the trick is to keep breathing

What the actual fuCK is insurance these days

So I’ve been off of Cymbalta for what is now 14 days. I’m absolutely not ONLY feeling the lack of the drug in my current all-over State Of The Union, but I’m ABSOLUTELY going through withdrawal now which let me tell you for duloxetine is absolutely fantastic. Have a story.

• about 4/10 realize I’m running out. Play happy phone tag w my rheumatologist (they always want me to come in for an appt before they will prescribe anything; i kindly ask them to check my records where it says I’m immunocompromised).
• 4/17 Dr office finally agrees to call in a 90 day refill and will do another one when i get an appt any time during those 90 days.
• me: waits expectantly.
• last week: no drugs, no notification of new prescription, no nothing. I call the dr office. They submitted it to Express Scripts on 4/17.
• call ES. They have absolutely nothing on record for me more recent than a 2016 script.
• realize my other prescriptions have been filled through CVS Caremark.
• call Caremark. They have the other prescriptions but nothing for Cymbalta.
• call my Dr. They won’t submit another script even though ES has nothing on file. They tell me to call Caremark and have them contact ES to get the script.
• call Caremark / Carefirst / whatever it is. I discover that the other prescriptions were run up through my old Bridgestone COBRA insurance.
• I spend 2 hours on the phone bouncing between 7 different people trying to explain the situation.
• Apparently there is a special team that is supposed to handle my current insurance plan, but as I am transferred around, I apparently haven’t talked to anyone from that fucking team yet.
• I eventually manage to find someone who can transfer all of my recent refills OFF the COBRA and ONTO my carefirst insurance.
• I’m then tossed through three other people before I find someone who can tackle the missing duloxetine.
• turns out CVS/Caremark does NOT call out so they will NOT contact ES to look for the script.
• They recommend that I ask the doctor to submit the refill to a local CVS so that i can get the drugs sooner.
• i start laughing uncontrollably and remind them that the dr has already submitted a prescription and has absolutely refused to submit another, that the office is waiting for some insurance to make the request.

At this point, mind you: The dr has submitted a refill request and therefore won’t initiate anything. ES has not received anything on file for me at all, and therefore can’t do anything for me. CM will not contact ES. My literal only option here is for CM to contact the Dr for a new refill script and just PRAYING that the Dr will mcfuckin fill it.

• I finally - finally - land someone willing to take down the information and request a 90 day refill (through the mail service, because that’s the ONLY way i can have the request initiate from CM, since my dr won’t initiate and ES can’t) from my goddamned dr office.
• they recommend i call the Dr office and explain what’s happening so that they don’t reject the refill request.
• fuck
• the dr office doesn’t really seem to understand what I’m saying. They have me schedule an appointment and they’ll ask the Dr if they can submit another request to CM. I’m desperately trying to explain that CM is going to send a request just like please just make it go through and don’t complicate this any more.
• i am transferred to scheduling, where I sit and let the phone ring repeatedly for 15 minutes before I hang up and call back. The phone lines take a lunch break from 11:30-13:00. They were just going to let me sit there for an hour and a half i guess?????

HOW is this the way things are SUPPOSED to work? (Spoiler, it isn’t; I’m american, i get it.) just. Like. I HAVE BEEN ON CYMBALTA FOR OVER SIX YEARS. This isn’t some new medication everybody has to be woo-boo careful about. This is a fucking maintenance drug I’ve taken for a big portion of my adult life.

And I’ve been off it for two weeks. I hurt. My brain is dumb. I’m fucking exhausted. And I’ve wasted all morning on this. I’m so frustrated I want to cry and punch things.

what the FUCK.

As of now:

• Tiers 1 & 2: 3 spots open
• Tiers 3 & 4: 2 spots open
• Tier 5: Closed

Wanna give me money for delicious words? Check me out.

Reasoning:

1. I make amazing money for my age and I should take advantage of that
2. I am in a good position: owning a house already, partnered but legally single, no dependents
3. I need my goddamn health insurance so cannot quit
4. I don't completely loathe what I do yet (it's more like a bipolar disorder relationship).

Plan:

• live well but frugally for the next 15 years
• enjoy the shit out of the next 15 years well but responsibly
• take good care of self and health
• pay off house
• save well
• retire at 50.
• become actual hermit
• spend rest of life writing and giving the world the middle finger
• become millionaire
• replace body with wheels
• profit

15 more years at my job gives me the new plant I want - covers everything from engineering to actually flipping the switch to development projects - as well as turnover to build a dynasty (not that I am arrogant BUT I AM but really it's to protect the years invested in the place): I'd literally hit the peak of my career then leave. and, if I work it right, lots of company buffing of my 401k.

50 will be a bit old on my poor broken body, but it's still an age you can do most things: travel, hobbies, open a bar with your friends, etc

The counter-thought is "take your break now" but I'm not in any kind of position health-wise to do so: need insurance, so need (a) job; this job has good/decent insurance; not good at traveling right now; too much house debt to really call off the paychecks. Trust me, it's tempting to toss everything and run to the woods, but it isn't a good place.

But working towards something makes the working seem slightly more palatable

1^0 edit I FORGOT TO MENTION what I want to do with my millions: I want to be a patron of the arts and sciences.

One of the things that sticks out in my memory from my Germany trip - touring an old palace - it's so weird that this was significant - but I was doing the headphones tour of Queen Sophie's palace and there was so much discussion about how royalty and the well-off were patrons -- of arts, sciences, literature, voyages, anything they wanted. It is this weird mindset - and ok I know that historical context etc life was NOT A MAGICAL BETTER BACK IN THAT CENTURY - but in our evolution to what we are now we have really and truly lost that spirit? Rich people don't go and support artists they personally think are cool anymore, or host salons for neat artists to get together, or sponsor someone to write a symphony or a novel, and --- there's something about that concept that really appeals to me.

So after my job and my novels and my millions, I plan to become a patron of the arts and sciences. If you can wait 15 years, you all get first dibs.

2^0 edit im not even drunk guys, seriously

For the record, I'm trying to post more; I've got a lot on my mind recently, and I've got a journal for a reason. I'm also trying to reply to comments more, which is something I'm bad at - I mostly reply via phone-Gmail*, at work, and it can be hard to keep up with. But anyway, I'm trying to post more consistently. For fun. And profit.

One of the things that has been dwelling on my mind lately is ... Well. I work hard. For the past 5 years I've been working doubletime, putting in 40 hours a week of a job and then grad school on top of that, plus I fill up the rest of my time with shit: running, races, taking care of people, bands, practices, exchanges, writing, commitments, hobbies, cons, cosplay, and an exhausting social life. As much as I joke about being a lazy fuck I'm not really sure I know how to 'take it easy' for more than a day or two; I just do stuff, I tend to do stuff, and I end up being busy by default. My job is both hard and a lot of work (they aren't always the same thing), and grad school is the same -- and even if the other things aren't 'work' and aren't 'necessary', they're still commitments, and they aren't 'taking it easy' either.

Nobody should be surprised to hear that I still feel burnt out, this year; my constant chorus of I'm exhausted should be familiar by now. I've been burning this candle at every available end for years. But I have this awful dichotomy warring in my brain about "deserving a break", and it's getting confusing.

What do you have to do to 'deserve' a break? I'll look at my shit some days and be like, gurl, all you did today was work your usual 11 hour day. You don't deserve a night off. You still have to run, and then cook, and then clean up at least half of it, and fold the laundry. Or I'll look at my week and be like, All you did was work and run and the usual chores. You didn't do anything extraordinary. You don't deserve a break. You still have shit to do! And I'll fill up my hours and my days with that to-do list that doesn't end.

And then on other days I will get to the point where I am like christ in a chevy, I am exhausted and I deserve a break and I am taking one so fuck the world, and I'll do something like drink an entire bottle of wine alone in my apartment while drunk-texting everyone I know and reading horrible fanfiction, or I'll spend an entire day knitting while watching Buffy the Vampire Slayer, or I'll skip working out for an entire week and just lie on the floor instead. And I don't really feel all that much better or feel relaxed; I feel like a giant waste of space because that's what I was. It's a little better, but it's a useless better. Like I feel like I'm entitled to deliberately spend a day doing things that don't mean shit just to prove that I can, because I can, because I am stubborn and want to waste time like everybody else does and no one can tell me I can't, especially myself.

It's like I don't know how to moderate. It's either all or nothing. And thinking back I actually don't even think it's that bad in reality, but my perception of it is: in my head it feels like all or nothing, on or off. I don't know how to hit a happy medium and realize it; I don't know how to feel like I'm compromising. If it isn't all or nothing, my brain makes it so.

And underneath all of that is the fact that I've been working for basically over 15 years straight now, and yet I still feel like I don't 'deserve' a really big break until I finish my fucking graduate degree.

But I think about all the shit that I want to do - I would like to write some fucking novels; I would like to (re)learn to draw; I would like to take more pictures; I would like to actually travel - and first I go, okay, let's do(u) it and then I go, oh god, more things, when do I get a break?

So that's what's on my mind. I need a better system to deal with both relaxing and getting my shit done. Blah blah blah whine more.


*I'm only moderately content with Gmail's iPhone app. It's decent, but not ideal. And I moderately dislike Apple's/iPhone's default email interface. Any iPhone users who use a different mail app that they adore?

So it's shutdown week at work. This means the steam's down, and they turn everything off for once-a-year maintenance and upkeep and fixing. It means it's a pretty boring week, so usually I try to schedule some doctor's appointments and stuff.

I went in for an eye exam today, and to get evaluated for corrective laser surgery. For those of you who may not be aware, I toe the line of legally blind (ie, non-correctable (not actively blind)). I needed to get my glasses looked at anyway, but I have been thinking about the laser surgery for years. My script is -11. Even if all they can do is cut it in half, down to a -6, that makes my life a lot easier: less expensive lenses, opens up more lines of contacts I can try for added comfort, has the possibility of being 100% correctable rather than the 80-90% I'm getting right now. (There is only one line of contacts that offers lenses in my correct -11 prescription and at my level of astigmatism. Only one.)

The first thing the doctor told me is that - how ironic! - my eyesight is actually too bad for a standard LASIK clinic. That's right, my eyes are so bad a clinic won't accept me - I'm past their cutoff point. Ironic bitter laughter goes here.

There are individual doctors who can make the yes/no call on nonstandard patients, though - and my eye doctor (Dr F) said there was only one in the area who would take someone like me, but that he was one of the top 5 laser eye surgeons in the eastern US, and he'd done over 37,000 surgeries in his career. Dr D. So there was potential enough there to go through the evaluation, so we did.

And it turns out that - probably because my eyesight is such crap - my corneas are just barely thick enough for the least recommended thickness level of LASIK. As in, they're like 425 [units] thick and the requirement is 415. There is not a lot of leeway there. Dr F said that while sometimes Dr D will still be able to work on patients who are that close, it would be entirely Dr D's call, and it was a very narrow comfort zone.

What I am eligible for, however, is PRK surgery.

[potential TW: eye grossness?]

LASIK shapes your cornea by lifting the upper layers and peeling them back, and then reshaping the layers underneath and laying the cornea 'flap' over it. PRK is more like a grinding and shaving of the upper layers, and then the use of a reconstructive contact lens bandage as the very top layer grows back.

[/grossness I think]

From what I have (very very incompletely) found from research so far, PRK actually has a lower complication(/fuckup) rate because it isn't as invasive into your eye. However, it has a MUCH LONGER RECOVERY TIME than LASIK. With LASIK, you can walk in, zap zap, maybe a day or two and you're good. With PRK, you literally and legally cannot drive your car or go to your job for 7-10 days afterwards. You may be in large amounts of pain, on Vicodin. It takes a few days for your eyes to grow back into their new shape, so your vision may not hit even 20/40 for up to 2 weeks. It's a much bigger deal.

I have an evaluation with Dr D on 23 August, so that he can look at my situation *hand gesture* here and make his professional decision as to what to recommend: traditional LASIK, PRK, or "You do not want to do either of these with those eyes." I am open to hearing any of them.

But it's hard to get a surgery time because Dr D is so good. And there's an opening on 26 August. That the secretary at Dr F's office had them tentatively pencil me in for, pending Dr D's evaluation.

So I've got a chance here, if I'm approved, to jump on something that could really improve the quality of my life. I am also holyfuck terrified of this surgery. I am ALSO thinking that maybe this is NOT A GREAT TIME IN MY LIFE TO HAVE A SURGERY THAT COULD LAY ME OUT FOR UP TO A MONTH WITH ALL OF THE CRAPS I HAVE GOING ON - but I'd have Becky AND my local friends to help me through it, too, and when WOULD there be a 'good time', really?

So, yeah, there's that.