a horrific car accident in Florida. Her husband was killed; there is a possibility he would not have died, if not for the substandard care he received. In addition, the driver who hit them, driving with murderous recklessness, was never even ticketed. My friend's friend nearly died as well, and received no compassionate or even intelligent assistance by 'healthcare' personnel, whatsoever. My friend had to fly out from three states away to take care of her.

Rah. Rah. Rah. Rah. I will do my best to garner support for your struggle, little as that is.

GUYK said...

I am sorry K. HMOs are bad when they are at there best and some such as yours is just terrible. However, you have gone to the right chanals. Airing the fraud and incompetence on TV and a law suit generally gets their attention. Although it may be too late to get you much satisfaction it might help others in the futrure from getting scammed by any HMO

Livey said...

OH OH OH Tell me if this is the same company: http://www.caremedicalequipment.com/company.htm
cuz if it is, I'm so calling them and telling them that I will call the airlines and WDW (whoever the hell they are!) and Universal resorts and theme parks to tell them what a shitty company they are if they don't deliver you a brand new fucking scooter by the end of the day!

Jean said...

oh, k... I so hope this gets resolved quickly for you. Wish I had advice or anything besides just heartfelt wishes for you.
Good luck with the lawyers!

Desert Cat said...

The AOL fraudsters went down. Here's to these scumbags going down in a blaze of glory!

It's the "in the mean time" that concerns me. You may ultimately get justice, but for how long will you have to wait, immobile?

Just what does a good working scooter cost anyway?

Desert Cat said...

Brainstorming with Daisycat (who sees this kind of thing frequently when people sell out their Medicare to an HMO), She suggests maybe Salvation Army has low cost used scooters? Again it's not perfect because it's out of pocket and not being paid by the people who should pay, but it's the "mean time" thing I'm thinking.

Desert Cat said...

Just for reference, what is the manufacturer and model of the defective scooter?

k said...

Cindi, my mom is a very nice lady. Lucky, huh? It's not her, it's me. Some people find it next to impossible to ask for help, even from their own family. I'm one of them. But...I did it.

Michael - oh, you know that fear. The question of the IV vs. oral antibiotics gets complicated, just like if it's outpatient vs. inpatient, IV vs. pic line, all that. You know the drill. My ID doc is fabulous, and she's also well grounded in immunology, which really helps because of the extreme allergies and all the autoimmune disorders I have. IV antibiotics for me aren't good because of the danger of spreading more CA-MRSA through the injection site, and also because if I suddenly sensitize (become allergic) to that antibiotic, if it's IV, there's a much higher danger of instant fatality. If it's oral, there's more time to fight off the allergic reaction.

This time, I skated. I was very close to going to the hospital that Saturday night, when the hot red flashed up all the way above my knee. It wasn't a surface infection or even a deep boil or isolated area of cellulits - it was the entire leg, toes to thigh, all skin, all muscle, and the external part of the bones. The entire leg, through and through, was infected. Very serious, that, very high risk of septicemia. No scabs because it was all internal tissue. That's why it's such a long recovery. It just tears one's whole body to pieces to fight off a raging infection like that. It drains you of all your physical resources.

Medicare...yikes. It ain't pretty. You are VERY lucky to have a backup insurance plan, that will help. I have to change my Medicare HMO and/or rx plan before Dec. 31. I don't even want to THINK about it yet. But...I've already started investigating. I'll be posting on it soon.

Pretty Lady, I hadn't known about your friend. I am so ashamed of what happens here sometimes. The inhuman coldness we see too often down here, they say it's because there are so many *transplants* that people don't build a sense of community. There's definitely some truth to that.

Believe me, your support is not a small thing.

Guyk - HA! The good ol' embarrassment and legal factors can sure do wonders. Suddenly they find they really CAN cut through red tape, gee, it's not IMPOSSIBLE after all! Knowing there are others who can maybe get some benefit, however small, from me yelling and hollering really helps keep me going. If it's just yourself, sometimes, it's more tempting to let it go. And really, that's not right, not just for yourself but because it makes the bad guys think they can always get away with their BS. So then they keep on hurting people.

Livey, you just crack me up! No, it's not them. For now, I have some calls to make tomorrow. You're on the top of my Big Guns list, and if those calls and things need to be made, you'll be the first to know. My only regret would be not being able to watch you in action, since you're all the way out in the Frozen Tundra.

Jean, believe me, your good wishes help more than you probably realize. Serious business.

DC, excellent points. I'm going to be...pondering them. (scuse please Jean! ;-)) I have some research to do tomorrow. Costs and such are on top of the list.

Yes, the *meantime* issue is where I fell down on the job. And what I'm making #1 priority now. Tomorrow and Monday will be interesting days.

Sassy Sistah said...

JUST DAMN, k. I'm so sorry - what you're going through is terrible. I wish I could do something to help. I wish you were just down the road and I could come over there and DO something - cause I totally would. If you know of ANYTHING I could do "long distance" let me know. In the meantime, I'm thinking of you, sweetheart. And mad as hell ON your behalf.

k said...

Miss Sassy, Happy Friday! Now if you DID live down the road, you'd still have a messed up back and some dumb rednecks tearing up that road in between! Right now your back is scaring me a lot worse than this scooter thing. This is not a new issue really, and one way or another, it'll get resolved. Then the fun part begins. Ya know. The calm and quiet revenge, appropriate to the harm caused. The kind of revenge that's my own personal favorite. And like all forms of revenge, it's one I virtually never use.

But your back is this new thing and they haven't pinpointed what's wrong with it yet. And, you're thrown into HMO Hell in a way that I think is new for you too. Getting your gall bladder out is bad enough. Dealing with a chronic and very painful condition, where they aren't sure what's causing it, don't know how to fix it, and anyway none of the most likely options aren't that good? Honey, I feel for you. The place you're in right now is a very, very hard one. It will get better for you over time, but right how, I'd rather be in these...shoes, so to speak, than yours.

A lot of folks I *talk* to on the internet have really serious health problems, and you know what? On the one hand it's like we're all the blind leading the blind. On the other? We all are sort of forced to learn health things that the others may or may not know, and it turns out all this shared info is really, really useful.

Not to mention the mutual cryin' shoulders and atta boy/atta girls and warm fuzzies and funny PO'd rants, and all. See? You just DID do something long-distance: you're a part of that. Of the spirit that makes me feel like I can get up in the morning and do it again. HA! You should see Livey with her damn 24" chainsaw!
http://northwoodswoman.blogspot.com/

Y'all come on by any time. If you like a good scooter war? It's gonna get even more interesting as we go on. That, I gar-on-tee.

GUYK said...

Ha! You've never seen me with my 24" chainsaw! Maybe I'll take a pic and post it.

livey42 said...

Shit I gotta get outta this guyk thing!

Livey said...
This comment has been removed by a blog administrator.
marilynguilford said...

I'm so sorry to hear of your problems. They sound a little familiar to me. I had hip surgery and because of a careless doctor and a filthy hospital, I got an infection called MRSA. I have had 4 total hips and spent nearly nine months in the hospital. I do have a scooter, compliments of the West Haven Vet. Hospital. I think the price tag was $700.00. When the doctors or the hospital send mee a bill, I send them a bill for the time that was taken from me while I had the infection. They do not think it's funny. Screw them. Youu should check with the scooter company, sometimes they have turnins that still work fine. Well, I gotta go, I'm gonna set up my own blog. Keep in touch. I wish you well. MRSA-MITH

k said...

Marilyn Guilford, welcome. MRSA is exactly what caused the recent infection in my left leg, and ongoing other infections as well.

Your situation is a horror story. It sounds at least like you're out of the hospital now, and out and about. I'm sure you're well aware that you're lucky to survive. I commend your strength and courage.

Please let us know your blog address once you're set up. One reason I started this blog was to help with whatever daily-life info I can provide for other people with similar conditions.

So come on by any time, and let us know when *your house* is open too.

Morris said...

K, I've landed here via Pretty Lady's blog, and learned of your plight. It leaves me horrified that these companies can be so lacking in any natural compassion. There's little I can do but add a little to your chest (and I indeed hope it becomes a war chest), and offer my sympathy. Unfortunately our health systems here in Australia are fast heading the way of the USAs. I'll be back to see how the fight is coming along and to offer encouragement.

k said...

Morris, thank you so much. I'm sorry to hear this is happening over there, too. Australians are so well-loved by Americans because of their kindness and respect for women and very funny humor and that steady refusal to take themselves too seriously. We could use some more of that here, too.

Oh! And before I forget - y'all KNOW how to appreciate great food, too. Like onions.

This is not just a health blog, here, so be prepared for things like flower pix, and bugs - I love bugs - and hurricanes, bricklaying, stuff like that. I have lots of fun in my life, but it isn't always the sort that others go for. But that's fine by me. I'm real big on *whatever works for you,* right? To each her own!

Thank you for coming by.