April chit-chat

[flatcap]

I have lately been thinking about what I would call the 20-Minute Limit for office visits with providers. On the one hand, it seems to be driven by Medicare and the insurance companies. On the other, it seems to be driven by providers who squeeze as may patients as they can into a single day to make more money. Maybe it's both.

In many cases, I think office visits need to be at least 30 minutes. In others, it's more like an hour as far as I am concerned. I have more than once thought this issue could be addressed by having a follow-up appointment a very short time after the first visit, but I haven't yet asked if this could be done. My impression is they are reluctant to schedule that way, probably for insurance issues. I don't know whether they would cover longer office visits.

I can't say how many times this has come up, but it's been a lot. I wish things were different. I keep written lists of issues I feel should be addressed in office visits, but it is rare I get though all of them. The unaddressed issues are put off to the next visit or the one after that — or the one after that, ad nauseum.

I don't know what can be done about this, if anything. I just wish something could be done by someone. I think many times the patient needs more time with their providers. I wish something could be done because I almost constantly worry about my PCP missing something that could be helped, if only we caught it at an office visit before it is too late. Twenty minutes isn't always enough time.

[flatcap]

flatcap, I translated mainly from Russian to English. Once in a while I did something from French or German into English.I'm not very adept at speaking any of these languages but I can translate documents. I'm not Russian but decided to major in it.

That's an impressive list of languages, agate.

Except for Spanish, I haven't had much exposure to other languages. I took it for three years in high school, and in my senior year became the teacher's assistant. I had aced the subject in my classwork. I wrote tests for the students and did things like that when I was the assistant.

The only problem I had with my Spanish classes was we never got much instruction in the conjugation of verbs. We were only taught the present tense in nearly all cases. Instead, we were taught the meaning of lot of verbs, more than we would have otherwise learned. I still remember some Spanish verbs but a lot fewer than nouns.

I used to be able to read Spanish fairly well, but I was never fluent. I never could understand what people who were native or accomplished speakers were saying. They spoke too fast for me. I wish I could relearn the language, but I doubt that will ever happen. I am too old, and I couldn't find someone to teach me if I tried.

I have thought of trying one of the various other ways to learn Spanish, such as online classes, but I would need a real-life teacher. That or someone else to prop me up all the time. I doubt I will ever meet such a person at this point. It's too bad because Spanish is a lovely language, and it is becoming more relevant in this counrty with each passing day.

[Virginia]

I had to come on tonight to see what I wrote last night and how many mistakes I made. I am usually on my tablet when I come on here and it is more difficult for me and I am slower on it than the computer, but I just have to sit where I can relax a little after I have had a frustrating day. My middle brother and his wife got a few groceries over yesterday.

The rest of the day was spent on making phone calls. Many I couldn't get the information I needed and some were long and rambling. A couple the people speaking didn't speak good English and I would ask them to slow down and try to speak plainly. One girl would for about a minute, then she going real fast again.

Still I got a few things accomplished. Today I started all over and called as many as I could. I am put on wait for very lengthy period of times. I did get social security today after over an hour wait. The lady I talked to was so nice and tried to be helpful, but she had to give me the name and telephone number of another agency. I am going to try to get them tomorrow. I haven't been able to get my house secured yet. I called the N.C. State Attorney General's office yesterday, but the lady I spoke to couldn't help me.

So when night comes I am tired. I am keeping records of where I call and telephone numbers and what they say. I will start again tomorrow.

Glad to see Flatcap and Agate carrying on. There is much I could add to what happened along the road to getting a diagnosis. One thing is the PCP I had for 25 years did cause me harm. Almost everything he saw me for was something that indicated I had a neurological problem. If I had had even a thought that I had MS I would not have remarried for that short 3 years and lost my insurance that I didn't have to pay for. All drugs no matter how expensive they are still cost $3.00
Per rx or $9.00 for 3 months. You can get it at regular pharmacy or for $.00 if you want to go to any military base.

The other thing is had we had a clue we would have done different things about finances. So it cost me a lot. The one good thing was my husband didn't have to die knowing I had this disease.

[agate]

Thank you for the compliment, flatcap. I do dabble in languages, and if you want to try Duolingo, it's free and is a way to get some practice in a language. I'm not sure it's a great way to learn a language but I've been trying there for over a year now, and they do try to prop you up but it's not a real person doing the propping.

Virginia, I know how frustrating having phone calls to make can be. I keep putting mine off nowadays and almost dreading any calls that I know are going to involve waiting for a callback or being put on hold or having to deal with someone I can't understand. It's not just people with unusual accents. It's also the way some people's phone connection seems to be bad somehow, with too much background noise or a sort of echo coming through.

Maybe it's my hearing aids.

Today I didn't get around to calling an audiology place because I am getting so reluctant to make phone calls. Instead I poked around on some Websites and on Yelp, trying to find a different hearing aid place because I think I'm going to have to change.

This will be the fourth hearing aid center I've been since moving here 14 years ago. With this one I'll be leaving, and with at least two of the others, I'm changing providers because the vans just can't find me. The buildings just aren't set up for people waiting for paratransit vans.

Looking for a new audiologist involved finding photos of each place and trying to figure out whether a van could manage the situation, then finding out about insurance coverage, hours, and the qualifications of the staff. I may have found a place but just couldn't bring myself to call. Instead I left a message through Yelp.

I really liked the people at the place I've been going to for about 6 years now, but they're probably not going to move to another location (I'm going to ask though, just in case). They're situated ideally for them, right in the middle of a vast retirement complex where there must be many people needing hearing aids and glad to have an audiologist so nearby.

-- I guess Ikoiko hasn't found her way back yet, or have I missed something?

[flatcap]

That's funny, Virginia. I go over and over what I have written to see if I have made any mistakes, but it seems I never catch them all before it is too late to do any editing.

I am not much for speaking on the phone. I'm not at all used to doing it anymore and just about always feel awkward when I do. And it's gall darn hard to understand them dang foreigners. LOL

Talking on the phone with the agencies can be especially frustrating. Long wait times, and you often get someone who isn't much motivated toward helping people. You wonder why they took the job in the first place. Still, you get some good ones sometimes. I think it was the last time I spoke with anyone at Social Security when a very nice lady got on the phone with me. She called me "Mr. David" a few times, which I thought was very sweet. She had a really nice voice, and she was very helpful. I would have liked to have met her in person.

I hope you can get your house secured. I guess it makes sense, but I never would have thought identity thieves can come after your house. I makes me angry when I hear of those people. And it makes me really mad that you are being victimized. I start thinking about what I would like to do to them.

I wish I had spent some time thinking about my financial future when I was young, but I pretty much spent none. All I spent was my money. I didn't even think about my pension until I was talking with the nice lady at the Benefits Department just as I was leaving the workforce. She told me my pension would still grow as if I were still working until I turn 65 because I am on disability. I thought, 'Well, that's great, but I don't really know what that means because I don't know squat about finances.' I didn't find out until a few years ago when I started worrying about what would happen when my disability insurance runs out when I turn 65. I was relieved when I found out that I will not be going to be broke. My income will actually increase some. My income will still be fixed, though, so now I worry about the future beyond that. I have some savings now but not very much.

The rent here is going up fast. I don't think I will be able to afford paying it for more than about five more years until I will have to move to a cheaper place. I don't look forward to that at all. My income will still be too high to get into subsidized housing, so I will have to go out there and live around who knows what. The place I am in now is for people over 55, and it is safe and quiet. I like it here and would rather spend the rest of my life where I am now.


Agate, I hope you can get your audiology issues worked out and you come out of it all with better hearing aids. I think about going in myself sometimes. After quitting aspirin, my ears still ring almost all the time. They are ringing right now but not too badly. When it's going strong, I have a lot of trouble hearing voices if there is any background noise.

Ikoiko has evidently not found this place since the recent changes. That's sad. I hope it one day occurs to her to google it, but it wouldn't surprise me if she just thought this forum had finally gone away for good. She apparently didn't receive the email saying we are all still here.

Like you, I am always on the lookout for new members and try to reply to them even if I know nothing about their condition. I figure that even I just say, "Hi", it might entice them to stick around. I also tell them that our MS forum is the most active here and encourage them participate with us. I tell them about our chit-chat threads and the others that pop up that aren't really MS-related. I tell them they are free to join with us in conversation. That worked with Prot. He has posted here a few times.

Two things I do almost every time I am here are checking both New Posts and Who's Online before I log out. In the case of the former, it sometimes seems it isn't working very well, so I will go the main forum and scan it for new posts. In the case of the latter, I am not only looking for new members but also for people who in the past were pretty quiet — people like Ikoiko.

[flatcap]

Meet Lynxsissie.

I found Lynxsissie in 2016 wandering around in heavy traffic. I immediately stopped and picked her up. It was about 100° outside, so I took her home, but she wouldn't drink any water.

Not knowing what to do, I kind of freaked out and called the pet store, They told me little kittens don't drink water. They said I should come down and pick up some formula, so I did. I had to bottle-feed her, but it was a lot of fun.

I was able to get an appointment for her, so I took her to the vet the same day to be checked out. The vet estimated her age at 4 weeks, said she was OK, and told me I was doing the right thing. She was very clearly a stray. No mama cat was with her when I found her and there wasn't one anywhere around to be seen. It was a very busy road on which I found her, and it was a very busy business district.

I took her home again, but then my cat kind of freaked out. He was a gentle soul. His name was Bilbo.

So, I put Lynxsissie in Bilbo's carrier (it was quite large) and put it up on the island in my kitchen. I gave her some formula, and she promptly went to sleep.

When she was coming off her formula, I started giving her small dishes of crushed dry cat food mixed with it. By then, she was more than ready to eat that. She loved it. She also started drinking straight water.

One time, I took her downstairs to the community room in our building so a very nice lady who lived here could bottle-feed Lynxsissie. She just about cried. So did I.

As time rolled on, I tried to get Bilbo and Lynxsissie together, but he wouldn't have it. He never attacked her. He would just run and hide and wouldn't come out. She would just roll around and play with me, then back to the carrier.

I didn't think that was fair, and I couldn't afford to take care of her properly long-term, so I went to the same pet store where they weekly host a rescue group. I asked them if they would take her for adoption and started weeping. I couldn't help it. They agreed to take her and didn't even charge me for it. They had me drop her off at the vet's the next day to be spayed, and I never saw her again. The rescue group came and picked her up from the vet's.

I wish I had a better picture of Lynxsissie, but I have only the one below.

I miss Lynxsissie soooo much. Writing this has made me cry. I am crying right now, so if this sounds mixed up, that is why.

Man, I need friend. Badly.


Lynxsissie

[agate]

What a touching story! Congratulations on being so devoted to Bilbo that you gave up Lynxsissie, whose life you had saved. That must have been terribly difficult.

I can understand that decision completely, and the chances are that she found a home. Kittens tend to find homes. Older cats are more of a problem. I've had a few cats and know how bad things can get when two cats in the same household just can't tolerate each other. If you don't have much space, it can be an impossible situation.

Bilbo is in the past tense? Did you lose Bilbo later on? Have you thought about getting another cat or kitten? It sounds as if that might be a very good idea...

[flatcap]

Bilbo passed away from digestive track cancer a few years ago. The vet said he was probably 16. I adopted him from the Humane Society when he was an adult, so we didn't know exactly how old he was. When I was there at the Humane Society, I told them I wanted the cat who had been there the longest. They gave me Bilbo. I gave them twice their adoption fee and took him home.

I think about getting another cat sometimes, but I'm not sure I could do a very good job of taking care of him or her. It costs a lot to have a pet, and I have to be free of them. It would be a strain on my budget, and having to move sometime in the future could mean I might not be allowed to have a pet. A lot of places won't let you have a pet, so having one limits your choices. Reason #2 or #3 why I wish I had bought a house. My choices wouldn't be so limited.

But you can bet I think about getting another cat. Telling Lynxsissie's story has made me think again I just might do that. It is one thing to be alone. It is quite another to be lonely.

I am lonely. Very lonely.

I should just do it. I think I might be able to afford it, and I certainly will be able to once my pension begins rolling in later this year. Things would probably go great for both of us.

I will let you guys know if I get another cat. He or she will be an older one if I do. Senior cats need homes, too. Everyone wants a kitty.

Meatime, I have no doubt that Lynxsissie found a new home. I just hope it is a good one.

Cats. They are the only pets for me.


In memory of Bilbo, the coolest black cat who ever lived.




Incognito Mode (lol)

[Virginia]

Flatcap, I would love to know you have another cat. You would then be our new "cat daddy". Bilbo was a very lucky cat. I know you miss him terribly. Our pets are family as much as anyone else in the family is. That was the way it was with my dog and my brothers are the same way about their dogs. When my husband died my dog was there for me to talk to, but she was also grieving. They truly do have feelings and are so loyal. They love us unconditionally and that is something you don't find very often. I cannot have another dog because they have to be walked in this community and I can't do that. I knew I would never sell the house I was in as long as my dog was alive. We had a very big back yard and we had most all of it fenced in just for her. She was a rescue and we tried to make her happy.

I do wish you enjoyed reading. It has been a true life saver for me. Unless one of my brothers call I sometime go for days without speaking to anyone. I get lost in my books and it really passes the day.

Today was another frustrating day on the phone. I just don't feel like I am getting anything done, at least not what I want done. Maybe it can't be done.

[flatcap]

Virginia, you are so right about our dogs and cats loving us unconditionally. My cats were always family to me. They are definitely sentient beings.

I had an interesting day too on the phone. My neuro is trying to make be pay a bill I don't owe. They are trying to make me pay more than the Medicare-allowed limit on the copay. That just won't happen.

I tried repeatedly and couldn't get the lady to call me back. I called several times and only got her voicemail. She is not returning my messages, so I called the front desk and told them she wasn't calling me back. I also told them they could tell her I wasn't going to pay the bill. I was shaking when I was talking with them and raised my voice more than I should have.

[agate]

flatcap, many housing situations will allow a house cat, I've found. This building I'm in allows any cat (one to an apartment) or even a small dog, with some exceptions on dog size if the dog is a service or companion dog.

Many privately owned apartment buildings probably aren't that tolerant of pets but in my experience a house cat has often been OK.

Bilbo and Lynxsissie both look like real winners to me. I'm so sorry you lost Bilbo and had to give Lynxsissie up.

I used to talk to my cat a lot.The cat was a great companion. All of my cats were, each in a different way. Some were always weaving in and out around my ankles, not so good if you have balance problems, but at least one of them never did that trick at all.

[Virginia]

Flatcap, I don't know what kind of insurance you have, but I didn't think they could ask for more than the Medicare allowed amount. I have United Health Care as my supplement and if they don't pick up the portion that Medicare doesn't pay then they don't bill me. Only one time that I can remember did I pay anything. I wanted my vitamin D level checked and signed that if Medicare didn't pay for it I would. That has been many years ago and I don't think Medicare was approving vitamin D checks but so often back then. I had not waited the required period of time. I was fine with it because I had been advised it could happen and signed taking responsibility.

Do you normally have any copayments when you go to the doctor?

[Mike Weins]

Hi folks

Flatcap have you checked your local animal rescues/adoption centers to see if they do fostering long term for senior cats. The rescue I worked with in Ca would do what essentially amounted to permanent fosters for folks that were wiling to foster senior pets or pets with special needs. Most foster scenarios pay for food and vet visits/bills/meds and most would be able to provide a litter box. Now depending on funds they may or may not be able to pay for litter.

[flatcap]

Hi, Mike.

Thanks for the tips. I will look into those approaches. I would really like to have a cat.


Virginia,

I have a former-employer-sponsored Medicare supplement. It is sort of a hybrid policy: It covers medical, Rx, and vision. However, I am somewhat restricted to local networks.

My medical insurer (Anthem) is part of Blue Cross/Blue Shield (BCBS), so pretty much everyone across the state accepts it.

Anthem doesn't pay anything until I have met the deductible (I believe the deductible is $400). Then, office visits cost me $25. If the amount I owe after Medicare is less than $25, then I pay that amount to the provider. For example, $14.02, which I just made up. Specialist visits cost a bit more than $25. I think it is $35, but I'm not sure.

The same goes for all other services. For example an MRI. Let's say the amount I owe after Medicare is $542.73. Then, my supplement picks up the cost, minus the copay. The copays are not large.

Or at least that is how I think it works. Sometimes, I don't know what is going on. I only know I have never been stuck with a large bill. Except once for an MRI, that is. Then, magically, it all worked out as expected in the end. All I had to pay was a small copay.

My supplement also includes Rx and vision: Caremark for Rx, and VSP for vision. I am restricted to a local network for vision. For Rx, Caremark has mail order for maintenance meds. For everything else, I can use any pharmacy I want, whether it is in my local area or not.

I should also mention that the Rx coverage is pretty good. For example, if I were on a DMT, my cost would be only $85/month. If I were on Medicare Advantage, it would be 33% or more of the full cost of the medication.

Technically, all of the above are separate policies — Medical, Rx, and vision — but they are all rolled into the premium I pay for my supplement. If I stop paying the premium, they all go away at once, and I can never re-enroll. I would have to go on Medicare Advantage or Medigap + Part D. In both cases, I would have to buy vision coverage.

I also have a separate dental policy through my former employer in addition to the supplement, but it is not expensive. I can still keep that if I ever go on Medigap or Medicare Advantage, or just original Medicare.

As for what Medicare pays, you are right (or at least I think you are). If the provider accepts Medicare, then the provider can't charge more than the Medicare-allowed amount. It doesn't matter what the provider normally charges private insurance. They are only entitled to the Medicare-allowed amount.

I carry my supplement because it is the best I can afford. In terms of major medical bills, I had a surgery a couple of years ago to remove what proved to be a rare benign tumor on the calf of my leg. All I paid in the end was $57.55: $50 dollars to the hospital (the copay) and $7.55 to the anesthesiologist (also a copay). I had already met the Anthem deductible that year.

If another similar situation arises, I hope my supplement works as well as it did for my surgery.

Wish me luck. It's about all one can hope for sometimes.

[Virginia]

In dealing with anything to do with doctors, pharmacies, dentist or hospitals I wish you lots of luck. It can be tedious to say the least. Just try to stay calm. Oh! listen to who is talking now. LOL I have lost my cool so many times on the phone during the past two weeks. I am constantly telling myself not to have a heart attack. So, while we are dealing with different types of situations, they are both stressful.

Whatever you do don't give up that employer health coverage until you have to. I know you are paying for it, but it is probably cheaper than you can get any place else for the amount of coverage you have.

I do not have dental insurance and really wish I did have. The only reason I don't is because the dentist I have been going to, or at least the office, has their own dental insurance and when I looked at it I felt that they were charging too much for what they covered. I would go to another dentist but I started going where I am when I first came back to Raleigh in the 70s. I just adored the dentist that was there then. He was diagnosed with MS. I would have left then, but I wasn't sure what his arrangement with the new dentist was financially and also he would look at the books and when I was coming in he would try to be there and talk to me until he was unable to be. Then I stayed with the second dentist until he mostly is retired now. His son-in-law took over the practice, so I am still there.

Speaking of the above, I have two fillings which have broken off. I have an appointment at the end of the month to get them fixed. I am expecting a whopping bill and I am trying to brace myself.

I really hope you take Mike's advice and foster an older cat. On our Nextdoor Neighbor site there are lots of people who foster both cats and dogs. They seem to enjoy doing it and often post pictures of them. The animals get a loving home and they get companionship.

I think it is time to do a little reading and get to bed. I will see all you tomorrow.