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Thursday, November 06, 2014

Making Tracks

When it comes to the apheresis therapy, I feel a bit like that Tom Lehrer line about being a Christian Scientist with appendicitis.

I'm getting better about my needle phobia. I used to faint during the anemia test at the blood bank, where they prick your finger and squeeze out a drop. I had to leave the room when someone else was getting a shot, and if there was blood to be drawn, I made them lay me down first, I was headed that way no matter, so might as well get there while I was conscious.

Now I can actually watch as the nurses come at me with meat hooks, not a lot, but a little, and I can look at the needles in my arms and not get queasy most of the time.

But the therapy that's supposed to take half a day takes a little more than that, owing mainly to the fact that it takes a couple of hours to get my right arm stuck. I'm not exaggerating, I've timed it. I sat down in the chair at 8:10 and it was 10:20 when they finally had the therapy going. My noon arrival at work ended up being 1:30.

Since I'm basically a one-man department, this is a problem. Besides which it's frustrating as hell. The left arm is no problem, these nurses aren't clods who don't know their phlebotomy. My right arm is compromised by having my radial artery removed and grafted onto my heart last year. Stuff just doesn't flow the same way on that side, I guess, and I get stuck five or six times before they have something good enough to work with. To really get the therapy over quickly, they'd like to use a 17 gauge needle, but the veins they can get on the right side won't support that, I guess, so they go with a smaller one, meaning that even once they get shit going, it takes longer for the filtration process to complete.

They tell me I don't really want a fistula, where they'd surgically install something in my left arm to bridge the gap between a couple of things and make the access quick, instant and one-armed, but the other patients who come in get there after me and leave before me and they don't seem to go through quite the level of suffering I do.

Besides the mess this makes of my arm every two weeks, it's not cheap. I have good insurance, but right now the billing department is looking for almost four grand from me, which is a bit of a shocker since my insurance is supposed to have a three grand max out of pocket. There's a financial aid office, and I visited them, got some paperwork to start, but besides the fact that it's an enormous amount of pain-in-the-ass paperwork to possibly get some of the balances forgiven, you can only apply every six months, it only takes care of what you've already racked up, and they send stuff to collections faster than six months if they don't think you're paying. Meaning that at best, the financial aid (if I'm deemed needy enough), will at best take the edge off the out of pocket.

So that out of pocket, that looks poised to eat up whatever I could potentially be putting in a Roth to save for my retirement. And there's the Catch-22, the Tom Lehrer reference above. I have good reason to believe that this therapy is the best shot I have at ever being a senior citizen: heart attack at 32, bypass at 44, I'm not on a track that leads to events happening in your sixties and seventies, I'll be lucky to see the bulk of my fifties at this rate. In which case, what's the point of saving money for when I'm 59-1/2?

I can do this therapy, maybe I find my self still alive in my sixties but unable to contemplate retirement because I blew my retirement savings on apheresis copays, coinsurance and all the other ways insurance companies pretend they're covering you while making you drain your bank account.

As a bonus, I have a right arm that looks like a combination of a survived suicide attempt an heroin addiction.

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