Out of Network & Out of Pocket

 Photo courtesy obraprima

When I was younger, my family doctor was the same doctor who delivered me…and my mom…and her mom.  Needless to say, my doctor passed away before I was a teenager.  Since then, I haven’t had a real family doctor.  I never needed to see a doctor much so I suppose it didn’t seem like a big deal then.  When it came time for me to need a doctor for regular physicals and things, I didn’t know where to begin.  I still don’t.

As I came of age and had a job where I finally had health insurance, I randomly selected a doctor that I knew of because he had done my dad’s colonoscopies.  This doctor was a DO, which meant nothing to me then, and practiced gastroenterology and internal medicine.  Fine. Whatever. I didn’t care at the time.  I really didn’t know what to look for or how to find a doctor. I just needed someone to give me a physical, keep my prescription for birth control current and see me for the occasional illness.

Of course, I was rarely ill and, when I did go to the doctor, I never actually saw the doctor. I saw the Physician’s Assistant. That was fine because the PA was a woman and I am much more comfortable seeing a woman for my womanly issues.  It was fine, at least, until the PA made a few remarks that made me very uncomfortable.  I was having a chronic problem with yeast infections. I was having one at least once every month.  When I inquired about what could be causing them, she said something about how the only two things could cause chronic yeast infections: diabetes and HIV.  Talk about scaring the hell out of someone…and for no reason. It wasn’t until I went off of the pill that the real culprit came to light.  It was, in fact, the pill cause my problem!

In recent years, I’ve made an attempt to find a doctor closer to work.  It makes sense to be able to leave work and drive 15 minutes to the doctor at any time of the day rather than trying to drive 45 minutes one way and fitting in a doctor’s appointment either in the morning (beginning of the day) or afternoon (end of the day) which never seems possible anyway.  But how does one pick a doctor in a town they are only vaguely familiar with?  By asking friends and coworkers, of course.

This led me to my last doctor who was ok, at first.  Then she started giving me life advice and telling me how to sort out my life and which decisions I should be making based on her own beliefs and only bits and pieces of my life story.  Thank you, but I’ve already seen a shrink for this.  There are also issues that I have been having that she had no idea how to fix or what to do.  She said to me, “I know that your issues are hormonal, but I don’t know what to do for you.”  It was probably a blessing in disguise when she sent all of her patients a letter saying she was leaving her practice to go explore opportunities at the local hospital.

At this point, I had had enough. I just wanted someone who wouldn’t look at me like I have two heads or three eyeballs when I say I’m having hot flashes!!!  Based on the advice of my friend/landlord, I went to see a doctor who is a D.O. and is also dedicated to holistic healing.  This doctor doesn’t accept insurance and, thus, is considered out of network.  Because I was/am desperate to find someone who will help me, who won’t make me feel like I’m crazy, and who can offer some kind of solution to my problems, I decided to give it a whirl.  

My initial visit was one full hour with the doctor and $425.  It wasn’t what I had experienced in the past as a typical office visit. No one weighed me, took my blood pressure, took my temperature or looked in my ears. I arrived a few minutes early and the doctor herself called me and took me back to the room.  There was no waiting and there was no one else in the office waiting to be seen.  She sat in a chair and I sat across from her. She said to tell her what was going on. I explained my main issues being that I feel like I’m having hot flashes even though everyone says I’m too young.  “In fact”, I told her, “I’m having one right now.”  She asked me to show her where I was feeling hot and I did. She said I was indeed having a hot flash!!! 

I explained more about the issues I was having - anxiety, panic attacks, I was edgy and not able to sleep, not being able to focus, fatigue, a chronic no-apparent-reason rash, weight gain, loss of libido, night sweats, some serious acne, a serious sensitivity to smells and perfumes, and digestive problems.  After listening patiently to my problems and my theories about what I thought caused some of them, she told me there is definite potential for a hormonal imbalance. She explained to me and drew a diagram about how our hormones work and are created, what affects stress can have on the production of different hormones and how things can be thrown off kilter.  When it was all said and done, she had given me a full prescription page full of labs that needed to be done, a 24-hour urine home analysis kit to check for toxins in my system and a suggestion for a natural antihistamine for my scent sensitivity.

I left that office beaming.  Even though we didn’t know exactly how off kilter my hormones were and I had to wait at least a month to find out, I had to drive 45 minutes one way, AND it cost me $425 of my own money, I was ECSTATIC!  Someone believed me! Someone actually thinks that there is something we can do to fix me!  (I actually ended up waiting six weeks to see the doctor again.  My blood tests had to be done in a three day window within my cycle.  Apparently, my cycle was off (another issue) and it takes two weeks to get the results from the tests.)

My second appointment was all of fifteen minutes.  Again, I was the only one in the waiting area and the doctor herself greeted me and took me to the room.  She showed me my test results and explained everything to me.  All of my hormones are out of whack and my testosterone levels were “the lowest of any woman I have ever seen,” she said.  I also had toxic levels of lead in my system. Kind of creepy, no?  I walked away with a page of instructions and my prescriptions were called into the super pharmacy that compounds their own medications and then mails them to me!  In the morning, I take 6 pills to “get the lead out”, 1 DHEA supplement, 6 drops of vitamin D that amounts to about 2500 times the daily value, and I slather on a testosterone gel.  In the evening, I rub in a progesterone cream. 

It’s too early to notice a change, but I am so excited to be doing something. I am excited to know that I’m not crazy. There is something out there to help me.  I want to share my doctor with all of my friends who are having issues that no one else can seem to solve. 

The medical profession is frustrating to me in so many ways.  So many of my friends have issues that there is no real solution for. Everything is a try this and see if it works approach.  If that doesn’t work, we’ll try something new.  My friend’s issues range from migraines and insomnia to epilepsy and chronic depression.  It’s so frustrating. And finding a doctor, a good doctor, is so very hard. 

Anyway, if all goes well with this hormone therapy program, I would love to recommend this doctor to anyone.  The initial cost seems like a lot.  Of the $425 initial visit, which I did turn in to my insurance (the doctor’s office gives you a medical billing form to help with that), $236 of it was covered by my insurance.  That, however, did not even cover my $250 out of network deductible.  (It’s sad that extremely good money is paid for insurance and you can’t see any doctor you want and have it covered.)  I am still waiting to see how much of the second visit will be covered.  But the doctor only makes you come see her when it’s absolutely necessary. She is having me check in around the two week mark via email.  If I have questions, I can call or email (which I have done).  If something isn’t working, email.  She makes it clear that she’s not there just to take your money.  She wants to help you and is willing to help keep the costs down and work with you in a manner that works for you.

Blogger editor

Well, I published the previous post and blogger isn't letting me go back and edit it so I can finish it.  But it's long enough. You get the idea.  =)

C25k Plus

For the last six weeks or so, I have attempted to incorporate regular exercise into my daily routine.  I, like many people, struggle with making/taking the time to exercise.  Since moving, however, I have had exclusive access to workout equipment including a treadmill, an exercise machine that does everything, weight benches, dumbbells and an incline bench.  So, I told myself that there is no real excuse for not getting off my butt and getting moving.


My initial plan was to exercise with My Friend five days a week. We were going to alternate equipment on alternating days.  On Day 1, I would use the treadmill while he used the machines and weights.  On Day 2, I would use the machines and weights while he used the treadmill.  And so on and so forth.  That was the plan. Of course, the plan didn’t work out like I had imagined it would.


My Friend realized that he is used to having a spotter when using weights.  He found himself doing a set and then sitting around wasting too much time during his rest in between sets.  Whereas, if he had a spotter, he would do a set, his spotter would do a set and then they would switch back and forth giving adequate rest time while not wasting time.  He also prefers to do more treadmill work which causes conflict because we both like hitting the treadmill each time we work out.


 The plan I had for myself was to follow the Couch to 5K plan three days per week and then weight train on the off days.  I found myself conflicted regarding this because I like to weight train and do cardio together in order to burn more calories.  (Thank you Jillian Michaels!)  And, I have found in the past that my legs benefit from a good days break in-between running.


So, the last six weeks have been a trial and error type thing until we could get into a routine that we both liked. Unfortunately, My Friend caught a wretched cold about two and a half weeks ago and hasn’t come back to working out with me since.  Though I enjoyed the idea of working out with a partner, I don’t mind going it alone.  I actually prefer it given we both want to use the treadmill. Now there’s no waiting or fighting over it.


My workouts got off to a rocky start. The first week that I started, everything in life just kind of blew up. My Friend had someone quit at work so he was having to work a lot more and a lot later to cover for this person.  We were house-sitting as well and some other odd things came up. I got in two workouts that week and then had three days of nothing so I gave myself a full week and started all over again.


I started with Week 1 of the Couch to 5K program.  After each session on the treadmill, I would do some weight training.  My favorite moves consist of the following:

·       Lunges with bicep curls with 5 lb dumbbells (moving up to 10 lb)

·       Side Lunge with Anterior Shoulder Raise with 5 lb dumbbells

·       Overhead Tricep Extensions with 10 lb dumbbell

·       Tricep Kickbacks with 5 lb dumbbells

·       Chest Fly with 5 lb dumbbells (moving up to 10 lb)

·       Standing Leg Extension with Shoulder Press using 5 lb dumbbells

·       Should Shrugs with 10 lb dumbbells

·       Sit-ups on the incline bench (2 sets of 5)

Most of these exercises come from Jillian Michaels 30 Day Shred dvd.  (I heart Jillian!) I also have to share that I had a bit of a misadventure doing sit-ups on the incline bench. Being a smartass, apparently, I executed 3 sets of 10 sit-ups on the incline bench during my first week of exercise.  I couldn’t rotate my torso for two weeks.  Standing up and sitting down without the support of my arms was torture.  I even gave it another week after that to make sure I was fully healed.  Now, I take it easy eeking out two sets of five.  They say you can’t do much harm to your stomach muscles, but au contraire, mon frère.  Really!  It hurt! Like hell!

I’m also taking it easy with the whole C25K thing.  I’m the kind of person that likes to be good at something before I move on to the next level or the next stage.  Instead of immediately going from week 1 to week 2 to week 3 and so on, I’m doing each week of training for two weeks.  I just finished my second week of week 3 and started my first week of week 4 last night.  This gives me time to build up a little stamina. It gives me time to get bored of something before I move on and I have a better feeling that I will be able to accomplish the next week.

Going in, I already knew that I liked to run. I don’t love it, but I like it well enough to do it.  I had never run on a treadmill though. I had only run outside. At first, I didn’t think I’d like the treadmill. There’s very little margin for error when it comes to footing and timing. You have to keep your feet moving. There’s no real cheating (which is good for me) unless you step off to the side.  I really have to make an effort to pay attention and keep my eyes forward otherwise I’m likely to veer off to the side and that is a tooth loss waiting to happen. 

The benefits that I have found when running on a treadmill as compared to outside is that the surface is smooth and consistent. No worrying about stepping in a hole or on something and twisting your ankle.  No worrying about someone coming up behind you on a bike or having to pass anyone.  You can maintain a consistent speed which I have found to be much harder when running outside.  You can track your speed and distance easily. 

I’m sure that, should I ever want to train for a race, it would behoove me to train outside or on a track. From what I can figure, and I have done zero research on the matter, there is a something lacking in treadmill running.  When you run outside, you have to use your legs to push yourself forward.  When running on a treadmill, you really just keep your legs moving while the belt moves for you. There’s no real force to keep your body moving in the forward motion.  Like I said, I’m not expert on the subject but this is what I think about when I’m on the treadmill needing something to keep my mind off the monotony of running.

The main purpose of my exercise endeavor is to try to have a healthy body.   My doctor once said that the only fountain of youth out there is exercise and I buy into that school of thought.  I wouldn’t mind toning up and losing 7-8 lbs either. Though, I do know enough about exercise to know that three days per week probably isn’t going to cut it if I want to lose weight. It will help me maintain my weight, but not lose it necessarily. And given that I only have 7-8 lbs to lose, it may take a lot more work to lose than if I had 100 lbs to lose.  I don’t own a scale so I couldn’t really tell you if I’ve lost weight or not. I did notice that my pants are a little bit looser, but it may be a fluke too. (I don’t want to jinx it.)  I would like to work up to getting exercise 5 days a week since we are planning another trip to Cabo San Lucas in about six months. So I have six months to get in shape. =)

So far, I’m enjoying my workouts. I usually have a Friday-Saturday break making my Sunday a great running day. My legs are well rested and I am eager to get back at it.  (I find my calves to be my biggest obstacle – always tight and always burning.)  Usually the second day, Tuesday, is the roughest. I’m tired from work, my body isn’t as rested and I am just dreading hauling my butt to the treadmill.  By Thursday, my third day, I feel accomplished that I made it through another week.  I am pretty proud that I’ve kept up the pace and kept going. I hope, again, that I’m not jinxing myself.

Way. Too. Busy.

The past several months have been extremely busy. I don't mean to complain about being busy. That is not my intention. I make it a point not to complain because I moved last year, in part, to have a life.  Or more of a life, anyway.  But it just isn't my personal life that is busy.  Work has been so crazy busy for several months now that I barely have a chance to catch my breath or to look ahead at what is to come because I'm still looking back at the whirlwind of the last several months. 

Everything remains overloaded. My work email has 129 unread emails, my personal email teeters on 200 unread emails and my Google Reader is lingering around 920 unread items.  I try to keep up, but end up sending brief, cold responses out to co-workers and friends instead of carefully communicated or caring messages.  I have missed important dates like the birthday's of my best friend's kids and baby showers.  I'm tired and cranky.  And I haven't had a chance to enjoy the summer at all.  Although, summer is always a busy time with the overtime that I try to put in.  This summer feels as though it's come and it's going fast and I haven't had time to sit outside and take in the fresh air, listen to the birds sing, marvel over the beautiful green trees and grass, or go for a boat ride on the lake.  I miss my family, I miss my friends and I miss just being able to sit and enjoy the quiet.

Things with My Friend and his personal issues keep us very busy too.  If it's not one thing, it's another with his situation. And you never know when it's going to strike.  Just when you think things have calmed down, you realize that that was just the calm before the storm.   

I'm hoping that as the overtime comes to an end, things will slow down.  Then again, I've been thinking that things will slow down for months now and they just keep picking up.

Home Invasion

First thing I usually do when I get home from work every day is change into something comfortable. So Thursday evening was no different. When I got home, I headed straight for my bedroom to change my clothes. As I was taking off my necklace, I noticed that my little decorative bowl that I keep change in looked like it was missing a lot of change. Instantly, I accused My Friend because he is always teasing me for saving pennies (along with everything else) as his change jar only contains silver coins. He keeps telling me that he is going to take my nickels, dimes and quarters and leave me just the pennies. Although, I thought it was odd that, if he was going to take my silver coins, why would he leave some and only take a few. But who else was there to accuse?


For a little while, we bantered back and forth about the whole thing. I kept saying that I felt like I was imagining things because who would come in and take anything. We were pretty sure that the folks who work on the property wouldn’t risk it because they would be cutting a great tie by losing their job there and they are all good, honest people. My Friend kept asking if I wanted him to go say something to the landlord, who just happens to be his dad. I hemmed and hawed about it some because I really didn’t want someone to unnecessarily be accused of something. Ultimately, we decided to let the landlord know which turned out to be a good move.

Apparently, one of the guys who works on the property had spotted a young man earlier in the afternoon walking down the driveway at which point the young fellow was told that he was on private property and was instructed to leave immediately. The young man had indicated that he was leaving but that he had just run away from home.

At this point, it was decided that the landlord would call the police just in case the guy decides to return at some point. Meanwhile, My Friend and I are in our apartment hashing out more oddities that were previously dismissed. For instance, when My Friend got home from work, he found a cup with Kool-Aid in it and Kool-Aid splatters all over the kitchen counter and floor. He assumed that it was messy me (granted, I’m messy, but not that messy) and cleaned up the spills and went about his business.

As we stood there in the kitchen discussing this, My Friend opens the refrigerator to find an empty pitcher with just a splash of Kool-Aid in the bottom. He’s like, “I thought you did this too.” Nope. Apparently, the kid who entered our home did that too. Not only did he take half of my change from my bowl (which had coins from my trip to England), but he drank the Kool-Aid out of a cup that I had used the day before, put the empty pitcher back in the refrigerator, spilled it all over, rummaged through the freezer taking a full bag of Taquitos and placing frozen hotdogs from the freezer in the refrigerator (which we joked about saying he planned on coming back later), rummaged through our pantry cupboard and took food from there and stuck his hands in bags of things and ate from them too.

Ugh! It was so nerve wracking. Of course, there has been great discussion about locking the doors now. At first, when we moved in, I was bothered by the fact that we couldn’t lock the doors (the landlord doesn’t have a key and has never locked the doors), but I let it go. Until now. The landlord insists that we still don’t need to lock the doors as the police office indicated that the kid who invaded our home (and another single ladies' home that same day) was a foster kid from down the road who was about 18 with a 3rd grade mentality and is “harmless”. This kid is said to not be able to have sodium because too much causes him to have heart attack-like symptoms. Since he is not allowed to have certain foods, he goes into other people’s homes and eats whatever he wants.

Regardless of this kid’s harmlessness, he still invaded my home and went through my things. All of which is nerve-wracking for any person. You feel so out of control and debilitated because there is nothing you can do. What is done is done and what is gone is gone. For someone who is co-dependent and depends on controlling certain aspects of their own life (even though there has been lots of therapy to learn to let go of some things, there are still things that drive me crazy when out of my control), this has been a very traumatic event no matter how minimal the damage.