Friday, May 19

RhoGAM: Bullseye

I am the official owner of a burning butt. Shot successfully administered.

In a fit of irony, it began to rain literally the minute I turned the car off in the parking lot. Rained on me (and Kid) up to the office, and on the way back to the car. It stopped about 3 minutes after we got back in the car.

There really is a little black raincloud hanging over me . . .

Thursday, May 18

4:56 p.m. update!

This afternoon, the supervisor from Caremark did call me back. And wonder of wonders, she was NICE and SYMPATHETIC and APOLOGETIC and ATE the cost of the RhoGAM (credited back to my Visa) so I don't have to bother filing for reimbursement with my medical coverage. Gave me her extension if I needed anything.

I called later, when FedEx still hadn't showed by their 3 p.m. deadline. She called the FedEx manager in charge of "my" delivery truck, expressed the "medical necessity" thing, attempted to get it delivered by 4:30 p.m. (enough time for me to get to the ob's before close of business.)

At 4:52 p.m., Mr. FedEx arrived at my ob's office just as they were getting ready to close up; not enough time for me to make it today. At least they have it safe and sound now.

The receptionist did page my ob earlier today, ob said I could have the shot as late as tomorrow. So stay tuned for the conclusion of the RhoGAM Wars Trilogy.

All this for a shot in the @$$. That's the real indignity.

RhoGAMboling: Give it Another Shot


*Meg goes on stuffed animal-killing rampage*

Okay. I am now completely and utterly calm and reasonable. *pops head off stuffed puppy*

It is now 12:45 p.m. and the RhoGAM has yet to arrive via FedEx at my ob's office.

So I called Caremark, the prescription coverage, from whence my RhoGAM was ordered. I learned that the FedEx flight was delayed 3 hours, and delivery is guaranteed by 3 p.m. today. I asked why it was not shipped until yesterday, when it was supposed to ship the day before. Turns out the person I spoke with mailed it Standard Overnight instead of Priority Overnight. She also failed to confirm delivery with my physician, as she failed to account for the different time zones, and called after the close of business.

Then I called Principal, my medical coverage, and asked again about their coverage of RhoGAM. The representative (unlike all the others) knew what RhoGAM is and when it is given. She assured me OF COURSE IT'S COVERED!!! and is listed under their codes as an injectable drug. She has no idea why the Caremark lady assured me that she has "worked alongside Principal for years and I KNOW FOR SURE they do not cover it." I will "definitely" be reimbursed once I submit the necessary information to Principal.

So, here's what happened:

*Meg does legwork, and finds out RhoGAM is covered under medical, not prescription. Calls dr.'s office and tells receptionist this.

*Receptionist messes up, calls prescription instead of medical. Prescription lady takes it upon herself to say, "I do not work for Principal, the medical coverage, but I KNOW they do not cover this drug. Neither do we." Calls me, tells me so, charges me for the drug OOP, and screws up the shipping to boot.

*FedEx delivery schedule goes awry.

I mostly blame Prescription/Caremark Lady. Fortunately I have her name, her extension, and a call in to her supervisor >:-p

Wednesday, May 17

RhoGAMboling: It's the Principal* of the Matter

*It's a pun on the name of my insurance underwriter, not a grammatical error :p

So. Today I am 28 weeks pregnant, and as I am part of the lucky 15% of women with an Rh- blood type, I require an injection of a nifty drug called RhoGAM. The shot is administered to every Rh- woman at 28 weeks, so this should not be a shocking occurrence to insurance companies. My doctor's office does not stock RhoGAM. She'll order it if insurance requires that she supply it; otherwise she writes a prescription and it's BYOR.

4 weeks ago I called my prescription drug coverage number; they do NOT cover RhoGAM. I called the medical coverage number; they said they would cover RhoGAM if the dr. ordered it. I called my ob's office and told the receptionist she'd need to order it for me. She did.

On Monday, 2 days before my appointment, I received a call from my insurance company. Oops, sorry, they don't cover RhoGAM after all. Not prescription drug, not medical, nada. They can give me a "cash discount" at $113 and send it directly to my ob's office. I can try to submit the claim for reimbursement later. But I need to pony up my Visa number on the phone, and they will order it the next day (Tuesday) and have it overnighted in hopes it arrives in time for my 10:15 a.m. Wednesday appointment. Yes, these people knew I needed the RhoGAM for 4 WEEKS and lagged. Why am I not surprised?

Today is Wednesday. And-- everyone get ready now-- the RhoGAM was a no-show. The receptionist at the ob's office got on the phone to my insurance company . . . it's en route now but will not arrive at my ob's office until tomorrow. I have already been charged (Visa.)

Did I mention that RhoGAM must be administered within 3 days of a blood sensitivity screening? Yeah, mine was done on Monday, as part of the blood drawn during my glucose test (see previous blog entry. Enjoy!) That means I must have the injection done no later than tomorrow.

And . . . did I mention that legally, an obstetrician must be present in the office during the administration of the shot?

My ob, however, is scheduled to perform C-sections at the hospital tomorrow. So, we've got three options:

(a) RhoGAM arrives at ob's office tomorrow. Doctor has time in between surgical deliveries to meet me at her office (located next door to the hospital) where she will have just enough time to pee while her medical assistant jabs a needle in my @$$ and sends me on my merry way.

(b) RhoGAM arrives at ob's office tomorrow. Doctor is unable to get away from the hospital, so I will courier the RhoGAM from her office to the hospital next door, where I will go up to L&D and arrange for one of the nurses to give me the shot there. Note: doc has no idea if the hospital will permit this, so if not, we're onto . . .

(c) RhoGAM arrives at ob's office tomorrow. Doctor is unable to get away from the hospital, and hospital will not permit me to receive my shot on their L&D floor. I will, therefore, drive to my ob's office, pick up the RhoGAM, and drive 25 miles to a third-party location: the office wherein my ob's partner practices two days a week and will be working tomorrow. (Coincidentally, this office is also home to my daughter's pediatrician, so at least I know where the hell I would be going.) That office would administer the injection.

So tomorrow is Field Trip Day . . . so I can put anywhere from 40-55 miles on my car, $113 out of my pocket, for a drug that is required, standard treatment for 15% of the pregnant population because my insurance company 1. claims they will not cover the drug and 2. failed to ship it in a timely manner. While 6 months pregnant, arthritic, and asthmatic, juggling a toddler who's got a runny nose and is exceedingly cranky.


Monday, May 15


Hoo boy. What scares me most about this particular experience is that the main offender works not for a fast food chain, but a medical lab. Biohazardous fluids are a far cry from French fries, tu sais?

Today was the grand occasion of my glucose tolerance test (GTT.) For the uninitiated, this involves forcing a pregnant woman to chug a high-sugar beverage (one brand name is Glucola) and then checking her blood sugar an hour later. I knew from my first pregnancy that I kinda like the taste of Glucola (orange flavor) so I wasn't worried about much other than sitting in the waiting room with my 2-year-old for an hour.

Little did I know . . .

I arrived at the independent lab at 10:15 a.m., paperwork in hand. I signed in, and waited 20 minutes before my name was even called to check in. When I presented the desk clerk with my paperwork, she said, "These forms are for Quest Diagnostics. This is LABCORP."

"I got this address from the Quest website," I informed her. She shook her head. "No, this is a different COMPANY."

"That may be," I said, "but is there some type of affiliateship? I only know this place is HERE because I checked the website. I even looked up locations that administer the GTT specifically."

"Ma'am," she snapped, "this is NOT Quest." I met her eyes evenly. "Is there a Quest location on this street, then?" I knew the answer would be no, and it was. Before I could progress to asking her to check the website herself, she grumbled, "I can call your doctor and have the order transferred here."

"Great!" I said brightly, with faux enthusiasm. I took my seat again and waited. As I monitored the volume on said 2-year-old's LeapPad to ensure Tigger's woo-hoo-hoo-hoo did not become too raucous, the desk clerk called out again, "Megan? Did you have anything to eat today?"

"Yes," I told her.

"Yes? You did?" she repeated disapprovingly. (Some doctors prefer fasting for the tests, while some do not.)

"Yes," I repeated, "I called my ob's office to che--"

"I just need a simple YES or NO," she cut me off. I just gave you one, you twit, I thought. (This is approximately the time when Evil Meg's Internal Monologue begins.)

More waiting. Tick-tock. Finally, at 11:10, nearly an hour after I arrived, I was called back by a lab tech. I entered a back room, and she asked me to sit in the blood collection chair. "Uh, don't we do that after I drink the Glucola?" I asked.

She frowned. "Oh, wait, you're doing that?" she exclaimed, suddenly looking at the form. My eyes widened. Perhaps it's silly of me, but for some reason I would expect that before forcibly removing bodily fluids from an individual, a competent lab tech might actually read and see which fluids are expected, when, and for what purpose.

"Yeeees, that's why I'm here," I responded. She stared at the form for a minute. "Okay," she said, "I need a urine sample first."

Fine. 6 months pregnant, absolutely no problem. I took the cup and my kid and headed to the restroom. Where there was . . . no toilet paper. Naturally! Not like they collect urine samples here *cough cough*. I made do with paper towels and returned to the back room, sample in hand. She took it from me and placed it on the counter, then handed me the Glucola bottle.

As she wrote something on the form and I began to chug (mmm, refreshing!) she pointed to Aurora, who had seated herself in a chair opposite me, and asked, "Is that a boy or a girl?" That? "She's a girl," I responded. "Hence the pink." (Forgive me-- my child was wearing gender-ambiguous jeans, but she did have a Pepto-Bismol colored sweatshirt AND pink shoes. I apologize for passing on hair growth-deficient genes. My husband had hair. I was bald until kindergarten. Or something.)

"How old is she?"

"She's two."

"Oh," replied the tech. Then she opened her mouth in a jaw-breaking yawn, so I could see her fillings. As I finished the Glucola, she did that three more times, the last couple of times groaning as she did so. How utterly professional!

When I had finished the drink, she said, "Okay, come back here in an hour, don't eat or drink anything in the meantime."

"I won't," I replied, and relocated to the waiting room.

While waiting, I overheard something that is best described as "customer disservice." It didn't affect me, but I sure wouldn't have stood for it-- it was way out of the league of misunderstanding "no mayo." It involved a little boy younger than Aurora, probably close to 2. He was playing in the waiting room with his brothers and parents, and was called back for a blood draw. Everyone in the office could hear his cries, presumably as the blood draw commenced or became imminent. After a minute, the tech (a man) barked, "Oh stop it, I've hardly touched you." Stop it? Like, stop crying, you stupid little scared toddler unreasonably afraid of the stranger with a needle? I could hardly believe my ears. In a moment the boy's cries became blood-curdling shrieks, at which time a door slammed, the shrieks became slightly more muffled, and the tech's voice boomed again, "Knock it off, you're FINE."

The boy returned with his mom, sniffling, a minute later. I think the entire laboratory should be duly contented that they were not drawing blood from my child with that attitude. My blood pressure was soaring from Mama Bear-by-proxy!

But my tech, though less obnoxious, was apparently not much more experienced or efficient. At 12:15 I returned to her lair for the blood draw. She said, "Sit down." I sat in the chair. She smiled at Aurora. "Is she your first?"

"Yup," I replied.

"That's nice." She turned back to the paperwork on the desk. "Oh, wait, first I need some urine."

I said, "Again?"

"Again?" she repeated. "Did you give me some already?"

My eyebrows raised. "Yes," I informed her, "as soon as I got here." She peered down at her notes. "Oh. Well, I need another one."

I asked, "You can't use the first one?"

She said, "I could have . . . but I threw it away."

"You threw it away?"

"Yeah." Silence.

Frustrated, I said, "Sure, fine. Give me the cup." She handed me another one, and I trekked yet again to the toilet paperless bathroom with toddler in tow, then back to the room with the tech. She accepted the sample and asked me to sit down again. While she readied the vials and needle, she asked, "How old is she?"

She had asked that an hour ago, but I was just another patient in the sea, so I replied again, "Two." She said, "Oh, is she your first?" I blinked. She had asked that only a few minutes before. They let this woman come at people with needles? I was kind of creeped out. "Yeah," I replied.

"Oh, that's nice." Doo-dee-doo-doo. Cue Rod Serling.

She took my blood, and that was that. I left the lab at 12:15, two hours after arriving. Now I have to trust that all went well, and the right blood and pee will be sent to the right place for interpretation, and come back to the right doctor with the right results. In the meantime, I may write a little note to LabCorp suggesting they perhaps interview their candidates a little more carefully.

And if my tests come back showing an elevated prostate-specific antigen level, we'll know who to blame.

Monday, May 1

DMV: Bicoastal Inefficiency

As mentioned in my rant about the Maryland Motor Vehicle Administration we need to have the title for our car reissued. The car was a gift to us from my father and we need to have the vehicle officially titled in our names and then registered in the state of Maryland (currently it is registered to him in California.)

Two months ago I sent the completed forms and required $16 check to the state of California requesting a duplicate title. I attached the invalid/mutilated copy of the title. And waited. La la la.

Weeks passed. My dad, eager to have the vehicle out of his name, went to the Ford dealership where he purchased the car and asked for their help. A very nice lady called her contact in Sacramento and discovered that . . . of course! Our request was lost in the mail. Or something. Whatever happened, they didn't have it.

Back to Square One. My dad obtained the forms (AGAIN) and filled them out (AGAIN) and sent them to us (AGAIN) to fill out the rest. We attached another check (this time for $31, since a replacement title is more expensive than a duplicate title) and waited (AGAIN.)

Incidentally: the registration is now expired in the state of California, and I cannot yet register it in the state of Maryland, lacking the title. The car is therefore unregistered. La la la.

Another two weeks passed. Tonight I receive a call on my cell phone from my mother, who is at AAA (their car insurance provider) seeking to clear things up once and for all.

So, she tells me, remember those forms the California DMV never got? Yeeeeah . . . .

Well, apparently they did get them . . . and were baffled. That a Maryland resident was requesting a California title was beyond their collective bureaucratic ken. Instead, they issued (to my father's California residence) a letter stating they had no fricking idea what we wanted of them. And it took them 6 weeks to articulate this.

I'll hate to learn of the ensuing confusion when the second set of forms arrive . . . though that's been 2 weeks, they still have no record of that ever arriving.

Thanks to the nice lady at AAA we hope to have our car titled in our names and registered in our state sometime in the next eight years or so. As it is, the car will need a repeat inspection . . . since the original was only good for so long, and thanks to those on-the-ball folks in Sacramento, we're way past that.