Medical

Unexpected

/ Re-Farmer / 2 Comments

Oh, what a day this turned out to be. I’m looking at the time and wondering why it’s not several hours later, because this day has felt much longer than normal!

But first, I share the pleasantly unexpected thing.

As I finished up my outdoor morning routine and headed for the house, I noticed something white in the window of the cat house.

Plus, something moving in the shadows behind!

Unfortunately, my coming closer startled the cats. You can just see a hind leg of mystery kitten, who dashed out as I got closer. Little Braveheart was still in the window, and I was pretty sure it was Tabby that I saw in the shadows.

Then, the Creamsicle emerged!

Creamsicle was the first cat I saw checking out the new shelter, and I’ve seen Tabby lounging in the window. I’ve seen other kittens coming out from under it, but this is the first time I’ve seen Mystery or Braveheart inside, and the first time I’ve seen more than one cat in there. This is very encouraging. I know, in past winters, even cats that didn’t get along would still join the pile on the swing bench to keep warm, but it’s still great to see some confirmation that they can use the new space peacefully together.

What I am really hoping to see if Butterscotch’s babies going in there! They are so much smaller and younger, they are the most as risk from the coming cold. Weather Canada is forecasting a long fall and late starting winter, though. I hope they are right, because I’ve also seen forecasts for an early, long and bitterly cold winter coming up.

Meanwhile, the predicted rains last night turned out to be a brief but wicked thunderstorm, complete with driving rain, thunder, lightning, high winds and – no surprise – losing our internet. Thankfully, we did not lose power. As I write this, in the early evening, we’re still at a very warm 25C/77F!

Among the things I needed to do today was head into town and pick up my husband’s prescription refills. Even with a box of insulin, thanks to his excellent private insurance plan, the grand total is rarely more than $100. Last month, his refills happened to include both his injections and needles, and for the first time since things got messed up with his restricted painkillers, his bubble packs had all of his medications in them. So it was quite a shock, but not too unexpected, for the cost to be closer to $300. This time, it should have been less.

It was more. The total was almost $400.

At this time of the month, I simply didn’t have that. The cashier started checking the slips for me and noted that not all of them had the 3rd party payment (what the insurance company pays) on them. With 16 medications, it added up fast.

So I got her to suspend the sale while I stepped aside to look through the slips and then, if necessary, transfer funds from our emergency account. I was perplexed, though. What changed?

I went back to the pharmacists and asked if anything new had been added. The pain clinic doctor was supposed to call our regular doctor and talk medications. Our doctor said that he would fax any new prescriptions directly to the pharmacy. Could that be what happened?

Nope. Nothing was changed. However, according to what was showing up on the computer, we had reached our limit with the insurance company for medications.

Our what???

This has never happened before.

In the end, the pharmacist took back the printed out slips and told me to just take the medications, and come back after we cleared it up with the insurance company. They would rebill the amount then.

Yes. The pharmacy let me walk away with hundreds of dollars of medications without paying for them! Her comment was “we know you’ll come back.” Which is true. There’s no risk to them, since we are regulars, but still… that’s a lot of money walking out the door!

The next several hours was spent alternating between my husband and myself on the phone, with him calling the insurance company first.

In a nutshell, because we now live in a province that has Pharmacare – a provincially run government insurance program – the insurance company covers the cost of the deductible, then stops paying out because the system then covers the rest – but the system didn’t kick in.

As far as I knew, when we sent in an application for Pharmacare, shortly after moving here, we didn’t get accepted. I remember getting a letter asking for my tax information from 2015, when no such information was asked for on the form (my husband and I were both on the one form). I remember getting another letter since then that was basically a giant word salad and, as far as I could make out, we didn’t qualify. So I assumed we did not have it.

The insurance company’s limit on the deductible was only $1500. I called the pharmacy and talked to someone there who looked up my husband’s file, and they’d actually paid out almost $2000, so we were well past the limit. Most confusing of all, according to what she was seeing, is that we were approved for Pharmacare. We had it. But it didn’t kick in when it should have.

She gave me the number to call and find out why.

It turned out our Pharmacare deductible was actually over $3000. Which meant we were on the hook for the rest. The guy I spoke to said we should have gotten a letter back in the spring with the deductible amount. That would have been the letter that I understood as telling us we didn’t actually qualify. He said he would mail us a new one, which our insurance company would probably want to see.

Also, two of my husband’s medications (one of which is the pain killer that comes in slow and quick release forms) are not covered by Pharmacare at all.

My husband then called the insurance company back. Sure enough, once they have the proof in hand, they will adjust the limit to match what our deductible.

I called the pharmacy back and explained it to them, and they are fine with our coming back after all this was done, so they could re-bill the insurance company, and we would be paying only whatever was left. How long that takes depends on how quickly the letter gets to us in the mail (after that, my husband can just email a copy to the insurance company), which could take more than a week.

Our pharmacy is awesome!

If we were living in a province without Pharamacare, this would never have happened. What I don’t understand is why this didn’t happen last year! I guess the new medications my husband was put on after his stay in the hospital was enough to kick it over this year, but he was put on them late enough in the year last year, that it wasn’t an issue.

By the time this was all figured out, my husband and I were both completely drained.

The rest of the day’s plans went out the window.

It’s time to de-stress!

The Re-Farmer

Broken. Like our system

/ Re-Farmer / 13 Comments

Okay.

I think this is going to be a difficult post to write.

To recap for our new followers (Welcome! Thanks for joining us!); about a year and a half ago, my husband ended up in the emergency room for what turned out to be pulmonary edema. He spent the night in the hospital, was sent home with a prescription (without being told what it was for) and told to follow up with his regular doctor. He had a week’s worth of what turned out to be water pills, but the earliest he could get an appointment with his doctor was almost 2 weeks later.

While he had been feeling a bit better for a while, once he ran out of the pills, he started to crash again. When we got to his appointment, he was in such bad shape, I had to ask for the use of a wheelchair to help him come in.

The clinic was part of a hospital building, but there was only 1 bariatric wheelchair. I can’t even remember right now if they ever found it. I think he ended up using a regular wheelchair. The nurse that wheeled him into the exam room was looking very alarmed, and was saying my husband would probably be going straight to the emergency room. Sure enough, the doctor basically took one look at him and sent him over. They were wondering why he hadn’t been followed up on after his time in the emergency before, and we told them that this was the follow up!

He ended up in the hospital for 3 weeks. In that time, along with almost killing him by giving him too much insulin and not checking his blood sugars before deciding on the doses, they managed to drain over 100 pounds of fluid out of him. His pulmonary edema was actually peripheral edema, and he was diagnosed with heart failure.

Since then, my husband had been expected to go into the city once a month or so, as they tried to determine the cause of his heart failure and decide on courses of action. There is only one cardiac clinic serving the entire province so, as you can imagine, it’s pretty busy.

These trips have been incredibly hard on my husband, his back injury and his pain levels. It’s one thing to be sitting in the van for the drive (about 3 hours driving in total). It’s another to be sitting in the waiting room for such a long time, then waiting again in the examination room, only to be seen for maybe half an hour.

Now, we deliberately leave early for these appointments. It takes an hour to reach the city, under normal circumstances. Getting to the hospital, if traffic is light and we get nothing but green lights, takes maybe 10 minutes. Most of the time, though, it takes about 20 minutes. That gives us another 10 minutes for me to pull in, unload his walker, leave him to find his way in, then search for someplace to park.

However, we don’t leave things to chance and leave 2 hours early, and today is a good example of why this is necessary. On the way to the city, we hit a section where cracks in the road were being patched. A two lane highway was reduced to one lane, and they were alternating each direction of traffic to let through. So we spent some time driving very slowly through the construction, then just stopped on the road as we waited for traffic from the other direction to pass through. Then, once in the city, we were delayed by more lane closures bottle necking traffic. That one area has been under construction for as long as we’ve been out here, so more than three years! I really would have expected them to be done by now. :-/

My point being, we respect their time and go out of our way to ensure we will be there before the scheduled appointment, so he can be checked in and ready when they are.

There was one day, however, that – after waiting for 1 1/2 hours – he was in so much pain he walked out. It was that day that we discovered they built in a half hour waiting period. So while he was told in to come in for a certain time, they had his appointment for half an hour later. We’d already come in 15 minutes early. Even with the built in waiting period, they were still 45 minutes late when he left. Who knows how much longer he would have had to wait if he hadn’t. They certainly didn’t seem like they were going to bring him in anytime soon.

He talked to the clinic on the phone after that, and for his next appointment, they had a stretcher for him. It helped, but the trips still wiped him out.

To make things worse, they have not been able to figure out why he has an ejection fraction of only about 20% (I think it’s up to 22% now). They can’t find anything to explain it. There is no reason that they can find, for him to have heart failure.

Then the pandemic shutdowns happened.

He was supposed to have an appointment in April, when they called in March. After interviewing him on the phone, it was decided to continue with phone appointments until they could start rescheduling. It was a surprise to be called back for a June appointment. We were expecting July or August.

He ended up having having to cancel due to pain.

He was rescheduled to July and had an appointment then, but with the pandemic measures, I couldn’t go in with him. It was a short appointment.

He had an appointment in August. Pain was a major issue again, so he called to ask if they would be able to accommodate with a stretcher again. I’m not sure what exactly they said, but he was made to feel like he was imposing on them significantly, so he cancelled the appointment.

Today was the rescheduled appointment. One of the things they want to see him for, is to decide if he is a candidate to have a defibrillator implanted.

With all the delays, I was still able to drop him off almost 15 minutes early, then found a place to park some 5 blocks away. I knew I wouldn’t be able to go in with him, so I just walked around to play Pokemon Go.

The high winds that broke our tent had clearly hit the city, too! This tree was in a park near the hospital, and I was seeing broken branches all over the place.

My husband was able to text me to keep me updated, so I knew when he was able to get checked in. Some time later, I got another text from him.

He was still in the waiting room.

Alone.

There was absolutely no other patients waiting. Not only that, but I found out later that at 12:30, which is he was told his appointment was for, he saw and heard a group of doctors, leaving. They were going for coffee.

Did they book in a half hour waiting time again? Without any other patients???

Finally, after he’d been waiting half an hour, and he was already telling me he was ready to leave, he was brought into an examination room. By that point, I was starting to meander back to the van.

Then I got a text simply saying “I’m out.”

So I rushed to the van. When I got there, I quickly texted him to let him know I had reached the van, so he would have an idea of how much longer I would be.

That’s when I noticed the time stamp on his last text.

There was no way anyone had seen him.

So off I went to pick him up at the main entrance. This is supposed to have a patient loading zone in front, with enough room for several cars, or a couple of handi-vans.

Of course, people were just parked there. The vehicle in front of me didn’t even do that. He just sort of half pulled in and stopped. I ended up having to drive around him, then stop in the lane – thankfully, there was no traffic behind me – to pick up my husband and load the walker into the van.

As we drove, he told me the rest of what happened. After waiting, in pain, for so long, he finally struggled to get his shirt back on, then simply left. As he was leaving, a tech was coming in with the EKG machine, and she called out to him, but he kept going. As he went through the waiting room (which finally had one other patient in it), the woman behind the counter started chasing him down. By this point, he had no tolerance left and simply said that next time, make the appointment for the actual time, and kept going.

We both realize that he is probably viewed as a problem patient right now. What we can’t figure out is how a cardiac clinic in a hospital can be so oblivious to accommodating the needs of disabled patients. I mean, besides heart conditions. After a year and a half, and his pain being an issue in the past so often, you’d think they’d at least have notes on his file or something, about his extenuating circumstances.

I don’t know.

My husband plans to write to the clinic with a letter of complaint – though he’s going to give himself time to calm down, first! I suggested that he send a copy of it to our new doctor, too.

At this point, he doesn’t want to go back. At all. He sees no point. They’re not finding why his heart is doing what it’s doing; everything else related to his heart is checking out healthy. He’d already been doing most of the things they recommend, and the things he isn’t doing, he can’t because of his back injury and pain levels. They did acknowledge this issue.

He is hardly the only patient they have with multiple health issues beyond a heart condition. How many other patients are going through the same problems he is, but aren’t confident enough to simply get up and walk out? How many are just meekly accepting being treated like afterthoughts, because they are too scared of their condition to speak out? I guess that’s one “benefit” for my husband; he’s been through so much over the last while, developing a heart condition is just another thing on the list, and not even near the top.

At this point, I don’t know what steps will happen next. For my husband, getting the pain under control is the greater priority. And that is waiting for the doctor at the pain clinic to talk to our new doctor. Which doesn’t seem to have happened yet.

This is all so incredibly frustrating.

The Re-Farmer

Get a little bit closer, and a follow up

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I headed out to water things this evening, but got distracted.

Junk Pile and two of her babies were out!

I ended up lying right on the ground, in hopes that would make them less intimidated by the tall(ish) human.

Creamsicle took full advantage of the situation.

What a silly boy!

Tabby didn’t come any closer than this, but did spend some time rolling around under the grapes, in between watching me.

Little Braveheart did come a bit closer to the stick I was wiggling, but not close enough to actually touch it.

It was funny to watch Little Braveheart and her mother. They share many of the same mannerisms, and often mimicked each other’s movements.

They also have the same eyes! Even though the markings in their fur are different, they have the same facial structure and many other similarities.

The grapes, meanwhile, did eventually get watered, and are looking really good.

The more shaded ones at the back of the trellis are noticeably darker than the ones that are more exposed.

While tending the rest of the garden, I found this.

The tallest of our sunflowers is starting to open up its seed head! So far, it’s the only one at this stage.

Awesome!!! I can’t wait to see how big the seed head gets.

Meanwhile…

My husband and I had our medical appointments today. Heading out two days in a row was really hard on him. Thankfully, we got in quickly, and didn’t have long to wait.

I learned one thing today that my husband forgot to mention after yesterday’s appointment at the pain clinic. The doctor there was going to phone our doctor here to discuss recommended pain medications.

Another reason I’m unhappy I wasn’t allowed to go in with him yesterday. He forgets things more often, these days. At least he remembered this while with our doctor!

The doctor had a couple of concerns. For one, he will be referring my husband to an endocrinologist, so we’ll be getting a phone call about that. He also wants to adjust my husband’s prescriptions, but will wait until he talks to the pain clinic doctor, go through his current medications, and think about it. Once he’s done that, he will fax any new/changed prescriptions directly to the pharmacy.

As for the rest of my husband’s bloodwork, it was all fine.

Then it was my turn. My bloodwork was fine, across the board. During the physical, we did get a laugh. After testing my reflexes, he did the usual putting his hand on my knee while flexing the joint, as he started to ask if I had any issues with pain, etc. When he lifted my lower leg, he cut himself off in mid sentence with a startled “Oh!!”

To which I responded to his half-finished question, “yes. Arthritis. You felt that, did you?” :-D

Yeah, both my knees do some interesting things when they’re flexed!!

One thing with both my husband and I was, what we thought were heat rashes turned out to be fungal infections. !! So we both got prescriptions for creams to treat that. When we were done, I dropped my husband off at home, picked up a daughter, then headed into town to get the prescriptions filled before the pharmacy closed. A stop at the mail on the way out found a letter from the heart clinic, with my husband’s rescheduled appointment, early next month.

I’ll have to remind him to phone them about it right away, to arrange some sort of accommodations, like having a stretcher available for him, for an appointment they say might take up to 2 hours.

So while nothing much changed at today’s appointment, steps were taken and others are being put in place, for the near future.

We shall see what comes of it.

The Re-Farmer

How it went

/ Re-Farmer / 2 Comments

So…

My husband and I are back from his appointment at the pain clinic in the city.

In a nutshell?

Nothing happened, and nothing will happen. At least not there.

To backtrack a bit.

When we first moved here, one of the first things we had to do was find a new doctor for my husband. Just a GP to start with, so he could get his prescriptions refilled, to start with. From there, he could get referrals to specialists, as needed.

Before the move, my husband had a primary caregiver (at first, a Nurse Practitioner, then a GP), a physiotherapist, an exercise specialist, a psychiatrist and, at the pain clinic, a team of 4 or 5 people; I can’t remember exactly how many, but there was the doctor that was “team lead” on his file, a doctor that specialized in medications, another on physical care/exercise, and one or two more that I can’t remember what they specialized in anymore. I might be forgetting another specialist.

It took him a year to get into the pain clinic in the city, but that was only because his paperwork somehow got lost.

Twice.

So somewhere between the regular clinic and the pain clinic, there were issues, but once he got in, things went quickly.

We were hoping to find something similar here, but really didn’t know what to expect.

The new doctor got a referral to the pain clinic in quickly. That was in February of 2018. What we were expecting to get was a phone call for an appointment. As months went by, the doctor would check to confirm, and yes, my husband was still on the waiting list. Then this doctor had to suddenly move, we found our current doctor and saw him for the first time in December of 2019.

When he found out how long my husband had been on the waiting list, he promised to push to get him in.

In February, my husband got – not a phone call, but 14 pages of questions they wanted him to answer. All of which was information that would have been in his medical file. He answered as best he could, but some of it simply went back too far, and we no longer had the details (which would have been in his file, anyhow), while others were too complicated to answer on the form. At one point, my husband even wrote in, “don’t you have this one file?”

Then the pandemic lockdown happened in March.

No more health care, unless you thought you had the virus, or were in an emergency situation – and even those got punted.

So that added another 6 months to the wait. Today’s appointment was almost exactly 2 1/2 years, to the day, since my husband was put on the waiting list.

We made the drive in, and it took about 1 1/2 hours to get to the clinic – about 15 minutes less than I’d expected, but traffic was pretty clear when we came in. (It took longer to get out of the city, later.)

When we got there, I was able to drop my husband off with his walker at a ramp, then parked nearby as he went in ahead of me. At this point, we were about half an hour early for his appointment. Plenty of time to go through the gauntlet to get to where he needed to be.

After I parked and went to follow him (he was NOT required to use a mask, Thank God!), I was told they were allowing patients, only. I could not go in with him.

They did, however, allow me to use their washroom, at least!

The city is even hotter than we are – it was 32C/89F with a humidex of 37C/98C. There was no way I could wait in the van in that heat. So I started wandering around to try and find some shade in the area.

I found some.

There was even a place to sit down.

Sort of.

Thankfully, I still had some waterproof cushions in the van that I’d bought so my daughter and I could sit outside on damp concrete benches to have lunch together, months ago.

By this time, my husband had texted me to let me know where he was, at the same time I was texting him to let him know I wasn’t allowed to join him.

Since it was a while before his appointment was booked for, I took advantage of the time and played some Pokemon Go. I even found a nice, little park next to a Pokemon Go gym I could battle in.

Such a lovely, shady spot.

Sometimes, people really suck.

I’d been playing for a while when I got a text from my husband – well past his appointment time – informing me that he was still waiting.

I walked around for a while longer before returning to the shade by the clinic. By the time I got the message that he was done, it was an hour past his appointment time.

So how long was the appointment?

Well, it turned out to be a two part appointment.

For the first part, a nurse came in to talk to him about his diet and diabetes, while skimming over his file.

He ended up cutting her off to ask if they could focus on why he was there: his pain.

It turns out that some of his pain issues was listed in his file as being diabetic related.

In reality, his diabetes is related to the pain. And the other pains that were noted as being diabetic related are actually from nerve damage due to problems with his spine, which in turn are exacerbated by the original injury.

The nurse left after about 10 minutes. He could hear she was talking to the doctor in the hallway before the doctor came in, and gets the feeling she “warned” the doctor in advance.

The doctor was to the point – which was much appreciated – and quickly ran through potential options.

Surgery.

That was looking into years ago, and my husband is not a candidate for surgery. He explained that, and the why of it, to the doctor.

Shots.

That was in the file as having been tried before, without success.

Physiotherapy/mental coping skills.

It turns out there’s nothing at this clinic as far as physical treatment that he can’t get from any physiotherapist locally. Certainly nothing to warrant the 1 1/2 hour drive each way. There don’t seem to be any of the exercise specialists that helped him before, in this province, in any variation. As for mental coping skills, as a martial artist, my husband was already well versed in the use of meditation techniques they would advise. He’s been using them to help cope with the pain for years.

It makes for very quiet trips to and from the city, as he spends almost the entire time using those techniques to control/cope with his pain during the drive.

That left one more thing.

Medication.

And there is nothing they would do that our GP can’t.

Finally advice?

Go back to your doctor.

Which is what we’re booked to do tomorrow.

On the one hand, okay. This is good. We know what they can or can’t do. Maybe if we lived in the city, there would be more options? I don’t know.

The thing that frustrates me most is that our first doctor would not adjust my husband’s painkillers, or related medications, until the pain clinic saw him first. He had no problem adding more medications for other things, but he wasn’t going to touch the pain issues without that. He was by no means a bad doctor; in fact, he was better than the others we had to deal with when my husband ended up in the hospital. I think he was just too young, inexperienced and lacking in confidence for a file as complicated as my husband’s.

As for our current doctor, he’s seen my husband all of twice, and 1) kick started the pain clinic response in the first place and 2) is already considering alternative medications that might help with the pain better than what he’s on now.

And this is even with the pandemic shut downs slowing everything down.

Which basically means we had 2 wasted years of waiting for my husband’s pain medications to be adjusted, that wasn’t necessary. Plus the 6 months of no health care at all, due to the pandemic shut downs.

We waited 2 1/2 years for less than 15 minutes at the pain clinic, and there’s nothing there to help him.

The van was parked close to the ramp where I’d dropped him off, which was handy, since there was an ambulance parked next to the ramp’s drop off/pick up zone. Still, I wish I could have brought it closer, because I could see he was really struggling.

Then, we went to a McDonald’s, mostly so we could sit in some air conditioning. As hungry as he was, he couldn’t actually eat more than a few fries, as he was in too much pain, but it did give us a chance to catch up on what happened.

Then there was the drive home.

A very quiet drive home, as he meditated pretty much the entire trip.

We still have the drive to the doctor’s, tomorrow, but at least that clinic is only about 40 minutes away.

I do have higher hopes for our current doctor.

We shall see what happens tomorrow!

The Re-Farmer

A little friend, and change of (medical) plans

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While picking cucalmelons this morning, I found a little friend!

We’ve been seeing LOTS of frogs about this size, every time we to go through the garden beds. Usually, they hop off too quickly for me to get photos, but this one didn’t move!

He was even okay with the cucamelon leaves being pulled aside.

I am very happy to see so many frogs in our garden beds. I’m sure they’re doing a great job of eating up things that would be eating our vegetables!

On a less cheerful note, the original plan for today had to change. This was the day I was supposed to bring my husband into the city for an appointment at the cardiac clinic. They want to discuss the possibility of implanting a defibrillator in him.

Unfortunately, about a week ago, my husband discovered cats had peed under his hospital bed, and under the small table with the mini fridge he keeps some of his medications in. He cleaned it up himself, rather than asking any of us to do it.

He still hasn’t completely recovered.

When his pain levels didn’t improve by Monday, he called the cardiac clinic about his appointment. The letter he received said to expect to be there for at least 2 hours. He explained his situation. The choices were to either cancel the appointment, or they could find some way to accommodate his pain levels and disability.

The appointment got cancelled.

They way he put it, the response was along the lines of, how dare he mess with their system.

They will send another letter with a new appointment (I find it interesting that they make these appointments with zero input from patients), and after he gets the new letter, he can talk to them about accommodations. Of course, he has no way of knowing if he’ll have a good day or a bad day – or even a good week or a bad week – that far in advance. That’s why he was stuck phoning them only about 48 hours before today’s appointment. No matter; even if he’s having a good day, being able to lie down on a stretcher of something would probably be needed, just after such a long drive.

I understand why the province has a single cardiac clinic in a central location. It is probably much more efficient, and allows for things like better access to equipment. The problem is, like almost all Canadian provinces, we are geographically huge, and not everyone lives in or near this particular city. We’re just an hour away from the city (though it can take another half hour to reach the clinic, depending on traffic), and it’s difficult enough. I can’t imagine living in one of the fly-in communities and needing cardiac care. Sure, the small communities don’t have the population base to warrant their own cardiac clinics, but there are large towns and other cities that could serve these more remote communities.

The fact that it’s such and inconvenience for them to accommodate my husband’s disability is also frustrating. They’re in a hospital, for crying out loud. And with so many hospitals cancelling care to make room for all the pandemic hospitalizations that never materialized, there are plenty of stretchers and beds available that could be used for someone like my husband, without having to prearrange it weeks in advance.

Another unfortunate thing with my husband is that his pain levels have forced him to cancel a number of appointments. He has also done things like walked out after being forced to wait well past his appointment time, due to pain caused by the wait itself, and basically has stood up for himself. He is likely now considered a “problem” patient. I don’t think they realize that, when it comes to his list of health problems, his recently developed heart condition is actually not at the top of the list. Not even close. With everything else going on, this new development doesn’t even phase him, and certainly doesn’t frighten him, as it probably more typical. His pain needs to be gotten under control first. Some of his other health problems are caused by the pain itself, and will improve on their own, accordingly. They have not been able to figure out why his heart failure developed in the first place, and we’re pretty sure it has more to do with the large number of medications he is on, and has been for such a long time, than anything else. We already know that there is no surgery or treatment that can “fix” the physical source of his disability, and it will continue to cause further degradation of his spine. The only real thing that can be done is treat the pain. That’s the foundational thing. Without that being addressed, treating his other problems are little more than stop-gap motions.

This has been explained at heart clinic appointments a few times. I’ve watched notes get taken for his file, that the whole team looks at. There is no reason for them to not be aware of his disability, and what that means for his appointments. Even the fact that we have to drive so far and the affect that has on his pain levels has been duly noted.

Yet when he tries to address this with them, he’s made to feel like he’s inconveniencing them somehow?

Not impressed.

Well, next week he has his first appointment with the pain clinic. Hopefully, that will get the ball rolling on more effective treatment.

The Re-Farmer

Melting

/ Re-Farmer / 2 Comments

It was a hot day to be taking my mother for her medical appointment in a van with no air conditioning!

It was already cooling down when I took the above screencap. 28C/82F, with the humidex bringing it to 35C/95F From the weather radar, I don’t expect to get that predicted thunderstorm; it appears to be moving to the north of us. I hope we’ll at least get some rain. It’s been a challenge to keep the garden beds watered. At least I haven’t needed to mow the lawn in a while. :-D

While driving my mother to her appointment, she actually asked me to open the windows more, even though we were at highway speeds. Normally, she’s asking me to close them because of the wind! Well, hopefully we’ll have her car back next week. I could see she was really struggling to get into our van. She’s so tiny! :-D

Her appointment went well. She is frustratingly healthy. All her tests came back excellent. She has obvious issues with arthritis, which there’s really nothing more she can do about, and problems with her knees. She could get surgery to fix those but, considering she won’t even wear her knee brace, there is significant doubt she would keep up with the post surgical requirements, so it didn’t even come up. Her major concern is with her “heart”. By which she means her breathing. But only sometimes, and only in the morning, when she sometimes wakes up gasping for air. The doctor suggested she try sleeping upright, to relieve pressure on her chest from certain generously proportioned parts of her anatomy. I mentioned my siblings and I have discussed getting her a sleep chair, and he said he thought that would help her a lot. He also suggested we try putting something under her mattress to elevate it. I figure we can try that for a few weeks, then assess how it helps or not. She might actually do well with a hospital bed, like my husband’s, which would allow her to lower the whole thing to get in and out easier, too.

He will also be referring her to a geriatric team to assess her. Or an “elder care team”, as he put it. She still didn’t quite understand what he meant, so when we were talking about it later, I explained to her about how some doctors specialized in helping older people, with their physical and mental needs that are different from younger people. Once she understood, she was quite excited about that, saying that yes, she needs that!

Since I was driving her around anyhow, I also helped her get some grocery shopping done, and then we had a very late lunch – in a nice, air conditioned restaurant!

All in all, it went really well, and she was on much better behavior than usual. She was having one of her good days, so it made a huge difference.

After I got home and updated my siblings on how things went, I went to do my evening rounds a bit earlier. The girls had already watered the garden beds. I tried weeding around the beets a bit, but so many of the leaves have been eaten by deer, I don’t know if I should even bother. I’d mentioned this problem to my mother, and she decided that meant we needed a dog. A dog will keep the deer away! I wish I’d remembered to mention that my sister has a dog, and they still had to fence their garden to keep the deer out. And bears, but that’s a problem we, at least, don’t have! :-D

With the bird feeder painted and done, the girls are still doing coats of paint on both sides of the screened window frame for the old basement. Today, I flipped the picnic table and scrubbed the bottoms of the legs clean of dirt, so that we can apply the spray rubber on the ends. I also cleaned a rain barrel I’ve moved near the squash beds, around the cracks it has in one area. I was going to look for some sort of silicon caulking or something to patch the cracks when I realized the spray rubber would actually be better. The application will wait until tomorrow. According to the instructions on the can, the weather we’re predicted to have will affect how well it works. The 14 day forecast predicts continued high temperatures, but no rain, so that will be a good time to start applying layers of this stuff. Meanwhile I want to make some sort of screen cover for this rain barrel, plus the one set up by the house, to keep debris and critters out. I found a bird downed in the one by the house once already – I’m guessing it flew into a sun room window, knocked itself out, then fell into the barrel. :-( Once I have a cover made, and the cracks coated, I will keep the one barrel filled so that we can use ambient temperature water on the squash, instead of cold well water. If we don’t get rain tonight, I’ll likely be filling the rain barrel by the house to warm up, too.

In the long term, I want to get some large tanks like this.

Image source.

They are sometimes available from salvage places for really low prices, and would be ideal for when we plant anything further from the house.

That, however may be a few more years into the future!

Little by little, it’ll get done!

The Re-Farmer

More deer damage, and a medical update

/ Re-Farmer / 7 Comments

We had a really hot day today, so when things cooled down enough, I went out to water the garden plots and sunflowers.

Which is when I found this.

All the leaves on one side of this one have been eaten!

This is the first of the large sunflowers that has had this kind of damage. :-( At least the top didn’t get chomped off.

One of the more recently chomped smaller ones is showing signs of recovery.

It also had a friend!

We’ve got a lot of grasshoppers and locusts this year, but this is the first green one like this that I’ve seen. :-)

When I was done and dragging the hose back to the house, I found Creamsicle napping on top of the straw bale. :-) My coming close for a picture woke him up…

I caught him mid stretch. :-D

Meanwhile…

Today, my husband and I had our doctor appointments that we should have had back in March. They were supposed to be physicals, but the doctor wasn’t expecting that. Which is when I found out he does physicals in the mornings, when, as he put it, his mind it still fresh. Which was not a problem, since we had lots to catch up on. He hasn’t seen my husband since December, and has seen me only while I was accompanying my mother.

Us all having the same doctor is coming in handy.

Before doing a full physical, he wanted us both to get fasting bloodwork done. For my husband’s part of the appointment, we updated the doctor on his upcoming visit with the pain clinic. Even though he hasn’t seen my husband in more than 6 months, he remembered that we’d already been waiting for almost 2 years, so he was a bit shocked that this was going to be a first visit. We also told him about the appointment at the cardiac clinic to discuss my husband getting a defibrillator implanted. He had questions about that. Mostly, why does my husband suddenly have such a low ejection fraction? It turns out that the cardiac clinic has not been sending any files to our doctor, so he had nothing. He still has nothing, really, because the cardiac clinic has not been able to find why my husband’s ejection fraction is so low, and are openly perplexed by him. The doctor has requested for us to remind the clinic to send the files to him, so he can see what’s going on. Same with the pain clinic, when the time comes.

In our previous province, all medical files were electronic, and could be accessed by any authorized doctor. So my husband could go from his GP to the specialists at the pain clinic (all 4 or 5 of them that were assigned to his case), to any other specialist, and they would all have access to the same information. Here, there is no connectivity. When our previous doctor suddenly moved out of province, we had to pay to have our files sent to the new clinic. A GP can access the electronic files at their own clinic, but not the files at the heart clinic or the pain clinic. They all have to send their files to each other, as needed. All of the specialty clinics should be sending everything back to the primary caregiver every time, so that at least that one person has all the information. Why that isn’t happening for my husband, we don’t know, but the doctor was not happy with having so much information missing.

We spent some time talking about my husband’s medications, and the problems he’s been having getting refills for the painkillers. So that’s been updated but, after we get the bloodwork done, he wants to look at switching my husband to morphine, and focus on pain management a lot more. There’s one medication in particular that he was wondering why my husband is on at all, and he just didn’t know anymore. I suspect the total number of prescriptions my husband is on will be reduced.

I’m happy to see him being pro-active about it. The previous doctor didn’t want to change anything until after my husband was seen by the pain clinic, but that took so long, the doctor moved out of province before that could happen!

My own part of the appointment was short. I have only one prescription, and I’ll see him again after my bloodwork is done. We ended up chatting a bit about my mother, since I’ll be bringing her back to see him tomorrow.

As for our follow up appointments, he started to ask if we could book them in the mornings when I mentioned I’d asked for the afternoon, because of the drive. When he realized how far away we live, he completely back tracked and said to make the appointment for whenever works best for us, and to book another “joint” appointment, and he will accommodate us. Since our bloodwork requires fasting, we will book the appointment after we get it done, which likely won’t be until Monday.

So we’ll have at least one more medical appointment this month, on top of the others.

With this doctor wanting to work proactively on managing my husband’s pain, I suspect we’ll be back fairly regularly.

By the time we were done, my husband was at his limit – and we still had the drive home to do. He was worried about his appointment at the cardiac clinic next week. The letter said that there have been a lot of delays, and to expect to be there for as long as 2 hours. That’s after a 1 1/2 hour drive. We’ll have to make sure to call in advance so they can have a stretcher available for him to lie down on; something they were able to arrange to do for him before, after a previous appointment was so late, he ended up walking out because he was in just too much pain. They’re a cardiac clinic. They don’t take into account any other issues a person might have, unrelated to the heart, unless it’s brought up directly.

Another reason why not having central files is a problem. When he goes to any specialist, he has to explain everything else to them. At the cardiac clinic, he could see any one of a team of 5 that works together, so he has to explain his disability, and why he uses a walker, all over again with each one. Otherwise, they assume that his use of a walker is related to his heart condition.

It’s frustrating, to say the least.

At least now we’re able to actually get appointments and treatment. The months of delays because of the pandemic shut downs have really messed things up for him. Our province has once again had more people testing positive for the Wuhan strain of coronavirus, and people are freaking out and demanding things shut down again. What the media isn’t including in their reports (though it’s on the provincial government website, for all to see), those new cases are from 5 days of testing, and represent only .9% testing positive. The total number of positive and presumptive positive cases for the province since March is .03% of the entire population. A person is more likely to get hit by a car than test positive for the Wuhan strain of coronavirus. People don’t seem to understand risk factors at all anymore, and the panic means people like my husband are having a hard time getting medical care. During our appointment, the only time it came up at all was when I mentioned we were supposed to have today’s appointments back in March, when everything got shut down. My husband’s appointment at the cardiac clinic got cancelled. While my husband did get one appointment rescheduled at the cardiac clinic, for a test in nuclear medicine, next week will be the first time the cardiac team will be seeing him. He’s had a couple of telephone appointments, but that’s it. He had also finally gotten contacted by the pain clinic just before the shut down, which that added a few more months to his wait.

If things shut down again, lack of treatment would certainly mean his condition degenerating further. Lack of treatment is more likely to kill him, than any of us coming in contact with the Wuhan strain of coronavirus.

He is certainly not the only person in this position.

Frustrating is really quite an understatement.

The Re-Farmer

A hint of what this August looks to be like

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Today, the girls held down the fort while I headed out early to take my mother for a doctor’s appointment – her first since things were just starting to shut down. Most appointments were being cancelled – thankfully, not hers – and they were only doing phone appointments. The clinic is still doing “walk ins” by phone, but are now doing in person appointments again.

The doctor had wanted my mom to be able to do fasting blood tests, so the appointment was shortly after the clinic opened. That way, she wouldn’t be without food for too long. The doctor also wrote her up for an EKG and chest Xrays. Without the results of those tests, he didn’t want to do a physical or address her prescriptions, etc. quite yet. So he did memory test with her, and talked about some of her concerns to address next time.

Which will be this Friday. He wanted to get her back as soon as possible after he got the test results. She also formally gave him permission to talk to me about anything regarding her health, at the same level as he can with my brother that has Power of Attorney. This will reduce the burden on my brother, as well as make things easier for the doctor, since I am more available to both the doctor and my mother.

Right after her appointment, we went across the hall to lab and Xray with her requisitions, only to be told that their Xray machine was broken and wouldn’t be fixed for 6 months. We could go to the hospital near my mother’s place, though, so we got that paperwork back while she got blood taken, then her EKG. The staff in the lab were the only ones we saw wearing masks and gloves, besides the odd patient.

We wanted to stop for lunch – breakfast, for my mother! – in the town the clinic is in, but the places we normally would have gone to were all closed. We ended up going back to her town before we found someplace open. By then, she’d gone 12 hours without food! Then we got her Xrays done. Thankfully, we didn’t have long to wait. At this hospital, there was one person near the door who was wearing masks and gloves and asking the usual “have you traveled, do you have any symptoms” questions. The only other people I saw with masks was a couple of patients. I found myself in the waiting room with a couple of people, with chairs physical distanced apart. The woman nearest me was wearing a cloth mask, and I could hear the poor woman struggling to breath through it. :-( At both hospital clinics and lab areas, they had the same sign saying who should be wearing masks. Few would have been required to wear them, based on their list. It seemed very reasonable; cautious, without being excessive.

I was going to help my mother with grocery shopping after she was done with the Xrays, but she was – understandably – too tired and just wanted to get home. I’m glad I persuaded her to bring her walker. She was ready to just cane it, but I told her it was better to have it and not need it, than need it and not have it. Plus, I have plenty of space in the van to bring it along, and don’t even have to fold it up. The only time she chose not to use it was when we went into the restaurant.

After dropping her off at home, I then had to head to the pharmacy – which made town number 3 I drove to! ;-) – to pick up the rest of my husband’s medications for the month. I let the pharmacist know about potential updates or changes in his prescriptions over the next while. As we were talking, she mentioned that my husband is the only person they have taking the painkillers he’s on; the ones with all the restrictions and regulations. He’s at the maximum dose already, and all they really do is take the edge off the pain. I really hope the folks at the pain clinic can help with that!

I took advantage of being in town to run a few errands. That included stopping at the garage to see when my mother’s car would be worked on. I was told they’d be able to work on it at the end of the week, or next week. I mentioned my mother having a doctor’s appointment on Friday, and that I hoped to be able to use her car, since it’s easier for her to get in and out of. He couldn’t say for sure, but they would try. We’ll see how that goes.

A stop to pick up our mail on the way home found a letter from the heart clinic for my husband. They made an appointment for him next week, to discuss implanting a defibrillator. His ejection fraction has improved, but not much – and they still don’t know why it’s become a problem in the first place. All the tests they’ve done have come back normal and healthy.

So we now have a phone appointment for my husband tomorrow, with home care. The day after, he and I have appointments for physicals with the same doctor as my mother. Then on Friday, I’m back at the clinic with my mom. Next week is the new appointment at the cardiac clinic in the city, and the week after is his first appointment with the pain clinic, also in the city.

I have to admit, I’ve become spoiled by our current situation. This is now a lot of driving for us. When we lived in the city, I did a lot more driving. Not drives of an hour or more, to be sure, but our mileage of less than half what it used to me. A few extra trips now feels like a big deal! :-D

It’s going to be tiring – especially for my husband – but I’m just grateful we’re finally “allowed” to get health care again.

The Re-Farmer

Good news!

/ Re-Farmer / 4 Comments

And it only took 2 years and 5 months.

My husband got a letter from the pain clinic in the city today. He has an appointment for next month!

Which will make it almost exactly 2 1/2 years since he was first put on the waiting list.

It took 2 years and a new doctor making some noise just to finally get their 14 page (or was it 17 pages?) questionnaire. That got sent in, but then the lock down happened and my husband, like so many others, got knocked off the priority list for health care.

He had to call in to confirm, then answer pandemic related questions. He was also told if he doesn’t have a mask, they’ll provide one.

He had a little chat with our daughter, and she will be making him a pirate mask.

Finally, he’ll be able to talk to a specialist about managing his pain. Who knows what will come of it. At the pain clinic before we moved, he had a team of 5 different specialists overseeing his case. The heart clinic out here has a team of 5 specialists, too, but they all work together on the same things, so when he comes in for an appointment there, he can see any one of them. At the previous pain clinic, each team member focused on a different area, such as pain medications, physical pain management, etc, with one primary care giver. We have no clue what to expect out here. So much of the health care in this province is different from before. Even with basic health care, they do things slightly differently, though at least part of that is the difference between living in the city, or in the boonies, like we are.

I am really hoping this is the start of some sort of treatment plan to at least get the pain under better control. We’ve known for some time – and at least one specialist made sure we understood this – that my husband will never be not-disabled again. He will never be 100% pain free. The best we can expect is an improvement in quality of life. Any improvement at all will be a blessing.

The Re-Farmer

Good grief

/ Re-Farmer / 4 Comments

What a runaround today has been.

But first, I will share something to make you smile!

Upside down, furry friends.

Two Face and Dave were busily playing, with Two Face grabbing, licking and biting Dave’s head and him… letting her. :-D

At about 1am. I just had to turn on a light and get pictures. :-D

So… today’s runaround.

When my husband’s bubble packs got refilled, the pharmacy told us that one of his medications was out of refills. For some reason, this one painkiller got only a 1 month renewal. He’s actually on two versions of this painkiller; a quick release and an extended release. The extended release version was missing.

The pharmacy had faxed the clinic, but as of Saturday, there was still no response. They did have a pre-bubble pack prescription left for 6 pills. Three days worth. So I took those. My husband will be out of them again, after today.

So this morning, starting from when the clinic opened at 9, my husband tried phoning the clinic.

After more than an hour, he still hadn’t gotten through, so once I finished my rounds, I drove to the clinic.

Which is in a town 45 minutes away (as far as I know, the clinic we had been going to previously, still doesn’t have new doctors to replace the two that moved away, which is why we had to switch to a town further away).

When I got there and talked to a receptionist, telling her we couldn’t get through by phone, she was apologetic. It seems that on Mondays in particular, the doctors all have telephone appointments and use up all the lines.

I explained the problem and she looked up my husband’s file. According to what she saw, the doctor had phoned the pharmacy on Saturday. She even had a time. It was maybe an hour after I’d already stopped by the pharmacy myself!

So as far as she could tell, the pharmacy should have had a 2 month renewal for these meds.

Once I was done there, I messaged my husband and let him know, asking him to call the pharmacy while I made a quick stop at the hardware store nearby to get the latches I needed, then drove to the pharmacy. Which was another 45-50 minutes of driving, so it would give them plenty of time to find the fax and fill the prescription.

By the time I was done at the hardware store, I had messages from my husband. The pharmacy had no fax. They said they would talk to the clinic about it.

So I drove to the pharmacy anyway. By then, the pharmacist had gotten through to the receptionist at the clinic at noon, which is when our doctor was supposed to be in, but he wasn’t yet. He needed to sign the triplicate, before the clinic could fax it to the pharmacy. That hadn’t happened yet. The pharmacist told me that, if she didn’t hear from the clinic by 2, she would call them herself. She knew my husband would be out of the painkillers by the end of today, and how much of an issue that would be.

I decided I would stay in town for a while and have breakfast lunch, then make a stop at the beach.

It’s been about 8 or so months since a storm completely covered the boulders at the main dock, and the waves are still only starting to reveal them again. Where I’m standing to take the above picture, I was about 5 feet above water level. Normally, there would be a lot more boulders visible, and the beach here would be more “slope” and less “erosion cliff”.

The beach was busy, though not crowded. This is a resort town and normally it would have been packed with tourists and people at their cabins for the holidays, even on a weekday. It was good to see people out in the sunshine.

I walked around the strip of beach I usually do, pausing at a Pokemon Go gym near the beach to do battle. I had gone to a tree for some shade, and would have leaned on it (since the park bench that used to be there is now gone), but found it was occupied.

This bumble was just wandering around on the bark, minding her own business, so I let her be. :-)

The pharmacist had told me they would phone our home number if the prescription was filled. By about 3, there was no call, but I swung by anyhow, just in case.

The pharmacist had called the clinic, but the doctor was with a patient and had not been able to sign the triplicate yet. She did not know when he would be done, and there was no fax, yet.

*sigh*

I told her I had to go home, and asked if they could phone us when they got the prescription. She told me they could deliver it to us, even as far out as we are. I told her we don’t have a credit card to pay for it, which is how they usually do payments on home deliveries. She said that we’re there so often, they would just set it aside (the printouts with the bar codes) to pay for it the next time we came in. !!!

Which would be amazing, though I don’t expect it to happen. As I write this, I can see that the pharmacy is either already closed or, if they’re back to regular hours, closing soon.

I really, really hope this can be taken care of by tomorrow. I will happily make the extra drive in to get them!

Thankfully, with my being gone most of the day, the girls were home to take care of the routine stuff. So while I can’t say it was a completely wasted day – I at least got the latches I needed, and even found pruning paint, for the next time we have to cut away live branches – but it feels like nothing tangible got accomplished.

I’m going to install those latches, just to say I got something checked off the to-do list!

The Re-Farmer