cdbaby now sells my music!

I was pleased to discover the email today saying that my page on CDBaby is ready to go. If anyone reading this hasn’t obtained a disc from me but would like to, you can check it out, purchase it, or just hear the tracks at:

http://cdbaby.com/cd/michaelroderick

So there you go.

american health care is fatally ill (Integris, etc.)

Update: June 08

We are still receiving “new” bills. (All my wife’s medical work was done in November-December 07.) The latest surprise was one we never received at all until the first notice from collections arrived in our mailbox a few days ago. The diagnostic lab didn’t even bother to call us about it, though when we called them they admitted to having a valid phone number on file. The saga continues.

The good news is that most of what remains for us to pay has been consolidated. The hospital bills have been discounted from somewhere around $18,000 to $4500 (for two hospital stints of a couple days each and one ER trip), and we are getting one of her medications for free because of our extremely low-income status. She was almost weaned off of prednisone, but the pain began to return at around 3mg/day. She’s back up to 10mg and we’re trying again, very slowly. The doctor has told us that if the surgery is necessary, he estimates that it would cost about $20,000 while we are uninsured. That would cover the cost of a procedure commonly performed after this type of “Crohn’s” diagnosis, to remove a small portion of the ileum. This will not “solve” the problem – in fact, it’s guaranteed to return (though possibly without some or all of the symptoms) within 15 years according to current research data. Needless to say, we’re looking for alternatives.

God has been gracious to us in all these things, and I am grateful to him for Jen’s life, her present good health, and for all the help we have received through our church body. When I wrote the post below, I was (obviously) angered and somewhat resentful. I should not have been so, but I was so. I’m leaving the post up because it’s reality, and it serves as a good reminder of how not to react during emotional turbulence. Placed by God in the midst of these situations, I struggle to maintain the long view – “I have learned in whatsoever state I am, therewith to be content.” Slowly, I am learning the difficult lesson; struggling to come to Christ for strength to bear up under affliction and instruction, rather than fighting Him over the presence of the afflictions themselves. I can only cry out with the publican, “God be merciful to me, a sinner,” and then be thankful in the knowledge that He is.

Original Post:

We are crouched in a bunker over here in Oklahoma, trying to avoid gunshot wounds and friendly(?) fire in the middle of medical bill hell. We are one small example of a nationwide problem.

I am a hardworking graduate student and my wife is a hardworking art teacher. Technically, she works “part time” (though she is constantly working, both for her classes and for the good of the home) and I also work part-time for the school and part-time for a church. My studies demand all of my time and then some, so there’s no way for me to work any more than I already do. For example, last Thursday when I had no “official” class on campus, I worked from 8:30 AM to 11:00 PM with no stops, except for meals, on coursework. I am in music, so my “coursework” also includes copious quantities of practice time in front of an instrument (2-4 hours a day minimum). My wife works equally as hard.

What matters at the bottom line for the insurance company, however, is not how much one is working but how much time one spends in a particular building away from home, officially on the clock. My wife was not (and is not) eligible for insurance through her school on that basis. Insurance costs are too prohibitive for us to have done otherwise, so we went without medical insurance beginning in August. We didn’t think much of it because neither of us have even had any serious medical conditions. Then in late November 2007, my wife began to have episodes of violent cramping that led us through two ER trips, two hospital visits of about two days each, and landed us here, two months later, in a pile of medical bills.

Her first trip to the ER (around Thanksgiving) followed a trip to a clinic (for people without insurance) where a doctor had told her she had probably eaten some bad food. He didn’t even prescribe any pain medication. Late that evening, when the vomiting and pain became unbearable for her, we went to the ER at Edmond Medical Center, which was closest to us. The physicians gave her a strong narcotic almost immediately (probably making it impossible for them to get an accurate idea of where her pain was), took an X-ray, told her she appeared to be perfectly healthy, and sent us out. They charged us $123 there, told us they had given us a discount, and did not inform us of the “other” charges that would come through the mail months later. They did nothing for us except prolong the waiting and increase our debt.

About a week later, she was having problems again and saw a general physician to whom we were recommended. He said he thought her problem was gastritis and gave her some stomach acid inhibitors (and took about $80 after the discount). That medicine only caused her a great deal more pain over the next couple of days. We called him back and he advised us to stop the medication – as if that were not obvious – and then it was almost impossible to reach him. He finally returned a call, referring us to a gastroenterologist who was booked until April 2008. That wasn’t going to work. But he never returned our calls when I was trying to get in touch about another doctor.

Did I mention that I was in the middle of final exams and juries?

Finally, we got an appointment with another gastroenterologist (with no referral, which is nigh impossible), one at Digestive Diseases at Integris Baptist Medical Center. By the time we were able to get in to see him (late December), my wife was already in awful condition and had not eaten for two days. She vomited often nonetheless and had lost about 20 pounds in the course of a month, putting her at just under 100. She was obviously not well and the doctor said as much, but, because we had no insurance, sent us home (after a $100 payment and a $20 prescription) to try to get her to take prednisone in pill form. Which is supposed to be taken with food or milk.

Of course, she vomited it like everything else she’d tried to put down for two days. She had a CT scan the next day ($465 up front in order to get the “discount”, which meant paying the same amount again within 30 days) but her condition only worsened. I called Integris and, unable to speak with a doctor, of course, I spoke with her doctor’s nurse, who was very nice, and said “the doctors suspect it’s Crohn’s disease; she can try to take the prednisone at home, if you want to try that, or you can have her admitted.” When is there such an option anyway? After some deliberation, only due to the high cost of hospitalization, we realized that she would need to be admitted. However, when we came to this realization, it was just after 5:00 PM on a Friday. Too bad! No one around, suddenly, but the answering service. We had the information about the “on-call” doctor, who was supposed to admit us in the case of emergency, and the answering service said they would get our message to him. He didn’t call. At 6:00, she was worsening and he hadn’t called. I decided I certainly would see her admitted and began the thirty minute drive to the hospital. I badgered the answering service again. They got angry with me. They said they’d send it again. Still, the doctor didn’t call.

We arrived and I helped my wife limp into the main entrance at about 6:45. The lady at the reception desk said she didn’t see my wife’s name on the list to be admitted, so she’d have to make a call. Imagine who she talks to. Yes – the answering service. Talk about introducing a single point of failure. So there we were, my wife sitting balled up on the couch, occasionally doubled-over in pain, with a receptionist telling us that hospital “didn’t have any beds” (why tell us a bold-faced lie?), for two hours while we waited for someone to get in touch with the on-call physician. Around 10:00 PM, she was finally admitted. When the doctor got in to see her (around midnight), he admonished us that we should have called the answering service to alert him to our presence. I was having difficulty not starting a fight at that point. I had called three or four times by then and the answering service folks knew who I was by name and were cross with me.

She spent two days there, being hydrated and fed a liquid diet, and then the doctor released her, giving her no dietary advice except “eat what you feel like eating” (how’s that for medical training?). The nurse who put her IV in compromised her sterile field while in the process, touching a few doorknobs with her “sterile” gloves on. (My wife was a nursing student for two years, so she’s very attuned to these things.) Doctor #2 did not prescribe us Pentasa or even offer us any samples, though they were giving it to her in huge doses both days in the hospital. The next day was Christmas. The night after Christmas, she was uncontrollably vomiting again, just as before, and we needed to get her back in the hospital. Unfortunately, her doctor was on vacation and the second doctor was not around either. Enter the third doctor. Because no one could talk with her doctor, and according to doctor #3 “we couldn’t get anyone in to see you tonight”, they MADE us go through the ER in order to get re-admitted, incurring all the charges appertaining thereunto.

So, ER trip number two. The Integris ER is even worse than the Edmond ER. The assistant who checked my wife’s vital signs was incredibly rude, yelled at my wife directly, and made her try to breathe into a barf bag which my wife had recently vomited into when she began hyperventilating. I was too chapped to even say anything because I thought I might do physical violence if I began. Oh, and they came in and offered me a no-insurance “discount” – if I could pay $200 on the spot. Who do these people think they are? Anyway, they wouldn’t admit her that evening, even after seeing her, but made her wait in the “medical decision unit” overnight, where we incurred more bills, and then Integris admitted her for the second time later on. Doctor three was a little more helpful with the diet than doctor two, suggesting that she not drink milk (one of the the things she had done in that two-day interval). At least he got her some Pentasa samples when we were leaving.

And here’s the thing: she’s not better. She’s been functioning more normally in recent weeks, but she has to have the drugs. As they wean her off the meds, she may find that she needs surgery. Of course, she’s now totally uninsurable. To get a month’s supply of Pentasa, with a “free drug card” (one of her only options) is about $400. We make $1200-$1300 a month. And this brings us to the present – medical bill hell. Thankfully, our church (and more recently, one family member) has helped shoulder the burden of the bills we’ve been getting. Otherwise we simply wouldn’t be able to pay any of them any more. The summary:

We’ve received a bill or statement (or phone call) about every other day for the past month and a half. Here are some of the total figures:

ER visit 1 – ~$1000 (about $700 now paid)

CT scan – $900 (paid)

Hospital stay 1 – ~$4000 (still waiting on “charity” paperwork to come back)

ER visit 2 / Hospital stay 2 – ~$3500 (after charity paperwork; was ~$11,000; not paid)

Separate physicians’ costs – ~$1000 and climbing (most not paid)

Drug costs – ~$400 and climbing (paid)

Lab fees (other than in-patient), associated other expenses – ~$300

We still receive bills and get calls from unknown creditors. And we are trying to get samples from our doctor until we find a way to get her this medication but often we call them at 8:00 AM and they don’t return a call until 5:00 or 6:00 PM (or worse, in a couple of days). If she has to have surgery, of course, all of the above debts will seem small. I can’t believe what we’ve already paid out of pocket. Anyway, if anyone among our creditors reads this, please don’t call right now. We’ll get to you as soon as we can. WE ARE DRY. You can’t get any more from us at present. I’ll gladly send you a copy of our budget so that you can verify this. The math is ridiculously simple.

passers by

“There is nothing left to write, that’s all,”

The thought occurred, an answer to another

Who would not deign to ask. My silent

Pen was not the culprit; standing still

Upon the page, upright, poised at attention,

Paused, untroubled by my accusation.

The page, unstained, blank as the pool at rest

Before me, uttered not a word in protest.

Neither surface stirred. No passers by

Had suffered to be parted with their way,

Not for a single inexpensive glance

(A fraction of the price of conversation)—

That is the way with all us passers by;

Listening only to ourselves, surprised

If ever we speak back at what was said.

“Nothing left to write”— I must have been

The other, begging reasons for depression,

Empty pens and papers, persons moreso.

What have they left us, waiting on the muse

Who, now exhausted with her exercise,

Would rather educate us, and explains

With weariness how oft our ‘inspirations’

Yielded already in better hands?

One bright eye affixed above my two,

Descending, I grope walls as rough as words

And heave the pick into them. Now the bright eye

Shows but little glittering to my two;

It’s treasure for a fool (that much I know),

The true veins long since stripped by older craft.

Might I avoid impoverishment, returning

Surfaceward with nothing, by forgetting

What I’ve seen of priceless gems and jewelry

To fix a cheap stone in a worthless setting?

Nature they have set—set and adorned,

With beauty at one face and truth another.

Nor was God too high an aspiration:

They have hymned him, and his virtue with him.

Love—and with love, war—need not the strains

Of latter, lesser art; nor paradise,

Nor hell, nor home, nor harvest—thus the question

(Or the answer) “What is left to write?”

So it is that pen and placid page

Converse amongst themselves, about themselves,

As is the way with all us passers by:

Mark time with small anxieties, unless

Striking the long-stripped vein (or being struck),

We live; but whom such tiny griefs oppress

(Who might live if they had something to fear)

May not be them—it may be you or I,

If it’s the way with all us passers by,

Not knowing we’re long dead before we die.

Roderick 11/14/07