Life is not about just surviving, we all do that in some form. It is about how we thrive after we survive that matters~Carole Sanek

Surviving Humana Gold Plus HMO Hell Part 3

April 10th, 2014

Surviving Humana Gold Plus HMO Hell always gives me something to blog about.  I feel I might have enough content for the remainder of the year with the hoops this organization has everyone jumping through.

My former doctor retired at the end of last year.  I called their office the other day to ask if they are providers, they are not.  However they told me they would take me as a self-pay and they really made the offer affordable to me.

However the lab work I need would not be covered so that throws me back to considering the walk-in clinic with the real complaint that I am out of diabetic testing supplies and prior to running out my fasting blood sugars were a tad out of line.  I would guess they can order lab work and then I could request copies and head back to the office of my former doctor where ALL my records are.

I can pay out of pocket for my own PAP smear at the gynecologist I was going to, I plan to pay for my mammogram myself.  I can use the walk-in clinic if I get really sick.

The final laugh today came from the fact that the very oncologists I was told I would have to use are the highest paid by Medicare in my area, I plan to go look at where my Moffitt doctor falls in this revealing news.

It’s bullshit corporate bullshit – I know that, and in a way it smells of favoritism.  Primary care doctors make the decision whom to send their patients to, and I have a feeling that personal feelings play into this.  Actually it’s more than a feeling.  The PC I am with had a “tiff” with my gynecologist so she won’t refer to them.  That sucks doesn’t it?

Surviving Humana Gold Plus HMO hell is a challenge for many people I am sure, for me it’s only temporary insanity.

Axis of Insanity Surviving Humana Gold Plus HMO Hell Part 3

The Axis of Insanity (Photo credit: Wikipedia)

 Surviving Humana Gold Plus HMO Hell Part 3
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Surviving Humana Gold Plus HMO Part 2

April 7th, 2014

Surviving Humana Gold Plus HMO has taken a turn for the worse.  I am a Type 2 diabetic and I will run out of testing supplies before the 5/2 date the staff at my new Primary Care physician’s office gave me for an appointment.  YIKES.  What is a person to do?

What is really truly sad is the fact that there are people with this insurance who wouldn’t know WTF to do.  I can hear their anguished voices in my head.

What will I do?  I will take myself to an Urgent Care Center and tell them that my Primary Care doctor’s staff told me to come there. (They did.)  I will ask them to write me a prescription for my diabetic testing supplies.  I will ask them to order blood work for me because I know my numbers are out of whack and waiting a month is absolutely not effing acceptable.  I will ask them to take good care of me because Humana Gold Plus HMO and the primary care doctor I chose don’t seem to give a crap.  I will also call Medicare.  I have had it……oh wait I did call them, maybe it’s a better idea to go talk face to face with them.

I will call Humana Gold Plus HMO tomorrow and ask them what they think I should do.  This just keeps getting worse and worse.  It actually sickens me for those who would not know what to do next.

I asked a dear friend today who is deep into the medical/insurance business.  She told me that the ONLY reason to buy an HMO policy is IF YOU ARE HEALTHY.  Well I do consider myself healthy to a point BUT to stay that way I need an doctor to care about me and a company to back me up.

I live in the United States and I cannot get my health concerns taken care of and I am trapped by the staff of my primary care choice.  Humana Gold Plus HMO you failed me, and without a doubt you are failing others.

I will be back to continue this saga.

 

bullshit Surviving Humana Gold Plus HMO Part 2

They can fail.

 

 

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Surviving Humana Gold Plus HMO Hell

April 4th, 2014
3613427221 50dc956f78 n Surviving Humana Gold Plus HMO Hell

Hell (Photo credit: KomodorO // Paco LopeH)

Surviving Humana Gold Plus HMO hell is a matter of praying you don’t get sick, injured or diagnosed with a serious disease and you survive by counting the days until open enrollment.

My advice to anyone who is even considering any HMO – run to a PPO as quickly as you can.

This has been a nightmare.

When my husband and I started to look at Medicare supplements we invited a Humana sales person to our house.  His name is Matt.  Matt sat at my kitchen counter in my house and this is how the conversation went when I asked for clarification to my health care providers:

Carole:  “Matt, if I understand you then I have to choose a Primary Care doctor here where we live but I can still see specialists as long as they are Humana providers.”

Matt: “Yes, that’s right.”

Carole: “Please check and see if these doctors are in network, and the oncology center I use for check ups.”

Matt (after checking) “Yes they all are.”

BAM done deal.

The problem with this scenario is it was ALL lies.  The Primary Care doctors I chose where I live do not refer out to my oncology center.  I am in the middle of post breast biopsy care for the next two years.  I have to have an ultrasound every February and my routine mammogram in July.  I have had one major surgery on my breast and 2 biopsies and my breast is filled with strange gobblelty gook that even the trained eyes of the top radiologists in my oncology center get second opinions on before discharging me from my appointment.  A new mammogram center will see all this and go nutty.  My oncology center doesn’t accept films from outside clinics so if they see nuts and bolts that would mean another mammogram AND twice the radiation.

Fact of the matter is that my breast surgeon and I had already discussed a mastectomy because my scans are so difficult to read.  That won’t happen while under the care of the Humana nazis.

What will I do?  I will call my oncology center and I will negotiate a price and pay for it out of pocket.  I will not have my mammogram done at a center I never used before so my bad, I will pay the bill myself.  Thankfully I can afford to do this.

Oh but it gets better.

The original PC doctor I chose did not make my RN socks roll up and down and I started the procedure of changing to a female physician for all things female.  The hoo-hah is tired of being in the hands and face of anymore male doctors.

Humana Gold Plus HMO in their infinite wisdom put my first choice to change Primary Care docs through but neglected to tell me that the request had been kicked and I did not get the new female PC.  However to be fair – the customer care rep got this fixed in about 20 minutes. Normally I spent almost an hour trying to get assistance and the people on the other end of the phone are not decision makers.

But…….I am also in the middle of a trip and fall at home and I had already seen my first PC for this and had been referred to his preferred Ortho doc (note I wrote “his preferred”.)  As an RN I am used to vetting my doctors with other nurses.  I went to see this Ortho doc and in less than 5 mins he told me I probably have a torn meniscus and only an MRI would give us the diagnosis.  I asked if this is a surgical repair only, and he said it was.  Well that’s not totally true. Depending on the tear PT can work.   I have not had that MRI because the first PC doc never gave us the referral approval to have it, and I filed a complaint on that.  Another screw up – almost a comedy of errors the change went through for the new PC doc so that was all behind me because she doesn’t use that Ortho doc.

Now I have just had my new choice of a Primary Care doc approved and I call for my first appointment.  My knee is hurting and I am also sick with an upper respiratory infection.  Ready????  May 2 is the appointment I am given.  I explain my injury, I explain I am sick – did not make one effing difference – May 2.

Let’s look at the timeline here.  2/19 injury.  Knee started to hurt 3 wks later.  I get to see new PC 5/2 which is 2 1/2 mos after injury.

By the time I see her chosen gods of orthopedics it will be 3 mos.  MRI will be about 3 1/2 mos of pain and potentially doing damage to my knee because no one has told me what to do, what not to do, and this is what you call good medical care?  Its NO medical care.

I cannot change to a doctor who would see me sooner because that approval won’t come through till 5/1 so I HAVE to see this new PC doc and only her.  What does her staff tell me?  Go to a walk in clinic.  What will that do?  Seriously they told me in the meantime if I get sick I should go to a walk in clinic.  I got back on the “Humana Not So Hot” line and was given a walk in clinic they have on their list – ready?  Doctors are only there Tuesdays and Thursdays.  I better not need a doctor any other day of the week.

I feel like I am a hostage to Humana Gold Plus HMO and that I am close to being denied medical care.  Until May 2 my hands are tied and this is worse then when I lived in Central America.  It is an embarrassment and I am disgusted beginning with Matt, moving on to Humana Gold Plus HMO, going on to the new PC and her staff, and with myself too for being fooled so a sales person could put a commission in his bank account.

 

Today is April 5, there are 270 days left this year and I am counting.  I will go back to a PPO and just move forward.  Yes, surviving Humana Gold Plus HMO Hell is something I can work around but my advice to anyone else is doctor shop and ask each office whom they refer you to if you need a specialist if you join any HMO plan.  Make sure you can get referred to that gynecologist you like,  that you can keep that cardiologist who did your angiogram that saved your life,  and that your oncologist whom you trust with all your heart is someone you can keep.  HMO’s are all about money they don’t have to spend not managing our health, not being a health care advocate.

There are many other complaints about Humana Gold Plus HMO on line.  I should have googled them before going with them.

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Surviving

March 18th, 2014

Surviving takes strength.  No matter what you are surviving and learning to live with or without, it take so much strength.  I look back on the many blog posts I have written over the years and I see where my flaws are as well as seeing where my strengths lie.  I have written in anger, I have written in humor.  I have written, published and gone back and trashed posts too.  I just did that this morning.

I thought a lot about this today and I came to the realization that in order to break the cycle of writing and living in anger means taking the first step.  That step is letting go of the crumbs that remain that trigger our feelings.  Several years back I wrote a blog post in disappointment and pain about a friendship that was heading downhill fast.  Unfortunately I had allowed myself to be talked into trying one more time to try to do an intervention over a serious drinking problem.  You know how it is when you confront someone with the truth, but they cannot accept it, even if they know it’s the truth?  Things change.  Our friendship disintegrated rapidly after that and sadly not in an honest way.  We should have been honest with each other about why it was ending.

There is another thing that we cling to in life that we need to let go of, and that is the belief we hold on to that people should act the way we would act.  The simple truth is, they won’t, they don’t, they can’t.  They own the way they do things just like we own the way we do things.  Yet we all get our feelings hurt because we hold on to that “I would have or I would never have” done/said/not said that.

The road to recovery takes time – the crumbs need to be swept out of sight.  It’s time to let go and that means doing what we need to do to remove the trigger points.  This morning I began by hiding people on my Facebook so their posts don’t serve as reminders.  It takes strength but it is the first step in moving on from feeling bad to feeling better.  Detach – I highly recommend it.CLS m24 Surviving

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Surviving Letting Go

January 29th, 2014

Surviving letting go brings so many different emotions to the surface of our hearts, guts and brains.  There are all kinds of reasons all of us have let go.  We let go of so many things.   The wrong person, best friendships that dissolve, the bad habit, the people we love who cross over, pets, our favorite sweater, jobs, and a lot more.

Most of us can’t begin to even keep track of all the things we have let go of, except for the letting go that hurts our hearts and turns our guts inside out, even though our brains know it is the right thing to do.  I am writing about letting go of your child as they move on in life, often thousands of miles away, to become what we always wanted them to be-superstars.

We carry our babies under our hearts for 9 months and then we carry them through life.  We know that as they grow we have to give them more freedom, we have to wave goodbye to them as they get in the car for the first time.  We hug them as we take them to college and they scold us for having tears in our eyes.  We are thrilled for them as they begin their adult lives.  We let go more when they fall in love and we remember how we felt when we were their age.

I am not sure we ever really consider that they may move on and out and head thousands of miles away though.  If someone brings it up we push that thought into the recesses of our minds until one day we hear them say “We have big exciting news to share and we want you to be happy for us.”  At that moment our hearts skip a beat, our guts start to grab at us, while our brains tell us to relax and try to look normal.

We say all the right things (that’s our brains kicking in again) but our insides hurt, and we are happy for them yet sad for us.

 

moving van Surviving Letting Go

I watched that moving van pull out of my yard a long time ago and I thought my insides would just shut down.  It’s hard.  It’s really hard.  I remember running down the road to catch a last glimpse of that moving van.  Yes, letting go hurts.

However, we do begin to know and understand that change happens, growth happens, and we know our children grow up.  We also know  amazing opportunities do not happen to everyone.  We were blessed, so blessed to have so much time together.  We know we can board airplanes.  We know our children do come home for the holidays, and other family events.  We have smart phones, we know we can text, email, Instagram, and more.

Our brains are rational about letting go, our hearts and guts are not.

I wrote this for someone I have known for a long time – I have always been “ahead” of you with experiences in life, and yes, I know, as you always pointed out, that I will always be older than you.  That always made me smile.  I smile for you today, and yes I have tears too.

 

 

 

 

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Surviving the Urge to Kick Someone’s Ass

January 25th, 2014

Surviving the urge to kick someone’s ass is not the title I wanted for this article.  I actually wanted to use “Surviving the Urge to Kill Someone”, then I realized that might a little too over-the-top as a title.  I started over.  I used “Surviving the Urge to Beat the Shit Out of Someone” and even though I really wanted to use it, I thought about it and came up with “Surviving the Urge to Kick Someone’s Ass”.  It’s a little kinder and gentler I suppose.

After all I do have an image to uphold and the urge to kill or beat someone is probable not the image I want people to have of me when this article gets indexed by Google.

Let’s get real though, we have all been angry enough to think those words at some time in our lives.  We may have even said them out loud.  Thankfully though most of us are reasonable people who don’t act on our thoughts and we rationally understand that thinking or even saying things like that are an outward or inward explosion of feelings that make us feel better after we say or think them.

Having the urge to kick someone’s ass is different.  I don’t actually want to walk up to them and kick them into the next county for example.  I just want to do something that makes them say “Crap I did not see that one coming!”  I want to catch them off guard, by surprise and yes blindside them with an action/idea/happening that kicks them square in the ass.  Some might see this as a friendly competition when they think this, but I am here to clearly say for me this is NOT a friendly competition.  This is not just about kicking someone’s ass for me, it is about kicking it hard enough to make it difficult for them to get back up completely.  It is about me winning and doing the dance in the end zone of life.  I promise no one will actually be physically hurt .  I am past that feeling (she says with a wink).  No really I am.  I even re-worded a certain board in my Pinterest account because I no longer want to bitch slap this person (she says with another wink).

 

Me You1 Surviving the Urge to Kick Someones Ass

So today, as I was in the shower, my plan came together.  Showers are more than cleansing the body, showers can cleanse the mind too.  I believe that this all worked out for me because timing is everything and I seriously believe there are no accidents.

I recently attended a big social media event that was running over with the biggest thought leaders in social media.  I absorbed so much but put a lot of it on the back burner to simmer.  This morning the pot boiled over and the answer to a question that had been bugging me for 9 months was born.  I finally know how to get past the urge to kick someone’s ass and actually do it.

I seriously promise this will all be done fairly and no blood will be shed (she says with a wink).  No really I promise.

Have to run now and start working on this project – it’s so exciting!

 

 

 

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Surviving The New Year’s Resolution to Lose Weight

January 13th, 2014

Yes you heard it here first I will be ready for surviving the new year’s resolution to lose weight.  Damn those resolutions, full speed ahead.  Why the new yrs Surviving The New Years Resolution to Lose Weight heck do we make them?  Do we make them to break them?  I don’t think so but why don’t we just do what we need to do when the spirit moves us rather than wait for the new year?

I need to lose weight.  I absolutely need to lose weight.  I have known that for quite a while.  Menopause wasn’t kind to me, throw in T-2 diabetes, and some bad decisions and I have officially achieved chubby cheeks and they are not on my face.

I resolved to lose weight.

OK so January 1 came (and went) and we boarded a jet plane for Las Vegas.  Now you tell me if you would start counting what ever needs to be counted on a trip to Las Vegas?  I think not.

First stop after checking in to the hotel, B&B Ristorante in the Venetian.  Look out everyone here comes my review of this delicious meal.  It was over-the-t0p delicious.  We were offered a chickpea bruschetta from the chef which went well with my glass of Prosecco.  We ordered a soft mozzarella cheese appetizer also served on bread, and we both had pasta dishes, wine, and Tiramisu.

We walked back to our hotel.  Does that count?  It was 2.4 miles.

We were bad the entire trip.  We ate so much wonderful food, and we drank wine with meals and other wonderful drinks.

The restaurants in Las Vegas are amazing.  It’s a foodie paradise.

At D.Vino in the Monte Carlo I had the best Linguine with White Clam Sauce I ever tasted.

The dinner we had at Red Square in Mandalay Bay before seeing Michael Jackson One  was fabulous.  Beef Stroganoff served over Wild Mushroom Pasta.  Yikes.  OK there was homemade ice cream too.

We walked to the Mandalay Bay – another 2.5 miles, does that count?

We also had wonderful appetizers like Hot Rocks (filet you sear on the 800 degree rock), Kobe Beef Flatbreads, Roast Beef Sliders, and then on our very last day there we walked to The Wynn – and we ate at their newer American tapas restaurant Le Cave.  I started with Ceviche’, Larry ordered Mushroom Grits – oh no!!!!  Those damn grits were so good.  I had Artichoke flatbread – I can still smell it.  No dessert and we did walk round trip 6 miles, does that count?

There were more wonderful food experiences but I find as I write this blog post I am getting hungry so I need to post this and trick my stomach into believing I am not because I want to be able to write a post in 6 months about my success in surviving the new years resolution to lose weight.

 

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Surviving Being the Convenient Friend Until

December 20th, 2013

Surviving being the convenient friend until a better offer comes along was something that happened to me as a teenager.  Marsha, my “best friend” would make plans with me to go out to our local dance club, to the movies, to dinner, whatever, and if a better offer came a long (a date) I got the phone call that cancelled our plans and was left holding the bag marked “loser”.  It hurt.

51YYXFWZRHL. SL300  Surviving Being the Convenient Friend Until

Cover of Loser

I know now that Marsha was not a friend, not a true friend.  Real true friends don’t do this to their friends.  It is a terrible thing to do to anyone because it goes right to the heart of one’s self-esteem.  It is 100% lousy, it is 100% mean, it is 100% crappy, it’s 100% thoughtless.

Many years have passed and wham bam it has happened again.  I opened my heart in friendship to someone I really like a lot and the first time it happened, I actually “called” her on it, and she apologized.  I really appreciated the apology, it meant the world to me.  Life went on and then several times this year we had plans but a better offer came along and I guess I was just supposed to be ok with it.  I wasn’t.  It hurt.  It really hurt.

What’s a more mature woman supposed to do when this happens (again)?   Marsha taught me a huge lesson.  Have more than one friend – simple answer.  I do, and I have a wonderful husband too who encourages me to have girl dates.  I just will pick a different girl from now on it’s all fine because in reality we know who the loser really is, don’t we?

 Surviving Being the Convenient Friend Until
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Surviving After Walking Away in Breast Cancer

September 26th, 2013

I brought this over from my http;//afterbreastcancerrevivingsurvivingthriving.com blog because I drank the breast cancer koolaid, it tasted good at first, then it went bad.

After Breast Cancer I have missed you.  I had some deep soul-searching to do.  I have also been busy with my incredibly successful business.  I needed to heal from being blind-sided by a former friend and partner.  All of this took time or took a toll or took a piece of my heart.

I don’t think there is any betrayal worse than that betrayal that comes from someone you trusted, someone who was almost family, someone who built you up for months only to tear you down in 5 days.

It’s all good now, so I have decided as I approach my 20th year and look back at things I went through recently that I would write about what I am grateful for here.

  • I am grateful that I can honestly say what I do in the name of breast cancer is NOT to put money in my pockets, but to give it to those who need it.
  • I am grateful that I am who I am, NO pretense, that what you see is what you get and that means you would never see me walk around as if I am better than you.
  • I am grateful that everything I have planned in breast cancer is to truly help others, to feed their spirits, and NOT my ego.
  • I am grateful that my husband has NEVER had to have a talk with me about my behavior.
  • I am grateful that I know better than to ever tell someone to NOT have conventional medical treatment.
  • I am grateful that I have NEVER put my hands on someone and told them that I can feel breast cancer in their body because I can’t.
  • I am grateful that I have NEVER said “don’t have a mammogram,” because I wouldn’t.
  • I am grateful that I have never said I had breast cancer twice, the second time I healed myself.
  • I am grateful that I have NEVER said that maybe my beliefs are too “woo-woo” because my beliefs are not.
  • I am grateful that I have NEVER said Stage 4 breast cancer serves the women who have it.

I could write more things I am grateful for – the point of my gratefulness is that when you take the words “never, not, no” out of those things I wrote that I am grateful for you might see what I moved on from and realize that while opposites attract they don’t make good partners in beliefs.

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The Top 10 Reasons I WON’T Shop at WalMart

July 13th, 2013

Here we go with my top 10 reasons I won’t shop at Walmart:

 

5487448787 4f1b8f0da1 m The Top 10 Reasons I WONT Shop at WalMart

Walmart (Photo credit: matteson.norman)

10.  Barefoot shoppers gross me out

 

9.  In 2008 a WalMart employee became an invalid in a truck accident.  When the employee won a lawsuit related to the accident, WalMart    sued the invalid employee to return the $470,000 in insurance payments made by WalMart.  As if WalMart’s future depended on the return of that money.

 

8.   WalMart is under investigation for allegedly bribing 19 Mexico stores. The report did not give a figure for how much Wal-Mart spent on all of the alleged bribes. But it cites instances in which the company allegedly paid $221,000 in bribes to build a store near the ruins in Teotihuacan, as well as $341,000 in alleged bribes to establish a store near the Basilica de Guadalupe without appropriate permits, and another$765,000 in alleged bribes to set up a refrigerated distribution center
in an environmentally fragile area near Mexico City. (WOW I don’t think we are going to see TV ads cutting back prices).

 

7.   Sweatshops in Asian countries for all those cheap clothes they sell (granted other companies were also involved.)

 

6.   The manager who said that female cashiers need to go outside and pick up carts because they need the exercise.

 

5.   http://www.care2.com/causes/walmart-accused-of-using-child-labor-at-shrimp-plant.html

 

4.   All of the above so far and they dump Paula Deen – really?

 

3.   Advertising generic drugs at $4/month and then arguing with me because my doctor wrote for 3 pills a day and 2 is standard dosing (according to them) and I had to pay $10/month or go elsewhere – I went elsewhere.

 

2.  Many people know about the parrot.  A friend in Phoenix sent me a picture of a Macaw on a woman’s shoulder in the check out line.  Don’t get me wrong I do like birds, I have birds, but not only could that bird poop anywhere it wanted to, conceivably if it got loose it could injure people or get injured.

 

1.   The Parrot story used to be my #1 reason – today I have a new #1 reason http://dogingtonpost.com/walmart-employee-fired-for-calling-police-to-report-dog-locked-in-hot-car/#.UeF6AG15lDM  now THIS IS #1 and WalMart you just have NO CLASS!

Everything I wrote here either happened to me, or I used Google by searching for WalMart scandals.  Oh and BTW #WalMart – your ads for being cheaper than Publix all show items that I don’t even consider to be food.  I wouldn’t buy those items.  Try comparing the produce/meat/dairy – you know real food OK?

 

 

 

 

 

 

 The Top 10 Reasons I WONT Shop at WalMart
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