Thursday, May 25, 2006

We're Gonna Getcha

I got the VISA statement for a not-for-profit for whom I do the books. The VISA account is from a large, national bank. On the statement was a late fee of $35 and a finance charge of $20 and change. I looked at my books and saw that I had mailed the check in time. I went online to the banking account we use and found out the check had never cleared. So, I assume it was lost either by our friends as USPS or at the bank’s credit card division.

I called the credit card’s customer service 888 number. The woman there really did not want to talk to me since I don’t personally have one of the organization’s credit cards even if I am the treasurer of the “company,” as she kept calling it. After some sparring about whether she would even discuss the matter with me, she told me, basically, “Tough it got lost. Not the bank’s problem. It’s yours. Service charges stand.” I tried to reason with her to no avail. So I said, and this is a quote: “Thanks for your non-help. I will be going over your head.”

I then called my personal banking representative. She was not in. So I hit “0” as requested and was transferred to another person (who knew by the transfer what the name of my representative is). I told her of the problem and the fees. She put me on hold for 30 seconds. When she came back, she told me the matter had been resolved and the late fee and finance charge would be reversed.

I next called the bank where the organization has a checking account to put a stop order on the errant check. No problem. However, I was told there was a $20 fee for a stop order. I told the representative that usually the president of the bank, who I named, waived fees for our not-for-profit. He said he would check with him and not charge us.

So, let’s review this. You send a check on time and it gets lost in transit. You are charged $55 in fees. You stop payment on the check that got lost in transit. You are charged $20 in fees. Having contacts at levels above customer service is the only way to get these fees waived.

I am sure that somewhere there is a meeting going on at each and every bank and credit card company where the full agenda is: What kind of fees can we charge and get away with?

Tuesday, May 23, 2006

Meet Me in This World, or the Nexium

Today, Medcrap emailed me the following:
“Thank you for your online inquiry. We sincerely apologize for the delay in your order. Please be assured that we are working diligently to get your order processed as quickly as possible. A request has been sent to your home delivery pharmacy asking that they expedite the filling of this order. As soon as your order is filled, we have requested it be shipped via an expedited carrier at no charge to you. You should expect to receive your order within the next 3 to 5 days.

To receive medication before your order arrives, please contact your physician to call you in a 5 day supply at your retail pharmacy. We have entered an override into the system for this short term supply to be covered at no additional cost to you.”
Okay, three to five days and I can get a five-day prescription filled. I looked at my account online and found out that they showed shipping on May 25. I am out of medicine as of May 24.

During the day when I was out doing my normal monkey business, I got a call from the assistant for the doctor who had prescribed the Prevacid. She told me that they had received some phone messages from Medcrap as I had told her they would. I asked that when she returned the call, would she find out if they would authorize a stop-gap prescription of longer than five days given the upcoming holiday weekend.

She called back about 15 minutes later. Seems like the co-pay for Previcid is $72, for Nexium it’s $36, and for a generic it’s $18. She said that the doctor was indifferent among the three. (I did not ask the question that if this were the case, why he had not signed the line “substitutions acceptable” on the prescription form.) She asked if I cared. I said I would take whatever drug the doctor wanted me to take. She thought Nexium would be the best choice. And she said that she would ask Medcrap if they would authorize a seven-day supply that I could pick up at Walgreens.

Five minutes passed this time before her next call. She was told that Medcrap would not authorize any short-term supply of Nexium since they were sending me my full order today via next-day delivery.

I wish I had something pithy to say at the end, but this entire thing has been pithy.

P. S. The next day, I received an email from Medcrap which said, in part: “If you need medication before your order arrives, please contact your physician to obtain a prescription for up to a 14 day supply of medication. This prescription may be filled at your local participating pharmacy.”

Say what? I guess they forgot the offered me that before (then refused to allow it when I got the prescription), told me to get a five-day supply (which I was going to), and then told me not to get any short-term supply since they were sending me the pills via overnight delivery. Finally, it’s mid-afternoon and the pills have not arrived. Their web site shows an enigmatic “order partially shipped” on it. How is something partially shipped? Like being partially pregnant?

I called customer service, fought my way through the automated voice whose program really did not want me to talk to a live person, and talked to a customer service representative. Overnight? Well, it’s semantics: seems it’s being sent overnight, but not out of there until today. Partially shipped? She had no clue.

Artiste at Art St. Louis Opening

Monday, May 22, 2006

Tell Me You're Kidding

The following is from the movie, Catch 22:
“There was only one catch and that was Catch-22, which specified that a concern for one's own safety in the face of dangers that were real and immediate was the process of a rational mind. Orr was crazy and could be grounded. All he had to do was ask; and as soon as he did, he would no longer be crazy and would have to fly more missions. Orr would be crazy to fly more missions and sane if he didn't, but if he was sane he had to fly them. If he flew them he was crazy and didn't have to; but if he didn't want to he was sane and had to. Yossarian was moved very deeply by the absolute simplicity of this clause of Catch-22 and let out a respectful whistle.”

As you know, I have been exchanging email messages with Medcrap (as reflected in a previous post). As part of their email messages, they keep saying the following: “If you need medication before your order arrives, please contact your physician to obtain a prescription for a short-term supply. This prescription may be filled at your local participating pharmacy.” In a previous email, they had defined “short term” as 14 days. And in their last email, they assured me I would have my Prevacid by June 2 from the prescription they had received on May 15. I’ll be out of pills day after tomorrow. They know this from my previous emails to them.

So, like the calm, obedient patient I am, I called my physician (as they suggested) and had a 14-day prescription called in to my local Walgreens.

I got a call from Walgreens telling me that Medcrap had refused to pay for the 14-day prescription since they had received a prescription for the drug on May 15. If Walgreens got back to them in July, they could approve it.

Somehow, I don’t think their right foot is connected to their left ear. Naturally, I sent a well-reasoned, succinct, and sanguine email to Medcrap.

Sunday, May 21, 2006

Sometimes, A Picture...

I received this check today. At least they didn't hit me with a rolled up newspaper.

Saturday, May 20, 2006

Medcrap Strikes Again

I mailed a prescription for Prevacid to Medcrap, my drug insurance company. They acknowledged receipt of the prescription. Today I looked deep into the vial to see I had five pills left (I had filled a 30-day prescription at Walgreens, that Medcrap had paid already). So, I went on line to see when they would be shipping my new order. They showed that it was scheduled to ship 11 days after they had received the prescription, meaning (given the upcoming holiday weekend), I would get it sometime around June something.

So, I emailed them to ask why they were holding my order. Their response:
Thank you for your inquiry regarding the status of your order. The order you inquired about is in process and awaiting a reply from your physician. Once the needed information has been obtained, your order should be mailed within 48 to 72 hours. Please allow for normal delivery time. If you need medication before your order arrives, please contact your physician to obtain a prescription for a short-term supply. This prescription may be filled at your local participating pharmacy. Thank you for visiting

I responded to them asking:

1. Why, when the prescription was for a specific drug (no substitutions or generics), they had to find out anything from my physician. (Of course, I know the answer: they want to convince the physician to change to a generic.)

2. How they thought it was fair to ask me to travel 20 miles to my physician to get a new stop-gap prescription.

I must admit, I did say a few other things, too.

You know, it’s enough to give you acid reflux.

P.S. The very next morning, I received the following email:
Thank you for your online inquiry. To assist you with your inquiry regarding the change in your medication, please contact our Patient Formulary Education Department at 1-800-xxx-xxxx Monday through Friday from 8:00 AM to 8:00 PM EST.
My response was:

“Nice generic reply. Too bad it does not address the questions I asked or concerns I raised.”

Tuesday, May 16, 2006

For a Moment, It All Made Sense...

But the moment has passed. This afternoon I had conversations first with my lung specialist and then with my allergist (after he had been called by the lung specialist). After my first conversation, all that I have been experiencing seemed to make sense. After my second conversation, I am back to being confused and not even on a higher plane.

When the lung specialist called, he went over my symptoms from the recent CT scan and blood work: my antibody levels are a little low (at the low end of the normal range), my airways are bigger than they should be. If he were to put a label on all of this, he told me, it would be “common variable hypogammaglobulinemia,” which, if I understand what this means, is a lowered immune response due to too low levels of antibodies in my blood. This can be treated. Did not seem like a big deal. Ah, an answer. The lung specialist said he was going to call my allergist since this kind of treatment is usually done by allergists. He seemed done with me, no need for a follow-up visit.

About a half-hour later, I got a call from my allergist, who had just finished speaking with the lung specialist. According to the allergist, the lung specialist had centered his discussion on the dilated, larger than normal airways. The lung specialist told him that his reading of my CT scan showed bronchiectasis. This can be a chronic condition that can get worse, cause recurring infections in the area, and can compromise the lungs. The allergist says if this is true, I should also be followed by a lung specialist to monitor the bronchiectasis. And he also described a way to see if my immune system needs tuning (including the pneumonia vaccine and further blood tests to see levels of antibodies). But if it’s bronchiectasis, it can be quite serious.

Now I seem to have two labels, both of which seem to have been given by the lung specialist…one to me and one to my allergist. It’s the old chicken and the egg question. Which came first? Which is the cause of the other? Are both there? For each, if it’s there, why do I have it? And the real question: Should I be worried?

I called my friend who is a radiologist and had looked at all my X-rays and CT scans. I told him of the differing messages from the two doctors. He said he did not see anything serious when he had looked at the films. I asked him to call the lung specialist to find out what’s what. I hope to hear tomorrow.

As a friend of mine pointed out, all that I have been through over the past weeks would naturally have lowered my immune response and raised my stress level. I totally agree. Those of you who have been following my postings on this know of the stream of diagnoses I have been given over time (some serious and some not) and how they keep changing.

Ah, it’s time to go feed the horses, sit on my barn bench with my two dogs, scratch their ears, and tell them the story of the blind men and the elephant.

P.S. My dogs really liked the story. The next morning, not only did I get a copy of the radiologist’s report on my CT scan, but also my friend the radiologist had talked to the lung specialist. Seems like there is no bronchiectasis problem. Well, one less thing to worry about.

Monday, May 15, 2006

Basal Ice

My photo, "Basal Ice," was chosen for a show at Art St. Louis running through June 30. Here is the artist statement that I put with the picture:

It’s all about change. This ice has been encased in the dark under tons of ice for hundreds of years, never been exposed to air before breaking off the base of the Tasman Glacier and floating to the surface. Now, its crystal clarity has snow-flake-shaped blemishes where air has infiltrated. Soon, it will be milk colored, opaque. Like life.

In Between the Colors

My baby blanket’s blue satin fringe is a pale
Remainder of sixty-five years ago.
The royal blue tassel from high school
Graduation has grayed.
Marian’s white wedding dress
Is ivory now, almost tan.

My eyes change, brown/then green/now blue
As they reflect
my wife’s hip-swaying walk
gray hairs in my son’s beard
grandchildren’s flushed faces
friends now gone
who shimmer like a mirage in my mind’s eye
the red and gold of sunset
just over the hill.

Diagno$i$ Reflux

What do people without medical and drug insurance do? I have been sick for over two months. During that time, I have had X-rays, CT scans, been prescribed several different (and pricey) medicines, had blood tests, lung function tests, even a test of my sputum. And I have gone to an internist, an allergist, two pulomonologists, and an ENT doctor. The statements from my medical and drug insurance policies are starting to filter down to me. It’s involved thousands of dollars. With all of this, the end result seems to be:

You were really sick, had something that was in your lungs. You’re better. We don’t know what it was. It’ll take another couple of months to fully recover.

Today’s visit was to an ENT specialist. It’s been so long and complex, I actually gave him a one-page bullet-point summary of all my symptoms with a time line, who I have been to, what the diagnoses have been, what tests I have had, what medicines I have been on, and the latest thinking from my lung specialist that the coughing was acid reflux induced.

He looked into my ears (cleaned out some wax), nose, and throat. He sprayed some stuff into my nose that deadened that side and my throat. Then he inserted a lit optic device into my nose and down to my larynx. He said that where the vocal chords come together, it was red, but this was to be expected from 10 weeks of coughing—each time you cough, it slams the chords together. Since there are no lymphs that clear vocal chord bruising, it would be a while before they healed and this is the cause of my hoarse voice. However, he did not see damage to the area of the vocal chords that would be caused by acid reflux.

Bottom line, then, was that he really loves acid reflux as a cause of many things, if I have any, it’s mild and not the cause of the coughing. He ascribes what I had/have to some virus that got into my lungs.

So when I asked for diagnosis votes, those of you who said “Some unknown confluence of things that no one will really figure out and will go away some day” are probably correct.

Think of the vein punctures, spitting, radiation, doctor visits, medicines, and insurance costs I could have avoided had I followed your advice.

Wednesday, May 10, 2006

There's A Hitch

I have a new SUV, a Cayenne. I had a similar SUV, a Touareg. The first is made by Porsche, the second by Volkswagen. They are kissing cousins that share some of the same technology. Today I took my new Cayenne into the dealership to have the trailer connection installed. The wiring came on the car, as did the trailer hitch, but there was a trailer plug to put in and the car’s computer updated. At least that’s what I thought (and what they thought).

After they had installed the plug and programmed the computer, the service manager told me they needed to install a trailer brake controller under the dash so the electric brakes on my trailer would engage when I stepped on the car’s brake pedal. I am well acquainted with brake controllers having owned pickup trucks over the years. However, I was confused.

I told the service manager (and the car technician who was doing the work) my VW Touareg had not needed an additional trailer control, that the car’s computer triggered the trailer brakes. They showed me the Porsche service bulletin that talked about the need for an additional controller for trailers with electric brakes and even checked the Porsche service database online again to see what they could learn. All the data pointed to the need for a trailer brake controller.

We decided to check on my assertions about no need for an additional brake controller on my Touareg. While I called my VW dealer and talked to the service manager out there, the technician called another VW dealer (who is across the street) and talked to the technician there who actually installs trailer hitches and the like on Touaregs. We got two different answers.

The technician across the street said that he had to install trailer brake controls on Touaregs just like the Porsche service bulletin said about my Cayenne. However, the service manager at my VW dealer told me in no uncertain terms that the onboard computer handled trailer braking and no additional trailer brake control was necessary.

Being a curious sort, I called VW of America when I got home (and could dig through their web pages to find an actual number to call). I asked whether I needed an additional trailer brake controller for a trailer with electric brakes or whether the internal computer triggered the trailer brakes when I braked the car.

After many pauses, questions, and being put on hold several times, the answer came back: the vehicle is not designed for that. For what? Well, I was told, the internal computer was not set up to trigger the trailer brakes slightly before the car started its braking. Hmmmm. Now I was confused on a higher level. So, does this mean that one needs a trailer brake control in addition to the internal computer? I was told this was a logical conclusion. He also said he could understand how two different dealerships gave me two different answers. Well, I still don’t. Do you?

As my electrician says: “Ain’t nothing simple.”

Tuesday, May 09, 2006

Turn Your Head and Cough

This could also be labeled:

Drop Your Pants and Bend Over
Does It Hurt When I Do This?
Time for Some Bloodletting
"Say ahh..." "Say AHhhh..." "Say AAARRRHHHH!!!" "Now Spit!”

The latest:
• Blood test negative on hypersensitivity pneumonitis. Whew! Nothing is showing related to allergies that could explain the length or level of coughing I experienced.
• Radiologist friend looked at my X-rays and CT scans and says I do not have pneumonia, that lungs look pretty normal. This was confirmed by the lung specialist.
• Lung specialist still thinks it was acid reflux induced coughing, BUT that does not explain why I still have noise in my lungs. So, he is going to try to rule out two other odd things I could have (but he doesn’t think I have): (a) aspergillus (ABPA), or (b) MAI syndrome (MAC). In order to see about these two, I had to (a) have more blood drawn, and (b) hawk and spit three times into three different containers.
• Jeff thinks it’s a toad or small dwarf resting in stomach. Please see which proves he may be right. The final part of the above is:

Joan: You charlatan! You killed my daughter, just like you killed most of my other children! Why don't you admit it! You don't know what you're doing!

Theodoric of York:
[ steps toward the camera ] Wait a minute. Perhaps she's right. Perhaps I've been wrong to blindly follow the medical traditions and superstitions of past centuries. Maybe we barbers should test these assumptions analytically, through experimentation and a "scientific method". Maybe this scientific method could be extended to other fields of learning: the natural sciences, art, architecture, navigation. Perhaps I could lead the way to a new age, an age of rebirth, a Renaissance! [ thinks for a minute ] Naaaaaahhh!

I go to an ENT next week. Oh, joy. More blood and spitting? Something not nice shoved into small cavities? All these weeks of coughing and varying diagnoses may get down to this:

“We don’t know what you had, but are glad you’re getting better.”

Saturday, May 06, 2006

Diagnosis, Too

This past week I have been to the allergist, gotten a chest X-ray, and then had a high resolution CT scan. This coming week I go to the lung specialist with films in hand. Here is what I know and don’t know.

1. I still have pneumonia (that’s seven weeks since it was first seen on an X-ray).

2. My coughing is much better. I don’t cough much and can lie down to sleep most of the time. I am not taking the codeine medicine to aid sleep.

3. I don’t have whooping cough (even though lots of you voted for that diagnosis) or asthma.

4. I don’t have allergies that would cause this. Had full panel of tests and no biggies showed up.

1. My diagnosis. No one has yet to figure out what I have so they don’t know how to treat it. Various theories that have been proposed by my internist, allergist, and lung specialists include:
a. Viral pneumonia with after effects that should go away soon. We’re into week 10. “Soon” is no longer an option.
b. Post-viral coughing that should go away when the weather gets and stays warm. Still possible, but unlikely with continuation of the pneumonia.
c. Asthma. Nope. Lack of medicines doing anything to help and evidence from lung function tests say “no.”
d. Whooping cough. Blood test is negative and I still have pneumonia, not a sign of whooping cough.
e. Acid reflux. The ultimate verdict is still out on this one. I am still taking Prevacid.
f. Stomach lymphoma (because of all the coughing spasms for the length of time I had them). But I have not have coughing spasms for a week and the pneumonia seems more likely as the problem, not a lymphoma, but it’s always a possibility.
g. Hypersentivity pneumonitis. This is a new one. I had blood drawn this past week for a special panel that would show if I have this relatively rare disease. If so, it’s a big problem for me since it involves keeping away from exposure to organic materials (read that as barn, horse care, hay, etc.). The new CT scan should also shed some light on this.
h. My vet offered heart worms as a possibility. At this point, she could be right.

2. Why nothing they have given me seems to cure me. It's possible that some or all of these have had some partial effect, but the pneumonia is still there.I have taken or am taking:
a. A round of antibiotics.
b. Two rounds of steroids over 12 days.
c. Asthma inhalers both general and acute.
d. Various antihistamines, allergy medicines, steroid nasal sprays.
e. A general lung dry inhaler.
f. Acid reflux medicine.
g. A sinus cleanser (you gotta see this apparatus, and it might even help).

3. Whether I am being used as a human Guinea pig by the Bush administration in its Wear on Tear or who knows what else in the WMD department.

And, in case you were wondering, I go to an ENT doctor a week from now. Hey, gotta give all the specialties their shot at this.

Wednesday, May 03, 2006

clASS Action

Today I received a notice of another class action suit. This time it was for a rental car company’s surcharges. And there is the usual part of the notice saying that if I want to be a part of the settlement, I should do nothing (but wait). I guess they got my name from the rental car company since I was never asked to fill out any forms. This happens a lot with suits for stuff you have bought.

Yesterday, I tore up an old $1 check from a class action settlement (check was too old to cash) from a package handling company. A dollar.

About two weeks ago, I got a notice of a pending settlement on another class action suit against a company that makes computer printers, among other things. The settlement I will get, if it’s settled, is $30 if I buy stuff on their online store (or about $15 if I want cash).

And then there are the class action suits against some of the companies whose officers are alleged to have misled stockholders about value of the company in a merger, accounting practices, etc. In order to participate, you have to prepare all sorts of documents and proof of stock ownership. Settlements there are better than nothing, but are a pittance.

So, I get $1 here, $30 there, a few bucks elsewhere.

And who brings these suits, anyway?

And who benefits? You KNOW the answer to that.