Bed Rest Blog
Bed Rest Blog: (or "How the HMO delayed getting my medicine")
A stuffed nose, scratchy throat, and a cough came for a visit on the
last day of 2005. A fitting end to a mostly forgettable year, I
thought. The symptoms seemed to subside after a few days, and
then rebounded with a little more oomph. That happened
again. And then again.
At one point I felt well enough to drive into NYC, meet a relative
at the airport. I even went to Katz's and had Chicken Soup
to ward off any recurrence of the cold. Two days later it came
back worse than ever. At the point last week when breathing
became difficult it became apparent that The Cold That Won't Go Away
required medical attention.
The doctor looked in my ears my nose, my throat, and listened to my
chest. He expressed amazement that I could think, much less
breathe, given how stuffed my head and chest were.
The doctor prescribed antibiotics, a decongestant, and bed rest.
He knows I am prone to Pneumonia, and with the persistence of this bug
going around, he made it clear that bed rest was not merely a
suggestion. The only deterrent to this enforced bed rest was
procuring the presciption medicine. I'd gone to the
pharmacy directly from the doctor. Only two of the three prescriptions
were filled.
The third one -the decongestant that would enable me to breathe- required a special 'pre-approval' from the HMO.
The pharmacist explained: the doctor would need to submit to
the HMO a specific request that this medication be approved.
Knowing my doctor and this local medical practice, the pharmacist
assured me they would quickly comply. But the HMO, she warned me,
would take three days to process their approval and get it to the
pharmacy.
If this were dire, I could die in the interim. From the HMO vantage
this would be perceived as a benefit, as they would not have to incur
cost for a drug not on their formulary, or whatever they call their
list of accepted drugs.
It took the promised three days. And I had to go get it myself,
bedrest orders notwithstanding, since it needed to be paid for and the pharmacy needed my HMO
card. Then comes the annoying irony. The prescription cost
$42.00 The HMO makes me pay the first $50 of any non-formulary
drugs.
So I could have just paid for the pills and had them three
days earlier. And would have begun the prescribed drug
regimen three days earlier. And have been able to breathe
more easily three days earlier.
Many have called, e-mailed, sending get-well-soon wishes. This
Health Management Organization communicated a different message:
Start to get well three days later.
Lose your voice, lie in bed coughing and phlegmatic and with the
rest of the symptoms. But first, the HMO dictates, wait three
days.
Thank you to the many who are calling, expressing concern and offering
to bring over chicken soup. I am overwhelmed and humbled. And embarrassed that I have no voice to say
thanks. Hopefully this compensates for that.
It took most of yesterday and today to compose this blog post, over
numerous short sessions. Lack of energy, combined with malady and
reactions to some of the pills have made it hard to concentrate.
The next Bed Rest Blogging post will cover laptop/bed ergonomics,
daytime TV, and sci-fi-like thoughts on how technology might assist in
communicating when one is bedbound. And now back to sleep.
