Play this video while you are reading the following.
Maybe you've noticed the dearth of
Monday Updates here?
That's primarily because there hasn't been much to update.
I'll bring you up to speed about what's been going on recently
[since the end of February].
You might remember GS went down to Stanford for a consultation and at that point we determined it was time to find a new oncologist to treat her here.
That took just a little longer than anyone thought it should because even when you find one there are scheduling issues ...and paperwork.
Since visiting Stanford ...and seeing a different doc from the first one down there ...GS has had another CT/Pet scan
[maybe I told you?].
The results were not what anyone would call good news.
...or bad news.
Interpretation is best left to the professionals.
The new doc, who we just saw again for the second time yesterday, is starting off with an intramuscular injection.
Both he (the new doc) and the Stanford doc came up with this independent of each other.
We will see how this goes.
Treatment will start whenever the insurance approves
[big sigh!].
Both docs, along with the last doc at the hospital, also were quite concerned about the constant diarrhea.
The main concern has to do with dehydration.
So each of them suggested a mild narcotic drug (tincture of Opium) to help control it (along with the anti-diarrhea medicines already prescribed).
What a joy-ride obtaining that medication is.
Fortunately for GS there was an alternative to use in the meantime.
Morphine is not just a pain med.
One of the side effects is constipation.
It isn't easy to get either... but we had some that was unexpired from after the aneurism repair
[who remembers that?] last year in 2012.
The doc at Stanford prescribed the opium.
But the local chain store pharmacy wouldn't accept the form he used.
The pharmacist told me he would accept a fax.
After going back to the pharmacy twice, only to be told they hadn't received the fax ...having been told twice by Stanford they had sent and re-sent... I called a third time.
I was told then that they didn't handle tincture of opium.
that was about a week of wasted time.
Another week passed and we had the first appointment with the new oncologist in Redding... after a slight comedy of errors I may or may not have told you about.
(that had to do with lost paperwork)
There is enough morphine to carry until we see him for the first time.
GS, PHG, and I meet him and like that he is really caring.
We have a little difficulty understanding what he is saying sometimes.
We weren't exactly happy with what we did hear.
Our decision to change docs was reinforced.
He'd been able to get the results of the CT/Pet scan.
There's been no improvement, which is kinda what we already knew from the colonoscopies.
He seemed to believe the cancer has progressed.
Anyhow, he wrote a new scrip for the opium tincture, also an order for lab work
[they have their own lab in house because they're affiliated with the hospital], arranged for another appointment in about three weeks
[that appointment was yesterday], and promptly left on paternity leave.
Our return visit was to be with an associate known as Dr. O.
I took the scrip, which was written on the proper form, and mailed it to the mail order pharmacy designated by our insurance carrier.
That was on a Wednesday.
By the following Monday there was no acknowledgement.
Finally, on Friday, at 5:30 in the afternoon, nine days later, there was one of those automated calls that there was an "issue with a prescription".
Really?
A machine makes a call with a general statement that there is an "issue."
On a Friday.
After office hours.
I did call the mail order folks back.
I was shuffled among three different departments before anyone even knew what I was talking about.
Then they had to determine whether it was my prescription or GS prescription.
After about a half hour or so it was determined that the dr. is required to obtain prior authorization before they could fill the prescription.
A notice had been mailed to his office.
We spent the weekend wondering what was going on.
Monday morning another automated phone call was received.
The prescription was denied.
I called again.
I was
jerked ping-ponged around for another lengthy period of time.
Because the dr. had not responded in a timely manner the prescription could not be filled.
So told them how he was on paternity leave.
They suggested I find another doc to write the prescription.
I made a suggestion about what they could do with their suggestion and told them to mail the scrip back because I could take it somewhere to get it filled.
(I might even have used the word f***wads to describe what I thought of the brilliant individuals who operate the company.
I have an inkling there may be a number of former government bureaucrats involve.)
Of course the person I was asking to mail the scrip back was not directly involved in the process of mailing it back.
That was a different department.
That different department would have to get it back from whatever department had determined the prescription could not be filled.
Evidently none of these folks are allowed to talk to one another because they have to send some kind of form to accomplish any task.
Clients are allowed to talk to all of them, but that accomplishes nothing other than confusing and irritating the client.
I was told it would take a week to ten days for the scrip to be returned.
Much of the vocabulary I learned to use on a regular basis in the Navy was coming back to me.
Fortunately I was able to suppress it ...somewhat.
I called the Doc's office and left a message on his assistant's voice mail.
I called the Doc's office again and left a message on his assistant's voice mail.
I called the main number at the Doc's office and explained the situation.
She strongly suggested I tell the voice mail the exact same thing and offered to transfer.
I accepted the offer and was put on hold.
Finally I hung up
[hanged up?] and called the Doc's office and left a message on his assistant's voice mail.
She called me back and I explained the situation further.
It was determined we could refill the scrip for morphine, but I would have to wait until the following morning to pick it up because the office was now closed.
The next morning I drove to Redding, picked up the scrip for morphine, did the weekly shopping at TJ's, Costco, the bagel shop, and then headed back to the chain store pharmacy to fill the prescription.
I dropped it off and was asked how soon it was wanted.
I said as soon as possible.
The clerk told me it would be about twenty minutes.
I said that would be fine, I still had some groceries to purchase at the supermarket.
About 40 minutes later I returned to find a line waiting for prescriptions.
I waited.
Finally my turn came and I was told the prescription wasn't ready because they had not yet confirmed it with the dr's office.
Huh?
I called the Doc's office and left a message on his assistant's voice mail.
I made it clear why I was calling.
I came home.
About an hour later I got a call from a friend who clerks in the pharmacy.
The prescription was ready.
I'm really glad these are not life-saving medications.
The original opium scrip finally arrived back in our hands on Thursday afternoon.
The chain drugstore is out of the mix now, too.
I can't decide if they are confused about what their function is or just plain incompetent.
It wasn't always this way with them... only since they started merging with one another.
We have a local pharmacy chain that does everything the big drugstores do except they only purvey pharmaceuticals
[what a concept!].
I can't remember why we haven't been going there all along.
It turns out they are also on the insurance companies preferred list.
They couldn't fill it immediately because they don't keep opium tincture laying around, but they would have it by Monday
[yesterday] by noon.
Is seven weeks to get a prescription filled too long?
(that's a rhetorical question meant to point out that some folks have no idea what service is)
Yesterday was also our second appointment at the new Doc's.
We didn't get to meet Dr O afterall.
GS doc was back from leave.
He has a new healthy baby daughter and all is well in that department.
That was when he informed us of the intramuscular drug treatment.
He also urged GS to get more protein and increase her albumin intake (eggs).
We left feeling much better about things than we had the first time we saw him.
maybe all posts should have theme music