Category: Personal (Page 16 of 48)

So here’s a post that has nothing to do with social media, marketing, the Sounders, Mariners, or pretty much anything I’ve ever written about.

It’s been a pretty nutty year so far, and somewhere just under the “Super High” part of the Priority List, I had this nagging item that never seemed to get dealt with.  It simply said, “Get lip checked out.”

It had started a few months back, when I noticed a few splotches under my lower lip.  After noticing it a little more, I had gone into the dermatologist to get some cream to make it go away.  Now here we were in February or so, and the splotches weren’t any better.  And when I finally got it checked out again, this time the dermatologist said, “It’s probably nothing, but it worries me a little, so why don’t you go upstairs to the surgeon and have them take care of it.”

So the consult with the surgeon was interesting.  A seemingly nice, funny, likable guy told me that he wanted to carve into my face.  Well his words were that he wanted to do a biopsy on the tissue to make sure nothing bad was going on.  I really only heard, “Surgery” and “Biopsy.”  He said he could do a simple “punch” something, but would feel more comfortable just using a scalpel and taking out all of the discoloration in a simple procedure.

Now I may be a giant sissy, but this was the first time I ever had to make any kind of crazy decision like this for my own body and I was a little freaked.  Option 1: Do nothing, assume that the discoloration was a simple anomaly that wouldn’t spread, and just deal with it.  Option 2: Take a tiny little sample, get a reasonably sound prognosis that the discoloration wasn’t a malignant tumor, and just deal with the spreading cells later.  Option 3: Go under a knife, take out all the discoloration, and learn for sure that the discoloration was or wasn’t malignant.

I was a little grouchy and stressed for a few days last month while I weighed the pros and cons.  Then I finally decided to just have the thing removed and tested.  I made the appointment, and walked around with somewhat of an odd attitude for a few weeks.  I was 95-99% sure that this was going to come out all right.  But, I couldn’t help thinking that if there wasn’t a chance it was going to turn out poorly, no one would want me to go through the risk.  I hate to be cheesy, but it puts a few things in perspective for you.

I’ve lived a pretty healthy life, so when my surgery day arrived last Monday, and I found myself sitting in the chair waiting for the guy to carve a piece out of my lip, I have to admit it was quite a new experience for me.  It’s not a subject that comes up in conversation at the pub, so I had no idea what the proper amount of fear was supposed to be.  So I pretty much had them stick the Novocain needle in, then I closed my eyes and listened while they went to work on my face.

45 minutes later, the cutting and stitching was done, and I was on my way home with a bottle of vicodin, a bunch of gauze bandages, and the promise of test results in a week.

And so for a week I tried to go on like nothing was different, except I was eating soft foods, trying harder than normal not to get hit in the head with a softball or soccer ball, and wondering why it takes 7 days for them to test a few little cells.  For the record, the hardest part of spending a week with a scar on your face is trying not to alarm anyone when they ask you what happened.  

And so today my little saga finally came to an end.  The good news – tests all came back with “Malignancy result negative.” And of course in this case, negative is positive, because it means there is no tumor and any worry was for naught.  The stitches came out, and I should have a normal looking lip again soon. 

As my friend Ari said, “Yup, we’re starting to get to that age where weird shit happens.” He may not be Voltaire, but the philosophy is still sound.   Thanks to everyone who provided the kind words of encouragement over the last month or so.  My favorite lines – “Well as long as they are there, have them fix the rest of your face.” And, “See if they’ll throw in botox for free.”  

The shots below were taken to record “Before Surgery,” “After Surgery,” “7 days of Recovery” and after the stitches were taken out.

Ok, it’s been a while since I ranted a little on here.  And truthfully, there’s a calmer gentler me who decided this is not a forum for ranting.

So instead, let me tell you a story.

Once upon a time, there was this guy, who was a partner in a small business.  Now, business is good, so the partners decide that they should start a health care plan for the team.  They do everything by the book, use a consultant to help them, and settle on a program administered by Group Health.  Now Group Health has to be reputable, because they sure do a lot of advertising that says they are.

Now when one of these team members was under their own insurance, they were diagnosed with an issue that would need some special testing that would require a small procedure.  All of this previous work was done under the watchful eye of another insurance company and accredited physicians.

This is where the fun begins.  Here’s a paraphrased transcript between Group Health and the patient.

Patient: Hi Group Health Insurance.  I got a weird call from the surgeon’s office.  Even though I was referred by a doctor, they said you aren’t sure you will cover it.

GH: Well was the referring physician In Network or Out of Network?

P: Well I don’t know. They were covered by my old insurance company.

GH: (Exasperated sigh) Well let’s see.  Well that physician is out of OUR network, so if you go to the surgeon, it counts as a self-referral.

P: How could it be a self-referral if another doctor did the referring?

GH: Maybe you didn;t hear me.  Because they are out of network.

P: So what does that mean? Do you cover it or not?

GH: Of course we do.  Don’t be silly.  We’re the greatest people on earth.  Even though you have clearly abused the system by going out of network, we – out of the goodness of our heart – are still going to cover 80% of the procedure, after the deductible of course.

P: Well what would you have covered if I was referred by an In-Network doctor?

GH: 80% after the deductible

P: So whats the difference?

GH: Nothing really.  If your surgeon has a contracted rate with us, he’ll charge the contracted rate and we’ll pay 80%

P: Wait, what’s this contracted rate thing?

GH: Oh it’s nothing really.  We work really really really really hard to get you the lowest rates from doctors, so that your 20% is nominal.

P: What if my suregeon isn’t on contract rate?

GH: Well then we pay 80% of what we WOULD HAVE PAID if the doctor was on contract with us.

P: So who pays the rest?

GH: Well I guess you would.

P: So…..you are going to pay the same amount either way, it’s just in some cases I have to pay more.

GH: But we negotiated these lower rates for you.

P: But…..you pay the lower rate.  I pay the difference.  Actually, the lower the rate, the more I pay.

GH: Well that’s ONE way to look at it I suppose.  Now, that’s only if you don’t see an IN NETWORK Specialist first.  It’s different if your surgeon is in network, under contract AND you get referred by an IN NETWORK specialist.

P: And has a dog named Blue?

GH: Huh?

P: Never mind.

P: Ok, so I guess I need do make an appointment with one of your in-network specialists so I can make sure my contracted, IN Network surgeon doesn’t charge me an arm and a leg.  No pun intended.  So, can I make an appointment?

GH: Of course.  Not a problem at all.  I will get you down for the next slot we have open for an IN NETWORK specialist.  Now that will be the 2nd week in June.  Should I put you down?

P: It’s March.

GH: So would you prefer morning or afternoon?

P: I’d prefer March.  

GH: Well June is the next time we have available for an IN NETWORK specialist who can refer you to an IN NETWORK contracted surgeon.

P: So even though a doctor suggests I get this tested, you want me to wait 3 months.

GH: No, you can just go ahead and do the procedure.  Like I said – and geez are you frustrating – we’ll still cover 80% of Necessary and Usual costs associated with the procedure.

P: Wait, what does that term mean?

GH: (SIGH) What term?

P: Necessary and Usual.

GH: Well like I said before, we cover what we think is fair.  We can’t be responsible for any extra fees the doctor tries to stick you with.

P: So let me get this straight.  You lowball the doctors into a “Necessary and Usual” rate in order to allow them in your sales pipeline.  Then you make the patients responsible for anything the doctors want to charge above that “Necessary and Usual” rate you’ve forced them into.  And the only way a patient can avoid those extra charges is if they are referred by an IN NETWORK specialist.  

GH: That’s right.  

P: BUT, AND A BIG BUT HERE, YOU DON”T HAVE ANY IN-NETWORK SPECIALISTS.

GH: Well we do have one in June.

P: Who’s on First?

GH: Huh?

P: Never Mind.

Now lucky for mortals like our Patient, there are people at the doctors offices who are fluent in the language of insurance phone reps.  Those people can actually explain how to avoid the traps that companies like Group Health try to put in your way.  Not that the doctor’s office is any saint in this matter when you think about it.  They’re playing the same twisted game, allowing the insurance companies to claim “80%” coverage when really just being responsible for 33-50%.  In fact, they are the ones who actually lose out if the patient is able to find an in network doctor to make the referral, though you have to imagine there’s a back door way it all gets settled later.

Anyway, here’s a toast to Health reform.  Thank goodness it’s taking such care to take care of the patients who need the care to begin with.

So the other day I was accused of bailing out of the 1/2 marathon since my training had seemed to come to a halt.  Not so.

Now I’ll admit, I’ve run into a few stumbling blocks.  I’ve had a few unexpected things pop up recently that have cut into my training time, but there’s no real reason to go into them here.  (I’m sure when I see you in person you won’t be able to get me to shut up about them.)  Plus, the every 2 year occurance of my back blowing out came about 15 months early this time.  So that has slowed me down a little as well.  But I managed to make it through the St. Paddy’s Day Dash thanks to an heavy dose of muscle relaxers.  God bless technology.

Anyway, the race is still a good 12-13 weeks out.  I’m at a solid 4-5 miles at around 9:30/mile.  The next big milestone is the Seahawks 12k in April.  Shoot me an email if you are up for some runs around Greenlake or Lake Union, or better yet up on Cougar Mountain where there are some hills.

It’s been nice recently – as we mix in a few sunny days – to catch Greenlake before the day gets going. Here, I’m playing with an iPhone app called “100 Cameras in One.”