Category Archives: Humor

Ambulance…”part trois”…..

Caregivers, Humor, Uncategorized, , , , , , , ,

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

Caregivers, Humor, Multiple Sclerosis, Uncategorized, , ,

   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

Caregivers, Humor, Uncategorized, , , , , , , , ,

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

“A girl should be two things: Classy and Fabulous” Coco Chanel

Caregivers, Humor, Uncategorized, , , , , , , , , , ,

My Auntie J from Australia is  fashion plate.  At 90 years of age and barely 90 pounds, she is a wisp of a girl, who never looks anything but chic. Even her ‘sweat suits’ are more along the lines of Juicy Couture than what I wear to the gym. When I met her almost 30 years ago, she was never without a matching handbag for her beautiful and expensive shoes.  In my ignorance of thinking back then(before I realized now how young 60 really is)that this was an ‘old lady’, I was also thinking, “damn, she’s a fine old gal with great taste!”

Up until last week when we had to take her to the hospital for the first time in 25 years, she had her hair done (as a blonde…..never gray) every week, and her nails done as well. She was an extraordinary example of fine grooming, beauty, grace, and the true benefit  of “just a little lipstick, never hurts.”

So after ten days in the hospital, where she was really very, very seriously ill, we took her yesterday to a rehabilitation center. For very complex reasons, she went to a center two hours away. The ambulance drivers were two young adorable men, who treated her like their very own dear grandmother. By the time we met up with them at the end of the trip, she was holding their hands and kissing them goodbye.

She had been very concerned about the fact that she was transported in a hospital gown, but I reassured her that we would take her clothes and pretty pink nightgowns to the rehabilitation center, so she could be properly dressed there.

My husband and I have been very concerned for her health during this time and my mom, a former nurse has been right by our side the whole way, comforting, advising and just being a strong shoulder. But because my mom was a white uniform, starched hat nurse of the 40’s and 50’s, she has looked askance every day at the ‘sloppy’ nurses, aides, and technicians who have come to care for Aunt J.

“Look at that,” my mom would say.

“What?”, I ‘d reply, expecting an inept stick of the needle to draw blood, or a hospital meal that was not up to snuff.

“Look at how that nurse’s trousers are dragging on the floor, and no one has their hair up in a bun or a pony tail.”

“Well,” I say, “I guess we just have to overlook certain things when we are happy with her care.”

Of course, now I’M thinking something is terribly wrong here. And then I realize that my mom has much higher standards for dress and presentation than I, or the world, does any more.

So knowing Aunt J and her true art of dressing and personal presentation, I start to wonder if this is bothering her too. She never says anything and the following incident makes me realize that for Aunt J, it isn’t about how people look to her, it’s about how she presents herself to the world.

We get to the rehab center, and one of the last things I want to make sure of, is that Aunt J knows how to push the red button to call for help. With my mother-in-law, when she moved to assisted living, and with many stories from friends about their elders, I KNOW that this ‘pushing the button for help’ thing is somehow difficult for them to comprehend.

So I disconnect the button from the clips on the side of her bed, and make sure the cord is long enough so she can have the button at her fingertips. This particular button is like a tube with a bright red button at the top.  So you would hold it in your hand, curl your fingers around the tube, and push on the bright red circle at the top of the tube with your thumb. That would be how most people would use it, and probably the easiest way.

I bring the tube close to her, and I pantomime what I want her to learn…pushing the button. And I’m telling her, “if you need help, you push this red button.” I put the tube in her hands and tell her:

“Now you practice. If you need any help, I want you to PUSH THE BUTTON.” And again, I show her what to do.

My darling, beautiful Aunt J, shakes her head in the affirmative, looks me straight in the eye with her beautiful blue-green eyes, looks at the tube that I have placed in her hand with the bright red button on top, takes her other hand, rubs the top with her index finger and promptly ‘applies’ the beautiful shade of red lipstick I have given her to her luscious lips. Classy and Fabulous.

You just have to laugh………………….

Cathy Sikorski

Walgreens on Main Street…..

Brain Injury, Caregivers, Humor, , , , , , ,

This is a continuation of  When UTI does not mean Understanding the Infirm only in the sense that that is why we are now at Walgreens on Main Street.

My dear disabled friend, who braves her brain injury with the utmost courage, must now go to Walgreens on Main Street to acquire her prescriptions. The PA  (Physician’s Assistant) has given her TWO prescriptions to relieve her infection and her discomfort from the UTI (urinary tract infection).

These adventures in medical care are half-day or whole day journeys for her because she must navigate her town by city bus or by walking. And although walking is a very healthy alternative that she often uses, sometimes it is too much for her and she must be at the will of the bus schedule(which for some odd reason changes constantly, because as we all know, people who NEED to use the bus have no problem not knowing when it will come and go, since they can just get on it, like the rest of us get in our cars)

Trekking from the doctor’s office on one side of town to the other, she gets to Walgreens on Main Street and unimaginably, her prescriptions are ready. And I might add here, that the pharmacists at this Walgreens are wonderful. I have been there with her many times and they are accommodating, understanding and extremely willing to help. But sometimes…….

The pharmacist tells my friend that the antibiotic is ready but that the other prescription needs more information from her doctor.

“You need to go back to the doctor’s office and take this form and have them fill it out, because Medicare won’t cover this drug without further explanation from your doctor.”

“But, I just came from there…it will take forever…..”

“Well, the only other thing I can do is send it to your doctor and then send it to Medicare, but then you may have to wait up to a week to get your medicine.”

“But, I don’t drive, and I just can’t get back there today,” says my friend, “it’s just too much, I can’t do it.”

The two of them stare at each other for awhile. Both of them locked in thought, and maybe even trying a “Sheldon’s mind meld” from the Big Bang Theory, to see who will crack first and make this better.

“Isn’t there ANYTHING else we could do?” says my friend, who is rightfully STILL worried about her brain.

“Well,” says the pharmacist, “you could just pay for it.”

So now my friend is thinking: “Okay, I’m on a very fixed income. I have to watch every incidental I pay for because I just don’t have enough money for everything. But I will bite the bullet this month and deprive myself of whatever is necessary to pay this exorbitant drug cost to protect my fragile brain. I know drugs are hundreds of dollars, but I just can not go through this one more day, or wait a week……”

“Okay,” she says with great trepidation,” how much is it?”

“Twenty-three dollars.”

You just have to laugh…….

Cathy Sikorski

When UTI does NOT mean Understanding The Infirm……

Brain Injury, Caregivers, Humor, Uncategorized, , , , , , ,

I have a dear friend who suffers from a brain injury. We are writing something to share with the world soon, a blog, a play, a memoir, so I don’t put that here (and yes, I have another person in my caregiving queue)but I asked her if I could share this one little tidbit from this week.

So she has to go to the doctor for a UTI (urinary tract infection). When you reach our age, you know when you have a UTI and in the OLD days your doctor trusted you and you could just call and tell them that you have a UTI and they would call in a prescription for an antibiotic. This really doesn’t happen now, so imagine her surprise at this conversation:

“Hello. Dr.’s office? I need an appointment because I have a UTI.”

“Ok,” says the receptionist, “which doctor do you see?”

“I see Dr. S.”

“Ok,” what pharmacy do you use?”

“I use Walgreens on Main Street.”

“Ok, very good.”

And, after getting her name and address and birthdate, the receptionist hangs up. So………………..what would you think? You would think that they talked to your doctor and called in a prescription to Walgreens on Main Street, right?

My friend goes to Walgreens on Main Street. Nope, no prescription. And the pharmacist checks with other Walgreens. Nope, no prescription. So my friend calls the doctor’s office.

“Ummmm, I called earlier because I have a UTI and the receptionist took my name and pharmacy and there is no prescription here.”

“Oh, well, you have to come in and see the doctor, we can’t just send out prescriptions without and appointment.”

“Well,” my friend says, ” since I am disabled, I don’t drive, and I have to walk or take the bus everywhere, it would have been nice if your receptionist would have made an appointment for me rather than sending me to Walgreens on Main Street without that vital information.”

Silence. Dead Silence.

“Can I make an appointment for you?” Says this receptionist. “Can you come in now?”

“Not unless you’re coming in your car to get me,” says my friend. I need to get to the bus and then get to your office. So let’s make that appointment for tomorrow.”

She goes to the doctor ‘on the morrow’ and gets the prescription called in, with an additional prescription, but not before this conversation with the PA (physician’s assistant—and BTW I LOVE PA’s I think they have made the world ever so much better MOST of the time):

My friend says to the PA: “So I have had this for about a week, but I worry whenever I get any kind of infection because my brain surgeon said infection can be very dangerous for me, as I am already compromised.”

“Well,” says the PA, “I highly doubt that a UTI would get to your brain. He was certainly being overly cautious.”

I so wish I had been there. I would have said, “Look, you can be overly cautious with your brain, but I have 40 titanium coils in my head to stop a brain bleed and I have miraculously survived a subdural hematoma that causes permanent problems……so I AND MY BRAIN SURGEON choose not to be overly cautious.”

Next installment…..Walgreens on Main Street….

You just have to laugh…….

Cathy Sikorski

HALLOWEEN: A T-P game you never saw before

Caregivers, Humor, Medicare, Uncategorized, , , , , ,

As October winds its beautiful way into our crisply chilled hearts, all thoughts turn to Halloween. This time for treats and tricks invariably leads to someone, somewhere using toilet paper to wreak havoc on an unsuspecting neighbor.

I, too, have become a victim of what we used to call “t-peeing”, which did not mean peeing, but meant wickedly and with abandon tossing toilet paper all over the trees, yard, cars and driveways during the All Hallows Eve season. This was deemed hilarious by all evil teens and pre-teens, and a pain-in-the-ass to all middle aged development homeowners who had to clean it up, not to mention the WASTE OF TOILET PAPER. Oh the waste!!!

So you’re probably wondering how this could possibly relate to caregiving. No, I’m not cleaning up my yard from some over-achieving juvenile delinquent who started the season early. My 90 year-old Aunt just LOVES toilet paper. It meets all her needs.

Aunt J uses TP for just about everything, tissues substitute, cleaning rag substitute, hold-it-in-my-hand-in-case-I-need-it substitute. Next to a pocketbook, tissues may be the second coming of the Savior.

But the scariest use for TP has become, pads and Depends substitute. She just absolutely INSISTS that she must fill every area of her granny panties with extra toilet paper. So she puts on her panties (or rather I put them over her feet and pull them up halfway), we put TWO pads in the crotch to line them against all accidents, AND THEN SHE ATTACKS. She unwinds that toilet paper like Christmas lights until the strand is long enough to circumvent the globe….and that’s ONE section for the front. Then she does the same for a section for the back.

Now I am certainly all for cleanliness, fresh smelling people, lovely scented perfumes, and armpits dusted with powdery smells ( I direct you to Cleanliness is Next to Godliness)but it seems to me that two or three pads, or Depends plus pads is really sufficient to meet her needs. And since I have become intimately aware of her needs, I can assure you the use of two or three strategically placed pads in those cocoon size panties are plenty.

But it’s the waste. I am going through 25 to 28 rolls of toilet paper every two weeks. And it’s the good stuff, Mr. Whipple would nominate me for an award or at least give me stock in Procter and Gamble. I don’t have time to squeeze the Charmin’, it flies off the roll like blowing a dandelion to the wind.

So finally, I entrust this dilemma to my Mom. A contemporary of Aunt J. She tells her , “NO more toilet paper, these Depends are fine.” And that’s enough. Waste is over. One Depression baby to another…..”stop wasting”…..problem solved.

You just have to laugh…….

Cathy Sikorski

Cleanliness is next to Godliness…..

Caregivers, Humor, Multiple Sclerosis, , , ,

 As of yesterday, I have officially showered with the following elders:

1. My Grandmother

2. My Mother-in-law

3. My Mother

4. My Aussie Aunt

And for several years, when I would go to take care of my brother-in-law, we would refer to him as “Naked L”. Because that was how it would be.

 

 

You just have to laugh…….

Cathy Sikorski

O the places you’ll go……

Caregivers, Humor, Uncategorized, , , , ,

Dignity is defined as : bearing, conduct, or speech indicative of self-respect or appreciation of the formality or gravity of an occasion or situation. You can be assured that once you become a caregiver, you pretty much lose any appreciation of the formality or gravity of an occasion or situation.

Aunt J has returned to stay with us for a couple of weeks. I adore her. Her Aussie accent, her amazing stories from New York City in the ’50’s and ’60’s, her willingness to be snarky with me when I just want to gossip and bitch….it’s all good. But, of course, she’s 90 years old. She doesn’t come to the table with what we would call “clean hands” in the legal world. Not that her hands are dirty, but that she has baggage like every other 90 year-old, and the whole reason she kind of needs a caregiver.

I need to watch her meds, her showering (yes, I sneak up to the door and watch to make sure she doesn’t fall down or out of the shower) and make her eat because she’s barely 90 lbs. and will forget, or say she’s not hungry.

I also help her get dressed, so that I can put her pain cream on her before she gets her 47 layers of clothing on. So today we accomplished everything….showering without falling, meds without overdose, pain cream in all the right spots, and choosing an adorable outfit for the day.

We are up and atem’ and I say:

“Hey Aunt J, where are your necklaces?”

She wears several beautiful gold bracelets, necklaces and beautiful gold earrings every day. Honestly, she is one of the hottest chick 90 year olds you’d ever want to meet!

“O dear, I don’t know.  I think I left them on, I don’t remember taking them off last night.”

“Well did you bring your gold charms?”

“No, that’s broken. but I’m going to get that fixed and I still wear my other two gold chains.”

“Here are your bracelets,” I say as I hand them to her.

She jangles around looking for the necklaces, but to no avail.

So I look under the collar of her blouses, and lo and behold, I find a chain. But I can’t pull it out. It’s stuck on something.

“Wait, wait,” I tell her, “I’m trying to pull out the chains.” So I try as gently as I can, but those gold chains will not budge.

“Okay,” I tell her, ” I’m goin’ in……”. So I stick my hand down her shirt, around her neck, into her bra and around her boobs. Yep, I said it….around her boobs.  I set the chains free, and we are on our merry way.

 

You just have to laugh……

Cathy Sikorski

 

 

No matter where I go….

Caregivers, Humor, Uncategorized, , , , ,

So I volunteered to be on an advisory board for a Catholic elementary school. I know, I know, REALLY? You need to do more volunteer work? But my really good friend, the principal of the school asked, and whenever she asks me to do something I say yes and have regrets later. But THIS time, I figured it’s about little kids, no elders, no Medicare, no Social Security, no nursing homes. Yay….little kids.

The parish priest leads the first meeting, and after we open with a prayer (and boy do I need all the prayers I can get), he tells this quick story.

“So, I’m a power of attorney for one of our parishioners who is 90 years old.”

Oh MY GOD (i’m thinking) REALLY, SERIOUSLY, THIS CANNOT BE HOW THIS MEETING STARTS.

“AND,” says Father, ” he was rushed to the hospital a few days ago, so of course, the hospital called me right away.  I went over there to make sure everything was fine, and they were going to keep him for a few days and then send him to rehab to one of two possible facilities.”

So I’m thinking: okay, he probably had some problem getting him in to the facility that he wanted. Or the elder parishioner had some unexpected medical condition. Nothing new here. And, by the way, I have not yet confessed to this group what my background is.

Father continues:

“The dear man is in the hospital for three days, and I’m waiting for a call because they have told me that he will likely be moved today or tomorrow. So I’m sort of hanging around, trying to stay close to home in case they call or need me for anything. Finally at 2:30 in the afternoon the nurse contacts me and says:

“Hello, Father?”

“Yes? I have been waiting for your call.”

” Well, I guess we should have called you sooner, like BEFORE we released your parishioner from the hospital.”

“REALEASED HIM???!!!! WHERE DID HE GO? He’s 90! He doesn’t drive and I’m the only one who transports him. WHERE IS HE?????

“Oh, he was transported by ambulance to a rehab center.”

“WHICH ONE…. where did you send him?????”

Poor 90 year-old guy, when he got there, he had no idea where he was, why he was there and what was going on. NOT BECAUSE HE HAS DEMENTIA…..he doesn’t……BECAUSE NO ONE TOLD HIM OR HIS CAREGIVERS.

Yup, true story (and I asked Father if I could put it in my blog and he gave me his blessing …and said yes, too)

You just have to laugh…….

Cathy Sikorski