back in hospital

8/4/11 4:33:56 AM 

This note is probably a series of disconnected thoughts – Oh well. There are a couple of bad words and/or phrases in here.

Today should be a pretty weird day. At about 0830 I need to wander over the Helen F. Graham Cancer Center and get some blood drawn. The primary reason for my jaunt is to get four hours more chemo – this is the stint where they drug with Demerol. But I suspect a red blood cell wrinkle.

The last time I had this treatment I needed at transfusion. It was my first transfusion – I was such a rookie. Anyway, as you know by looking at me, I don’t miss a whole lot of meals, so when I started getting winded going from my chair in the parlor to the refrigerator I was concerned. Nothing escapes my notice. I suspect my blood counts will be all over the place this morning.

I discovered a huge hole in the Christiana Care referral system. Here’s how it works – at least for me – I’m sure you guys are way smarter than I am about this stuff. When you go see a specialist, your primary care doctor has to make the initial referral and your insurer may give you a couple of subsequent referrals with an expiration date. 
Now in my case, between blood work and doctor’s appointments, I can go through five referrals in a week and a half.

Here’s the rub – if you call the Christiana Care referral hot line for additional referrals from your primary care manager, your request may be (likely is a better word) summarily denied if you want the referrals before the expiration date regardless of how many times you must see the doctor. 
To exacerbate the problem, specialist neither can nor will deal with insurers (especially if yours is a Health Maintenance Organization type). HMOs believe referrals are sole province of primary care managers. To more exacerbate the problem Christiana Care won’t call you and you have no idea you have no referrals until the specialist calls and says, “Hey you ain’t got no referrals.”

At this point, I am reminded of the words of Sonny Corleone as they plot the murder of police captain Mark McCluskey and drug dealer Virgil Solozzo in an Italian restaurant where a gun will be hidden in the bathroom for triggerman Michael Corleone, “I don't want my brother coming out of that toilet with just his dick in his hands, alright?"
Anyway it's up to the patient to follow up, follow up, and follow up again to ensure the primary care manager is on the ball.

CHANGE #1

I had planned to tell you all about a vacation I can’t take, but things have changed. I am back in the hospital because all blood numbers are dangerously low.  I ain’t scared – really I’m not; it’s all pretty standard stuff as far as it goes.

My doc said I’d be here a couple of days getting blood, platelets, and some more chemo. Apparently I have a fever too, which could complicate things. This morning I was so lethargic that after I took a shower, which took all my strength I dried off and lay in bed under a ceiling fan hoping it would dry me the rest of the way.  I guess it worked. Had a dickens of a time catching my breath, that’s why I wasn’t to surprised when the doc chose to hospitalize me.

My phone number is 302-733-6123.

Peace,

Bill