And the Greatest of These Is

My father and mother both had their 90th birthdays this year.  They have been married over 65 years and every time I see them together, when they kiss, hold hands or just help each other up and down a step, I'm reminded of little acts of love that run together to make lives of love.

We need more of those, or at least we need to talk about more of them.

It’s been several years, when Marty was recovering at St. Catherine's,  but I clearly remember seeing an older gentleman in the nursing home, he was  on a constant vigil for his wife who had clearly suffered a massive stroke.  He was there every day, morning, noon and night, staying right beside his wife.  

It was an act of love.

A woman from our church who has adopted her special needs grandson posted about their most recent travails at the hospital.  She detailed the very real palatable fear and pain and occasional joy of the young boy’s hospital stay.  She was by her son’s side, all the time, every day, for weeks, caring for him, advocating for him, laughing with him and crying tears of fear and pain with him.

 

An act of love.

My wife, every now and then, as I’m standing beside her bed preparing torture devices for her health care will occasionally reach out with her right hand and grab my butt, tweak me just enough to get my attention or cause me to jump.  She does it and then smiles, sometimes laughs. I ask her just what in the hell does she think she is doing.  She smiles, that old Marty smile, the one that reminds me of her love for me.

An act of love.

Marty has an old classmate I have become acquainted with through the miracle of social media (sometimes it’s a good thing).  She has a special needs daughter that was recently in the hospital for an extended period, apparently riding the knifes edge of recovery or death.  She stayed with her daughter, night and day, for weeks on end.  I’ve been there, it is misery, but she stayed and eventually took her daughter home, knowing sooner or late they would get to rinse and repeat.  

An act of love.

When Marty had surgery for her first stroke, the hemorrhagic one, the one that almost, almost killed her, they removed part of her skull to make room for the swelling of her brain.  I wish I had a picture, but back then I was too focused on Marty living to memorialize the recovery, but visualize a woman recovering from brain surgery and she is missing the front left part of her skull.  There was a huge indention that was unsafe and weird looking.  It had to be fixed so she had one more surgery.

They took Marty in to surgery and when she emerged, she had a brand-new prosthetic part of her head.  She looked better and the part would protect that lovely brain,  but the surgery, the anesthesia affected her cognitive functioning.  We had worked so damn hard getting her thinking back, her memory back, her id back from the first cerebral assault and there we were, home again, but back to the first base of recovery again.  

It was too much for me and I walked away from her as she lay in our bed at our home, I was broken, and I didn’t want her to see.  I went into the bathroom, sat on the edge of the tub and cried, I cried real tears of anger, frustration and despair.  As I sat there with my tears and misery in walks Marty, slowly but deliberately and she sits beside me on the tub and puts her arm around my shoulders, pulls me close and says, “It will be okay.”

An act of love.

I'm not a scholar of the scriptures by anyone's standards, but I have one thing kind of memorized from the Bible.  It’s where Jesus talks about some of the important stuff in all our lives.  He talks about how we should treat each other, he teaches about love, he says faith, hope and love are important but that love, love is the greatest of these things, the greatest of commandments.

I get that, I see that almost every day.  It’s hard sometimes, there are so many ways to read and hear and see things these days and too much of what we read, hear and see is untrue, hateful and harsh, the antithesis of that greatest commandment.

It’s there though, the stories are there, they are right in front of us because love is what we all want, we all crave, we all need.  It’s like the Beatles said….Love is all we need…..just look for it…..and then share it so more of us get to see it.

Dealing Drugs

Marty had a UTI a couple of weeks ago. Over the last few years I have learned that urinary tract infections are no joke and if not quickly treated they make people really sick, especially those with compromised systems like Marty.

The strokes, the results of the strokes, poor muscle control, makes Marty very susceptible to this malady, so every four weeks, like clockwork, our friendly neighborhood nurse rolls by to get some clean pee to check for infection.  On her last check there was a bug, a bug which was different than normal, I can’t remember what it was called.

Patty, the nurse, called Friday and told me the test showed a moderate number of bacteria in her urine, so we immediately started her on a broad spectrum antibiotic.  I knew at the time it probably wouldn’t do the trick.  The last few times Marty popped a UTI it has been a bug that is not sensitive to any oral antibiotics she can take without turning red and puffing up like a toad and becoming mortally ill, all bad results.

To make it a little more complicated my annual  ski trip with our kids and grandkids was scheduled to depart the following Thursday to Deer Valley Utah.  I knew at the time if Marty had to be in the hospital my kiddos were going to ski without me, the bestest skier in the crowd. 

Monday morning nurse Patty calls and says the Levaquin Marty has been taking would not do the trick and she gave me two or three other options asking if Marty could take those.  I didn’t know and we punted to Great and Wise to figure out whether we were spending time in the big house with IV antibiotics or I was gliding gracefully down the pristine Wasatch mountains.
 

Around lunch we got a call from one of our very favorite nurse type people at Great and Wise's office. She said there was one and only one antibiotic dear Marty could take orally, only one antibiotic standing between the hospital and home for Marty, Zyvox.  My response, hot damn that’s a good thing.  Jessica says it’s expensive, I say that’s why God invented insurance, call it in.

Mid afternoon I got an email and phone call from Walgreens saying Marty’s insurance was requiring the dreaded “prior authorization”.  Now you would think Great and Wise’s prescription was “prior authorization” but it’s not.  They needed paper work before they would pay.   

I talked to the lovely Jessica more than once Monday and she essentially did back flips for our scrip plan, OptumRX and United Health obtained through AARP.  We ended the day at 5 with Jessica reassuring me she would stay on this and call me first thing in the morning….Tuesday.

Tuesday came, Marty appeared still appeared to feel fine to this point, so I wasn’t in too big a hurry, aside from the fact that I knew she was growing bacteria inside her bladder, not a good thing.  Jessica, true to her word called and updated me saying United wanted more information and she was on it.  The insurance folks promised to make a decision by end of day, remenber we are still growing bacteria while we fiddle away the day.
 

I then get a call from the insurance company saying they hadn’t heard from our doctor and they were waiting on them to respond.  Obviously not true, I just got off the phone with the doctor's office.  This is where I didn’t do a good thing, I got mad, not a good idea when you are asking people to do stuff.  In my defense you can call me anything you want but you will get a negative reaction from me if you diss my wife, my kids, my dog or Marty’s doctor.  I don’t react well.
 

Suffice it to say the call ended with me wanting to know when I would hear from OptumRX.  In about 30 minutes I heard, I got a recorded call, they had denied the use of the Zyvox.  Peachy, they made a decision based on some manual, they made a decision that would put Marty in the hospital, expose her to CDiff, flu, MRSA and other lovely things.  They made a decision that would cost Medicare $10000 for the hospital, brilliant.
 

I wasn’t finished with this whole deal and to their credit neither was Great and Wise and his office, they persisted and made a mission of fixing this.

In the meantime, I started doing some research about Zyvox and started pricing it at other drug dealers, also known as pharmacies.  Lo and behold, I find me a coupon, a coupon from a web site called GoodRX.  The cash price for 14 Zyvox doses ran $2500 at Walgreens.  This coupon said I could get 28 for $238 from CVS…I scored.

Never one to assume the veracity of what is found on the internet I called CVS and sure enough, it was a real deal and they would honor it, but they only had 7 doses.  I think, not a problem they can get the other 7 the next day, we can start Marty on the antibiotic in time for me to make sure she wasn’t going to go all blowfish on me and I could catch my flight to the mountains.

Great and Wise sent the scrip to CVS, I drove over with Marty and said is this real.  A nice young man said sure, he got the meds, looked at my coupon and said, Oppsie Daisy (he really didn’t say that), this scrip is for 14 and the coupon is for 28, 14 pills will be $700. 

 

You all would be so proud, I was cool, I’m thinking well that’s stupid but I can get Great and Wise to change the scrip to 28 and just hold this drug in case of a zombie apocalypse.  The dude looks at me, whips out his phone and does some calculation and said, wait, I can do 7 for $70.  It felt a little like buying drugs from a dealer but I said sure and about 30 minutes and $70 later I walked out with the pills, thumbing my nose at United Health Care and thanking my lucky stars for GoodRx.

Long story short Marty took the meds without any reaction, of course CVS did not get the other 7 pills the next day or even the next because they forgot to order it.  I found myself sitting in the locker room in Deer Valley Utah calling other CVSs in Waco to see if they had Zyvox.  I found the meds, sent our trusty Nykkie over to get it and the rest is history, Marty took the meds and she is infection clear.  We got it done.
 

When I got back and checked on what they charged us for the last 7 pills I found out it was only $9.  That made no sense but I wasn’t going to look that gift horse in the mouth.  Turns out United finally approved the meds.  I found out in a letter we received the day after Marty finished her course of antibiotics.  I had a letter waiting for me denying the claim and another approving the claim.  It was a cluster.

I am grateful for the outcome but I have to say this is a critical problem for patients, for doctors and even for pharmacists.  This is not an Obamacare issue, it is not a Trump care issue, it is a structural issue, it is an issue with a profit motivated entity rationing healthcare by denying reasonable treatment from a really good doctor.  It is an issue.
 

I don’t know the answer to the problem except to shine a light on it and turn all of you guys on to things like Good Rx which saved our bacon because Marty would have been in the hospital dropping about $10,000 if we had waited for the snail mail approval of something that should have been approved immediately.

Bottom line, it is crazy that any insurance company would choose a hospitalization over a medicine being used for something other than its primary design intent.  Bottom line, I was lucky to hit on an internet search and find a legitimate coupon.  Bottom line, I have a great support system between the offices of Great and Wise and flexible care givers that allow me the opportunity to fall in some snow.
 

The real bottom line, Marty is fine, until the next time and we will once again do what we need to do….just like you do.