Tuesday, February 3, 2015

Saint Blaise, Somewhere on the Seventh Floor Observatory, With a Papier Mâché Chalice of Prior Approval Paperwork

Marlinspike Hall sleeps around me with such intensity, precision, and natural beauty that I mistook the funky quiet for that muffled, inimitable blanket of sound that falls with heavy snow.

Turns out, it's just cold, mid-morning, and a Tête-de-Hergé National Holiday, of which there are only two, so the Genetically Indentured Domestic Staff are sleeping in arduously, as well as the Cistercian brotherhood next door (their sleep carries, let me tell you!), amplified by the trained cadence of the overly red-wined snores of their Abbot Truffatore, whom my powers of echolocation place at the second Medieval half-renovated kitchenette nearest our wing of the Manor.

The Holiday?  Now, keep in mind that it's nothing to do with religion, more with husbandry, mostly of the animal sort, and veterinary medicine, light years more advanced than t'other sorts.  Most vulgarly stated, however, and to keep things simple, which is how we like it, it's to celebrate, by a grand sleep-in, celebratory, mostly, of the grandest adenoids in all the land, and of the Catholic Feast Day of Saint Blaise. It all makes our kind of sense.

Many Catholics might remember Saint Blaise's feast day because of the Blessing of the Throats that took place on this day. Two candles are blessed, held slightly open, and pressed against the throat as the blessing is said. Saint Blaise's protection of those with throat troubles apparently comes from a legend that a boy was brought to him who had a fishbone stuck in his throat. The boy was about to die when Saint Blaise healed him. 
Very few facts are known about Saint Blaise. We believe he was a bishop of Sebastea in Armenia who was martyred under the reign of Licinius in the early fourth century. 
The legend of his life that sprang up in the eighth century tell us that he was born in to a rich and noble family who raised him as a Christian. After becoming a bishop, a new persecution of Christians began. He received a message from God to go into the hills to escape persecution. Men hunting in the mountains discovered a cave surrounded by wild animals who were sick. Among them Blaise walked unafraid, curing them of their illnesses. Recognizing Blaise as a bishop, they captured him to take him back for trial. On the way back, he talked a wolf into releasing a pig that belonged to a poor woman. When Blaise was sentenced to be starved to death, the woman, in gratitude, sneaked into the prison with food and candles. Finally Blaise was killed by the governor. 
Blaise is the patron saint of wild animals because of his care for them and of those with throat maladies.

We lit-crit types, especially we of the bad sort, ill-trained, and sleepy, could get a dissertation out of that, then kick back at our Defense, and start an almost natural fight among our Friends There To Judge Us that could easily last the requisite three-to-fifteen hours, no bathroom breaks required.

Bad habits die easily, thank God, and now that Fred is stumbling about and phones are ringing, the better habits promise to prevail and coffee cannot be far behind.  Buddy just vacated the wheel chair, after sneezing, pointedly, and with prodigious productivity, upon my joy stick, finishing his work with the careful application of a single 6-inch strand of this Marlinspike Hall Maine Coon's Serengeti counterpart's tawny mane sun-drenched fur -- still warm and redolent of the male markings of which modern veterinary science has rendered Buddy incapable. If you followed that, free parking for 2015 ManorFest!

While everyone slept, I worked.

I confirmed that the snafus Fred and I assumed to be true, were in fact, true.  Call this the polite, fact gathering portion of the endeavor.  Included were the more important confirmation of fax numbers and phone numbers, contact persons, hours of operations, and the names of any interesting listen-while-you-wait music.
No growling, no brains on the ceiling.

[Damn.  Fred made himself coffee.  But none for the gimp.  You want brains on the ceiling? Now there are gonna be brains on the ceiling.]

[Double Damn with cherries on top.  Fred has another luncheon date.  Followed by a mission of mercy for me, so I can hardly beg for coffee.  I hate Catholics. Blaise was sure gonna get coffee while they starved him to death, I betcha.  Whatcha wanna bet?]

[Triple Damn and be it on Fred's Flat Head this time. Said luncheon date, which, okay, truly is a kindness and a genuine act of fellowship on his good part, not to mention that it takes place outside of this godforsaken bed and bedroom, far away from the Feline Triumvirate and the intricacies of Manor Domestic NitPickiNess... However, it's a good hour-and-a-god-damned-half away, leaving a good god-damned languid enough period of time to cafe-presse a cup of decent coffee. "But I'm going to run 'cross the drawbridge, through the snoozing carnies, up the barn loft defenses, through the hay gate, shimmy across the ropes to the computer turret, have Sven send up my coffee, and have loads of emails to get through before I have to be in town for this luncheon gig..."]

[All Damns revoked.  I hear the kettle singing.  A line missed by both Angelou and Whitman. Throw in each to each and it could be Eliot.  But I resent the guilt out.]

Yeah, and now my detailing of my work on this Saint Blaise Day is all soiled, piggy, and dead, sour meat.

I'm trying to get the pain medication that was prescribed on 23 January 2015 filled.  It's available.  It's not strange.  It's in my new insurance formulary.  Because I did not know whom my new pain management doctor was going to be, I surely did not know that we were going to change my long-acting pain med, something I longed for, but dared not hope for (not with PF Flyers on the concrete kind of wanting, if you, Dear Reader, get my drift).  So when the marvelous and tremendously overworked Dr. Ramasubbu actually wrote the prescription, without ANY records or any bona fides beyond my writhing self and half-coherent history, corroborated by what I had been able to download and print -- okay, with Sweet Fred's assistance -- well, I was... in disbelief.

She also prescribed Topamax.  She permitted me to continue with my breakthrough meds though my impression was one of less-than-happiness.  She made a one-month appointment.

There were many innuendos and eyebrow sentences.  Had we not passed most of the larger holiday seasons, I'd have been watching for fingers placed meaningfully, tropefully, alongside various-sized noses. I had broken many rules.  Ignorance, good intentions, scientistic experimentation, frugality, desperation, take your pick.  I also did what Fred abhors. "Abhor" does not begin to cover it.  He SLAMS poor Ruby's tender steering wheel when I launch into my tale of "how did it go with the doctor?" When I get to the part which starts, "So I told her/him the truth..." -- BAM, BAM, BAM! Poor Ruby and I cringe and go quiet for a good ten miles or so, as I listen to "Why? Why do you tell them the truth? Etc."

Anyway, the truth went well.  Dr. Ram made a passing reference to being required by law to destroy the pain meds I had brought in to show her.  At the time, thinking that new meds were as available as a quick stop at a nearby pharmacy, I was almost okay with that.  But then some sort of libertarian me surfaced [I know!] and bombarded my brain with thoughts of:  Wait a minute, I paid for those, they're mine, and I've used them as directed, of even UNDER as directed!  And wait a minute, I paid for those, they're mine!

None of those thoughts exited my brain, which was good, as I was dealing with law-abiding but stern folk with whom I had not yet signed any forms, and whose eyebrows had been wriggling like crazy.

Oh, the truth?  I had cut down the dose of my Fentanyl patch, from 100 mcg to 75, on the off-the-cuff but, I thought, well-considered, advise of an excellent nurse practitioner chez my last pain management provider, with those thriving Kaisers. In order to do this, I'd dug into a lovely, large and fragrant woven bag meant for Indian Basmati rice, into which I had tossed the dregs of prescriptions over the last 5-6 years.  Antibiotics that were changed after the first very expensive dose.  Anticonvulsants that made me insane and did nothing for neuropathic pain.  Inexplicable bottles of Methadone and Baclofen, in quantities for which I am now grateful. Mostly the work of overzealous, unthinking, unsavvy doctors, though looking at the doses of some of the methadone bottles, I am thinking that guy wanted me dead.  Thinking back... he almost succeeded, with the blame placed squarely on me. But he, he no longer matters!  However, I may take Dr. Ram one of those [empty] bottles to explain my reticence at being put back on methadone, that and the whole experience of getting off of methadone! [ HERE are just this blog's methadone entries labelled "jump-off," when I -- w/o medical supervision or approval, took myself off all opiates in roughly a month so as to best approximate a treatment protocol that was my best shot at a cure.]

The rest of the truth?  That nothing was working.  I'd reached the point thought unreachable, of 10/10. Blah, blah, and blah. I think that was about it.  I warned her that I'd continue to tell her the truth, comfort for either of us be darned and dratted.  She preferred it so. I finally relaxed. Someone told me, "Pack up my meds, sign here, here, and, uh, here, here are your prescriptions, get dressed, make your next appointment on the way out and you are good to go!  Nice to meet ya!"

Each of those things was as a marathon.  But I was so happy.  I was free of the greasy-haired man everyone thought so great, who loved to fold my now unfoldable hands [shut up] into his long, i-should-have-been-an-oil-painter-in-amsterdam hands, and say, "There is no hope for you, no cure, nothing is going to get better."

I packed up my meds. I signed.  I tucked my new prescriptions in my pocket (after screamingly getting dressed).  I made my next appointment, face dripping in ladylike perspiration (channeling my sweet stepmom), and found what's-his-name, the object of admiring stares by two babies in strollers, watching him softly snuffle-sleep, book on the belly, ignoring the educational DVD cued for their learning pleasure.

"I'm not asleep!" yelled Fred, and the girls giggled.  He giggled back.  Kids love Fred!

On the way down to the parking dungeon in what was called "The Tower," I spotted a pharmacy. A bright girl, head full of Merlyn and birds and stones, I cried, "Halt!  Let's stop here and get these Rx filled, Mr. I-Am-Not-Asleep, Fredster!"

Great place. Small but fully equipped, being essentially in a hospital and next to a cancer treatment wing.

"Topamax? Not a problem.  Seven bucks!  As for the other?  Didn't you check with your insurance company? It requires Prior Approval."

By then, I'd been hit with hypoglycemia as well as the pain wall.  The pharmacist started her sentences speaking to me and finished speaking to Fred, who was lost, having just not-woken-up.

So I told him to run upstairs and ask them what to do.  And ate pretzels. He came back, said the pharmacy should hang on to the prescription, and that Dr. Ramasubbu would fax the PA paperwork to start the approval process with the insurance.  It might take as long as 7-10 days. Sounded like a plan. New plan, new docs, kinks, and so on.


Except that yesterday, ten days later,  I got up the nerve to call the pharmacy, who said they'd heard nothing.
Checked with the insurance company, who'd managed to mail order 90-day supplies of all other meds within the week, and they had no record of the prescription at all. I asked them to fax the necessary paperwork to Dr. Ram and received a crisp, "That will be done in 6 to 8 minutes, and when we receive her response, it will take us 24 to 72 hours to make our decision." I saluted from the bed.

I yam what I yam.

Marlinspike Hall slept around me with such intensity, precision, and natural beauty that I mistook the funky quiet for that muffled, inimitable blanket of sound that falls with heavy snow.

It seemed prudent to check with the hospital pain center to see if the fax was successfully received and whether anyone had had a chance to look at it.  Twenty-five minutes on hold -- but fascinating music.

Bottom line.  Nothing from yesterday, but a bunch of stuff from "the 18th" [of January?  A Sunday?] "Could that be it?"

There's more and it was all equally time-consuming, stupid, and led nowhere.  Like, Fred was to pick up CDs of imaging studies, either at building 2001 or 2045, but the "good news" was -- get this -- that at either building, it would be on the 7th floor!  One tech guy was responsible for putting this video game together, but where it ended up depended on how his mind worked:  did he favor the hip orthos (2001 building) or the ShoulderMan (2045 building).

No mercy, however, for the woman who thought there was comic relief in the fact that, whichever building it might be, it would definitely be on a seventh floor.

I'm gonna take a nap.

© 2015 L. Ryan

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