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Prescription Frustrations

Saturday, February 04, 2012

Living in the United States we hear day in and day out and how much of a money maker the health care industry is for the pharmaceutical companies and health care providers. It's a fact of life and becomes more expensive every year. I am thankful that I have coverage my employer offers and for the first time in my professional career I don't have to contribute. Therefore, I am not looking a gift horse in the mouth.

Recently and at this time I am experiencing difficulty in getting a simple prescription filled for a medication I have been on for the last two years. Nothing has changed regarding the availability of a generic so the brand name is the only option I have. What has changed is the health care company wanting to pay for any portion of it. Perhaps my frustration is felt at the level it is because this is the first time I have ever experienced this challenge. Not only is the health care company giving me the run around but they are doing so with the pharmacy and my doctor's office. As I have come to learn, each year a policy renews the health care company and pharmacy determine the formulary and are in no way required to notify the patient of said changes. I think they should be required to do this so there are no "surprises" when someone goes to have it filled, which is the only way of finding out when a change occurs it seems. Credit card companies are required by law to advise when changes occur in their policies so why can't the same be expected of the health care companies?

I don't like an administrator somewhere who just sees bottom line dollars determining what is best for me when they are not my doctor. I am aware this has been going on for years. It is beyond frustrating to have an administrator somewhere who knows nothing about me, my doctor/patient relationship and my medical history to suddenly demand I change to something all for the sake of them saving a buck. I have no idea how I am going to react to something that wasn't prescribed and should there be an adverse reaction to something and I should happen to land in the emergency room the health care company has now just cost themselves more money.

What's even more frustrating is there is nothing I can do about this except get what they will cover or pay for things out of pocket. I know I am not alone in this and there are many who are also experiencing increased difficulty in obtaining medication prescribed by a doctor.

It's been almost a week this has been going on. While they fight back and forth and the insurance company gives my doctor's office a run around I have to go without until something is figured out. Thankfully, I have a good doctor who has a staff that has kept me in the loop through this and are doing all they can.

The level of surprise I have experienced is a result of seeing this simple fact for the first time and how much things have changed through the years and the fact its something totally out of my control.

  Member Comments About This Blog Post:

L3DESIGNS 2/4/2012 6:31PM

    That sounds frustrating....

My grandmother is on two meds that her healthcare won't cover, nor can the hospital (where she has been for 3 months) pharmacy get it - so my mom has to go out and get the meds and take them into the hospital!

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HILLRUNNER 2/4/2012 6:24PM

    Well said! I really hope a resolution to all of this is found soon so you can tontinue on your course of medication!

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Growth through set-backs

Thursday, June 30, 2011

Set-backs can be a disappointment there is no doubt about that, especially when we think weíre doing what we should and making a concerted effort in our life style changes. My most recent one came during a follow-up at the doctorís office last week. I get stomach flutters every time I go for the blood work discussion, bracing for numbers that may or may not be what I want to hear. I have been surprised the last few times since progress has been seen while made to face realities there is still work to do and no, itís not going to be easy.

What puts my mind at ease after these visits where itís not the best is the thought of brushing off and continuing to move forward. There are going to be up days as there are going to be down. Life is a roller coaster and itís a fact of life, taking each day as it comes. I also have to think Rome wasnít built in a day therefore my goals wonít be obtained in one. Also one step at a time helps considerably.

In order to walk one must first crawl
In order to run one must first walk

In time I know what may be temporary set-backs are just that, temporary, later becoming accomplishments.

I just have to stay at it.

  Member Comments About This Blog Post:

HILLRUNNER 6/30/2011 11:21AM

    That's wisdom! Roll with the punches, make lemonaide, one day at a time..all those sayings to keep you moving ahead!
You WILL get there!! I'm cheering for you!

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A new perspective

Tuesday, June 14, 2011

I haven't a clue what has kicked me in the butt to get me going and more focused on living a healthier lifestyle but I am glad that something did. Some realizations hit recently like:

I am not getting any younger
40 is rapidly approaching
I ll be out of HS for 20 years next year
Triglycerides for the first time in 2 years were finally below 250 during the last blood test.

I have embarked on a walking and I hope eventually jogging program. I am not rushing it and taking my time so that I don't give up. It's been too easy in the past to say "forget it" when the going gets tough, however, this time its different. My mother just completed her 9th marathon at almost 60 and I have a girlfriend who has also made great progress with her goals. Yeah, I can do this.

Things that keep me going each day:

* Location, location, location - I have a wonderful park close to where I live with a great walking/jogging path. It's scenic and a bit hilly so it gives a nice workout.
* Music - Is a MUST for me. The tempo and songs keep me from focusing on how much further I have to go. I really like steaming Pandora through my phone.
* Good shoes and socks - Make all the difference in the world. Happy feet are a good thing.
* Climate appropriate clothing - Cotton on a 96 degree day isn't good.
* A cool shower afterward - I love it.
* The overall feeling after having done it when it was all too easy before to talk myself out of it.

Lastly, I have to tell myself its not so much the destination but the journey. It will happen in time, one day at a time. So much is mind over matter.

  Member Comments About This Blog Post:

HILLRUNNER 6/15/2011 4:57AM

    Love the blog! Great seeing your goals and insights on monitor! Oh yeah... SOCKS are MY friends!

Yep...you CAN do this!! emoticon emoticon emoticon

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BYUTIFULLE 6/14/2011 2:54PM

    Yay, I like your blog. It's so inspirational. I'm definitely going to have to get out to some parks on the Weekends, that sounds like fun. Keep doing what your doing. Enjoy your journey!!

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UNIQUELYBETH 6/14/2011 2:04PM

    I love your attitude!

I like your tip about the socks. I always get good shoes, but I must confess I throw on whatever socks are handy. I'll have to invest in some better socks I think :)

You are doing great! emoticon emoticon emoticon emoticon

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    Great plan, great attitude. emoticon

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JCUNDIFF8 6/14/2011 1:58PM

  I like the title...A New Perspective

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