Showing posts with label HMO. Show all posts
Showing posts with label HMO. Show all posts

Tuesday, May 13, 2014

Jose Ochoa, Famed Medical Turd, Has Doppelgänger in Metro Atlanta

dop·pel·gäng·er
ˈdäpəlˌgaNGər/
noun
  1. an apparition or double of a living person.
    "he has a doppelgänger named Donald, his invented twin brother"


*******************************************************************

I am beyond upset.  As is Heinrich, er, um, I mean, of course, Fred.  Let me start over.

You must be wondering about the title of this post: "Jose Ochoa, Famed Medical Turd, Has Doppelgänger in Metro Atlanta."  Please do not take the opening lines of this already gooberish bit of writing as an insult to your intelligence.  I know you know what or whom a doppelgänger is, and that the example Google chose to offer for correct usage -- that hilarious bit about the invented Donald -- is Gooberism at its most extreme.

First, Jose Ochoa.  If you don't know His High Turdishness, feel free to enter "Ochoa" in the upper left search box on this page.  Actually, I believe there is also search capacity on the right side of this page, as well.  We aim to enable here at elle est belle la seine la seine elle est belle. Here is the short version, in case you're getting so hot under the collar that me asking you to do something so small and [ultimately] time-saving as reading a bunch of old posts about The High Turd Ochoa has caused you to develop a rash on your poor overworked neck:  He's a doctor, or so people believe, who has made a large fortune testifying in workers' compensation hearings, or performing sadistic forensic "independent medical exams" for workers' comp or other large insurance agencies.  He specializes in making sure CRPS patients never receive appropriate medical care or desperately needed funds with which to buy food and pay rent.  His specialty is thus refined because inherent to his qualifications are numerous humorous articles which refute the very EXISTENCE of CRPS.  Unfortunately for His Turdishness, Big Science, Big Workers' Comp, and virtually all Big Insurance Companies, have left him in the dust, especially now that he can only use citations of his own "work" to bolster his baseless and hilarious claims.

Now, I've no desire to be sued by Jose Ochoa, and from the number of "hits" that articles about him receive that originate within 5 miles of his home base, he and his misled associates are constantly checking on his "turd" status here in Marlinspike Hall.  

"Hmm, I wonder if I am still a Turd.  Better check that helpful blog again..." [logs on to elle est belle la seine la seine elle est belle via a well-traveled link to his favorite laudatory post, "Three Months Later: José Ochoa, *Still* A Big, Fat Turd."]

There's an excellent unbiased summation of the non-board certified (in *any* medical specialty) Doctor Ochoa by the Third Circuit Court of Appeals in the State of Louisiana HERE

While I'm ranting, and I'll stick with that verb choice, despite its inaccuracies, I'd like to dispute the ugly rumors that I am just angry at being stuck raising an Ochoa Love Child with no support from my Baby-Daddy.  Doctor Ochoa and I have never had the opportunity to meet, speak, exchange emails or psychically teleport (in terms of matter, as well as thought, including his submicroscopic, sluggish spermatozoa and my plump, beautiful ova).  I know nothing of his personal life, beyond logical deductions of habits groomed by greed, and assume that he's happily married, and probably the head of some dynastic empire. I don't really know.  There is NO LOVE CHILD, so just stop repeating that. And if there were, you can be darned sure that Jose Ochoa would pay support for the poor thing... or my name isn't Retired Educator!  er, Profderien!  um, Channeller/Medium of Bianca Castafiore! oof, Definitely not that "L. Ryan" person!

Okay, so now you have the broad outline of my personal opinion of Jose Ocho, as well as that of the Third Circuit Court of Appeals in the State of Louisiana, that bastion of liberality. 

*** I just dropped by the general web site of the Third Circuit Court of Appeals and was RUDELY escorted out.  Let me share with you what I learned through ignorance, which, when of the law, is no excuse.  They have a freaking DRESS CODE: "All counsel appearing before the court shall be appropriately dressed in business attire. Men shall wear a coat and tie. No denim is allowed." Despite my assurances that my advanced and highly hoity-toity degrees were all related to French, literary criticism, and linguistics (though I might have blubbered "linguini," which would explain a few things) and that, as channeller of the Milanese Nightingale, Bianca Castafiore, my neon yellow beret and 1859 hot pink silk ball gown over red hightop, stiletto-heeled, punk tenny pumps were perfectly appropriate...
The next thing you might be curious about is how Fred and I got to Metro Atlanta from our usual location West of the Lone Alp in the land of Tête de Hergé.  Well, that's easy!  We "borrowed" one of Captain Haddock's miniature submarines and used the wormhole extending from the bottom of Our Algae-Plagued Moat to get to Atlanta's very creepy northern suburbs.  Since that's where my new ACA-provided MarketPlace HMO health insurance wanted me to go for my first neurological appointment for the accursèd CRPS spasms and CRPS-induced hypertension... who was I to complain about the minor inconvenience of hitching a ride through [?] a wormhole in a miniature submarine belonging to my cartoonish boss?

Captain Haddock.  Hey, is YOUR boss on Wikipedia?
Now, having resolved any possible qualms my more habitual readers might entertain about this post -- fear that the Turd Ochoa will breach the defenses of Marlinspike Hall with a warrant for libel or slander or false paternity claims, concern that we had to travel to the center of backward fake conservatism for medical care -- I can finally proceed to an explanation of Dr. Ochoa's doppelgänger.

Because I am Honest-to-God afraid of Dr. Ochoa's doppelgänger, I shall not name him.  Okay, his initials are RJW.  Roald Joseph "Joe Cargo" Wasserman.  Yeah, that'll do.  Dr. Roald Joseph "Joe Cargo" Wasserman, it is!

Roald Dahl (/ˈroʊ.ɑːl ˈdɑːl/;[1] Norwegian: [ˈɾuːɑl dɑl]; 13 September 1916 – 23 November 1990) was a British novelist, short story writer, poet, fighter pilot, and screenwriter.
Joseph Michael "Joe Cargo" Valachi (September 22, 1903 – April 3, 1971), Italian American, also known as "Charles Charbano" and "Anthony Sorge" was the first Mafia member to publicly acknowledge the existence of the Mafia. He is also the person who made Cosa Nostra (meaning "Our Thing") a household name.
The Wassermann test or Wassermann reaction (WR)[1] is an antibody test for syphilis, named after the bacteriologist August Paul von Wassermann, based on complement-fixation.

Because I believe in sharing as many spontaneous "excited utterances" as possible, I will now resort to copying-and-pasting a recent electronic wormhole transmission, because Fred and I are safely back at home in Captain Haddock's ancestral manor.  It may be slightly redacted.  But whose blog is it, anyway?

An Anonymous and Amazing Friend (I have a few!) wrote, having intercepted some rabid but innocent, off-the-cuff, breezy allusion to "NEUROLOGICAL RAPE":

Okay, what's going on with you????
Are you in HIGH pain????

You'd like her.  I sure do.  We are, in fact, sending a drone miniature Haddock Corporation submarine to her secret location as you and I "speak," Beloveds.  Why?  She's bringing PIE, a known curative for all that ails one.

It's a Marlinspike Hall rule, cross-stitched on a pillow even:  "You must answer all Anonymous and Amazing Friends' electronic or cross-dimensional communiqués, no matter how freaking painful it is to type or twitch your nose à la Bewitched."  What is not mentioned on the pillow is our true motivation 
-- "Keep your friends happy and they might bring you pie!"




Actual Official eDocument concerning the Doppelgänger of 
Famed Medical Turd, Jose Ochoa, in Metro Atlanta

Official Seal


hey.  i had made an appt yesterday that i was actually looking forward to, with a neurologist through my new insurance..  this guy does research at emory on movement disorders, and was a perfect match for my spasms and other CRPS weirdness.  

i made sure to send fred an email from the computer turret with the directions, as we have gone to this location once before and GOT LOST. we are sooooooo used to Tête de Hergé, and the miniature submarine trip through the wormhole is sooooooo disorienting! 

i also made sure we left a half-hour earlier than necessary, as we had to transfer from the captain's sub to a rental car and atlanta traffic is infamous. we got in the car, i asked fred if he had the directions, and he said, "don't need 'em, i know exactly where it is." of course, his eyes were spinning like lemons on a slot machine.  bless his bones!

first, there was a wreck on I-285, and I-285 is already a wreck!  look what wikipedia says about it, even:
Interstate 285 (I-285) is an Interstate Highway loop encircling Atlanta, Georgia, for 63.98 miles (102.97 km). I-285 is also un-signed State Route 407, and is colloquially referred to as the Perimeter. Suburban sprawl has made it one of the most heavily traveled roadways in the United States, and portions of the highway slow, sometimes to a crawl, during rush hour. It is also signed as Atlanta Bypass on Interstate 75 and Interstate 85.It is estimated that more than two million people use the highway each day, making it by far the busiest Interstate in the Atlanta metropolitan area.

but that was okay, we allowed for the time!  then we got lost, got confused, started screaming at the rest of the millions of drivers, who all screamed back at us, the nerve of those atlantans! 

we did not get there on time.  i was, they told me, 21 minutes late.  i tried to call them but due to the noise in the lamentable excuse for a car, that was not possible. they called the doctor to see if he would still see me and he said "no." we felt like dorothy and friends during their initial attempt to see the wizard of oz.

"Fred, I don't think we're in Tête de Hergé anymore."

Dang it!  Another secret photograph of me, Fred, and Sven Feingold going about our Daily Labors
 at Marlinspike Hall.  We have an Instagraph stalker.  Yes, I know I CLAIM to be a bedridden,
wheelchair-riding GIMP.  It's all a lie.  Read on!


i burst into tears, having been up all night for 3 nights in a row with spasms.  they get worse when the infection in my left shoulder flares and when i am under STRESS (worrying about brothers, nephews, mother-units, and my little buddies brayden and nolan -- and my big buddy, the outrageously large maine coon with separation anxiety!).  they said they would work me in with another doctor: Dr. Roald Joseph "Joe Cargo" Wasserman. 

"my big buddy, the outrageously large maine coon with separation anxiety"

they don't accept faxes at this neurological clinic (the building is under construction, the wiring hanging through plastic sheeting), so i had been told to bring my records from my former WONDERFUL neurologist. you remember him? the hawaiian-shirted, birkenstocked dude who diagnosed me in 2003, some 19 months out from CRPS onset? he had carefully selected the important parts of my long, well-documented records, studded with studies and exam/treatment results --  and also had written a wonderful summary for whomever the new neurologist turned out to be. 

Dr. Roald Joseph "Joe Cargo" Wasserman is whom it turned out to be.

diana, it felt like i was being RAPED.  (not literally, just neurologically!)  dr. m, my former neuro, NEVER touched me without permission or without warning me to do stuff like pulling up my pant leg or moving my arm.  yes, in the beginning, he HAD to do nerve conduction studies (EMGs) but even then, he was as gentle as humanly possible -- because he understood CRPS, he diagnosed it, he saved my freaking life!

well, no. he did not save my freaking life.  he told me, and this is something one never, ever forgets: "retired educator, you've been dealt a shitty hand."

to which i replied:  "aces over eights?"

at which he snorted coffee up his nose, and did not answer, eyes aglitter.  dr. m has cried in my presence a couple o'times through the years.  when i did clinical drug trials, when i did subanesthetic ketamine treatments for three months, to no avail.  oh, okay -- and when i told one of my patently bad knock-knock jokes...

Dr. Roald Joseph "Joe Cargo" Wasserman did not read the records, or even the summary.  for an hour and a half, he poked pins up and down both legs, my back, both arms, my face.  repeatedly.  then he used the effing reflex hammer, and did not believe that i had no shoulder on the left, and bone infection in both shoulders.  i have to hold up my left arm with my right to have it examined, and he would push my right hand off my left arm, making it fall.  repeatedly. (i just saw my beloved dr. shoulderman last week, the orthopedic surgeon who has seen me since 2005 and operated over 10 times -- and he saw infection in the SOFT TISSUE as well as the bone on the left side... and we decided to just pray for the next 6 weeks!  and i was to "rest that arm" after he injected it with anesthetics and steroids! 
so the bleeping ex-shoulder area HURTS even more than usual... and the CRPS in the lower arm is, consequently, flaring, and twitching.  twitchtwitchtwitch!) 

Dr. Roald Joseph "Joe Cargo" Wasserman kept asking about a damned "rash" and demanding, "why is this so painful?" 

like the fool that i really am, i kept repeating, "i've had CRPS for 12 years, that's why, and avascular necrosis, and infected bones/joints..."  and he would go, "yes, but i am barely touching you!

like the fool that i really am, when it got to the point where i could barely speak, i tried spitting out one-word important bits of information, like "ALLODYNIA" and "fgaweorjaoneonbyvwyqq"!

maybe it would have been more fruitful to save up one last bit of verbal heroics, and spit out an entire sentence, probably something from the Great Physician HimSelf"Sometimes I am quite certain there's a Jertain in the curtain."

excuse me, all this one-handed typing is getting to me... let's take a Great Physician break and watch a short bit of YouTube entertainment.




okay... returning to the neurological assault.

so i stopped talking and basically tried to meditate my way through Dr. Roald Joseph "Joe Cargo" Wasserman's "examination." 

he deliberately ran into my right leg, that was extended over the edge of the exam table.  not once but several times.  he dragged his highly starched long white coat over both legs, again demanding: "how can that hurt so much?  why are you crying?" i asked for tissues, as i'm not fond of my mascara ruining my blotchy foundation, and snot running down to the chin is simply not fine. each time, i would transfer the tissue to my now claw-like left hand (handy for clutching things!), as there was a sneaking suspicion in my mind that i'd need tissue again in thirty seconds.  he would then pry the dirty tissue out of my left claw, throw it away, and then we would replay that little scene when next the snot reached my dimples. 

finally, because i had a bit of a fever (that would be the INFECTION!), high blood pressure (that would be the PAIN!), and his insistence that i see infectious disease specialists, orthopedic surgeons, and have a brain MRI (all of which has been done and done and done, by much better than RJW!), this highly organized Unsub began to insist that i needed to be admitted PRONTO.  
do not pass go, go directly to the hospital.  

and yes, i've been watching too many Criminal Minds ION Television marathons. fred and i can profile unsubs with amazing alacrity.  here, i'll prove it to ya!


UNSUB
  • 27-35 year old white male
  • enucleator (removes eyes) -> Usually enucleators are males with a diagnosed mental disorder, lack social skills, disorganized, sloppy, repeat offenders. They don't usually take the eyes. It's usually not about the eyes, but about what the unsub sees in them (delusional!)
  • This unsub however is quite organized and strategic, and does take the eyes with him. (Possibility: trophy/consumption)
  • Apart from the first victim he's very precise with taking the eyes -> might have some medical training (but will not have made a career out of it)
  • Blitz attack - he lacks the social skills to charm his victims.
  • Very likely to have been institutionalized/ halfway house/ treatment facility.
  • Less than 48 hours between kills (he is escalating) No cooling off period will make it hard to get ahead of him.
  • Area of 22miles between locations (usually the kill area is smaller)
  • Leaves body in somewhat public area where he could have easily hidden it there - he is not afraid to get caught
  • Used a trip wire -> game hunter. He may have applied for a hunting license.
  • He waits until he is alone with his victims -> patient
  • Killers usually get more sloppy when they escalate, this unsub only gets better.
  • Drives a van or pickup that's easy to clean (his dad's)

heh heh.  i ripped that off from a fellow rabid unsub, i mean, FAN... of Criminal Minds. i ain't no freakin' enucleator, and i shore as shit ain't lackin' in any social skills.

there's more to tell about RJW but that's more than enough (i am SORRY to be dumping on you again, again, again, when you've got more than enough troubles of your own).

he did increase the dose of one of my meds.  he printed out my "discharge notes" and told me he wanted to see me again in 3 months (but expected me to end up in the emergency room by evening).  
i said, exiting my meditation silence, "thank you, doctor," revved up my power chair and found my sweet fred in the waiting room, snoring.

we went to the pharmacy on the ground floor.  then we thought to look at my paperwork and... we blew up. like balloons, pretty much.

the guy had diagnosed me with SHINGLES. "postherpetic neuralgia"! that's why Dr. Roald Joseph "Joe Cargo" Wasserman was asking about a rash, and was obsessed with my allodynia symptoms, which are just standard fare with CRPS neuropathic pain, but "present" in a much different way. oh, let's just cut to the freaking chase. shingles very rarely ends up creating gorgeous gams such as these:


this was.labelled "summer legs 2013" -- ha! 

aha, here's a video from 2011! the neuro rapist wouldn't accept that my "condition" was an old one, and not a recent attack of "postherpetic neuralgia."  and oh lordy, please don't think i am underestimating the pain and suffering shingles patients must go through, 'cause i am not!

sweet dobby still sniffs my feet, full of suspicion!  "where did my hooman get these butt-ugly thangs?"





so... we were in the pharmacy, so close to the parking lot and the car that would take us back to the miniature submarine dock, adjacent to the wormhole entrance that would return us to calm domesticity... i told fred to calm down, let it go, let's get the medication, and just GO HOME, where i could climb back into this blessed hospital bed, curl up, and recover.  with sweet dobby probably sniffing RJW's scent from my bed head to my gnarled tippy toes.

"no, we are going back up there, RIGHT NOW." 

the workmen putting up dry wall were all staring at him, but one of them proceeded to help us get on the right elevator!  even held the door as it started closing on the wheelchair! yet another hero to add to my hero collection!

we get to the 4th floor.  to the reception desk.  she says we cannot see the doctor, "he is out to lunch." [i start LAUGHING].  fred demands that she get him on the phone.  she finds a nurse, instead. i end up speaking to her after fred has finished the first detailed and footnoted explanation of the differences between shingles and CRPS.  she claims it was "a computer error." 

yeah, typing out "postherpetic neuralgia" just HAPPENED -- that's how computers operate, they just do whatever they feel like doing, those darned computers. 

surrounded by artificial intelligence.  
like a noose closing around a proffered neck, AI was tightening its grip... mwa ha ha!

there's more. the story continues into today, tuesday. RJW ends up calling my primary care doctor (not dear go-to-guy, but the HMO woman who, at our first meeting, said "our 17 minutes are up!").

her nurses are calling, telling me i MUST go to urgent care, i MUST check into the hospital, i MUST be seen, and yaddayadda. but the last nurse was GREAT.  she listened.  and she let me lie and say i was considerably improved and would come in tomorrow "if i wasn't completely better." 

mwahahahahaaaaaaa!

poor fred had a tooth pulled this afternoon, just got home. but at least he could have it done by one of the Haddock family servants, one of the stable workers who got his DDS in his down time.  so he is completely unable to run through the fruit orchard, vault the rock wall, and retrieve the BP medication that go-to-guy called in to the monastery infirmary.  such is life.

but writing YOU, a true friend, has likely lowered my sky high CRPS-induced hypertension just as well. 

plus, now you are sure to send pie.  cherry, please. deep dish? 

and i dearly want fred to sleep, rest, relax.  he woke me up this morning because he was yelling in his sleep.  gladly, when i asked if he had bad dreams, he could not remember any, just noted that he woke up "already tired." that breaks mine heart. 

i'd turn off the phone, but i want to be available for grader boob in the highly unlikely event that he might call. or that other shifty-eyed brother-unit!  how odd is it that we all detest the telephone so much?  ah, genetics!  no, that's not it.  ah, darwin!

that's about it. did i neatly tie up every loose end?  be sure to put that pie in a sturdy, waterproof box. the wormhole can be squirrely and ends, of course, in our algae-afflicted moat. we will post sven feingold's son, cabana boy, on Moat Pie Watch Duty.

god, i love you!


***** ***** ****** ***** ***** ****** ***** ***** ****** ***** ***** ******

THUS CONCLUDES THE EXPLANATION OF THE TITLE OF THIS LONG AND WINDING POST: "Jose Ochoa, Famed Medical Turd, Has Doppelgänger in Metro Atlanta." 

Any detail is fair game for the Final Exam!

Smile.

Wednesday, April 2, 2014

Go-To-Guy Meets Obamacare

CLPS:
Crumpsall Lane Primary School



CRPS:
NOT a primary school in Manchester, Great Britain

Some people think I'm mad for retaining the services of a "concierge" physician when I've successfully run the marathon of applying for coverage through the HealthCare.gov Marketplace, set up by that wonderful bit of legislation known as the Affordable Care Act.

Okay, "Obamacare." Jeez.  A girl tries to deflate the negative connotations of a term by providing and modeling alternative linguistic monikers and is shouted down by her imaginary millions of Dear Readers.

Yes, I've adequate and affordable coverage now, and desperately needed it.  But nothing has changed, really.  Even when I had wonderful but not so affordable coverage under the ACA's early version of Obamacare -- the PCIP (Pre-Existing Conditions Insurance Program) -- that began back in 2010 and saved my miserable self, I was considered mad for retaining the services of my Go-To-Guy and his flat fee service, then under the aegis of MDVIP.  He's no longer with them, he and his partner.  They're Wild Medicos.  They've gone rogue.  They're MDVIP without the corporation around their neck.

Go-To-Guy saw me through several valleys of death, always opining, in his crisp dark suits, understated cologne, funky eyewear, and with all of the surety of a hardheaded grandmother: "This, too, shall pass." When I had no insurance, he kept me on, and kept me OUT of the hospital. Why was I uninsured, being a bona fide State Employee 'n all?  Because my Bizarro World version of BCBS decided it was fair to charge me $1513 a month as a premium, with a deductible over $5,000.  So while it wasn't a game, it might have been a sporting challenge for myself and Go-To-Guy, as he kept dozens of balls in the air, and never let one fall to the ground, not even once. I became dirt poor, got sicker, but did not die, mostly out of a desire to see my staid and superb doctor kick major butt. Undoubtedly a conservative sort, he hooted and hollered and did backflips when Obamacare was passed, because then I could finally get the surgeries I needed, and the medications that he preferred, instead of the ones that Walmart sold for $4.

It was fun introducing him to the real world.  "Really?  You've got to be kidding!" became the standard iterative upon which all of our problem-solving conversations were built.  I doubt he's ever been in a Walmart.

The real Go-To-Guy is a compassionate, insightful, incredibly well-informed physician who decided that he wanted to return to the art of medicine as well as perfecting his scientific approaches to care. He was tired of dealing with insurance companies and rushing through patient visits -- though, having been with him a good decade before he changed his practice model, I can attest to never once having felt that he was timing the visit or needed to be anywhere but where he was. That's not to say he hasn't had his moments of rapidly rising color from chin to brow, complete with beads of sweat, and a cramping hand grip -- moments when I'd touched some nerve or other.

Go-To-Guy believes in the best of people.  He's shocked by any anecdote that relays an example of less than outstanding human behavior.  He's cute that way and I figure that attribute to be an excellent counterweight to my inbred pessimism.

And yes, there's that business of him saving my life a few times, and there's that aspect of acute intuition bolstered by being up-to-date and actually listening to this whiny, bitchy patient with the weird cluster of diseases.  Truth be told, however, the next time he is going over labs or a radiology report, muttering to himself, and I hear... "That doesn't make any sense... but this is Retired Educator, so who knows?" -- I'm going to bop him on his pate.  Well, as my reach is shortening and my strength waning, I probably could only whack one of his bony knees.

But... with the improvements being made in the field of assistive devices, add a flowery cane or a rubber-tipped grabber, and I could infict serious damage almost anywhere on his lanky body.

Right.
So.

I see Go-To-Guy this week for the first time since January.  We maintain an email correspondence, mostly consisting of Q-and-A sessions and my need to vent.  This meeting will be our first when, technically, I have another physician serving as "primary care provider."  And so, I imagine we will still do a soft shoe rendition of quizzing and catch-up, medication reviews, but now he won't be able to order labs or imaging, or write for meds.

What shall I call my new Primary Care Provider, a young, inexperienced, very pregnant, well-intentioned and woefully-unprepared physician in her second year of practice?  Go-To-Guy and I had gleefully thought to outsmart my new ACA Market Place HMO by slipping the list of available providers to his partner's wife, who works as a hospitalist for the same HMO.  We giggled and called her our "mole." The mole eliminated my new Primary Care Provider straightaway, first thing, with nary a hint of hesitation.  Next to my new Primary Care Provider's name, she wrote, in caps, "NO." Then Our Mole underlined her capped "NO."

NO.  Okay. I bolded it and turned it red.

Mole-guided, I picked the guy with sterling credentials, 15 years experience, row upon row of accolades, and the highest approval of the hospitalists with whom he worked.  I made the appointment and the acid levels in my stomach decreased.

And so, of course, at my first "Meet and Greet" appointment with this fine doctor we chose, talented physician dude announced that, unfortunately, his patient load was already too large, and so, like a snake, he transferred me to the medico who had been branded with the capitalized, underlined negatory.  I must have looked like a large-mouthed bass hungry for oxygen as my lips flapped in the overheated exam room.  He did slip in, the sly devil, that she was scheduled to go on maternity leave in May, and that he would probably pick up my care during that time.

Why insist on choosing that facility?  Why there?  I dunno, really. It's brand new and everyone is super nice, super efficient, super interested in customer service evaluations.  There are onsite lab, radiology and pharmacy services.  The truth? I had visions of needing to flee, and hoofing it over to the safety of Go-To-Guy's office, one street over, and the adjacent two hospitals, in case I needed urgent care. Perhaps, too, a compulsion to talk politics might come over me and there's no one better than Go-To-Guy's gatekeeper nurse, Justine, for potty-mouthed dissing of right wing extremist asshats.

Having now had my second "Meet and Greet," I think I will call my new PCP "The 17-Minute Uh-Huh."  This commemorates our first encounter, spent ordering most of my medications, during which "uh-huh, uh-huh" was the response to each medication I pronounced aloud.  Well, actually, the "uh-huh, uh-huh" began to arrive mid-drug name after the first three prescriptions.  I was getting peeved, but then a strobing pink light induced seizure activity as she interrupted a response with: "Our 17 minutes are up!"

The 17-Minute Uh-Huh has many redeeming qualities.  She's cautious.  She can explain the parts of the ear in great detail (I am having that benign kind of vertigo that comes on whenever I turn my head to the right!  "So don't turn your head to the right!").  This was at our second meeting, brought on by a high temp, a high white count, the aforementioned benign vertigo, and a messed up thyroid assessment that kept stomping its little computerized feet and claiming I had both Hashimoto's hypothyroid AND Grave's disease.  Since everything else defied logic (she's new), The 17-Minute Uh-Huh glommed onto ear physiology.

But I will have a hard time getting over her blank look upon hearing "CRPS," and the aha-moment when I offered up the acronym "RSD," instead.  The trigger of a vague memory brought on the explicitly memorable: "Oh, yes!  Something Sympathetic Something!"

Go-To-Guy has this annoying habit of pulling out some electronic device and looking up things he does not know, or to verify information.  He's particular. And he loves learning. He has other habits I've noted through the years, like the first time he saw me after I "developed" CRPS.  Actually kneeling on the floor, he was carefully examining my right foot -- at the time, the only visibly afflicted part of my body, and that was only a subtle blue hue and swelling, despite the outrageous pain there and in my left hand and forearm. Well, my left hand had a "claw" formation, but I don't like remembering it, so I'll forget it again now. He asked permission before touching the thing at the end of my leg -- compare that to Jose "The Turd" Ochoa and his reputation for suddenly grabbing at affected limbs; compare that to the countless doctors, nurses, and aides who have poked, grabbed, and stuck needles in that region without warning, much less permission.  There are two nurses and one doctor who learned the lesson well when I kicked them in their respective midsections -- I was semi-conscious and on a respirator at the time, if that absolves me at all of such violence.  It doesn't, of course, but all three were wonderfully forgiving.

See how I run from what needs saying?

At that time, the day Go-To-Guy first saw the purported foot, the orthopedic surgeon responsible for its pitiable condition, was Dr. Eric Ward Carson?  Let's get philosophical and call him the Thick Necked Truth Deflector.  In the beginning, there was a different word, a different descriptive expression, very stylized, ladylike:  Dr. Doo-Doo Head.  He denied, deflected, referred, mumbled, threatened, demeaned... did everything but diagnose and treat the obvious.  It was after weeks of that barrage of crap that I saw dear Go-To-Guy.

Me:  "Dr. Eric Ward Carson says this will go away, it's not a problem, I'm over-reacting, and that there is no such thing as CRPS.  He says that CRPS is a psychological disorder."

[In desperation, I had seen a partner of Dr. Carson's, someone very trustworthy, who had replaced my right hip the year before, and had referred me to Dr. Carson for the left shoulder replacement gone woefully awry.  This partner took one look at my leg and said, "Oh no, you've got RSD..." He then went on to deconstruct the acronym, and introduce its pal, CRPS, writing it all out on the crinkly paper covering the exam table.  I still have the bit of paper.  It was my first clue to what was causing so much pain and... well, you know my tiresome litany.  He urged me to see Dr. Carson as soon as possible and start treatment.  But, as I said above, Dr. Carson's reaction was to deny the evidence before him.]

Go-To-Guy:  "It is very real, it is not in your head, and yes, you have it. I'm so sorry."

Why am I ruminating on this bad stuff today?  The mail.  In one large envelope, I received a copy of the labs and my "current problem list" from The 17-Minute Uh-Huh.  In another large envelope, I received a copy of my records from the neurologist I can no longer see -- the Hawaiian-shirt sporting genius, in shorts and Birkenstocks mid-winter, who made the "official" CRPS diagnosis in 2003, who ranted and raved about the cover-up operation put into play by Saint Joseph's Hospital of Atlanta, Dr. Doo-Doo Head, with the ample and able assistance of Doctors Leslie Kelman and Steven Sween.

This Stylish Neuro-Guy, seeing my confusion (at that point, pure fatigue), had grabbed a big book, what we love to call a tome, dedicated in its entirety to CRPS / RSD, and flipped to the big, bright, colored photographic section... and there I was.  "See!  This could be you!" He even loped out to the waiting room to drag a sleepy Fred into the exam room.  "See!  This could be her!"

No, that's not how it reads in the medical records.  There, I am an "unfortunate woman." There, I am diagnosed clearly with causalgia, not RSD -- or in the modern parlance, with CRPS Type II.  Why does it matter?  Ultimately, it only changes a bad attitude.  Doctors who still resist the diagnosis of "RSD" will sing a different tune if you change the name to "causalgia." And there are those who do the same if you say, "I've CRPS Type 2, not Type 1."  The difference relies on the identification through EMG, or nerve testing, of nerve "lesions" as the cause of the neuropathic pain in the path of that nerve. Stylish Neuro-Guy identified three separate nerve lesions, two in my right leg, and one in my left forearm -- the original sites of injury.

It's not a cause for rejoicing, this shift in designation.  In any event, now I have both Type 1 and Type 2, as the disease spread from left arm to right, and right leg to left.  The facial involvement was God's private joke.  But there were times I might have been able to shut up some Talking Irritant by producing the EMG results.  It never occurred to me to get copies, as the "treatments," or lack thereof, are the same, no matter the type.  Causalgia / Type II is taken more seriously because it has demonstrable proof, and, I guess, because its "outlook" is more dire.

So that's why this is all spinning in my head.

Because here I am again... reinventing the wheel with "Oh, yes!  Something Sympathetic Something!" and referrals to the same orthopedic surgeons who have already tried their damnedest to save my bones, likely infected at the time I "acquired" CRPS.  Oh, to take that moment back.

Here I am, still fighting bill collectors who are calling to grab illegal "balance billing," stuck in a wheelchair and a freaking hospital bed, reliving the diagnosis with each newbie doctor, repeating tests that do not need repeating and that has done nothing but grind, grind, grind in the reality I'd be best served to forget.

My new Primary Care Physician, The 17-Minute Uh-Huh, still has CLPS listed as Number One on my Problem List. I wonder what that stands for?  A quick search turns up:

CLPS Colipase Pancreatic
CLPS Closest Lattice Point Search
CLPS Criminal Law Policy Section (Canada and Australia)
CLPS Calibration Lamp Power Supply
CLPS Common Logic with Power Supplies
CLPS Center for Logic and Philosophy of Science
CLPS Crumpsall Lane Primary School (UK)

I'm going to go with... "Common Logic with Power Supplies." I definitely have huge problems with common logic, and power supplies?  Don't get me started!

So, heck yes, my mocking detractors, I will forego my one Diet Ginger Ale a day, consider halving my coffee intake, eat canned tuna in lieu of fresh tilapia, cut off television service, sell whatever I have left to sell (a food processor, meat grinder, and a snazzy fondue set), to pay for access to Go-To-Guy, my concierge practitioner, who knows to ask permission before touching the thing attached to the purported limb adjacent to my rotting right hip.  He's my back-up, my reassurance.

He's Go-To-Guy.



2013 L. Ryan
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