Monthly Archives: November 2013

When Sexy follows you wherever you go……

So if I made you sad, I’m here to make amends.

The other day I went to the gym to workout. I haven’t been going as much as I was, due to being at the hospital and funerals and what not, so I took myself to the gym for a good old-fashioned sweaty workout.

Laundry had also gone by the wayside. But I was feeling quite proud of myself as I had managed to get two or three loads of laundry squeezed in, mostly because my husband needed T-shirts and I needed gym clothes. Yes, you caught me. I wear gym clothes even when I’m not going to the gym. Sweats are the greatest invention for the stay-at-home anything. But I was going to put those sweats to their real use!

So this fine morning, I drink more coffee than I should to get motivated and I put on my freshly washed gym clothes and off to the YMCA I go. I am pumped. Well not yet, but I’m gonna’ be!

As I place my purse and jacket in my locker, I realize the coffee has made other demands. Darn, I have to go to the bathroom. UGH. I don’t have time for this, I have to workout. But as all middle-aged women know, when the bladder calls, it must be obeyed.

I begin my rush to the stalls, knowing this inconvenience will take precious minutes from my time on the elliptical. As I take the corner, I feel a weird sensation  in my pants and at my feet.

“Oh, no” I think, “now I am incontinent”.  “Really? I can’t be, I just took care of two other incontinents. I buy Men’s Depends for L. I really am not ready for this. Say it isn’t so, Lord!”

Weirdly, though, I don’t feel wet. I ever so slowly look down at my foot where I had the odd sensation, and there next to my shoe is a really cute and sexy pair of black silk panties…..that fell out of my workout pants.

So my first thought is, “Yay, no Depends for me….yet!”

And my next thought is, “Thank God that didn’t happen on the elliptical machine. Everyone in the gym would have thought I was truly working my ass off!” Or sending some other message that I dare not even think about.

I shove my black silk panties into my purse and hope I don’t take them out as I’m looking for my wallet when I go for coffee after my workout. Yup that’s EXACTLY what I do.

The good news is, you can blame grief on just about any crazy ass thing you do for at least one year. Yay me, I can be an idiot AND SEXY  and no one will blame me.

You just have to laugh…….

Cathy Sikorski

I apologize in advance…..

I went out to dinner with my husband last night. Just the two of us. I spent the entire day at home working on my marketing plan. I was tired and kind of cranky. And I was really bored with myself. So we went to one of our favorite places, and I drank Jameson and Ginger and started to feel, well not better, but not so dejected.

I was trying so hard to figure out why I was in such a funk…to which my husband said, “yeah, why are you in such a funk?” So, it was established. I was in a funk….for some days I think.

And so after those Jameson (yeah I had more than one….) and some teary chat over dinner with my husband, I realized, I think I’m just grieving. I’m sad.  Since this past spring, my darling, sweet mother-in-law and my sassy, Aussie aunt died within about six months of each other. And although one was 96 and the other 90, I’m sad. I’m not sad for them. Although one was ready to go and the other clearly NOT, which made it harder, they lived good long lives and lots of people loved them and they loved lots of people (which was evident by the throngs of people at both those nonagenarians’ funerals).

So I’m sad. It’s the start of the holidays and I’m sad. My dinner table guests are changing over time, and this year is just one more sad reminder. I don’t want to clean my house, or cook a turkey, or work on a marketing plan. I just want to be sad. It seems like that’s what I should be doing. Of course, I realize that the way to get OUT of a funk is to DO something.

Maybe sometimes we should just respect the sadness.

Cause sometimes, you just have to cry……..

Cathy Sikorski

Ambulance…”part trois”…..

Just a very brief update…..

I am taking my cell phone with me absolutely EVERYWHERE. I am NOT going to miss the call again from the Medicare independent contractor, CMS. Because, as you know, if you miss the call, you can NEVER talk to anyone. Out of sheer exhaustion one afternoon this week, I go to lie down, just for 20 minutes or so, and put that cell phone under my pillow…like shotgun….I am NOT going to even think about RESTING without that ordnance by my side.

Lo and behold, that cell phone vibrates under my head like a 25 cent bed in a cheap motel. Of course, I’m in  a dead-to-the-world sleep, but, as a caregiver, I am so committed to alertness that any signal of distress, alarm, help, or hunger has me jumping up like a thoroughbred at a starting gate.

“Hello?  Hello?” I’m yelling into the phone like it’s a crank phone with a party line.

“Hello. may I speak to Cathy?” says the other line.

“Yes, this is me,”I say.

“This is Rebecca at CMS, the independent contractor for Medicare Appeals!” (you may wonder why I always put that in italics. It is because they use that phrase like it is a papal dispensation for everything that is about to follow)

So I carefully and slowly and without rancor(really I try as hard as I can to keep under control, “more flies with honey than with vinegar” theory) explain to Rebecca that I have sent them the necessary documents for my AUTHORITY for this appeal, three times.

( n.b.(which means ‘note well’) they readily admit they have all the documents for the ACTUAL appeal, they just claim to not possess the documents needed for ME to appeal. And you wonder why caregivers sometimes pretend to be 96 year-old men just to get something accomplished. I digress……)

To her credit, Rebecca stays on the line with me for 10 minutes or so and by listening to me  as I document every date and page I have sent them, and looking, really looking: EUREKA! She finds ‘my authority’!

“Ok, she says,” now I have to see if it was filed in a timely  manner.”

Since I KNOW it was filed in a timely  manner, I just sit on the other end of the phone with steam coming out of my ears waiting for her to confirm that.

As we wrap it up, she tells me:

“Okay you will get a confirming letter re-opening this appeal from it’s dismissal in about 2 to 3 weeks. Then we will review the appeal and send a notice of our decision.”

“So, just so I understand, since I have to report this to the collection agency,” I say through clenched teeth,”you will let me know you FOUND the paper work I’ve sent you three times and THEN weeks or months from now you will let me know your decision on the appeal?”

“Yes, ma’am, that’s correct.”

“Thanks, Rebecca,”I say as I reach  for the Pinot Grigio and go back to bed.

You just have to laugh……..

Cathy Sikorski

I knew there was a reason I didn’t go to nursing school

   Sometimes, I just feel compelled to tell a tale because you just want to share with the world the things you discuss on the phone, that you NEVER thought would be a part of your lexicon.

I have had a few difficult weeks, but during that time, brother-in-law, L, with multiple sclerosis has been magnificent. Last year was very difficult for him, he had a myriad of health issues and he was in a rehab center/nursing home for a few months. It was pretty awful. But we were able to get him back home. Get him on his feet (figuratively not literally) and through a lot of medical care, ultimately put him in a pretty good place. He has these AMAZING caregivers who come every day to get him up and dressed, in his wheelchair, and then at night get him ready for and into bed. His MS prevents him from walking or standing any more, but he gets around like a champ in his electric wheel chair, and goes to meals, plays poker and smokes a pack a day out in the beautiful sunshine every day.

He has been SO good for the last year…..that on some level, I’m just waiting for “the other shoe to drop”. But his attitude is positive (for a curmudgeon, which is what he’s ALWAYS been) and he is truly adored by his caregivers. He’s even gotten a fish tank from his son, and watches the fishees like they’re his new best friends.

I am so very, very grateful that he has been well and happy for the last year. And I pray every day  for just another ordinary day. So today my phone rings and it’s not a number I recognize. I always answer those numbers in case it’s about anyone I’m caring for. Most of the time, it’s a robocall. But this one went like this:

“Hello?”

“Hello, Cathy?”

“Yes, this is me.”

“This is Mrs. W, a nurse from the facility where your brother-in-law lives.”

NOOOOOOOOOOOOOOOOOOOOOOOO, I’m thinking.

“Uh-oh,” I say, “anything up?”

“Oh no, everything is fine, it’s really ok, no worries.”

YEAAAAAAAAAAAAAAAAAAAAA,I’m thinking, but I’m suspicious. Nurses don’t call for no reason.

“I just wanted you to know that we were called by the caregivers because L had an open sore and they wanted us to look at it and treat it if necessary.”

“Oh, yes,” I say relieved, “I know about that, they asked me to get some derma-patches for the area. Are they not working?”

“Well, the patches he had were not staying on, but I got some ‘industrial strength’ ones and they seem to be staying on, so we will probably be able to get this sore to heal. We don’t want it to get too bad, or then he would need to go to the doctor or hospital.”

“Oh yes, of course, ” I say. And now I am almost giddy with relief that it is not anything serious and these great people are on top of it.

“So, just so you know, the area is a bit pink with a little clear injury showing. It is located between his anus and his scrotum, so it’s hard to keep the patch there, and we may have to work on keeping that there without peeling off, just to make sure we have significant healing time.

I’m now thinking…..well, I don’t have a scrotum, but ‘industrial strength’ patches  there probably really hurts.

I say:

“Ummmm, okay. Well is there anything else I need to know or do?” (Please God, say ‘no’)

“Oh, no just keep an eye on it and I think he’ll be fine,” says this fantastic nurse.”

“Ummm, okay,” I say. But I’m thinking…yeah I’m not keeping an eye on that….ever.

You just have to laugh………

Cathy Sikorski

Never call an ambulance if you’re old…..Part 2

I think I have spent about $5,000  ( at least in legal time and photocopying) trying  NOT to pay an ambulance bill. I began this tale as one of my first blogs, Do you really need an Ambulance? I think not. I related that my dear 95 year-old mother-in-law was found in pain in her assisted living facility, and the staff correctly called an ambulance. Her pain was evident, so even though she suffered from dementia, which was documented, the ambulance drivers decided to take her to the hospital.

For over a year now, I have been fighting with Medicare to pay this bill. I have told the Ambulance Company, I will not pay this bill, as there is no way my mother-in-law could have made the decision to go to the hospital, let alone  CALL for an ambulance. I do not wish to leave these hard working emergency first responders without pay. However, there has to be some manner in which they can support the patient when the first responders make a medical call, that requires an ambulance.

My mother-in-law does not drive. She has never driven. She has never had a car. In an assisted living facility, she has no transportation to go anywhere without it being directed by someone else. The facility is also doing the right thing by calling for an ambulance for a client who seems to need medical help.

Okay, so we’ve established that everyone who actually PARTICIPATED in this trip to the hospital made a rational and correct decision. The only people who don’t agree with this is Medicare and it’s not even Medicare. It’s a company called CMS, an independent contractor, who assesses whether the claim should be paid. So I send 22 pages of documentation with a letter of explanation telling this independent contractor why they should pay this bill.

The first denial is because this darling old lady really didn’t need to go to the hospital. They found nothing wrong with her and sent her home. Yep…..that’s absolutely true. But, I persist with an appeal.

The SECOND DENIAL is because I have NO AUTHORITY to appeal. I call to clarify this.

” If you would like to leave a message, please leave the appeal number, the claimant’s social security number, the date of service and the provider for which you are appealing. Please leave a phone number and we will return your call.”

YOU CANNOT TALK TO ANYONE…..EVER.

They do call me back, and I explain that I am holding in my hand the appointment of representative form that gives me authority to talk to them AND to APPEAL.

“O well, sometimes Medicare doesn’t send us all the paper work in the file so you need to send it to us again.”

I grind my teeth. Call the ambulance company AGAIN to reply to the bill they have sent ME again, and tell them I am still appealing.

The THIRD DENIAL comes because they still didn’t get my paper work. I call them again and they say….”oops”….and ask me to send it again. I ask the representative to explain to me how I will know if they get it…she says:

“Well you might get a notice that we received it…..wait, no, no I don’t think you will.”

Yesterday, I got the ambulance collection agency notice. They are going to sue my mother-in-law, which I kind of want to let them, because she died.

But I leave a message for the independent contractor, who calls me when I am in a meeting and can’t answer the phone. AND THE MESSAGE IS:

“This appeal was dismissed twice for failure to have the proper paper work to authorize you to appeal.”

I am not fing kidding. I’m not.

I was just going to pay the $797.20 bill. I mean they are just wearing me down to the nub. But I decided to give it one more try. I’m waiting for the return call.

To be continued……

And you really, really do…….

Just have to laugh….

Cathy Sikorski