IM DONE!

I HAVE HAD IT WITH MY DOCTOR, WITH MY CASE MANAGER, WITH THE WHOLE DAMN CLINIC!  I REFUSE TO GO THERE ANYMORE, EVEN THOUGH IT IS THE ONLY CLINIC I AM ALLOWED TO GO TO.  

HERE IN AZ, IF YOU ARE ON MEDICAID, AND YOU ARE DETERMINED TO BE ‘SMI’ (SERIOUSLY MENTALLY ILL)  YOU ARE ONLY ALLOWED TO GO TO ONE OF FIVE CLINICS FOR ‘SMI’S.  YOU ARE ASSIGNED TO THE ONE CLOSEST TO YOU, AND CANNOT JUST SWITCH.  ALSO, THEY ARE ALL RUN BY THE SAME AGENCY THAT CONTRACTS FOR MENTAL HEALTHCARE FOR MEDICAID FOR THE STATE.  SO THEY ARE ALL THE SAME.

SO I HAVE NO OTHER OPTIONS FOR WHERE TO RECEIVE MENTAL HEALTH CARE.  I CANNOT GO TO A ‘GENERAL POPULATION’ MENTAL HEALTH CLINIC, BECAUSE I AM ‘SMI’.  I CANNOT GO TO A DOCTOR WHO IS IN MY MEDICARE PROVIDER LIST, BECAUSE THEY DON’T ACCEPT MEDICAID PAYMENTS.  SO I WOULD HAVE TO PAY THE MONTHLY PREMIUM MYSELF FOR MEDICARE PART B, AND I WOULD HAVE TO MEET THE DEDUCTIBLE FOR PART B AS WELL BEFORE MEDICARE WOULD PAY ITS 50% FOR MENTAL HEALTH CARE.  IF I USE A PROVIDER FROM AN SMI CLINIC, THEN MY MEDICAID IS ACCEPTED, AND THE TOTAL BILL IS PAID.  ALSO, IF I GO TO AN SMI CLINIC, MEDICAID WILL PAY MY PART B DEDUCTIBLES AND PREMIUMS AND COPAYS.

SO I HAVE NO OTHER CHOICE THAN TO STOP SEEING A PSYCHIATRIST, SINCE I REFUSE TO KEEP BEING TREATED LIKE CRAP AND NOT HAVING MY NEEDS MET AT THE SMI CLINIC THAT IS THE ONLY ONE I AM ALLOWED TO USE.

SINCE I AM NO LONGER GOING TO GO THERE, I CAN NOT GET MEDS ANYMORE.  SINCE I AM NOT GOING THERE, I CANNOT GET TEGRETOL LABS DONE SO MY NEPHROLIGIST DOES NOT KNOW HOW MUCH TO ADJUST MY MEDS FOR THE ACIDOSIS AND EDEMA I HAVE THAT WAS CAUSED BY THE LITHIUM AND WORSENED BY THE SWITCH OFF OF IT TO FIRST DEPOKATE AND NOW TEGRETOL.  SO HE CANNOT HELP ME IF I CANT GET PSYCHIATRIC LABS DONE.

OF COURSE, THIS ALSO MEANS THAT I CANNOT FINISH MY PHP PROGRAM (PARTIAL HOSPITALIZATION), BECAUSE IN ORDER TO BE IN IT, YOU MUST HAVE AN OUTPATIENT PRESCRIBING PROVIDER.  AND SINCE I NO LONGER DO, WELL, THAT AVENUE IS NOW CLOSED TOO.

SO I AM NO LONGER SEEING ANY DOCS OR GETTING ANY MEDS OR PARTICIPATING IN THE PHP PROGRAM.  I AM GOING IT ALONE, SINCE I AM THE ONLY PERSON I CAN COUNT ON TO BE ON MY SIDE. IT IS TRUE WHAT THEY SAY–ALWAYS LOOK OUT FOR NUMBER ONE, CAUSE NO ONE ELSE WILL.

I WILL DO ALL THE THINGS I KNOW TO DO TO TRY TO STAY STABLE, AND IF I CANT, WELL, I CAN ACCEPT THAT I WILL HAVE MANIC AND DEPRESSED AND MIXED EPISODES AND THAT I WILL JUST HAVE TO TOUGH MY WAY THROUGH THEM OR GIVE IN.  AT LEAST I WILL NOT HAVE ANY EXPECTATIONS OF THE DOCTORS OR BE DEPENDENT ON THEM FOR THINGS THAT THEY FAIL TO DO, FOR FAILING TO LISTEN TO ME AND MY SYMPTOMS.  I WILL TAKE CARE OF ME FROM NOW ON, WITH EPISODES OR NOT, AND DO THE BEST I CAN.

OF COURSE, I FORGOT TO MENTION THAT THE SMI CLINICS HAVE THE RIGHT TO PETITION AND COURT ORDER ANY PATIENT WHO REFUSES TREATMENT AND REFUSES TO TAKE MEDS OR KEEP APPOINTMENTS.  IN OTHER WORDS, BECAUSE YOU ARE SMI, THEY HAVE THE RIGHT TO SAY THAT YOU DONT HAVE THE RIGHT TO REFUSE TREATMENT AND THEY CAN COMMIT YOU.  I SAY, BRING IT ON, BITCHES!  

Just When I Think I’m Out….They Pull Me Back In

Thanks, Al Pacino, as the youngish Don in Godfather 2 for that quote and sentiment.

Tonight, just a list. A ‘food for thought’ kind of list.  A list that says, ‘how am I supposed to be getting well, when “it just keeps getting piled higher and deeper” ‘ kind of list.  Well, enough confabulating, the list:

Son’s car repairs, beyond what he can pay from his salary as part time at Taco Bell–$310.  Without this repair, the car will not pass emissions testing and will not get its tags and will be undriveable. The testing must be completed by the end of this month. 

My car repairs, which cannot be completed because I still owe the shop half the money from the last repairs.  And because my son’s car is already off the road.  $–unknown (due to accident, see later on list)

My son’s school fees-$200.  Daughter’s school fees-$200.  Son’s clothing needs-Some of everything.  Daughter’s clothing needs–all of everything.  Total-$400’ish.

Moving costs for August 3-rent on old place, rent on new place, +$300 deposit on new place, plus renting a moving van for 1 day-$50.

Copays ex just reimbursed me for that now have to go to other costs than to reimburse me.  Still need to pay provider the copays ex just gave me tho.  Hmm…$200’ish.

Insurance company for woman who rear-ended me on freeway in May.  On June 30, representative for insurance said they accepted 100% responsibility, but in mail 10 days later, written notice they were denying any responsibility.  They still had their adjustor come and do estimate (he said it was definitely the other car that caused all my damage, and he has completed and sent in his report–I talked to him to be sure).  They refuse to return my calls, even though their voicemail says will reply in 24 hours, I have left messages every day since June 5th.  Meanwhile, my car is driving very scary and am afraid to use it, or to have it seen at my shop, cause if I fix it, then the other insurance definitely won’t reimburse me.  Actually, this is the insurance that refuses to call me back:

Got divorce finalized in December 2011, applied for deferment or waiver at time of filing, so I had to pay nothing at that time.  Have never received anything from court since, until, July 15 when they sent me a collection notice for 20% interest in 30 days time if not paid in full by end of July–$400.  Told them I could pay it in September, they said too bad, so sad.  Pay or go to collections. Or try to get new deferral, but it won’t be approved because is from so far back.  Apparently, that is not their responsibility that they did not bill me appropriately, I was supposed to know I had a bill for x amount and pay it without a statement or invoice, etc.  They said I did not update my address, I said I did, and I had the scanned documents to prove it that I mailed in, and the postmark would prove it.  They said it has to be in person update of address to their specific court billing department, and that the normal updating of address for court is not for them and means absolutely nothing, even though I could prove I had sent it in.

Oh, and additionally, I get to refile for modifications to my divorce child custody and support and insurance, since my ex just told me he’s moving out of state on Friday, so he won’t be seeing the kids on weekends anymore and so he will have to increase the amount he pays in support for each of them.  Wonder what the fees for filing that will be, on top of the above $400 from 2011 that I was magically supposed to know about.  Maybe they can roll it all together?  And hit me for it all at once?  so I’ll be even more broke–if I get any more broke, I’ll be homeless eating at soup kitchens.  And I’m not being mellow dramatic.  And this is the courthouse and court that is acting so ridiculous:  

And then there’s the things that don’t cost money, but are so much fun to deal with that I just couldn’t leave them out.

First one, a 1.5hr conversation with a supervisor in my ‘team’ at my mental health clinic where I was trying to request a perishable food box, not the dry goods one.  I knew they were separate and from separate places.  But I didn’t know the names/labels the staff and case managers used to refer to them.  So, it turns out Food Box A-Dry Goods, is from a church and requires one’s case manager to fill a form out with the client a week before it is delivered to the clinic for client pick up.  You can only make one request for Food Box A-Dry Goods in a 3 months period.  I have never filled out a form, and have often received food boxes more than once in 3 months.  Also, the food boxes I have received were perishable, and my case manager delivered them to me, or told me when she had them so I could pick them up.  So, after going round and round that I never signed or filled out a form in 5 years of going to this clinic, where I was afraid I was going to lose it and burst out in tears, or ‘get that tone in my voice’ that makes people just walk away from me and ignore me forever, he finally said ‘well, case managers have the ability to go to 22+ food pantries to get perishable food boxes and deliver them to their clients.  Maybe this is what you are talking about?  And I said, flooded with such relief that I was afraid I was going to bow down on my knees and pray to God right then and there thanks that I was finally being heard, understood, and listened to, YES, THAT IS EXACTLY WHAT I HAVE BEEN TELLING YOU FOR THE LAST 1.5HRS.  THAT MY LAST CASE MANAGER DID THAT.  THAT THAT IS WHAT I WANT FROM THE NEW CASE MANAGER.  THAT IF SHE DOES NOT CHOOSE TO DO THAT (as it is optional for them to do that) THAT THEN I WOULD GLADLY FILL OUT THE FORM FOR FOOD BOX A-DRY GOODS, BUT ONLY IF I COULD NOT GET FOOD BOX B-PERISHABLE GOODS (which are up to case manager to do or not to do).  Then, he finally agreed to have her contact me tomorrow to find out if she does do FOOD BOX B-PERISHABLE GOODS, or not.  And if not, then I will fill out the form for FOOD BOX A-DRY GOODS, tomorrow.  And it only took 1.5 hours.  But I was REALLY proud of myselves for not bursting out into tears (the guy would have walked away if I had) or for ‘sounding’ argumentative/belligerent from frustration.  He would’ve walked away then too, maybe set security on me even.

And the piece de resistance, the mignon final, my late father’s wife, who is listed as Co Power of Attorney, Durable, for Health Care for my only living family (2 cousins who are sisters, who raised my dad) has shunned me, blocked me out of the loop concerning my two cousins, and has made my cousins believe that I am trying to steal their money and place them in nursing homes, when in actuality, I am trying to convince them to accept some home health and cleaning services so they can stay in their own home, by contacting the Area Agency on Aging and having them do a service counselling appointment.  Well, my step mom, now that my dad’s dead, has been trying to get their money for the last 3 years.  But when I actually want to step in and help them by having her do that, she shuns me and intimidates my cousins from talking to me or allowing the staff at the nursing home from talking to me, or allowing the Area Agency on Aging from talking to me, or their doctor’s from talking to me.  So, I am now effectively out of the loop because my step mom is going against my dads’ last wishes that my family should be in their house as long as they can be safe and healthy and have their needs met.  Since he died, my step mom has been trying to get them out of their house and take their money.  Now that I saw how they are living as hoarders (y’know those real life TV hoarder shows, ya, my cousins could be on that show) plus the filth under the hoard.  Plus they don’t bathe or wash their hair.  And the need assistance to get in and out of the house and in and out of the car.  So they need help if they are to stay in their home. They think if they accept help, they would spend down their estate/savings (which is true, but then they would be eligible for medicaid and would have every service covered).  They also think if anyone sees how they live, they will be forced to leave their home, but that is only true if they are found by a doctor or judge to be incompetent.  They are certainly not that.  So, step mom has made me the scape goat and has convinced my cousins that if they speak with me, they will lose everything and that I hate them.  I still have power of attorney, durable, for healthcare, because the only way that can be revoked is if my cousins themselves tell a healthcare provider that provides any service for them that they do not want me as their poa any longer.  They can also put that in a short note in writing.  Or, they can have it witnessed by 2 competent people or by a notary.  But my co-POA, my step mom, cannot just go around saying I am no longer POA just on her sayso, without any statement from any healthcare provider of my cousins or a written notice of it properly recognized by the state.  But still, step mom is doing just that, and is just going around announcing that she has removed me as POA, or that the cousins have, but there is no proof that the cousins have done any such thing.  Therefore, until proper recognized written notice is provided or until one of their healthcare providers says the cousins told them these wishes, I am still POA, no matter what step mom says.  But the hard part is proving it, and in engaging in and staying through to the end and winning this battle.  Just the thought of having to engage in this battle is epically depleting.  I don’t know if I can even see it through if I engage fully in it.  Especially with all the above stuff already weighing on me and being immediately pressing.   This really is the actual place they are at right now:   

Sorry.  Didn’t mean to whine.   Others have it worse.  I should think of all those in Ethiopia or wherever.  I am completely overwhelmed just in contemplating the oncoming battle over the cousins…don’t think I have the stamina to see it through or win either one.  This was really just meant to be a list that I could refer to to see what all I am dealing with daily because it all gets jumbled up in my head and I get so stressed and anxious and short tempered when it all gets tangled up and I can’t find room to think or breathe and at least in this list it is all laid out so I can keep each thread separate and at the very least know what is on my plate, even if I don’t want any of it, or know where to start or what to do with any of it.

 

 

I knew I Shoulda Kept My Mouth Shut

i should never have said i was feeling the teensiest tinsiest bit better, a tad bit happy even.  because after i spent a great session i went home and found out that the agency that will be providing behavioural health services to the state Medicaid beneficiaries has been changed effective April 1.  OK, no so bad by itself.  but the then the letter says since MI is going to now be providing all Medicaid people with mental healthcare, they decided it would also be more efficient (and allow them to more closely monitor their conditions) that they will force any people who are ‘SMI”, or Seriously Mentally Ill (basically if you are unable to really work a real job full time due to mental illness—and that is me—)  all Medicaid mental health beneficiaries who are SMI will be forced to change their Medicaid insurance plan to the MI plan as well (the one that will be providing general mental health and SMI—if you are SMI, you will also be forced to use MI plan for all you PHYSICAL healthcare as well.  If i am forced to change to their Medicaid physical health plan, then i will automatically be dumped from my Medicare plan since, it is a dual plan, meaning my current plan gives me all my Medicare and Mediciad physical health coverage.  If i am forced to drop my physical Medicaid plan because I am SMI, then I will also be forced to drop my Medicare plan, and the only plan I will be able to get for my Medicare services would just happen to be, yes, you guessed it, the new MI plan.  So, because my mental health care is categorized as SMI, and MI is now going to provide all SMI and regular mental health Medicaid services, I will be forced to change my Medicaid physical health plan as well.  And, if I am forced to do that, then I will also be forced to drop my Medicare plan and again go to the MI plan.

I have seldom felt more raped, abused, beaten and whipped than I do right now.  I no longer have choice of Medicaid physical health plans, I no longer have choice of Medicare physical plans, and it is all because I am listed as SMI instead of ‘regular mental health’.  So, this insurance plan gets to force anyone listed as SMI to take all of their insurances, but those listed as general mental health get to choose their Medicaid plans and if they are on Medicare, they also get to choose that plan.  But not us SMI–apparently since we are such a ‘sick’ population, we dont’ get the right of choice in healthcare, on insurance, rx, or on doctors.  I will have to stop seeing all my doctors.  All.  And get all new ones covered by MI instead.  Why should I be persecuted just because I have a more Serious Mental Illness than some?  Why should my choice of insurance and doctors be taken from me?  What will I do without my therapist?  I have been working with her almost 3 yrs and I am just going to be forced to change within the next 6 mo.  And i will lose my psychiatrist, my case manager, my nurse, not too mention all of my non mental health related providers.

Well, I shouldnt have talked about starting to feel better.  I should have known something like this would come along.  It always does.  And now it has.  And now i wish i never started to heal, to feel better, i wont win anyway.  i wont accept what they say. and since i cant keep seeing my therapist, or any other providers, there is nothing for me to gain–only lose, i wont let them win by forcing me to take something i dont want instead, i wont roll over and play dead, i wont let them control me.  so maybe i die,but they lose to. they wont make me say ‘thank you may i have some more’ either.  they’ll see what happens when they try to take away control from the people they are supposedly trying to help.  even one person refusing to be abused by them and dying will be enough to make the state take a look at what they are allowing MI to do underneath their very noses to the ‘vulnerable’ population they claim to be serving.

At What Point Is It Actually Worth It?

I just found out, since moving (and thus changing the branch of the pharmacy that I use) that for the entire last year I was paying copays on all of my mental health-related meds when I was supposed to be getting all of them for free between my Medicare and Medicaid.  This is only true for psych meds–meds for physical conditions I do have to pay a copay for that Medicaid will not cover.

Anyway, the point is, when added all up, its about $70.  Now, in my book, that is a chunk and I could do a lot with that chunk.  But on the other hand, if I need to physically interface with my alternate second payer for mental health meds (aka Magellan), that could be enough to drag me back down and drown me.   So, I don’t know how much work it will be, how many forms they will ask for, or how long it will take.  And I really don’t know if they will be pleasant to deal with either.  I do tend to have defensiveness and hostility issues when trying to get something from someplace that should make it right, but doesn’t want to, with me.  And this amount is just right on the cusp, I could go either way.  It’s enough to be a good chunk that I could really use, but if I’m gonna turn into a screaming mimi because of attitude by the reps, or because of the paperwork, or because of how long it could take,  I don’t want to get myself so frustrated and out of joint that I go off the deep-end either.

 

If It Wasn’t For Bad Luck, I Wouldn’t Have No Luck At All…

Ah, Cream…one of my favorite bands.  And they got it so so right in this song.  Although I wasn’t born yet when they wrote it, I think somehow they knew they were writing this about me.  I just found out I am being denied subsidized housing, after being on the list for 5 years, and after being in subsidized housing just 6 months ago (but had to move because of my ‘friend’, B, who had a stroke, and they wouldn’t let her move in).  So, in just 6 short months, they are now claiming that I am over the limit by $60/mo!! Yes, that extra $60 really makes a difference–I so don’t need any help with rent cuz of that big whopping $60 each month!  And just how much is that per year?  A ginormous $400 over the limit.  Wow!  I feel so glad to know I should be able to afford housing on my own because I have an extra $60/ mo.  I shouldn’t be bitching that my rent takes up 2/3 of total income.  I should be praising the subsidized housing gods for wasting 5 years of my life on empty promises, knowing that now I should have smooth sailing because I can afford to pay ‘normal’ rent, all because of the $60.  And what about my being in subsidized housing a mere 6 months ago, and now not qualifying?  Turns out the extra $400 a year is from one extra child support payment my ex made in Feb, because he wanted a passport to go to China to see his fiancee.  In order to get it approved, he had to pay extra to me just in case he didn’t come back.  So, my ex’s lovelife has torpedoed my shot at subsidized housing.  And the housing authority didn’t even care that the payment was a one time thing, that he won’t have to do it again if he travels,  that if you remove that one payment from my 12 month income, I would qualify and be getting help, just like I did 6 months ago.  I asked if I could appeal, and the so lovely and sympathetic (sarcasm) lady said no.  No, there is no appeal.  There is no having this issue brought to someone higher up.  This is it.  One extra child support payment and now I’m so fucking rich I don’t need assistance.  Yep, I can now easily afford to pay 2/3 of my income to rent, and the final third to bills and food.  Wow.  I feel great being so rich.  And get this, I now am still approved for food stamps, but the amount they give me each month is $0.  Wow!  I feel so blessed to be so rich.  I’m struggling more than people with $60 less income now.  Aren’t I fucking special?!  Now, I’m terrified they are going to take away my dual eligibility (If you’re poor enough, and you’re on medicare for disabled people, you also qualify to get the remainder of you medical expenses paid by the state medicaid program).  So, now I’m afraid they take my medicaid and I’ll end up having to pay premiums, deductibles, copays and 50% of all services rendered by medicare. Which I obviously can’t afford to pay, which would mean that even though I’d still have medicare paying half the cost of services, it would still be too expensive for me to go to my doctors, or to get my medications.  So, if they take my medicaid, I pretty much lose all insurance since I won’t be able to afford to use the remaining coverage.  Anyway, that’s the only benefit I still have that hasn’t been taken away (so far) because of $60.

So, ya, all that sounds fair, right?  and I should be tickled to be so rich, right?  And this is Good luck?  I don’t think so….But that’s my kind of luck, anyway, the kind that keeps on kicking you when you’re down.  Is it any wonder every time I try to pull myself up, I find myself kicked back down to the floor again?  No wonder I can’t ever get anywhere, improve my situation.  I’m destined to stay in the gutter no matter what or how hard I work to move up.

New Horizons: Fears and Anxieties

First off, to those of you who follow me, I am so sorry I haven’t written recently.  But I have been reading and doing things in real life—this is a first in many years!   So, what have I been doing?  I have been getting up earlier (without an alarm!), I have been looking for a small part time job, and even applied at Target (it’s across the street, and I love shopping there!)  As long as I don’t work too much, I won’t lose any of my Disability benefits like Social Security and Medicare and Medicaid.  And that’s fine by me…I don’t want to work too much just yet!  What else?  Oh, yes, I changed ‘teams’ at my mental health clinic.  My med provider was always triggering me every time I went in for a med check.  Even when I would remind myself that he is just like that, he just seemed to always get me to react.  The most recent visit he asked if I was suicidal (standard protocol for mental health patients) and when I said sometimes he told me not to do it because my soul would get stuck inbetween planes and he knew this was true cause his grandfather told him so.  My team nurse can’t draw my blood, so I can’t use the lab at the clinic so I have to drive across town to a free-standing lab instead.  And my Rehab liasion insists to me that I cannot possibly have an open case and a case manager at Voc Rehab, because I didn’t meet with the VR counselor who visits the clinic once a month to do it.  She insists I could not have possibly have opened a case with VR myself (which I did 2 years ago) and that in order for me to get VR services I must close this supposed case and then open one with the VR counselor who visits the clinic instead.  Now, what I want to know is, why should I close a case just to open one?  Why go through all the work of that again, when all the information is already there?  Why can’t my VR counselor just transfer my case and files to the one who comes to the clinic? But my clinic Rehab liasion insists this is impossible.  She has no proof, no evidence, nothing to support her position.  She just keeps repeating that it is impossible, until I am ready to jump over the table and strangle her!!  So, since that is my current ‘team’, it finally occurred to me to switch teams.  It can’t possibly be worse.  Cause right now, all my ‘team’ members are horrible and triggering.  It can’t possibly be worse with another team, although I admit, it may possibly not be better… but we’ll take that chance.  We can always switch teams again!

So, what have I been up to?  I have been up to taking care of myself and feeling better!  I also am now volunteering at the animal shelter where I got my dog, looking for a job,  and switching teams at my clinic…and having a much, much easier time getting out and about, doing tasks more easily.  The only thing now is, how long will this last?  I know I shouldn’t be thinking about that.  But I haven’t felt this good in over 7 years.  For the last 7 years, I have been wearing a suit of armor and slogging through quicksand to do anything.  It has been so difficult that I have been able to do very, very little in all that time.  But the quicksand is gone now, and the suit of armor has been shed.  Movement feels easy again.  But how do I know this will last?  I mean, I have gone so long looking for it I’m not sure it’s real.  I want it so badly to be real, but at the same time I am afraid to believe it is real because it is probably only fleeting, and if I rely on it being real I will make commitments and plans and not be able to follow through on them as this feeling of well being slides away again, leaving me back in the quagmire, sinking all over again.  I am just as afraid as I am excited to get a job, to volunteer.  I am afraid that after 7 years of NOT doing anything useful, anything with a commitment, that I will fail.  And if I fail, that I will end up in the depths of despair yet again.  I am afraid of ruining this good feeling by failing at living and also afraid that even if I do well at these tasks that this good feeling will escape me also.  I’m so afraid of jinxing it, I’m not sure if I want to follow through on these ‘good’ commitments so I won’t be let down.  And yet, if I don’t try, I will never know if it might work out, if I might succeed, get well, become productive.  So I am trying to take it one day at a time trying to not think about anything more, success or failure, fleeting or staying well-being.

Just Shut UP and Agree!

I have drilled SO many things into my head over the years, by me (to remember what to do or not do) and by others (like, you’re worthless, stupid, crazy, etc.) and now these things are automatics, things I accept now.  So why can’t I drill something in now?  Especially since it’s something I’ve been trying to drill in to remember automatically for a really long time.  I keep trying to remember to just agree and keep my mouth shut!  but I can’t seem to get it in there for some reason.

In my state, there are 3 paths of mental health care: 1) Private Pay, 2) Medicare and/or Medicaid—a) SMI (seriously mentally ill) or General Mental Health (‘regularly’ ill, I guess).  S MI people are required to go to only specific clinics that see only SMI people.  You are supposed to get more care, more support services, etc. this way.  All GMH people can go to any clinic other than SMI clinics.  So, I am classed as SMI, and go the SMI clinic I was assigned to.  The problem is, not only do they not really provide extra services or supports, I get upset EVERYTIME  I go there!  I can’t understand why they always manage to trigger me and get me to blow up!  I really can’t understand tho, why I don’t just REMEMBER to JUST SMILE AND AGREE!!   

I mean, what does it matter that my shrink thinks I drink too much water?  Instead of arguing my position and explaining why I drink that much, and getting ticked off with him, why can’t I just remember to SMILE AND AGREE?? When he asks me about my suicidal thoughts, and I tell him, and then he says ‘you don’t want to do that, your spirit would be stuck between places’, why do I have to get into a philosophical and theological debate?  Why can’t I just let it go and JUST AGREE?! Why, when he tells me my therapist is wrong about diagnosing me with DID, do I even try to argue?  Why can’t I just let it go and AGREE?  Why, when he tells me to see the nurse to get my lab slip and I do and she prints out the wrong one (as always) and I point it out, do I have to join in the argument that she thinks she’s right when I know I’m right?  Why can’t I just AGREE?!   When after my appointment I meet with my Case Manager (and today also my Rehab counselor) and the Rehab gal says even tho I already have a case open with Voc Rehab and all they needed to get me services was a packet from my clinic, I am working with the wrong Voc Rehab counselor and I need to come to the clinic to meet the correct one.  And I need to close my already open case and start all over, because I’m not doing it right and Voc Rehab does NOT need my packet from the clinic—I just need to start all over with the RIGHT Voc Rehab counselor at the clinic instead.  WHY can’t I just SHUT UP and AGREE with her instead?

I HATE going to my clinic!  I HATE that every time I go there, every person I talk with, everything I ask for or about, I am ALWAYS in the wrong.  I am ALWAYS getting triggered, and then Anti-Kitty jumps in.  Then We have to fight, as though it’s that important.  And We know none of this is THAT important.  Even if I AM usually right, is it really worth getting triggered and so upset that We switch and lose it with all the people we deal with in the clinic?  I don’t think it’s that important, even if I AM right.  I just want learn to remember to STOP ARGUING AND JUST AGREE!!! Why can”t I get this lesson into my head??  Why can’t I just agree instead of getting so upset and looking like the completely crazy psycho out of control patient they (get riled up in the first place) and expect to see?  Why can’t I just learn to AGREE? Why can’t we just quit letting them trigger us about everything by JUST AGREEING??  I just need to learn to remember to AGREE no matter what.

Worries Begone

Well the good news is I talked with my therapist about all the worrying I’ve been doing, things that are always in the back of my mind, and sometimes too much in the front of it.  And what is the good news?  I don’t have to worry about them!

My worries about not getting better and my opposite worries about actually getting better, DON’T have to be worries at all!  I was so relieved when she told me, even though I didn’t quite believe her at first.  But she explained that as long as I didn’t feel ready to go back to normal life, ready to work full time, then that meant I’m not ready yet.  And so, since I’ll be seeing her up to at least that point, that she will know I’m not ready (obviously!) and so I don’t need to worry about her saying to a Social Security review board that I am ready.  Ad she also said since I have been categorized by the state as ‘SMI’ (some states use this to group Seriously Mentally Ill persons into one system so they receive all or most of their services from a single location.) my case will remain open basically forever (even if I recover completely) as long as I need meds.    Sooo, the upshot is,  my therapist’s notes will show if I am ready to return to ‘normal life and work’ or if I’m not based on ME!  And my clinic will keep me active indefinitely.  So, I don’t need to worry about if I look too healthy for how I feel, or feel too depressed or fragile for how I look!  Which also means, I don’t need to worry about a Social Security review.    Long story short, nothing about my situation will change, until I’m ready for it to.

And she also said it is ok to feel both still not recovered AND better at the same time.  And that I will know it when I truly feel good again.

Anyway, I was just so thrilled with her explanation and reassurance that for the first time in 4 years I am not carrying those worrisome burdens around, wearing myself out being afraid of losing everything all over again.  Now, I can finally take that tumor out, worry less, feel more comfident, and free up space in my brain for other much more worthy worries.

Just Because You’re Paranoid….

Well, today was just another one of those days being a parent.  One of my daughter’s permanent teeth is coming in at 10&40 instead of 12&30.  So her dentist sent us to an orthodontist to see if it would naturally fix itself, or if we would end up needing to go to and oral surgeon to manually correct it.  Well, the orthodontist, being an orthodontist, was really pushing braces.  Braces would fix everything.  They would fix things that are not even problems!  They would fix the spaces between all my daughter’s teeth…even though those spaces will naturally fill in through normal migration of teeth during adolescence.  They would fix her extremely slight overbite…which I never heard ever hurt anyone.  And they would use the braces to pull her top front teeth almost an entire tooth-space to the right to try to give her angled tooth more room to descend more up and down.  But they weren’t sure it would work.  How long would we have to wait and see if it worked (and of course, keep the braces on)?  Oh, well, they would recheck the angled tooth after 6-9 months of braces, and if it hadn’t started to correct itself, then we would need an oral surgeon.  But—get this–we would have to keep the braces on to pull the top front teeth back to where they are now, AND, we’d have to go an additional year (to fix the problems that nature already fixes by your early 20’s)!!   Well, I wasn’t too keen on the whole braces idea.  Seemed pretty fabricated to me.  Seemed like they just wanted to do braces, cuz that is just what they do. Their reasoning didn’t seem to hold up to well, but I was still willing to consider it, if another dentist made the same recommendations.  Then, just when I was getting ready to go, they said-Wait, Hold on!

OH, Yes, they had MORE!  They had a 5 page written contract, which showed a treatment plan for the angled tooth as consisting of wearing braces for 2 yrs, even if oral surgery was indicated after the 1st 6 months.  And that wasn’t all.  Oh, no.  They had a financial contract too, where I would pay them $5000 cash money at $500 a week!  I said, don’t you have my daughter’s insurance plan information?  Because she is on the state Medicaid program, and all routine services of any kind are covered, as are specialists, labs, tests, etc.  And, even non-routine services are covered if they are medically necessary (like an oral surgeon, to fix an angled tooth).  She didn’t even look it up, or make a call to the insurance.  She didn’t even bat an eye.  She instantly said, “oh, no, you are wrong.  Medicaid never pays for dental work.”  I fired right back and said no matter what my daughter has ever needed, the insurance has always paid and this should be no exception.  Unless of course, the insurance calls braces for what they really are, cosmetic and unnecessary.  In which case, she doesn’t need the braces, (just like I already said) and should go directly to a surgeon.  “oh no,” she said again, ” you don’t understand your insurance at all.  NO DENTAL WORK  is covered, except routine services.  So, I got up and walked right out with my daughter.  She thought I was over reacting.  And sure, my voice got pretty stern and unyielding, but can you really blame me? I mean, here I go to get a problem fixed, and they aren’t even interested in that.  All they wanted to do was get 5k from me and not even bother making the proper referral or treatment plan.  So, we got home and I immediately called the health plan.  The lovely lady that answered was so helpful, especially when she told me that I was exactly right about the insurance and how it worked.  She even said that if the tooth was the way I described it, braces would never have helped (and that is why they don’t ever cover braces, she added) and they should have immediately given us the name of an oral surgeon, knowing they couldn’t do anything to help this tooth.  What’s more, they never should have tried to sit there and sell me on braces when all of us knew they weren’t indicated.  And they flat out lied when they said oral services are never covered and this was my only choice for now.

So, finally, after getting such a wonderful affirmation from the insurance plan, I am reassured that I really did know how the insurance worked, and I really did know what services should have been indicated, and I really did know when I was being flim-flammed.   I am only glad I will never have to see those people again.  I wish I could make pariahs out them and get them run out of town on the next train, lol!  Charlatans and snake-oil salesman is what they are, yessir!  And, the best part is, we can fix my daughter’s tooth in one visit, AND it WILL be covered by the insurance.  The insurance will have to get a prior authorization, because this is not routine, but the rep assured us that if the xrays and doctors reasoning were anything like what I said, then it was a shoo-in for approval.

But the point of all this is, just because you’re paranoid that people are out to get you, by taking advantage of you at every turn (y’know, like by trying to sell you 5k of non-insured, unnecessary dental work), this DOES NOT mean that they aren’t really and truly out to get you, as these lovely dentists were certainly trying to do today.  So beware and remind yourself, just cuz you think you might be thinking a little crazy about being taken for a ride, you might still also be correct!