Anti-ci-pation......

Anti-ci-pation......

Anti-ci-pation......

You remember that song, right? I think it was Carly Simon who was lamenting that anticipation was makin' her late and keeping her waitin', but that refrain is dominating my mind right about  now.
Oh, you want to know why (or what) I'm anticipating? Let me share.....

A week from today, almost to the minute as I write this, I'll be boarding a ship for a 7 day cruise to the southern Caribbean. Heaven.....

Worth a little anticipating, as far as I'm concerned.

Some folks, upon learning of my upcoming trip, look at me aghast, wondering why I would agree to get on a CRUISE ship! Don't they run aground a lot, or lose power due to on board fires, or forget how to back up? How about diseases that run rampant throughout the ship way out there in the middle of the ocean, with no easy escape?

Well, yes...all of that could happen, I imagine. But I know an intersection near my house that makes Daytona Speedway look like a senior citizens' exhibition, and I still travel it every day. And even though planes fall out of the sky once in a while, I get on one occasionally if I want to get where I need to be.

In other words, I play percentages. The chances of disaster befalling ME on the cruise I chose are miniscule, taking into considering the number of voyages these ships make with no incidents at all. Could it happen? Sure, but I'm betting on the side of most likely not.

And I've learned, since I've reached the point in my  life where I can take some trips like this, that the anticipation of the journey is almost as fun as the actual voyage. We booked about three weeks ago, and ever since we've noted the number of days on the calendar in a variety of ways: 

"Do you realize that two weeks from RIGHT NOW we'll be boarding the ship??!"  

"Seven nights from tonight we'll be dancing in the night club on the cruise!!"

"It's only five days until we'll be arriving in [name of port] to take the sightseeing tour!"

 Anti-ci-pation......

And the other thing I learned from my previous cruises is that the actual event lives up to all this pre-excitement, something that is not always the case. No phones, no computer, no demands at all: just people waiting on me hand and foot, lots of quiet time to read, write, snooze, whatever I choose to do. As I have aged, I have become a world-class cloud-watcher, with the ability to sit and do absolutely nothing for long periods of time, with no guilt about it at all. For someone like me, a former Type A personality, that is huge. And wonderful. 

And a cruise plays to that new ability. 


A writer has to write, though, so I'll keep a journal and share some of my experiences on the cruise when I return, especially for those of you who think I'm a little crazy for getting on that ship to begin with.


Anti-ci-pation......

“Oh the places you'll go! There is fun to be done!"

Dr. Suess

Something else happened for sure......

Who would have thought?

Getting older--aging to perfection, in other words--is tough, there's no doubt. Especially in a society that idolizes those who are NOT older, wiser, more experienced. We are discounted every day by those who think it will never happen to them.

Just like we did.

So, when an event like this happens, it shouts to be shared. You deserve to know that some part of one's body can actually get better as it ages.

I got my first pair of glasses when I was ten. And I endured all the mean comments from my classmates: four-eyes and brain jump immediately from my memory banks. Today I guess some of that would be called "bullying" behavior, but times were different back in the olden days. I learned to maintain a poker face, and coupled with the fact that I was moved all over creation as a cog in a Navy family, I knew I would be in a new classroom soon anyway. I was a kid; I always thought the next one would be better.

So, imagine my surprise, and delight, a few years ago when my eye exams began to show something odd: my eyesight was actually improving. I thought that the fact that I was having to blink a lot to read my book meant what it had always meant: my eyesight had slipped a bit more and I needed a stronger prescription. How thick can lenses get, anyway?

Not so, said my eye doctor. It turns out my prescription is headed down the number scale instead. What??!

Well, you know me: I had to research this phenomenon. But all I can find are articles about natural ways to work at improving your vision, foods that promote good eye health, exercises you can do with your eyes (I think I exercise quite enough already, don't need any more), but nothing about an unprompted improvement. The optometrist did tell me that it happens, though; I'm not weird or anything (OK, OK, stop the jokes). But it didn't occur to me to question her in more detail at the time, even though my vision has shown improvement for the past five or six years. Now I'm really curious, though, and will keep searching the Internet to learn more about it.

But, we don't have many chances after 60 to find some part of our bodies that haven't turned on us so completely that mirrors are forbidden in our homes. Especially anywhere near where we change clothes. 

But new frames with thinner lenses? Maybe some day I can go look up all those mean kids and flaunt the new look.

Every time I think that I'm getting old, and gradually going to the grave, something else happens.

Elvis Presley

Is that silly jester joking THIS time?

Apparently not.

He showed up in the patient holding area, where my friend lay in a silly hospital gown and an IV dripping into his arm. The pointy hat with all the tiny silver bells all a-jingle was missing when the jester arrived--maybe he left it in his Porsche--but it was certainly him standing at the foot of the bed, Dr. "Smith" stitched across his white lab coat.

At least he had the grace to look marginally sheepish. You know the expression that steals across someone's face that whispers, "I really messed up this time, but how can I get out of this without coming right out and admitting it"? You know...THAT look.

Do you remember the test that had to be administered before a final determination could be made about this life-extending procedure? The test that was done right there in the doctor's office in plenty of time prior so the procedure could be scheduled? Yes, that one......

The patient, in his medical-establishment naivete, assumed that when the hospital called to confirm that the procedure was, indeed, on the schedule that the doctor had in fact READ THE REPORT. And that the results indicted it was a "GO." Sounds logical, right? 

Perhaps in a sane world.

So, here he was, IV stuck in his arm, all ready to get it over with when the jester shook his tambourine in our faces. Again.

And told us that the patient was no longer a candidate for the procedure at all. Due to the successful tweaking of medication over the past few months, the function in that body system had improved to the point where the procedure was no longer indicated.

Good news, right!  Of course.

But why wasn't that pesky report read before the final go ahead from the hospital? Before the patient was subjected to the pre-op process, AND the costs associated with all of that?

Because we all know those charges will be showing up, both in the patient's mailbox as well as within the gargantuan Medicare system.

For me, aging to perfection means getting older with some dignity intact, learning from my mistakes, accepting some of the unfortunate side effects of the whole process.....

.....AND staying away from the jesters in white lab coast at all costs....literally and figuratively.

My doctor tells me I should start slowing it down - but there are more old drunks than there are old doctors so let's all have another round.

Willie Nelson

The jester continues to giggle.....

Well, the laugh's on us, I guess. What else can we attribute such incompetence to, other than we are stuck in a cosmic comedy of some kind, with no visible escape?

Remember the follow up doctor's visit from two days ago? Here's a reminder for those who need it:
http://agedtoperfectiondeborahhansen.blogspot.com/2013/02/the-jester-wont-stop-laughing.html

The patient called me again THAT evening and said, "Oh, it gets better! I got home and noticed a paper stapled to my checkout form, and called the doctor's office to find out what it was. Remember when you asked the doctor if there was going to be any pre-op lab work that needed to be done between tomorrow and Thursday? He said, NO, just go to the hospital and they'll take care of it that morning, right?"

Yep, that's what the doc said, I recalled.

"Not true, apparently. But after being switched around from phone to phone for about 15 minutes, they said, 'Well, just go ahead to the hospital on Thursday morning, and they'll do it on a STAT basis, and have the results in about two hours."

(And if you believe that, I've got a bridge to sell you, too.)

Guess that problem has been resolved, then. Right?

You'd be wrong, as the jesters shakes his bells and snickers in glee. Yesterday afternoon, when the patient was back at the doctor's office to [finally] get the test that they couldn't find in the file but that is probably there after all, they looked at him like he was crazy when he mentioned the pre-op lab work. "NOOOOOOO!," the nurse screeched. "That has to be done here before Thursday! You need to come in tomorrow and get it done!"

So, that's where he is right now. There are no more shoes that can drop......are there??

I'll keep you posted on the outcome of all of this, and then we'll talk about who consumers report this kind of incompetence to, especially when there are multiple billings going to Medicare for each return visit, even if it's the result of that incompetence. 

And I'm NOT kidding.

The jester won't stop laughing.....

We looked at each other, and burst out laughing. What else could we do?

If you haven't followed this blog before, you might want to catch up before returning here for the fun:

http://agedtoperfectiondeborahhansen.blogspot.com/2013/02/the-jester-has-left-building.html

OK...now that you have the picture: Today was the follow up visit, two weeks having passed since we were sent away--again--from a doctor's office for lack of medical records that they all have within the tips of their fingers, but seem too disorganized to make the effort to obtain.

A SCREENPLAY IN MADNESS:

Scene 1: Patient is ushered into the examining room by a nurse.

She turns and, perplexed, says "So, you are here for a two week follow up, is that right?" She flips through patient's file.

Patient: "Well, we were here two weeks ago and had to come back today because the doctor didn't have my records from my hospital stay in November. He said he needed that before he could decide for sure about [THE PROCEDURE]."

Nurse: "Oh." She keeps flipping pages in the file. "Well, I don't see those records here. Are you sure it wasn't the [NAME OF ANOTHER PROCEDURE] that he needed? I see that one here!"

Patient: "No, it was the records from the hospital he needed."

Nurse: "Oh. Well, I'll just call over there right now, since they're in the same practice we are, and have them faxed over! It should only take a few minutes!" Happy nurse. Irritated patient and friend.

Time passes.

Scene 2: Nurse skips back in. "OK! I called and 'Denise' is going to fax them right over! It should only be about 10 minutes! I'll be back." 

Patient: "Why didn't they ask them to do that two weeks ago when I was here?"

Nurse: "Well, we thought we only needed the results for the [NAME OF ANOTHER PROCEDURE], and they did send that!"  Did she not realize that she didn't answer the question at all? Or is that the ploy?

Twenty minutes pass. The doctor opens the door wide enough for his head, and says, "It should only be a few more minutes!" Gone again.

The examining room gets colder. The hallway outside the closed door is quiet now. Did they all go home?

Ten more minutes pass. Rustling noises outside the door, which means.....something. 

Scene 3: Doctor enters. "The forms just got here!" He stands and silently skims each piece of paper, gets to the end and does it again. Not a good sign. "When was your last [NAME OF YET ANOTHER PROCEDURE]?"

Patient makes his best estimate. Friend is thinking, "Isn't that what the file is for?" Friend can feel her own blood pressure rise, which only reinforces her general attitude about staying away from doctors at all costs.

Doctor: "I'll need to do another one of those [NAME OF ANOTHER PROCEDURE] before I can make this decision. How about tomorrow?" Is he kidding?! It appears not.

Patient, trying to be agreeable instead of violent, a state the friend is quickly reaching: "Fine. Can I come by after I get off work, around 1:30?"

Doctor: "Sure. Just come by and we can do it then. I should have the results in plenty of time that way, and we can schedule the procedure for Thursday." Spends 3-4 minutes entering the information into his phone. Hands the patient his check-out form and ushers us out.

Scene 3: Patient and friend go to the front desk to turn in form (this would be the BILLING and scheduling form.) How many bills WILL Medicare get for this situation, I wonder?

Receptionist: "Who is your primary doctor?" Oh, you mean the one that referred the patient here, the same one your office had to contact for records--twice--and the one that is supposedly in the same practice?? The one whose name you asked the patient for twice already, just since he's been here today, not to mention the two times (at least) you asked at the previous visit? Is this information never retained ANYWHERE?? 

Patient sighs. Patient answers. Again. 

Receptionist:  "Can you be here tomorrow morning at 8 AM for the [THE MISSING PROCEDURE]?" She smiles sweetly.

Patient: "No, the doctor said I could stop by after 1:30 tomorrow, since I have to work!"

Receptionist laughs at that answer. "Who told you that? The doctor?! We don't do it that way!" She's getting a real chuckle out of us right now.

Patient: "Yes, he said to stop in, but go ahead and schedule it for 8AM and I'll be here!" Friend walks away in order to prevent "an eruption of violence in a doctor's office," probably some kind of felony.

Receptionist: "OK. Then the [REAL PROCEDURE] will be done on Wednesday."

Patient: "But the doctor said it would be Thursday, so he could get the results back from the OTHER procedure in time...."

Receptionist: "No, he has Wednesday's date here."

Patient: "He definitely said Thursday."

Receptionist: "Well, have a seat in the lobby. He's in with another patient, and I'll ask him when he comes out."  Patient sits--again--while friend leaves to work out at the gym or die from frustration, thus putting herself in the "care" of these people. She would rather keel over from over-exertion on the treadmill or some other instrument of torture.

Scene 4:  Friend is driving away when her cell phone rings. Patient says it's all set for 8AM tomorrow, with the [REAL PROCEDURE] scheduled for Thursday. Receptionist apparently seemed surprised that the patient was right after all!

Patient and friend hang up, since they are both driving, being good citizens and all.

Friend's cell phone rings again. Patient is laughing so hard he can hardly talk, "You won't believe it!" They just called me and asked if I could come tomorrow at 3:30 for the [MISSING PROCEDURE] after all!"

THERE ARE NO DISCLAIMERS NECESSARY FOR THIS SCREENPLAY! EVERY WORD OF IT IS TRUE........

“Taking crazy things seriously is a serious waste of time.”
― Haruki Murakami

The jester has left the building......

After the third time, I wanted to strangle a doctor. Whichever one said it again. With my bare hands.

I do try to see the humor in just about any situation that crosses my path, but occasionally the jester just doesn't juggle that day. Plus, the issue is one that appears in the news periodically, with much lamenting and commission-forming, all to no avail apparently. Memories are short (I can't even joke about that one right now), and we are all busy folks, tending to our lives without worrying about things so overwhelming.

But here it was.....again....within the span of about four weeks. I'm not in a laughing mood.

The man in my life was ill in November. Ill enough that he ended up in the hospital for a week, and you know what that meant. Every test known to man (and woman) was performed on him, some of them multiple times. Finally he was released with strict orders to see his own doctors for follow ups to determine a course of action, if action was deemed necessary. So, the first appointment was made with the appropriate doctor, two weeks in the future.

We sat in the examining room after the nurse did nurse-type things, and left us sitting there. Without too much of a wait, the doctor came in and proceeded to ask questions that indicated to me that he had no idea why we were even there. But, hey, I AM a wiser woman than I used to be, so I stayed quiet. (Stop laughing. I really did!) When the purpose of the visit was made clear, he said, "Oh, well, I can't do anything until I get the records from the hospital. Make another appointment at the front desk for two weeks, and we should have the files by then." And he left.

OK, I'm confused. They knew when the appointment was made that this was a follow up from a hospital stay. I know they did. So, now more time will pass before any action will be taken, plus two visits will be charged to Medicare, with more co-pays for the patient, too. Why weren't the records requested in the two weeks between the appointment being made and the actual visit?

Oh, well. What can you do? So, in two weeks, he returned to the doctor's office, an appointment was made with a specialist based on the files obtained from the hospital (finally), and another two weeks goes by. In between, more doctor's visits with other providers, all of whom have to....surprise!....request the records from the hospital! (Can you say "coordination of care" very loudly, please?) More delays, more billing to Medicare, more co-pays and deductibles for the patient.

Finally, we show up at the specialist's office, thinking we are there to schedule a life-saving procedure, and guess what? He needs the records from the hospital, even though the referring doctor has them and could have provided them himself. Or, what a concept, maybe someone in a doctor's office could be tasked with checking a few days before patients show up to see if such a thing might be needed, and take care of that BEFORE the patient shows up. One visit instead of two. Seems logical to me, but what do I know?

I try hard not to get sucked into conspiracy theory-type thinking, but maybe that's the point of all this waste. We often hear of patients committing fraud of one kind or the other, but how about doctors and other health providers? I'm only the one paying for all of these superfluous visits. And so are you.

I know the arguments about reimbursement for services, but I also know what we tell our children about following a bad course just because someone else is doing it. When does it stop? How will it stop? Will my daughter's generation have anything left for them?

Does anybody think this is funny?

We are on the top of a national trend that is causing a hemorrhage of tax dollars ... 

It's a tsunami of fraud..  

Orlando Sentinel 2013-02-17

You can't get there from here.....

I’ve learned that categorizing people tends to come back to bite you in the butt. Over the course of my life, I have tried really hard to refrain from doing it. I don’t like it myself when I hear sweeping generalizations:

Women drivers……

Those teachers……

Blondes……

And it’s not simply that I happen to fit into two of those groups, either. 

Honest.

But once in a while, events and the subsequent temptation overwhelm me and I succumb. I fall right into the jaws of that trap faster than my “teacher” look can be activated in a classroom full of 13-year olds.

Men and directions.

What’s up with this, anyway? We have dashboard-mounted or handheld GPS tools, computer sites that will find our way for us before we even leave the house, complete with visuals AND text, PLUS the old standby, books of maps under the front seat. (For those under the age of about 30, that’s called an ATLAS.)

Let's take a hypothetical situation, told as if it's true:

I had occasion to ride with a male of my species (I think they’re the same species, although  sometimes I’m not certain) a week or so ago, and we got lost. I had gently asked early on if the driver knew how to get to this particular destination, and was assured with lots of male surety that it was so. I am a wiser woman than I was before aging has perfected me, so I kept quiet. He had printed out a map, just in case, so I thought this would be a piece of cake. Right?

Oops. There was only a map, with no text, so when the map took us to somewhere unrecognizable, we had no backup. There was a nice looking young man in a yard, but he didn’t know that street, either. We started driving in circles, so I retrieved the GPS from the glove box and programmed it as the car started circling the area yet again. Soon, the voice stuck in that box was telling us what to do. Whew! Saved.....

Not so fast. The driver decided he didn’t want to follow the voice. Was going to ignore it. Plus it was talking too loud, so turn the darn thing off, how about it?!

As a teacher, I learned the fine art of playing deaf, mainly to keep myself sane enough to move among the rest of the population at the end of each school day. Came in handy here, I can tell you. The GPS kept talking and I started gently pointing and speaking very softly, hoping that we would get back on track. And there it was, just as if we had never lost it to begin with.Turns out we COULD get there from here.

Technology is wonderful if you use it, isn’t it?

I guess the difference between men and women in this regard is that I always assume I don’t know where I’m going while men always assume they’ve got it under control. Therefore, I’m prepared for all alternatives.

Need I finish that sentence? Hypothetically, of course.....

History teaches us that men and nations behave wisely once

they have exhausted all other alternatives." ~ Abba Eban