Hey, I know from experience that sometimes logistics can be hard. Getting an item from Point A to Point B in the right quantity at the right time can take a bit of work. When the chips are down and time is a factor, I’m glad I can count on the prowess of the United States Postal Service to let me down hard.
But seriously, an item I ordered landed in Philadelphia last Saturday. In the four days since it has been transferred to Hyattsville, onward to Baltimore, from Baltimore to Washington (where it rattled around the Regional Destination Facility for 6 hours getting scanned repeatedly), back to Baltimore, and reverse coursed back to Washington where it has been sitting since 7:34 this morning. But I suppose I should be confident in the big bold promise of “Delivery by 29 November.”
I mean it’s not like the USPS has been charged with delivering mail and packages for well over 200 years now. Getting a little padded envelope from Philadelphia thirty miles down the road to Elkton is clearly one of the more logistically complex efforts every devised and executed by the mind of man.
Thank the gods that the package in question absolutely does not contain medications that in any way are responsible for keeping me alive.
Sigh. Apparently, in mail, as in war, even the very simple things are so very hard to do.
1. Inefficiency. Look, I’m delighted that Big Pharma is reimbursing me 93% of my out of pocket costs for the meds that one of the smart docs from Hopkins tells me will contribute to being able to continue to living better through chemistry. I’d be even more appreciative if their reimbursement scheme allowed for ordering more than a 30-day supply of the stuff at a time. Everything else rolls in as a 3-month supply that’s simple enough to refill once a quarter except this one little pill. It feels like I’m online getting that one refilled or coordinating the refund about every seven days. If you’re going to spend the money either way you could save us both processing time and effort by doing it four times a year instead of 12.
2. Single points of failure. The world is full of people who want to gather all decision making and power unto themselves. I’ve never understood that particular logic for several reasons. First, the ones who seem to be drawn to absolute power are generally the last ones who should be engaged in decision making. Second, there’s nothing more ridiculous than a few dozen people standing around knowing what needs done but being paralyzed for lack of having someone explicitly telling them to do it.
3. Consistency in the space program. I really wish we lived in a country that had consistent and achievable, manned and unmanned space exploration goals. I want NASA to be above politics and be maybe the one instrument of government that is the best reflection of ourselves. I want to see big rockets with the stars and stripes plastered to the side hurtling American astronauts back to the moon and then getting their ass to Mars. To think that’s not the next logical step in exploration is nonsensical and flies in the face of humanity’s eternal struggle to expand into the unknown. Other people will tell you this should be way down on the list of priorities, but those people are wrong and should be quiet.
I’m not going to lie here, I was a bit skeptical when I was given a link that promised a “significant rebate” on one of the more expensive meds that are currently keeping me alive. Sure it was all nice and official and came to me by way of bitching at my doctor about the ridiculous cost of this new pill, but the claims of being rebated almost 95% of my out of pocket expenses seemed outlandish and unrealistic.
After getting my second check back from the nice folks at Merck, though, I had to admit to being pleasantly surprised. Sure, they make they process convoluted and require a fair deal of bureaucracy, but in the end what would otherwise be an obnoxious monthly expense ends up costing a total of $5.00 out of pocket. I’m just going to ignore for the time being the small fortune I’m sure to be costing Blue Cross for all this, of course. I just think of myself as an insurance industry loss leader. They an feel free to use me as an example of someone who’s wildly pleased with their products and services.
As much as I like to bitch and complain, I think it’s worth doling out credit where and when it’s due. From my perch, kudos to Big Pharma for the solid work at delivering new and effective medication and for having a means and method to help offset costs for he end user. Well done.
One of the many exciting parts of my recent run of days off was a visit with my frighteningly Teutonic primary care doctor. I actually like the guy – Not just because he’s instrumental in keeping me alive despite my best efforts to the contrary, but also because he’s not a pushover. I’ve had docs in the past who were probably a bit too willing to give way in the face of a strong personality. This guy, well, he’s not a pushover. Even when I’m blatantly ignoring his advice, I appreciate his frank and direct approach.
This most recent visit resulted in a few tweaks to the daily chemical cocktail that’s doing its best to keep me from dropping dead. Although I’m feeling fine, we added a fairly new drug to the mix because some of the underlying numbers were starting to creep off target. Yeah, it’s another hundred bucks a month out of pocket, but when weighed against the previously mentioned dropping dead option, I suppose it’s really a bargain.
As a responsible drug user, I try to be at least minimally informed about what I’m swallowing down with my morning coffee. Reading the list of potential side effects checked off most of the usual unpleasant check boxes: May cause runny or stuffy nose, sore throat, headache, irritability, back pain, joint or muscle pain, nausea, stomach pain, or diarrhea. Basically what the helpful information packet told me is that the side effects are a subset of conditions I already expect to experience on a regular basis. Super.
I got a call today from a number I didn’t recognize. Usually I (not so) cheerfully ignore those, but since I was working from home today, I accepted the call… at which point I started down the rabbit hole.
Them: Hi, Mr. Tharp. I’m Casey from Whatever-the-Hell-Company. I’d like to talk to you today about your prescription pain management program?
Me: Uhhh. My what now?
Them: I’m Casey from Whatever-the-Hell-Company and I’d like to talk to you today about your prescription pain management program?
Me: Yeah, I don’t have one of those.
Them: Well, Mr. Tharp, I’d like to talk to you about…”
Me: *Ends call and wishes hanging up a cell phone felt any bit as good as slamming down the receiver of an old fashioned rotary telephone*
Now this was a live person who I’m assuming was working off a script based on my three days as an inbound tele-marketing center employee. Cold calls are fine and all and since she had a pleasant voice and didn’t immediately try to sell me on Amway I was trying to be cordial… but when I’ve told you for the second time that whatever information you have is incorrect, it’s best not to keep telling me that I do, in fact, have a prescription pain management program. Frankly I feel like that’s something I’d know about.
I’ll be reinstating my policy of letting all unknown numbers ring through to voicemail immediately. I should have known better.
1. Brain fog. Perhaps worse than actually being sick is the pharmacologically induced brain fog that comes from trying to stave off the more obnoxious effects of the human condition. It makes everything happen just a little bit slower and makes it well near impossible to craft well formed and coherent sentences. Don’t even ask how badly it tends to mangle spelling and grammar usage, which isn’t a particularly strength of mine to begin with. Despite the annoyance, I’ve got a few more days of self medicating left before letting the stuff work its way out of my system. Until then I’ll continue to be the poster boy for short attention spans.
2. Two months. We’re still two months from the 2016 presidential election. I usually like this stuff, but I think at this point I’d rather take a jackhammer to the side of the head than listen to another day of the back and forth.
3. Afternoon television. It’s something I only notice the once a year or so that I find myself home and otherwise unengaged between the hours of noon and 4:00 pm, but there really is absolutely nothing on television on a typical weekday afternoon. Which makes perfect sense when you consider that most of the people who have jobs to earn disposable income are at their jobs earning disposable income instead of home watching television. Still, I’d like to note how wonderful it is to live in an age of Netflix and Amazon Prime. They saved me from endless hours of crap programming on the networks and cable providers this week.
After spending the better part of an hour this morning with the orthopedic surgeon, he basically confirmed what was a foregone conclusion. Winston has a complete tear in his cranial cruciate ligament (CrCL). The only interesting bit I gleaned from the appointment was that the tear most likely occurred long before he started showing signs of it two weeks ago. His knee is already showing signs of scar tissue filling in and trying to stabilize the joint. That’s the good news.
For the moment, as long as he’s taking anti-inflammatory and not putting any undue strain on his leg, he’s getting along without any real sign of trouble. The bad news is that he can’t stay on the anti-inflammatory indefinitely. When that prescription runs out in a few weeks, we’ll have to make a judgment call on how severely his range of motion is effected, how much pain he’s in, and how much his quality of life is disturbed. For the moment, we keep him medicated and keep him relatively calm (which isn’t particularly hard with a bulldog).
For now, all options remain on the table – from basic medication and plenty of rest to the repeat of the TPLO surgery he had on the opposite leg three years ago. I wish there was something more definitive to report this evening. As you can probably well imagine, I’m not at my best when dealing with the vagaries of time and a whole lot of “maybe.”