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Gail Gurman
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Gail Gurman [userpic]

As of June 1st, I'm now on Medicare. Before that I was on Medicaid which, in Oregon is the Oregon Health Plan aka CareOregon (the latter administers the former, but as far as I'm concerned, they're the same thing). Now that I'm on Medicare, CareOregon remains my secondary provider. That is, Medicare pays 80% of medical bills and CareOregon pays remainder. I also have a third company that covers my prescriptions, although they do require small co-pays (CareOregon never required co-pays for prescriptions).

This change to Medicare has good and bad aspects. First the bad:

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Current Mood: calmcautiously optimistic
Gail Gurman [userpic]

Last week, I got on the bus in my power wheelchair and there was a group of very large people sitting in the front (forward- and center-facing) seats. One guy said, "I wish I had a chair like that."

Now, I think we can all agree that that was a stupid thing to say. But the truth is that, before I ever needed it, I kind of wanted a chair like I have now too. Of course, no one wants the *need* it, but it is kind of cool, especially you find walking challenging.

(Long update coming soon.)

Gail Gurman [userpic]

[This post was meant to be a reply to Lenore's blog post Medical Insurance Companies Suck the Big Bone but, perhaps due to it's length, I couldn't post it to either of two blogs where her post appeared. So I am writing it as a public LiveJournal so I can link to it instead.]

At least you have the hope that someone will get a clue and realize that a mistake was made (and I certainly hope that happens soon). After I was laid off from Wink and my COBRA ran out, I was denied coverage because of my weight. So I was uninsured for a few years after that until I went to law school, during which I was covered as a student. After that, I was unemployed and once again, uninsured. But I have always been healthy, so I didn't really miss having health insurance.  

Then, mysteriously, in the Fall of 2008 I started experiencing weakness in my legs. I couldn't afford to see a doctor, so I went to the local free clinic and was told that I had edema and I should wear support hose and put a pillow under my legs when I sleep. I did those things and still got worse.  

Finally, someone told me that Providence Medical Group provides low-cost care to people who can show need. Through them, I was able to see a doctor in May 2009 and get a referral to a neurologist. (Providence eventually totally covered the visits to the doctor.) The neurologist ordered an MRI, a very expensive test. The receptionist at the neurologist office said that not only would they not charge me, but she also put me in touch with an organization called Project Access that helps people in need get free medical care. So I was able to get the MRI for free.

When the MRI showed that I needed surgery, I had to apply to Providence to ask them to pay for it and they eventually said they would cover 70% (they eventually covered all of it except the anesthesia, which is kind of weird).  

I couldn't apply for Medicaid (Oregon Health Plan) because I didn't fit any of the eligible categories. My only hope was to get Social Security to grant me the official label of "disabled." I had applied for SS Disability in June. My MRI was in August and my surgery was scheduled for November.  

In December I finally heard that I would start receiving SSDI in January. As you know, Lenore, the operation was a success, in that the spinal problem discovered in the MRI was fixed, but the immediate outcome was not expected, in that I was paralyzed from the chest down.  

(For those not familiar with my story, there was no evidence of malpractice and I have improved a lot since then, so whereas I was getting progressively worse before the surgery--I was barely walking with a walker when I went to the hospital--for the year since the surgery, I got progressively better. My progress lately has plateaued. I am back to barely walking with a walker, but now I have a power wheelchair too.)  

When the SSDI approval was announced, I suddenly became eligible for OHP. And as of this coming June, I will get Medicare! Meanwhile, OHP has provided a lot of services for me, for which I'm very grateful, including dental coverage, which I haven't had since leaving Wink. And Medicare promises to be even better.  

Incidentally, while having medical coverage would have allowed me to see my doctor earlier, my neurologist said that, for various reasons, it wasn't until that exact point in the progress of my condition (in July) that he would have known what to look for and been able to diagnose it. So it's not clear whether it would have been more comforting to have been able to see someone earlier, or if it would have been more stressful to go through more tests with inconclusive results. Only the time between diagnoses and surgery would have been shortened.  

One final note: My progress plateau may or may not be due to the fact that OHP only approved a limited number of physical therapy sessions which, even spacing them out as much as possible, ran out last November. Private insurance might have paid for more.

Gail Gurman [userpic]

We had a serious tub overflow situation Saturday morning. I won't go into the details, but it involves Tony running the water in the tub with the intention of cleaning it, and then walking away and forgetting about it. It overflowed so much that it turned both bedrooms (on opposite ends of the apartment, with the bathroom in the middle) into veritable swamps.

After Tony's attempts to soak up the water with towels and a blanket quickly proved to be useless, I called the apartment office. The office is closed on Saturday but there was a message with an emergency number, which Tony called. It turned out to be an answering service, but within 15 minutes, with no call back, the maintenance man for the complex showed up and started vacuuming up as much water as he could. Soon after that, a carpet expert (or whatever) showed up and figured out where exactly the wet extended to and set up blowers directed under the carpets.

By the time he left, the situation was this: The blowers stay on until Monday when he'll come back. Meanwhile, we keep the heaters on and on max. We were to crack the windows in the affected rooms an inch until midday today, and then close them.

As a result, although the temperature outside is in the mid-40s, inside it feels like about 100 degrees.

Current Mood: hothot and miserable
Gail Gurman [userpic]

Today is the anniversary of my surgery. When I arrived at the hospital that morning, I could walk with a walker, but my mobility had been deteriorating for over a year. After the surgery, I was paralyzed from the chest down, but it marked the beginning of a slow recovery.

Now, a year later, I am at about the point, mobility-wise, where I was when I went into surgery, but the difference is that I am on an uphill trajectory.

For over six months leading up to the surgery, my life was basically restricted to my second-story apartment. The only times I left were to visit doctors. That's sort of still true now in that most of my excursions are for medical reasons, but I have more of them (due to physical therapy, etc.), and I do occasionally go out by myself for other reasons. Last week, I went to a 3-day continuing legal education workshop. Tomorrow, I'm planning to take a series of buses to go visit PHR, the rehab facility where I spent three months last winter.

It's been a while since my last real update, and I don't want to detail everything that has happened since then, but here's a brief summary:

At the end of July, my PT requested approval from CareOregon (Medicaid) for 12 more visits, but CareOregon only approved 2 based on my having a chronic condition. I appealed and they added 6 more visits. We've been spreading them out and now I have 2 left which I will be using this month. After that, I'll have a re-evaluation in December and then probably not again until March. The bright side of this is that, in fact, we had a goal of getting me to the point where I could walk at home and we're just about there. I need to do more practicing on my own, but I've been walking, with a walker, in therapy for the last several sessions.

Another problem I've had to deal with has been a small accommodation situation at my apartment. Ever since I moved in here, the management has been very amenable to changes and very accommodating in several ways. They agreed that an agency called Unlimited Choices could install safety bars in the bathroom, widen the bathroom door, and install a small ramp at my front door to make it easier to go over the threshold.

However, since the beginning there has been a problem with parking spot in front of my door. I have a short path that leads from my door to the parking lot. Where the path ends, there is a handicapped spot. The problem is that, if someone parks in the spot, it blocks the path. For a long time after I moved in, I was told that the contractor couldn't do anything until the rain stopped, and it was a long rainy spring. When it finally dried up, they were swamped with work, so there was more delay. When the work was finally done, what they did was to widen the bottom part of the path, remove the curb in the widened part, and paint a diagonally striped path between the handicapped space and the space next to it. The problem was that, where they widened the path (i.e., removed landscaping), they didn't pave, but rather left it as just a patch of dirt. When I asked about this, I was told that I should contact Unlimited Choices to ask them to pave it. Well, they don't do outside work. My transitional case worker (who had gotten Unlimited Choices involved in the first place) got me in touch with someone from Fair Housing who said that the management was responsible for paving the spot and that she would contact the manager. This is still in process. Meanwhile, the dirt patch is now a mud patch.

So anyway, I'm starting to think that it might be time for me to start thinking about working again. The problem is that I wasn't working before this all happened and my legal work experience is limited to a couple of internships. I am going to explore some volunteer opportunities, but it would be nice to see a paycheck again. It's been a long time since I saw one last.

Current Mood: coldcold
Gail Gurman [userpic]

This is not one of my usual updates. It's just something I felt like I wanted to talk about and I figured it was too big for a regular Facebook status update.

I'm actually not sure when I first heard of and created my account on Pandora. Apparently I didn't do much with it so probably it was early on and they didn't have anything I was interested in yet (or I just didn't get it). the first time I really started playing with it was when Facebook changed their security to allow sharing of profile information with other sites. I made a point of turning off profile sharing with the sites they listed, including Pandora. But then I realized that they used FB info so I could see what stations my FB friends had created, so I turned it back on.

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Current Mood: gigglyupbeat
Current Music: Pandora
Gail Gurman [userpic]

Not much going on right now. My physical/occupational therapy sessions expired last Monday and Medicaid has only approved two more. My PT says I should have one in the next few weeks, with Tony attending to learn how to help me walk, and then one in October. (During that session last week, I walked with a walker 30 feet, for two minutes. It's the longest I've walked and I was tired when I was done.)

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Current Mood: blankblank
Gail Gurman [userpic]

[Okay, one final reference to the generous donations I received recently: One of the items I received was the Etac Beauty Body Washer, which arrived without any information inside to indicate who sent it. If you had this item sent to me, please let me know so I can properly thank you. Incidentally, the coffee filter I mentioned in my last post was accidentally sent to me by my parents, so I was able to give to them when they were here—very convenient.]

As my father mentioned in a comment on my previous post, my parents came to visit last week. Our original plan was for us to make plans at least a day in advance and then get Trimet LIFT to pick me up. Trimet LIFT is a program run by Trimet, the local transit company, that provides door-to-door rides for people with mobility problems. The regular Trimet buses all have lifts too, but (like most city buses) they have to be ridden from set stops at set times. The only problem is that, for Trimet LIFT to give me rides, I have to go to their evaluation facility and get my chair measured and weighed. (Oddly enough, they will give you a free ride there even before they've done the evaluation.)

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Current Mood: optimisticmotivated
Gail Gurman [userpic]

[Warning: This post contains a fair amount of discussion about my butt, though nothing graphic. Please try to imagine your own butt rather than mine when you read it.]

Once again, I'd like to thank everyone who responded so generously to my request for help. I've received several of the items I requested, and I've already started putting them to good use.

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Current Mood: recumbentcomfortable
Gail Gurman [userpic]

First, I'd like to thank everyone who responded to my request for help in my last update. I feel like I've been over-using the word "appreciate" lately, but I can't think of a better word to describe your generosity.

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Current Mood: happyhappy
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