Archive for January, 2008

ups and downs

Posted in Cancer Life on January 28, 2008 by lawler

As many of you probably know, I had a follow up with Dr. Arbaje today. I wasn’t thinking much about it before today, and was surprised by the anxiety that lightly bubbled to the surface in the hours before the scheduled sit-down with my oncologist. The news? Not much. They are basically tracking two tumor markers in my blood nowadays — alpha-fetoprotein (AFP) and Human chorionic gonadotropin (HGC) — and they seem to be swapping trajectories. That is, the AFP is now slowly coming down, and the HGC has begun to rise somewhat more rapidly. The good news there is that the AFP is the marker of greater concern. Why? Arbaje says it’s because it is a more specific indicator than the HGC is.

Probably the most significant thing to happen while at the Oncology and Hematology clinic today was when Arbaje said, “how’s the insurance going?” I put my hands to my face to rub eyes and said, “bad.” It was a bit disheartening that such a thing even has to come into consideration. Arbaje asked as he tried to decide how soon I should have more expensive testing done — specifically a CT scan. Dawn told him, “don’t let our troubles with the insurance company affect your decisions about what Mike needs.” He assured us it would not, and advised us to speak to the social worker before we filed a complaint with the Office of the Commissioner of Insurance. So, Dawn left the little room and went to speak with her as the doc examined me (I always wonder how much he can tell by listening to me breathe and putting his hands on certain points of my abdomen). The social worker advised to move forward with the complaint, telling Dawn that while we must be our own advocates, the Insurance Commissioner would take over much of the legwork once we filed the complaint, and might help get the ball moving more quickly.

So, now, we must sit down and figure out everything that has gone on with “Assurant Health sucks” over the past five months since my diagnosis. Fortunately, Dawn has kept very good notes on all phone conversations, as well as a folder full of email correspondence with the “company.”

That’s the update for now. It’s a bit of a letdown, I know, but think about how it makes me feel. Especially in light of the fantastic news of late that Tara was given the cancer “all clear” by her doctor. She is officially cancer free! Don’t worry, I’m next.

(By the way, I’ve made a decision about folks that oppose Health Care reform — or support a watered-down version of it: they have never been through the machinations of the current health care debacle.)

sick and insured, part II

Posted in Cancer Life on January 28, 2008 by lawler

I took Bev Davis’ advice and wrote to my representative in Congress (after being sure that she was a co-sponsor of HR 676, the United States National Health Insurance Act), Tammy Baldwin. I received an almost cookie-cutter response from one of her staffers today. This is it:

Dear Mr. Lawler,

Thank you for emailing Congresswoman Baldwin regarding your private health care concerns. She appreciates hearing from you and asked that I contact you to share some ideas for assistance.

The Wisconsin Office of the Commissioner of Insurance oversees private insurance companies operating in the State of Wisconsin. They can investigate your complaints. To contact OCI visit their website at www.oci.wi.gov or call (608) 266-3585.

If you come to believe you need legal assistance you may wish to explore the services offered by the UW Center for Patient Partnership. To learn more about CPP visit their website at www.law.wisc.edu/patientadvocacy or call (608) 890-0321.

We hope you find these resources helpful. Please do not hesitate to contact Congresswoman Baldwin again if she can be of assistance with some federal matter, or if you simply have a concern or opinion to share. Thank you.

Sarah Benedict Anstaett

Office of Congresswoman Tammy Baldwin

phone (608) 258-9800

fax (608) 258-9808

And I thought: tell me some things I don’t already know. But then, what did I expect — Tammy Baldwin calling “Assurant Health sucks” and demanding they pay what they rightfully should?

And then I got a rare phone call from Tara last night. She said, “guess what I found out?” I said (what else?), “what?” Speaking through a friend, she learned that it is illegal for an insurance company to claim a pre-existing condition if the patient has had uninterrupted coverage — the change of companies does not matter, in other words, if the transition was seamless. Therefore, since our coverage was not interrupted, “Assurant Health sucks” cannot claim that I had a pre-existing condition (even if I did prior to their coverage, which I DID NOT).

Okay, so now what? It all comes back to the burden falling to the patient. I still have to call the Office of the Commissioner of Insurance and explain what’s going on, file a detailed complaint, and wait more. I still have to call our medical creditors and explain why we aren’t paying the bills. I still have to hope we don’t miss a call and send one of the bills into collections. I can’t imagine how any of this is supposed to help me, how any of this is supposed to heal me. If there was any doubt in my mind before, I now am convinced that the insurance industry really is about nothing but money. The insurance companies want to turn huge profits, and pay out as little as possible — and they will do whatever it takes to keep the money in their pockets (or, at least the pockets of their CEO’s and major stockholders). And this is what we pay for. We pay premiums so that we can be harassed by creditors and hassled by our insurance company. Interesting. I can think of better things to spend money on.

Last night, Dawn and I went up to Blockbuster to rent a movie. As we walked by the “S” section of the new releases, I said, “hey, let’s get Sicko.” She didn’t think that was funny.

'What can I do?' - SiCKO

sick and insured

Posted in Cancer Life on January 22, 2008 by lawler

First, a disclaimer: I’m mad. Dawn is mad too.

What are we so upset about? Who is to blame? My health insurance company, Assurant Health. They suck. And I’ve reached the point in this medical debacle of mine that I’m not going to hem and haw about saying so. They suck, suck, suck. And just so this can be found more easily on google: Assurant Health sucks. If you have them, ditch them. If you’re in the market, avoid them. Of course, I write that and immediately think: are any other insurance providers really any better?

Why do they suck? I’ll tell you.

Dawn and I moved from Texas last summer, and found that our Texas insurance coverage was pretty much worthless in Wisconsin, due to a lack of providers that accepted it here. So, we started shopping around. We wanted a company that would provide maternity coverage, since we had decided to start trying to get pregnant in the Fall. On the advice of family, we contacted an insurance agent to help us in our search. He highly recommended Assurant (I know, he probably gets a good commission from them) and since they were one of the few companies that even offered maternity coverage, and the rates seemed affordable, we went for it (it should also be noted here that I was appalled at the way insurance companies treat pregnancy as a pre-existing “disease”).

Our policy took effect on August 1, 2007. I was diagnosed with testicular cancer on August 31. That’s when the real underbelly of the insurance industry began to emerge from the stinky depths of the insurance bog of America. It quickly became apparent that the burden of proof was on us–even though they put us through a rather stringent approval process before the policy took effect. They seem to be sniffing their noses around the fact that I had previously visited a doctor (in Austin in 2005) with a complaint of testicular pain; however, I underwent an ultrasound at that time and it came back negative. My doctors now have told me that my pain was probably nothing more than a coincidence, since most men with testicular cancer do not have any pain.

Meanwhile, “Assurant Health sucks” has been bungling my case since it began. They repeatedly (three times, I believe) sent requests to us that were addressed to a different policy holder. They have continually dropped the ball on my case, and without Dawn constantly hounding them, nothing would get done on it at all. Which isn’t to say they have accomplished much as it is. They haven’t. Today I received a call from “Assurant Health sucks” telling me that they had finally reviewed my case documents, but it has led them only to demand more information from other doctors–information that has been available to them for months. What makes this all the more frustrating is that our medical bills continue to pile up, and last time I looked they had surpassed the $50,000 mark. Say what? That’s right, fifty grand. And our insurance (or I should say my insurance, since Dawn wisely opted into her employer plan recently) has yet to even accept responsibility for the bill.

Does it get worse? Yes. It seems as though it will be difficult, if not impossible for me to leave “Assurant Health sucks,” especially if they finally accept my claim, because I have had cancer. I won’t be able to get the admittedly decent rates I pay “Assurant Health sucks” elsewhere for a long time.

I know that I haven’t laid out a very damning case here, really. I don’t have the patience to go into all of the detail. I will be filing a complaint this week with the Office of the Commissioner of Insurance in Wisconsin with the hopes that it will convince “Assurant Health sucks” to stop giving us the run around and expedite the claims–something they told me today they could not do.

In the end, I just don’t want to have to turn red, and holler at strangers over the telephone about this anymore. And I really don’t want Dawn to shed another tear–she put up with so much during my chemo, and kept a lot of this insurance struggle to herself then too. It seems like when people get sick, they should get help, not the runaround.

'What can I do?' - SiCKO

life

Posted in Cancer Life on January 19, 2008 by lawler

It’s been a while since I’ve been here, I know. I suppose that is because when my chemo ended and my body (and mind) began to feel like the old Mike, I stepped a ways back from cancer–the thought of it, the feeling of it, everything about it. I made a decision to make certain changes in my life (diet, exercise, etc.) and hoped the doctor would tell me what I wanted to hear. I have followed through on some of the changes, but the doctor has yet to really tell me what I most want to hear: in the words of George Costanza, “Cancer? Get outta here!”

Around Christmas time, I was speaking with Fanou Walton, the mother of Dawn’s oldest and dearest friend, Aurelia, and an extended family member in residence (the Walton clan in general is extended family for us) and she brought up my blog and how valuable it was for her. She mentioned the ideas and thoughts that a person in my state formulates, and how such things are meaningful to others too. I told her that when you feel healthy again, and it becomes easy to distance yourself from the sickly patient you once were, it also becomes difficult to hang onto those ideas. It is a bit of a struggle to keep them around since there is no longer the constant reminder of their origin, their rationale.

But still, Dawn and I have learned to look at the day to day stresses of life in a new way. We have learned to look at each other and say, “Remember what we learned from cancer? Life is bigger than this.” She had to say this to me on the phone recently when I was fuming about receiving my first traffic ticket in several years. Traffic tickets have the power to make even the most blatant violator an indignant, self-righteous asshole. I just couldn’t believe I had been slapped with an $80+ ticket. I really didn’t think I had done anything wrong, and I have a reputation these days of driving like a grandpa (one that still can see, anyway). Furthermore, it was my first day driving the pickup truck we had just purchased to make my job easier. “Remember what we’ve learned….,” she said. And she was right. We have definitely learned a thing or two about life–and some of them are not too hard to recall. Remembering how insignificant a traffic ticket is in the grand scheme of things is one of them.

So, in a little over a week I return to Dr. Arbaje’s office for a check-up. He will give us the results of my latest blood work, and we will continue to forge ahead, regardless of what he says.

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In other news, I can’t avoid the topic of my hair. It’s coming back strong. The hair atop my head is the strangest in its return, for sure. It has this downy feel about it. The other night, Dawn and I were at a small party held at the Monroe Street Fine Arts Center where Dawn teaches flute lessons a couple of nights a week, and there were lots of young children about. A young boy, probably two, walked into the room and I noticed his hair was just like my post-chemo hair. It is similar to a newborn baby’s hair. It is also far darker than my natural hair color.

I’m also shaving again, which I have quite mixed feelings about. I look like myself again, but dammit I hate shaving. Once a week, and no more than that.

Perhaps I’ll post a new photo soon.

I’ll try not to wait so long to write next time….