Living In My Own Dark Comedy

Lucy sorry to hear things are so awful for you. Can you change from the HMO you are on over to perhaps a PPO thru your employer? I know many times this can only be done at a certain time of the year. Is this dr the only one on your plan, the PM dr? One thing I learned about managed care years ago when it first was started was to never get on an HMO plan. We always had to pay a higher premium to be on the PPO, but it was always well worth it, they were not near as controlling as the HMO and the dr selection was much greater.

I hope you can get something done soon. Take care.

Maybe you can find a PM outside your plan. Most doctors offer a cash discount. My PM charges $110 under Blue Cross and I know he offers a reduced rate for cash patients. So, you might have to pay close $100 for an office visit, but if you only need to see the PM every three months or so for your refills, the total annual cost would be around $400. I assume you're probably paying a few hundred in co-pays with your HMO and ER visits are probably costing you money too. I am guessing, but $25 co-pays for office visits and $100 for ER visits? If so, then 4 office visits + 3 ER visits = $400.

Even if my numbers are wrong, it sounds like you need to step outside your HMO and just find a real PM. You might ask the ER doctors you've seen to give you a list of names. The ER Doc may also be willing to formally refer you? Alternately, have a look at ratemds.com. This and other sites can help you find a sutaible PM in your area.

You can keep your HMO for its drug benefits, etc. but if there is a real PM in your area whose office charges are reasonable, then you can get the help you need outside of your HMO. I assume that your HMO does not prohibit you from seeing doctors outside the HMO and hopefully they will cover prescriptions written by a non-HMO doctor (something you need to check).

When I had an HMO, I gave up and went to a few outside the plan, but I don't recall whether there was an issue with prescriptions.

It is not a fair solution, since you do have insurance, but it may be a practical solution both with regards to your unmet medical needs and maybe financially as well.

Oh Lucy, I'm sorry things are so bad for you still. Is a different doctor an issue? Next time you are forced to go to the ER, can they do anything about referring you to another pain management centre or GI?

Thinking of you.

Laura

Hello Lucy,

I've been keeping a check on you, although I haven't been posting much for a while.

I wanted to give you a word of encouragement and some well wishes.  I can't even imagine what you must be going through right now.  I know it is scary to get into a new Dr search.  I had to do that on a different kind of Dr lately and was so stressed at the first apt that my BP was "at stroke level" and my BP meds usually keep it low.  It's so hard to go in to any new Dr and tell them who we are (CP) and what meds we have taken (or are taking) because of the judgement.  In your case, however, you are going through too much for one person to deal with and it's wrong to continue suffering.

Have you considered a physiciatrist?  Ok, so that is a "crazy" question to some....but my psychatrist can prescribe and does prescribe for patients in chronic pain.  It's at least a start.

All my best to you!

Thanks for all the suggestions, I've actually done everything I can do to advocate for myself in a HMO--not easy when you're weak and not feeling well.  I did talk to my latest GI yesterday and I heard some "fantastic " news; if I lose 10 more pounds, MD wants to put a feeding tube through my nose to bypass the stomach b/c stomach is not working properly; the BEST part is that I will have to go to work with this thing in my nose, taped--I already am sick of explaining things to my coworkers, can you imagine all the attention I will get with that? A friend suggessted I should just get a button made that says, "Feeding tube, don't ask" with an arrow pointed to my nose.

All this without pain relief.  It's so bizarre now that I can't stop laughing or won't because I'm afraid if I cry I wont be able to stop (crying that is).