"Long Term Care...Continued..."

At 11:00 PM, the night before my scheduled prostate biopsy, I had a second dinner, and prepared to "fast" until after the procedure.  Reluctantly, due to past experiences taking antibiotics, I took them the day before, and then the morning of the exam, and took my "fleet enema" at 7:30 AM, and then drove to the urologists office for the 9:00 AM check-in.  I was taken to the back room and given the rear open surgical robe and told to lie down and wait for the doctor...

"How are you doing this morning?  Despite needing to evacuate this morning, you should have eaten so you have the strength for this. It will take about 15 minutes. You will hear a series of loud "thuds" and then feel consecutive razor cuts. There should not be too much pain. Lie down on your left side facing away from the screen and raise your left leg in the air at a 45 degree angle and hold it there.  Here we go..."   "Ouch...ouch...that smarts...I seem to be feeling every cut...my left leg is getting a "crazy horse" cramp...should I feel this?  I feel like I'm going to pass out...snap nine...I can't hold my leg up anymore..."  "We are almost finished...hang in there...nurse, how are the views on the screen?  We need to redo that one."  "That's 4 more cuts...oh my gosh, this hurts!"  "You are done.  You did VERY well during the procedure!  You can dressed and check out at the front desk.  You can't take aspirin,and need to continue your antibiotics for a day.  You may experience blood for a few days.  Call us if it doesn't stop..."   "Nurse...should I know anything else?"  "No, just drive home, eat, and then you can have a regular work day. Come in a week for your results..."

I drove home, and the pain of sitting on the car seat developed. By the time I got home it was all I could do to get a protein shake out of the downstairs refrigerator and crawl into the downstairs guest bed on my right side.  It hurt too much to lie in any other position.  I put the cell phone under my pillow and fell asleep.  When I awoke, still in pain, I called the doctor's office (and amazingly got someone to answer!) to ask what I should do. I was told to use Tylenol Extra Strength, and I called an associate at work to get some.  A few hours later, she arrived, reminding me that Tylenol Extra Strength had been removed from the shelves, nationally.  She found a generic substitute.  I made dinner,  fell back to sleep, and woke up the next day sore, but ready for a day at the office!

A week later, the doctor's office called to say that the results were delayed, and would take another week.  "Why?  Is that a normal response time?"

I flew to California for a family event, and returned the following week.

"Your results are in...come in at 4:15 PM.  The doctor will have to reveal them."

At 5:15 PM, I was taken from the waiting room with four patients to the back exam room. When the nurse's aide said she was going to take my blood pressure, once again I said to hear results it wasn't necessary unless I had to wait much longer!

At 6:00 PM the doctor came in and once again apologized for the wait..."I'm getting used to it...this is the state of our contemporary medical system!  But I don't mind waiting to hear good news!"..."Well, I've got bad and good news...The bad is that the biopsy locations determined that you have prostate cancer, but the good news is that after treatment, you should expect to live!  I can't give you too many details because our computer system is down, so think about how you feel about this news and call me for another visit, and we can go over the results more specifically, and tell you your options...I can perform traditional or robotics surgery, and I would also recommend that you speak to doctor Patel in Celebrations, Florida who is ranked as one of the top surgeons with the DaVinci Robotics procedure.

"Oh boy!  This is not what I expected to hear!  And I had just thought not being able to get Long Term Care insurance was my only problem!  This must be psychosomatic!"

I left the office and drove to a business card exchange to have a cocktail and take my mind off the news...

 

"Long Term Care...Maybe Happening..."

After a week, I was called to come in to get the PSA results.  It was now three and a half months past my initial physical where my PSA test was 6.4, and now it was 9.7.  Well, hasta la vista being able to be given a Long Term Care insurance policy wit a letter negating an issue from my doctor!  My G.P. said that I needed to schedule an appointment with a Urologist.  When I said that I had never been to one, he recommended one, locally that was in my health insurance "network".   I called and the earliest I could be seen, was two weeks later. 

I walked into the small 10 by 15 foot waiting room of this doctor that had about six elderly patients for my 4 pm appointment at 3:45 in order to have time for the sign in paperwork.   Two patients were checking in ahead of me..."Your co-payment will be $20".  "Your co-payment will be $40".  "Your (mine) co-payment will be $183"!  The previous two were on Medicare!  I sat down to start seven pages of medical history forms and releases...at least the print was large because I had forgotten my reading glasses!  The gentleman across from me asked what my guess for time to complete the forms would be?  "You're a young "whipper-snapper"...what are you doing in a urologists office at your age?  I'm 94 years old and I'm just coming!"

At 5:30 my name was called (as there was no one else in the waiting room by then!).  "And how are you today?  What is the purpose of your visit?  Come to this back room.  Roll up your sleeve...I need to take your blood pressure and then your temperature!"  Then the nurse's aide left.  I noticed two framed objects in the room...one was a painting by an artist friend of mine an offered for sale...the second was a diploma from the College of Medicine and Dentistry of New Jersey, where I had architecturally designed the Forensic Institute for the State of New Jersey.    My patience was growing thin, as  continued to wait...so I opened the door to the hall and started pacing back and forth...

At 6:30 the door opened and a young man entered.  "How are you today?   You seem anxious!  I'm sorry that you had to wait so long. Yes, I received my  medical education from The College of Medicine and Dentistry" in New Jersey.   Please tell me why you're here today?  Have you ever been to a urologist?"  I informed, "My grandfather was chief of surgery at St. Francis Hospital, where I was born.  He specialized in prostate surgery and he passed away from it.  His twin sons, in practice with him at St. Francis, also both were diagnosed and treated for prostate cancer".   The doctor related that he had done his residency there....another case of "once-removed" coincidences!

"Please remove your slacks and lean over the exam table...I'll need to do a rectal exam...I cannot detect any abnormality...but with your quickly increased, and high PSA, and family history, I am going to schedule you for a prostate biopsy.  It is done by me in the office, under local anesthesia, and should only take about 15 minutes.  A good result could be that it will be negative, and I may be able to write a letter to have your Long Term Care policy reinstated." 

I was scheduled for the biopsy in one week.  "Your co payment will be $785.  You can use a credit card (yeah, cash back or miles!)".  As I left the empty office at 7 pm I felt confident that my $968 + investment would result in reinstatement of my insurance at my $6,000 discounted rate!

"Envisioning..."

After a recent business card exchange during the dinner hour, a couple of trays of "finger food" were passed.  While delicious, these weren't enough to make a meal, so I was still hungry afterwards.

Driving home, my mind wandered to the Greek diners that were so popular up north.  They always offered a lot of food for a reasonable price.  I envisioned a Gyro platter with a Greek salad, while passing thru a northern section of West Palm Beach, and I looked up and there was a sign on the street..."complete Greek dinners from $6.99 including a large beverage"! I pulled over, knocked on the door because no one appeared to be inside, and the owner said he was open, and to have  a seat!  I took one of the about 30 seats inside, and I had the best Gyro I've  ever had with a delicious Greek salad and large iced tea!  The owner related that on Fridays they feature Greek music and dancers.  He also handed me a breakfast menu..."complete breakfast from $2.75...featuring a feta cheese, gyro meat Greek omelet, potatoes, toast and coffee for $4.99"!

We told friends about it, and went there after church the following Sunday! 

"Long Term Care..."

I was pleased to receive notice from my professional architecture society that it had made arrangements to offer the membership discounted rates on Long Term Care Insurance policies.  I contacted the recommended agent who came to the house and presented that he was able to write policies for a few months longer at rates that were equal to policy rates of five years ago...extremely competitive.  The policy with the current most notable provider of this type of insurance would save at least $2,500 per year less than other quotes I had received.  After he explained the policy provisions, he interviewed me to fill out an application.  With my non-smoking, limited drinking, daily exercise, good diet, good annual physical ("clean bill of health") results of one month prior, "underwriting" would have no problem issuing the policy.  No doctor's visit or medical records transfer would be required as part of the arrangements made for the group policy, but I could expect to be called to determine that I am "mentally coherent"!  A caller might contact me to give me a list of names or sentences  that I would need to repeat back by memory under an "honor system" (although since it was a phone call, the agent related that some have been known to write them down to assist with the memory!) the list.  I gave my credit card (travel miles!) for the first two month's premium, and I was told that I should expect the issued policy in 1-2 months.   After a month, I checked the status of my application and was told that it was in "underwriting" and I should receive the policy soon.

A few weeks later I received a letter from the provider that due to an undisclosed high PSA prostate test result in my December physical, three months prior, the policy would not be issued, and a check for my paid premium was enclosed!  The letter added that with a response from my primary doctor, that the test results were incorrect, my application would be reconsidered.  This was a surprise, because it had been years prior that I had any symptoms of "evening frequency" or "strong elimination urges", and as mentioned, I had been told after a physical exam and blood testing, that I had no issues with anything!  After a few days of (typical) unanswered phone calls to my doctor's office, and two drive up-drop ins, I finally got to see the doctor. He related that my PSA result had been 6.4 (above 4, plus patient family history) was considered an alert.  "And wouldn't have been good medical practice to contact me?"  He arranged to have my PSA retested and agreed to write a letter after my anticipated good results would arrive. I contacted the insurance agent to give him the good news and he said that he would be able to expedite the policy issuance at the lower rate upon receipt of the doctor's letter...