On Monday, I spent most of the day in the hospital for a chemo treatment. After more than six years, it’s a trip accompanied by low levels of anxiety -- especially when the drug I’m scheduled to get is as benign as gamma globulin.
This week’s visit was going pretty well. Tara, my regular gentle chemo nurse who knows every available vein on my body, painlessly inserted the catheter and the crystal-clear liter of globulin began dripping into my body right on schedule.
I need periodic infusions of this stuff because my cancer-ravaged blood manufacturing system doesn’t produce antibodies in sufficient numbers and that compromises my immune system – which, of course, is not a good thing. So every six to eight weeks, I get a load of the immunoglobulins collected from thousands of blood donors to boost my immune system and keep me alive.
I’m very thankful of this process and consider myself extraordinarily lucky to have it available to me. I know that fluid in that little bottle hanging upside-down next to my chair is very expensive. Like $25,000 expensive. Lucky for me the good people at Aetna HealthCare have agreed to pay for infusions of the stuff for a year at a time. I think this is the third or fourth year they’ve approved this treatment. And I thank them. I know how important it is to keep the folks at Aetna on my side.
That’s why what happened a little later in the afternoon scared the shit out of me.
It was about half-way through the slow four-hour drip process and I was feeling pretty good from the great neck and shoulder massage I got from the therapist at the NYU Clinical Cancer Center. (This is a wonderful little perk given to chemo patients at NYUCCC that deserves to continue and be financially supported. More about this program later.) The therapist who gave me my massage today was especially effective and I had a pretty good buzz going. When it wore off, I restarted the movie on my laptop and watched the last few minutes of “Doubt,” the Meryl Streep movie I was sort of enjoying as the last of the harvested antibodies made their way into my capillaries.
Then the phone rang.
I have to explain some things here. First, my life has undergone a little change lately – mainly due to my sudden lack of employment. And since this was my first visit to the hospital in 2010, I had to undergo the dreaded yearly checkup in the hospital’s infamous “payments receivable” office. This is never a good way to start your day of getting healthy. For one thing, NYU always manages to schedule these visits so there are two or three administrators available to screen at least 20 anxious patients. These officials all move like they are receiving massive doses of Xanax. It’s not a speedy process.
I’m no longer intimidated by this detour. I expect it after the first of the year -- and I have my own Xanax prescription. This year, I knew there was going to be red flags put up when I told my interrogator that I was no longer employed by New York City. But apparently she had heard this from other people recently and just pressed something on her keyboard and told me to go upstairs to my treatment.
But now she was back on the phone and she sounded panicked -- telling me that I had lost my health insurance when I lost my job. But I’m not stupid and I know that had not happened. Knowing how important health insurance is to me, I took pains to perfectly follow the rules of how to extend my health coverage using for the Consolidated Omnibus Budget Reconciliation Act (COBRA), which gives workers who lose their health benefits the right to choose to continue them. But the bottom line was that I wasn’t insured. What did NYU want me to do, I asked her. Did they want me to give back the immunoglobulins that I had absorbed into my bloodstream?
Fighting back panic, I got on phone. Still hooked up to intravenous tubes, I called my secret weapon. I’ve written many times before that the back office people in the health care system actually, in many instances, control the system. In my case, the registered nurse Aetna assigned to assist me over five years ago has been invaluable through the years in keeping me alive. In Hartford, Nurse Rebecca Valenti listened to my problem -and did what she does best – keeping me insured and alive.
Within 30 minutes, Becky tracked down the trouble, put me in touch with the right person and got me covered again. When I spoke to the NYU biller and told her I had straightened out the problem, she just said she would check Tuesday and “we’ll see.” I haven’t heard from anyone at NYU so I guess they did see.
But the real story here is what actually happened and what it means for the present and for the future. It was an inexcusable mistake that I hope I managed to fix for the hundreds of NYC employees who followed the same instructions I did and mailed their COBRA applications to the wrong address. I was lucky to have my laptop with me in the hospital and had available the name and address of the person I had directed my application to. This gave Becky the information she needed to get to the bottom of it. It also gave her the location where she could go to find my application and deliver it to the right place. Hopefully, the other misaddressed applications also found their way there.
I was going to make some calls today to make sure that happened but decided to leave things as they were because any calls might only serve to screw things up again since it is so easy to screw up. Just imagine what will happen as the government starts taking over more of the health care system.
But I’ve decided to add another rule to my survival list: Never panic!
1 comment:
For all its deficiencies, such a problem could not happen with the British NHS.
The intravenous immunoglobulin you received was once a by-product of the manufacture of factor 8, the clotting protein that hemophiliacs need. Then came AIDS and to prevent future generations going down with the virus factor 8 had to be produced much more expensively by molecular techniques. This meant that there was no surplus plasma for fractionating into immunoglobulin. So it had to be made as a primary product from donated plasma and the price rocketed. Another blow was struck when the British got mad cow disease. It meant that all that plasma from British blood donors was no longer available on the open market, and this has led to shortages of the raw material. At certain times recently it has been impossible to get hold of immunoglobulin for injection.
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