Friday, September 12, 2008

Doctor's Appt

So, I am finally being a grown up and going to the doctor about my stomach problems. I guess, in the end, I'll be going to the doctor about quite a few problems I've had lately. Aimee and I have been using a 'No Appointment MD" for the last few years on the rare occasion that we actually need a doctor. This is usually just for a physical to keep our foster care license but since my blood pressure problem I've had to go back for checkups and what not. We have no primary care physician. This may sound strange, but since we moved to Phoenix I've been almost paralyzed by the decision. I looked up which docs are allowed by my insurance and there are almost 300 in the valley. 300? How do you choose one? I narrowed it to our zip code and nearby zc's (there are 12 within like a 5 mile radius) and it dropped to like 30. Wow. So, yesterday I called a gastroenterologist because someone at work suggested that I might see one about my stomach problems (more later on that). I just picked one at random from the list, there are only like 8 of those, and called. They only take referrals. Called another one. They only take referrals. Ok, so I told them I didn't have a PCP and they were dead silent. I asked if they had any recommendations and they said someone on my insurance. They didn't pick a name, they literally said, "Someone on your insurance". I said, "Really, there are hundreds, how do you choose one? You must have some recommendations..." Well, they did. They recommended a 'group' nearby to where I live and so I gave them a call. They take my insurance. I said, "Great, let's make an appointment." They responded by asking which doctor I wanted to make an appt with. I was flabbergasted...I asked them who was accepting new patients. I got nervous when they named 2 docs who weren't taking new patients, and said that the 'female doctors often took a long time to get an appt with.' Now, one might think this is strange until you remember that on the phone I sound like a 17 year old girl. They suggested I go to their website and look at the doctor bios and pick the one I think I'll feel most comfortable with. I kid you not, I was looking at a list of 15 doctors and PA's and had to just pick one who would become my doctor. It was very strange, but I picked a guy who seemed like he would be ok (really, what criteria do you use?). Called up and got an appointment this morning. He was new to their group and they said they thought I would really like him. We'll see.

So, a few points to add some detail. Please feel free to skip this if you're not interested in the nitty gritty.
1. Why all of the sudden, my stomach has been an issue for years. Well, to be honest the 'growing up' thing has a bit to do with it. As I've mentioned before, I had the same doctor in Florida since I quite going to Dr. Kenniston as little kid. He was this gruff Hispanic man at Mima that told me that every problem I had was because I was too fat. Even my allergies. So, I was a bit jaded about the whole process. I guess really it's two things. I have been accumulating reasons to need a PCP for a couple of years now. The foster care thing is ok, anyone will give you a physical. But then I got put on blood pressure medicine and I really need someone to manage that aspect of my health plan. It is awkward to get refills for my meds because they don't do call ins (or faxes) there for refills. So, every 3 months I have to go to the doctor to get looked at and get a new prescription. Which costs me 90 bucks a pop. On that note, the biggest reason that I'm going is that we hit our insurance deductible which means it's now covered 100% by our insurance. We have a $5000 deductible so this is no small event. Having the baby definitely moved things alone in the ole deductible arena. I suspect we'll hit it every year now, since babies have to see a doctor like every 3 days. This alone is why our insurance scheme is screwed up and we need someone to change things. I won't use our insurance unless it's an emergency because it costs me money out of my pocket. This is a good thing, unless you're someone that believes that preventative medicine is a boon to society. Having a $5000 deductible is ridiculous, and it means you're treated like someone with no insurance. I really don't think you should be treated like a criminal when you go to a doctor's office and they realize you have a $5000 deductible that you've only met $200 dollars of (for example). Well, I'll tell you what happens. When they see you have a huge deductible, they make you pay cash. Right there, before you can leave. Do you know what it's like to go to the doctor because you have a broken leg and have them run your insurance and tell you they need $500 before you can leave because you haven't come close to your deductible. Don't worry, they say, if your insurance pays it we'll refund you the money. Yeah, don't worry until I have to pay the electric bill. Luckily we're responsible and pay into our HSA, but do you know how hard it is to have $5000 in a savings account that you can only use for medical expenses? Especially when you get screwed because you have insurance. Here is something that happens that really irritates me. A lot of the offices here in Phoenix have a separate price list if you pay cash. As in, if you have no insurance this is what you pay. It's always less than what they bill the insurance. So here's the thing with my insurance. Until we hit our deductible, we have no insurance. But, I am informed that it is 'insurance fraud' for me to tell them that I'd like to pay cash instead of use my insurance. So, for example, at the No Appointment MD an office visit is $75 dollars cash money. Unless you have insurance. Then they bill your insurance $190 for the visit, and your insurance negotiates it down to $95. That's great and all, but I then have to pay $95. This is $95 dollars that comes out of my pay check, otherwise known as real money. And I could have just given them $75 dollars at the office. This is stupid and pisses me off.

2. So really, why all of the sudden? Haven't you farted constantly for the past 12 years? Ok, this is where it gets dicey. PLEASE stop reading if you don't want the intimate details of my digestive tract. Yes, my stomach has been an issue since I was in high school. I couldn't eat in Melbourne because I would have an attack of diarrhea before I could make it back to Merritt Island. I pretty much always have gas, I can almost fart on command at any hour of the day. This makes married life wonderful. Lately, it's been much worse. I am gaining weight because I always feel horrible, I gave up Aikido primarily because of it. I stopped going to the gym primarily because of it. When I'm home lately, say in the last month, I'm just lying down trying not to be miserable. I can't eat ANYTHING without my stomach blowing up and becoming rock solid. The gas is horrible, it smells so much worse than ever and there is an awful lot more of it. I have 6 -10 BM's per day (sorry) and they are not pleasant. I don't know if you'd classify them diarrhea, but they're not normal. They are almost always accompanied by a lot of gas which doesn't help the consistency, and they are not solid. Not liquid, but not your average poo. Did I mention the smell. Vile. On top of that the indigestion has come back. I thought I had licked that years ago but now it's almost every night. I woke up one night a few weeks ago choking on stomach acid. I had to get up and puke it out and it like burned the back of my throat. Finally, my intestines feel like they're always full. When I go, it almost feels like there's a center channel where things squeeze through but there is just this whole digestive tract full of stuff stuck in there unable to move. It is so disheartening to go to the bathroom and get up feeling like you have to go to the bathroom. It's so embarrassing to pass gas in the bathroom right after having a horrible stinky poo. Ugh.

Anyways, sorry about all of that. I'm going to the doc at 10 am this morning. Hopefully some things will get answered or at least a process will begin. I'd really like that. Hopefully they don't just tell me I'm too fat.

 
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