Monthly Archives: May 2020

Headaches and Insurance

On Tuesday, I had an appointment with the Headache Clinic at Dartmouth. I first went about six months ago, so for the past six months I have been taking monthly Emgality injections, which are very painful, by the way. Anyway, before I started taking the Emgality, I was having a headache seven days out of the week. Since the medicine kicked in, it took almost two months to begin working, my headaches have dropped to about four a week. Obviously, this is an improvement, but not the kind of improvement the clinic wants to see. In my appointment on Tuesday, the nurse practitioner who does all the follow-up visits talked to me about switching to Aimovig and/or Botox injections. Aimovig is another auto injector like Emglaity, but supposedly easier to use, not that Emglity was hard to administer. She asked which I would prefer. I have never been too keen on the idea of injecting poison into my body, so Botox is not something I really wanted to consider. Also, it’s thirty-one shots in the head, and I don’t like needles. However, I am getting desperate. I have dealt with headaches my entire life, and I just want some relief. I asked the nurse if I would be taking Aimovig and Botox or just one or the other. She told me that they would prefer that patients try both at the same time. Though research is being done on the combined effectiveness and not much information exists about this yet, it is believed that they work well together to prevent migraines. Here comes the caveat: very few insurance companies will pay for both treatments at the same time. She advised that I call my insurance provider and ask if they would cover both simultaneously.

Let me begin by saying that I hate insurance companies. They are crooked and cheap. They are always trying to cut corners and not pay for treatments advised by doctors. While my friends in other countries will say that the United States needs universal healthcare, and I am not going to argue with that, the US government is so colossally incompetent and corrupt that I am afraid it would actually be worse than the current situation. Considering that a large number of people were stupid enough to elect Donald Trump, how can I have faith that they would ever support truly universal healthcare? I just don’t believe it is possible in the greedy, capitalistic economy of the United States.

Now that I have given my rant about insurance companies, I will tell you what happened when I took the nurses advice and called my insurance company. Right off the bat, I got am idiotic computer giving me vast amounts of useless information that I did not ask for. So, I finally asked to be connected to an operator. I was given their pharmacy department. Finally, a live person! So I told her about my neurology visit and what had been recommended and asked would they cover both treatments. That’s when I began to get the runaround. I was told by the customer service representative that they had not received a preauthorization  request for the Aimovig and therefore could not tell me if they would cover it or not. I already knew they would probably cover one or the other, but I wanted to know if they would possibly cover both. The reason I knew they would cover Aimovig or Botox is because when I was first prescribed Emgality, their reason for the initial denial was that I had not tried Aimovig or Botox first. Then she proceeded to tell me that Botox is a medical procedure and does not fall under her department, and I would have to talk to a representative from the medical department. So, she transferred me over there. I went through my explanation again. Again, I was told that he could not tell me if Botox would be covered because they had not received a preauthorization request. So I explained to him again that I was not asking if they would just cover Botox, but would they cover both treatments simultaneously. Again I was given the spiel about the Aimovig was covered by the pharmacy division and Botox was covered by his divisions, and he had no way of knowing if they would cover both since they would have to be requested separately. He told me to have the Headache Clinic request a preauthorization for both treatments.

At this point, I gave up on talking to the insurance company since they were obviously not going to tell me anything. So, I did as he suggested and called the Headache Clinic. This is when I got really annoyed. I was given a clerk to speak to and explained what I was calling about. I told her I needed them to request both treatments before they could tell me if both would be covered. She took down the message, and then had a nurse call me back. This was not the nurse practitioner I had spoken to earlier that morning. The nurse reviewed my chart and told me that it did not mention the Botox treatment and therefore the nurse practitioner must have decided against that course of action. I tried to explain that before she would order the Botox and the Aimovig simultaneously, that she wanted me to talk to the insurance company. I was basically told the since it was not in the chart, I needed to forget about it for now. When I tried explaining again, she finally said she would make a note of my call and ask the nurse practitioner, who would call me back. Do you think I have gotten a phone call back? No. While I like the people at the Headache Clinic, they are really bad about returning phone calls.

As it stands now, it appears that I will only be taking the Aimovig. Here’s what worries me, I was told by the pharmacy that by changing medications, it would take two to three months for the new medicine to begin working. If they had been able to schedule the Botox, the effects would be immediate and the botox would be working its magic while I waited for the Aimovig to begin working. I had been told that a Botox appointment would not take long to get scheduled because with the pandemic, they had a lot of appointments open. I am writing all of this because I had a major debilitating headache yesterday and was really hoping for a treatment that would work. Now, I wait.

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I don’t often post about politics on my blog. There are just too many opinions about politics, and also, there is some internet troll out there who keeps saying nasty things about my political posts and my beliefs in a more democratic society. Whoever it may be, it may not be just one person. The message is almost always the same; he or she waits about two weeks after a political post to comment. This is a good thing; I have my comments set so that comments on posts over two weeks old must be approved by me. So, I just don’t approve them and mark them as spam. Anyway, this post is about something else that has been bothering me lately.

Quite frankly, I just don’t understand the Republican Party. They just baffle me. Most claim to be evangelical Christians, but they are the least Christ-like people in America. They follow absolutely none of Jesus’s teachings. Then there is the fact that they often say America is a democracy (it’s actually a Republic, you’d think with a name like Republican they’d embrace that), yet they work the hardest to make the United States as undemocratic as possible. Their latest scheme of opposing mail-in voting really confounds me. Trump and his Republican allies are launching an aggressive strategy to fight what many of the administration’s own health officials view as one of the most effective ways to make voting safer amid the deadly spread of COVID-19: the expanded use of mail-in ballots.

In this current voting cycle, Republicans are fighting tooth and nail to stop voting by mail. Why? I did a bit of research to see why this was the case. Why make it harder to vote? First of all, it should come as no surprise to me since Republicans want as few people as possible to vote because they believe it helps them in elections. This is why they have created voter ID laws. Even though in those states, it is relatively easy to get a free government ID, it’s still difficult for some people to get to the courthouse and apply for that ID. The push to limit voting options is in keeping with Republicans’ decades-running campaign to impose restrictions that disproportionately affect people of color, the poor, and younger voters, under the banner of combating voter fraud — which is exceedingly rare. Democrats have more core constituencies among the nation’s disenfranchised, and both parties have long believed that easier voting measures will benefit Democrats.

Trump views the issue in a stark, partisan way: He complains that under Democratic plans for national expansion of early voting and voting by mail, “you’d never have a Republican elected in this country again.” I’m not convinced this is true; even stupid people will vote by mail. Trump has said he believes vote-by-mail has been abused to hurt Republicans, and he “will not stand for it,” though the hypocrite that he is, he says that mail ballots could help some older voters — an important part of his voting base. It was a slight change that came at the urging of his advisers. Trump was roundly ridiculed for suggesting that expanding vote-by-mail would hurt Republicans in November. The New York Times called it a “false claim,” declaring that “there is no evidence to back up the argument from the right that all-mail elections favor Democrats.” But the truth is a little more complicated.

The United States has had absentee ballots for many years. I voted absentee the whole time I lived in Mississippi because the State of Mississippi wouldn’t allow out-of-state students to become Mississippi citizens, and thus we could not register to vote in Mississippi. It was all to charge us exorbitant out-of-state tuition, so I had to vote in Alabama by absentee ballot. The current public health crisis brings new urgency to the battle, as Democrats and a few Republican state officials turn to expanded voting by mail as an important way to avoid the serious health hazard of crowded polling stations amid a pandemic. In a pre-coronavirus world, Republicans found that the threat of voter fraud and the need for tighter voter restrictions were popular messages with segments of their base. If there was a chance that the political equation might change with the pandemic, Trump and his cronies have not seemed concerned. A lot of Alabamians vote by absentee ballot, yet Republicans control every statewide political office.

There are basically three categories of vote-by-mail in the US. The most restrictive level, found in seven states, including Alabama, is traditional absentee balloting, where voters have to give a reason why they can’t vote in person. Next is no-excuse absentee, where anyone can vote by mail but must request a ballot. About half of states have a version of that. Then there’s universal vote-by-mail, or “vote at home,” a system now used in five states—Colorado, Hawaii, Oregon, Utah, and Washington—plus many counties in California. New York just joined this group, at least for the primary. In this third system, the government automatically mails a ballot to every registered voter, and voters have about two weeks to mail the ballot back, or they can drop it off in person by election day.

Perhaps wary of the politics of taking an absolutist position amid the pandemic, and aware that absentee ballots can also be a preferred form of voting for some of Trump’s supporters (my mother being one of them), his advisers have pushed him to soften his position. After all, state’s rights have for the past 30 years or more been a hallmark of Republican ideology, and voting is the purview of the states, not the federal government. Republicans are highly focused on stopping Democrats from loosening absentee voting restrictions, which they have portrayed as a Democratic plot to inflate voting tallies.

Democrats and voting rights groups have filed lawsuits seeking to expand mail and absentee voting options and pushed for an extra $2 billion to help states adjust their election systems. National Republicans are fighting those efforts, while Trump doubled down on claims, without any evidence, that mail-in voting is vulnerable to fraud and that it helps Democrats. The studies done on mail-in-voting does not show this to be true. It merely shows that more people vote when it is easier to cast a ballot and does not universally favor one party over the other. It just shows that Trump is scared of the masses, and afraid they will vote him out of office, which I fervently hope they do.

While Trump and his cronies fight to prevent expansion of absentee ballots, nothing illustrates the mixed-up and hypocritical politics of the opposition to vote-by-mail better than the world’s most famous absentee voter declaring the practice corrupt. “Mail ballots are a very dangerous thing for this country, because they’re cheaters,” Trump told reporters in early April, a few weeks after casting an absentee ballot in Florida’s primary. “They’re fraudulent in many cases.” If this is the case, why did he vote absentee? Did he commit fraud by doing so? He’s broken so many laws and told so many lies, I have lost count.

The only thing we really know about voting this year is that absentee ballots are going to increase dramatically. Maybe making that easier would benefit Democrats, who live in densely populated urban areas where viral transmission is more likely. Or maybe it would benefit Republicans, who are older in general and so have more to fear of getting infected. There’s no way to know—which makes treating the question as one of partisan advantage thoroughly insane. Instead of focusing on which party might gain an edge, legislators and election officials would do well to spend their energy on what’s safest for voters and poll workers. It’s better to be remembered for keeping citizens safe than for forcing voters to choose between their health and the right to vote. Yet, we know, Trump and his ilk do not care about the health and well-being of the citizens of the United States. If they did, they wouldn’t be opening states back up to boost the economy. They care more about money lining their pockets than they do about the health of the average American.

Sorry this is so long. I guess I had a lot to say.

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Rudyard Kipling – 1865-1936

If you can keep your head when all about you
Are losing theirs and blaming it on you;
If you can trust yourself when all men doubt you,
But make allowance for their doubting too;
If you can wait and not be tired by waiting,
Or, being lied about, don’t deal in lies,
Or, being hated, don’t give way to hating,
And yet don’t look too good, nor talk too wise;

If you can dream—and not make dreams your master;
If you can think—and not make thoughts your aim;
If you can meet with triumph and disaster
And treat those two impostors just the same;
If you can bear to hear the truth you’ve spoken
Twisted by knaves to make a trap for fools,
Or watch the things you gave your life to broken,
And stoop and build ’em up with wornout tools;

If you can make one heap of all your winnings
And risk it on one turn of pitch-and-toss,
And lose, and start again at your beginnings
And never breathe a word about your loss;
If you can force your heart and nerve and sinew
To serve your turn long after they are gone,
And so hold on when there is nothing in you
Except the Will which says to them: “Hold on”;

If you can talk with crowds and keep your virtue,
Or walk with kings—nor lose the common touch;
If neither foes nor loving friends can hurt you;
If all men count with you, but none too much;
If you can fill the unforgiving minute
With sixty seconds’ worth of distance run—
Yours is the Earth and everything that’s in it,
And—which is more—you’ll be a Man, my son!

Rudyard Kipling’s (1865-1936) inspirational poem ‘If’ first appeared in his collection ‘Rewards and Fairies’ in 1909. The poem ‘If’ is inspirational, motivational, and a set of rules for ‘grown-up’ living. Kipling’s ‘If’ contains mottos and maxims for life, and the poem is also a blueprint for personal integrity, behavior and self-development. ‘If’ is perhaps even more relevant today than when Kipling wrote it, as an ethos and a personal philosophy. Lines from Kipling’s ‘If’ appear over the player’s entrance to Wimbledon’s Centre Court – a poignant reflection of the poem’s timeless and inspiring quality.

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Not Enough Sleep and the TSA

I’ve been sleeping pretty good, when I fall asleep. However, it takes me a while to fall asleep and when I do I wake up long before my alarm goes off. On Saturday, I woke at 4:30 am, and Sunday, I woke at 5:30 am. Both days I’ve awoken with terrible migraines and just wasn’t able to fall back to sleep.
Hopefully, I feel better when I wake up this morning. After five or six cancellations, I finally have an appointment to do my fingerprinting and background check for my TSA Pre Check. I’ll have to go to Burlington. There is a center closer to me, but they’ve been the ones canceling on me. Finally, they notified me that the local center was closed until at least June 1 because of COVID-19. So I rescheduled for Burlington, and it looks like they will keep this appointment. It’s only supposed to take ten minutes. Hopefully, that’s the truth. Honestly, I’ve never known of the TSA to do anything quickly. I’ve been waiting on an appointment since January. But, once this is over, I can go through the TSA lines a bit quicker. 
You’d think as small as Burlington and it’s airport is, that you could go through fairly quickly, but the wait is always nearly an hour. In Burlington, you have to get to the airport at least two hours early, but it helps if you’re even earlier. When I fly out of Montgomery, Alabama, I’ve never had more than two people of in front of me at the security check, which is probably why they don’t have TSA Pre Check there.

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Seen in Him

And his disciples asked him, saying, Master, who did sin, this man, or his parents, that he was born blind?  Jesus answered, Neither hath this man sinned, nor his parents: but that the works of God should be made manifest in him. (KJV) ( John 9:2-3 ) 

It’s a common belief that people suffer as a way of punishment for their sins.  Yet, Jesus used the blind man’s disability to glorify God, not to punish him because of his own or his parents’ sins.  Could the same apply to our suffering?  We can view our suffering as an offering to God.  It helps to strengthen our faith, teach others about faith, and bring glory to God.  When you are low and struggling in your suffering, ask God to show you His perspective. 

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