Medicare & other

Got Raj signed up for a different set of Medicare benefits for 2012.  Instead of Parts A & B with Humana Medicare Advantage in 2011, I'm going with Parts A, B, D and F.  So far, the prescription plan (D) got processed, we've received the Member ID & card, and they've even processed my POA so I can communicate with the Community CCRx on Raj's behalf.  With Humana, these processes took 3 months!  We'll see what happens when I try to fill the first prescription, which is waiting for me at Osco.

Hopefully, BCBS-IL will be a good choice for a High-Deductible Plan F.  Since the first set of expenses just go toward the deductible, parallel to base Medicare, I'm not worried that this coverage isn't in place immediately. 

High on the list of what's needed is a hospital bed for Raj.  With his knees so rigid, he literally crashes into the single bed we have there for him, and it can't handle the impact.  Because of the reflux, he should sleep with his head elevated anyway, and this bed will address that, as well.

The patient advocate assigned to help me with the backlog of 2011 Humana claims is working on the first one; We'll see if someone internal to that organization can make any progress!

Raj was home for Christmas-gift opening several days ago, and he was cooperative.  His coughing was almost constant, though, so he's not remembering what the speech therapist taught him.

I heard back from one of the two life insurance companies I applied with today.  I need the cash, so I'm planning to surrender my VUL and replace it with basic term insurance.  I haven't seen how my physical exam turned out, but I was surprised to be quoted at the "Standard" rate.  I have no chronic conditions or diagnoses, am experiencing pretty normal "female" stuff through a long peri-menopause, and take one prescription to manage those symptoms.  I keep up with regular massage and all shots/tests/labs/maintenance/dental/eye stuff, and take supplements for optimal health .  I haven't had a cold or flu in years, BP is great, and my only ER visits were 7/2009 (bad headache after cushioning one of Raj's falls with my whole body on a concrete floor) and 9/2011 (tripped while walking the dog & had sore wrist X-rayed).  Hopefully, the other insurance company will come through with a better rating.

Contact Made!

I finally heard back from the new psychiatrist at Raj's facility, and he's making the necessary med changes to (hopefully) avert mania.  Apparently, Dr. G reduced the main mood stabilizer due to his liver counts.  Raj had mixed up this information, and requested dropping one med while starting another.  Now I think we're on the right track with those meds and liver counts are OK at the moment.  Also, I followed up with his PCP on the new cholesterol med & reminded her to run labs on that.  I even had an initial conversation with Dr. G's billing rep, and was assigned a "Humana Cares" representative to help me with the backlog of claims that they keep denying!  Merry Christmas to me!

Mania?

Raj's mood has been stable for so long, I know I should be grateful.  But his new psychiatrist hasn't ever spoken to me directly, so when he asks the "kid" about the "candy store", the kid certainly isn't going to tip his hand.  For the past couple of weeks, Raj has been increasingly irritable and demanding.  I don't know how long it's been, but my only medical contact for his care at the assisted living facility (Nurse Judy) lost her job.  All I have for the on-site psychiatrist is an email address, so I sent him a message tonight regarding Raj's symptoms and clarifying various med changes.  I hope it's not too late to prevent a full-blown manic attack and/or hospitalization . . .

Maybe he's right.  I do the best I can as his caregiver and Power of Attorney, but he's saying (again) that I'm just not doing well enough.  He's miserable and wants out of that facility right now.  The grass is always greener (blah, blah).  We've gone through this more times than I can count; Each time, I wonder if I can endure yet another round.  I tell myself that there's no one else to take this responsibility, that he doesn't intend to lash out at the kids and me, that this phase of aggression/lying/complaining will eventually pass . . . but it takes a lot of energy and constant vigilance to erect and enforce the necessary boundaries to protect my sanity and safety.

Lord, help me to focus more on the good that is all around me, and less on everything else.

Hopeless

I'm sorry.  I just don't have words.

Catching up on medical stuff

At this facility since late May, it took a while for me to have an official first meeting (last week) to coordinate Raj's care with the onsite nurse, Judy. I'm relieved to finally have contact info for her. And I'm not the only one getting bossed around by Raj's new friend, Don - During our meeting, a resident died, so Judy needed to step out and speak briefly with hospice; Don was furious that he couldn't discuss getting a new cell phone with Judy at that moment; Apparently, in Don's work life, he was CEO of some big company and he's never experienced waiting. He doesn't like it.

Raj saw the neurologist yesterday & the lung/sleep specialist today.  Though we still don't have a diagnosis or hope for recovery, he hasn't gotten worse; This is both good (not requiring higher level care) and bad (no movement toward specific diagnosis or treatment).  His sleep study yielded helpful info, C-PAP adjustments have been made, and he hasn't been to the ER for falling since June.  I also received contact info for the psychiatrist Raj has been treated by at the assisted living facility, so I can try to catch up on his 2 med changes and maybe half-dozen labs.  I also stopped by the new PCP for samples so Raj can try one new cholesterol med instead of the 3 he currently takes.  Got a copy of the medical records from his Rush stay (only had a few pages before), but haven't had a chance to read through.

Ponderings on Retirement

Since I only taught for one year ($8K salary with minimum contributions to retirement), my North Dakota teacher's retirement paid out as a lump sum in 1991.  I worked in IT (programmer, Business Analyst, etc.) for 16 years, with annual salary ranging from $40K to $100K+ depending on overtime, where I always contributed the maximum to my 401K.  I've kept both in separate IRAs over the years, though they've been invested in the same market with the same funds, just out of curiosity:  Public vs private retirement benefits.  I wondered if there was a difference regarding what one "put in" (contributions and years of service) vs the benefit received.  I have several years before official retirement, but I've noticed a great disparity - $11K+ in my account for the teaching year and about $85K for my IT years; Granted, in today's economy, my totals are down 30-40% from a few years ago, but these numbers still drive home the point:

For 1 year of teaching and about $200 in contributions, I now have $11K
For 16 years of IT and about $80K (avg of $5K ea year) in contributions, I now have $85K

So return on investment, in years:  $11K/year vs $5,312.50/year
                        and in % increase:  5500% vs 6.25%

Interesting, huh?

Mornings

Every morning, for as long as I remember, I've gotten up with a song in my head.  It's not the alarm clock, since I use an annoying buzzer!  Sometimes, it's inspirational or uplifting to set the tone for the day.  Other times, it's some rockin' party dance music.  It might be an old hymn, an unfamiliar phrase (that I should probably write down), a drum cadence, even a nursery rhyme!  I wake every so often to commercial jingles that I've heard before on radio or TV, to recent iTunes downloads, 80s hair-band ballads . . .  I've never questioned why this happens, but recently experienced mild panic in a passing thought that this could disappear.  Maybe some morning I'll wake up to silence - no melody in my heart.

That's when I decided it might be a portal, of sorts, for the Holy Spirit.  You recognize a source by its fruit, right?  Sometimes, I wake up with a particular song I associate with an old friend, and I may reach out to that person, prompted by my morning thoughts.  Sometimes I feel the need to pray for a particular person, whoever is brought to mind by the music.  Other times, I'm awash with gratitude;  The dance beats and Big Band sounds energize me; Jazz can be bluesy and sad; But I'm never unaffected.

I can't be sure God's sending me messages daily, but I hope I can always feel this connection, and be open to its possibilities.