Nov 21, 2011

Been Gone too long

It's been a month since I've posted and I missed doing it.  I have been crazy busy at work, doing overtime every day, and generally being the information outlet for what seems like a gazillion patients, MD offices, pharmacies, and health plans.  I come home dead tired, and have no inclination to much more than dinner, homework with the kiddos, dishes, and sleep.  I am recording 4 different TV series because I'm just too tired to watch at the time they are scheduled to air.

WE NEED HELP!!!!! It's out of my hands but each and every one of us would love to scream it.  I guess busting our asses catching up is better than sitting around twiddling our thumbs right?  But seriously, we all need more rest.....and appreciation.  Did you hear that managment team?

Oct 14, 2011

Worst Call at work Ever!!!!!

On Tuesday afternoon, I was training yet another new person in our department at my desk.  At about 2pm or so, my phone rang, so of course, I picked it up but did not expect what I heard on the other end of the line.  Here's what happened:

Me: Prior Authorization dept, this is PA Honeybee how can I help you?

Patient: Oh God, oh God, help me!  I am hurting so bad.  He beat the shit out of me, pushed me on the bathroom floor, and smashed my head against the bathtub!
(she sounded like she was hysterical, in agony, with a shaky voice)

Me (eyes wide, heart now racing): Have you called the police?  You need to call the police and seek medical attention for your injuries!

Patient: I need my medication so I can get out of here....Oh God, what if he comes back for me?  I need pain gel, I have already been hospitalized they let me go.  But I need it I need it, I gotta get out of here before he comes back to beat the shit out of me again!  (sounding super frantic/shaky/terrified)

Me: (heart racing, feeling helpless) You need to call the police.  You need to talk to them, not me.  They can help you. 

Patient: they don't do anything, they don't care unless there is blood!  Oh my God!  Aaaaggggghhhh!  If he comes back he could end up killing me, please hurry!

Me: You should call them anyway, this is extremely important.  Let me see if we have received a request for your pain gel.  Yes, we did earlier today, I will expedite it for you.

Patient: Oh God, Oh God!  Please hurry, I gotta get outta here!

Me (in my head): Why the hell would you be calling about a pain gel Prior Auth instead of packing up your crap and getting the hell out of there?  If you had the shit beaten out of you, that pain gel is not gonna do much to help you out unless you have some superficial contusions not major bodily injury as stated.

Meanwhile, all the co-workers around me stopped what they are doing, and are staring at me with puzzled looks on their faces during the exchange.  My mind is racing as to her rationale, my heart is racing, and I'm freaked out. 

To make a long story shorter, I got the auth taken care of for her, we disconnected, and I felt the huge urge to run down the street to the nearest bar to have a few shots to calm my nerves.  Instead, I did some deep breathing and drank water since working while intoxicated is not a good idea.  This was the most bizarre day I've had in my position to date.  I hope it's the last, but, it probably isn't.

Oct 6, 2011

Busy, busy, busy!

Now that October is here, we are increasingly busy in general, but have added a new health plan to the mix and they are fairly large.  GuitarGuy and Youngin' are doing pretty good, but aren't on phones yet :0( so the rest of us have our phones periodically ringing off the hook all day.

I had an urgent request earlier that I knew we were going to deny due to off label use but the MD office was adamant this was an emergency, so I complied and took the information over the phone.  I had it reviewed urgently so the office could take another course of action for the patient.  I am fervently hoping they don't call back to chew me out.  Offices in this situation usually do call back but hopefully they chew out Snort instead.  We shall see.

Speaking of Snort, he's trying to be "mentor-ish" to the newbies but I have to wonder, how does a stupid moron mentor the new hires?  He doesn't read everything, he blazes through triage making errors all the time, and acts like he's the "PA God" and is infallible.

GreenGirl and I let it slip to GuitarGuy how much we really dislike Snort.  We didn't say much, no details or anything, but just made a general statement....I know we shouldn't sway any opinions, we're not trying to, but if they're going to be a part of the team, I guess they should know the internal source of our frustrations.  We periodically make vague comments regarding frustration to each other after a call where we had to fix one of his errors & they look at us a little strangely.  Whatever.

On another note, I find it interesting how someone's reputation that precedes them can be turned on it's head once that person is a part of your company.  I mean this in a good way though I know it can be the opposite as well.  In my case, it is the former.  GuitarGuy had a reputation as an arrogant, woman-loathing, jerk according to a source from his previous company.  In my experience training him, he has had fleeting moments when speaking of his experience prior to working here, but is a pretty humble guy (so far), and seems to treat GreenGirl and I with much respect.  I guess time will tell & we'll see if he reverts back to previous behavior.

Oct 3, 2011


Last week, GreenGirl and I began training the newbies: GuitarGuy and Youngin'.  So far, so good; they are picking up their new roles pretty quickly with Youngin' being the faster of the two.  GuitarGuy is slower and more methodical, but is doing pretty good. 

I had to tell (demand actually) the newbies to ignore Snort's directions to leave certain information off when they triage as GreenGirl and I did not teach them that way, therefore, it is incorrect.  I must admit we're getting pretty annoyed by Snort, he isn't training (thank God!) so doesn't get a say in how they need to make changes, but tries to give them insight anyway.  We told them that if they want to listen to him instead that they shouldn't be surprised if they are presented with a stack of errors they made which may or may not threaten their newfound positions.  It's their choice.

On another note, Mastiff Lady came into the department (gasp) 4-5 times since Tuesday last week, that's been different.  She comes into our section of the department too infrequently preferring to stay in her office.  Not terribly exciting from a reader perspective, but from my perspective, she at least knows we're at our desks and physically here.

Sep 21, 2011

Packing up my desk

So, due to the newbies joining our stafff on Monday, I am packing up my crap and moving to a different desk in the corner of the department.  Apparently, this is to ensure more accessibility for one of them due to the location.  Now, I agreed to change desks a couple months ago,  as I don't like the orientation of my setup, but I'm a little hung up on the accessibility issue.  I'm moving 2 cubicles away, an equivalent of 15 or so feet away from my current desk, and within my department's area in the building. 

What exactly do they need that allows my current desk to provide better access?

Only a few things come to mind:
  • The copy machine that isn't typically going to be used by a newbie for awhile.
  • The Clinical Pharmacy staff-but we have phones to call them/legs to walk over to them and talk to them
  • MastiffLady's office but she likely won't be coming out of it much anyway, so what's the benefit?
  • The Lunch Room (?) they'd be about 6 steps closer than I will be once I move to the corner
  • the Restroom-again, maybe about 14 steps closer as the ladies' is further away than the men's
Regardless, it's just a silly statement that doesn't really mean anything-and I got hung up on that one piece of information.  Like a pitbull, I am.

Sep 14, 2011

So Slammed!!!!!

My hands are hurting increasingly.  I am typing like a madwoman, and busting my butt to get stuff done but it seems almost futile.  I'm tired, I'm achy,  I keep getting phone calls that take forever and cause setbacks in work.  We're down to 3 people this week thanks to Snort's vacation and we're drowning!!!!

Lord help us.

On the flipside, we have two new people starting next week (yay!).
We have to take time to show them how to do their new job so it slows us down (boo).

The following week we get a new health plan and a previous one back (yay for job security!)

We'll still be training the new guys, learing all about a new plan, CuteShoes is going on maternity leave, and we'll be dealing with even more workload (boo!)

Sep 9, 2011

Questions to Ponder

I just got this email and I loved it so much, I just had to post it here.  Enjoy.
Can you cry under water?
How important does a person have to be before they are
Considered assassinated instead of just murdered?

Why do you have to "put your two cents in".... But it's Only a "penny for your thoughts"?
Where's that extra penny going to?

Once you're in heaven, do you get stuck wearing the
Clothes you were buried in for eternity?

Why does a round pizza come in a square box?
What disease did cured ham actually have?
How is it that we put man on the moon before we figured
Out it would be a good idea to put wheels on luggage?

Why is it that people say they "slept like a baby"
When Babies wake up like every two hours?

Why are you IN a movie, but you're ON TV?
Why do people pay to go up tall buildings and
Then put money in binoculars to look at things on the ground?

Why do doctors leave the room while you change? They're going to see you naked anyway.
Why is "bra" singular and "panties" plural?
Why do toasters always have a setting that burns the toast
To a horrible crisp, which no decent human being would eat?

If Jimmy cracks corn and no one cares, Why is there a stupid song about him?
Can a hearse carrying a corpse drive in the carpool lane ?
If the professor on Gilligan's Island can make a radio
Out of a coconut, why can't he fix a hole in a boat?

Why does Goofy stand erect while Pluto remains on all fours? They're both dogs!
If Wile E. Coyote had enough money to buy all that
ACME crap, why didn't he just buy dinner?

If corn oil is made from corn, And vegetable oil is made From vegetables, What is baby oil made from?
If electricity comes from electrons, Does morality come From morons?
Do the Alphabet song and Twinkle, Twinkle Little
Star have The same tune?

Why did you just try singing the two songs above?
Why do they call it an asteroid when it's outside the hemisphere,
But call it a hemorrhoid when it's in your butt?

Did you ever notice that when you blow in a dog's face, he gets mad at you, But when You take him for a car ride, he sticks his head out the window?
Why Did Kamikaze pilots wear helmets?

Sep 6, 2011

Ah, September.....and some other crap

I love Fall!  There is something about September through December.  I really love this part of the year.  (we're far from feeling like Fall here, but that's ok, I can jump in the pool) Granted, my favorite holidays are during this period of time, but I think it is more than that.  I love the change of weather, change of tree colors, school events, the county fair in October, my wedding anniversary,  and the air seems cleaner, more refreshing. 

The weather also reminds me of our favorite place in the whole wide world: Monterey, CA.  I love, love, love Monterey!  When I open the windows every morning, if I feel a nice chilly breeze and the air smells fresh and clean, I tell Mr.CooksALot that it's a "Monterey Day".  Yep, I love Monterey.  That is our "happy place", it never gets old.  We got married there, and spend most of our anniversaries there partaking in the Great Wine Escape Weekend.  I highly recommend exploring the wines of Monterey, very satisfying, the wineries/wine estates are beautiful, and the wines are tasty!  Although we live in a lesser-known wine region, I am way more informed on the wines from the Monterey area!  Ironic, I know.  I will explore the local wines more, I should, it is my duty.

Here's the other crap: 
My kids have been re-treated for lice, they are in the clear (yay!)  For two weeks, I have been the "Lice Nazi" checking hair twice daily, washing sheets often in hot water, vacuuming like crazy, and thinking about it constantly, hoping for a quick eradication.  I however, just discovered Monday morning that I became "inhabited" at some point.  I was sitting on my bed, watching NFL Network with Mr.CooksALot, and I felt something moving in my hair.  I fervently hoped that it wasn't what I was dreading, I asked Mr.CooksALot to check my hair, and he looked at me with this look like, "Noooooooooo"!  He checked my scalp, asked me some questions to help identify, and confirmed what I was feeling was indeed lice.
(screaming incredulously inside)
How can it be, I was careful, I was on constant alert, we kept our distance just in case!  Why?!?!

So, off to CVS I sped to get a big bottle of lice shampoo, I treated myself, and very graciously, Mr.CooksALot went through my long, thick hair in tiny sections with that lice comb, ridding me of my acquired scourge.  He originally stated that he had 10 minutes to spare before the next football game came on.  I told him that there was no way in hell he could get it done in 10 minutes so he better just deal with it.  Once he finished, a little over 2 hours later, I looked like Mufasa from Lion King, I was really fluffy! 

I now look like I have fried my hair, it feels kinda like straw, and is very frizzy.  If you are a woman, you know this is not a good thing.  Conditioner is my very good friend, my hair is thick, wavy, long, and not being able to use any for 48 hours really sucks!  I may have to cut some of my hair off for my own sake as well as Mr.CooksALot so he doesn't have so much length to go through when it's time to re-treat.  What an experience this has better be the first and last.

Aug 31, 2011

Fresh Meat

We have been increasingly busy, so we are hiring in my department.  Only the reviewers' numbers are growing, we have nobody new in my part of the department and we're barely keeping our heads above water so to speak.  We need at least two people as of a month ago!  There is always a lag when it comes to filling the jobs for triage so we get screwed.  To my knowledge, we have held two interviews and we need someone (or two) in less than a month or we're all gonna flip out.  Here's what I wanna know: if we have to enter everything into the system, then send the letter after it's reviewed and a decision has been reached, (that's touching each PA twice so double work) why, why, why don't we already have the process accelerated?  AAAAAAAAGGGGGGGHHHHHHHH!!!!!!!

The End.

Aug 24, 2011

Annoyances on multiple levels (Caution I'm talking bugs!) :0{

So, school is off to a good start, the kids like their new teachers, and are getting back into the daily routine of going to school.  So far, so good with one exception: It was discovered that our kiddos have lice on Sunday.  The SILs' kids have lice too.  We all treated like crazy, all wondered where it came from, and how long they have had this issue.  As far as we're concerned (hubby and I), it doesn't really matter where it came from specifically, who had it first and spread it, what matters is that it is treated immediately and the various household items exposed get vacuumed/treated thus eliminating the issue. 

We're not pointing fingers, but I guess it goes back to the childhood saying, "Whoever smelt it dealt it" therefore, we saw it first so it must have come from us.  Following the discovery, there have been comments made to my nephew about our home, comment to me "he was sitting on your couch", messages on the answering machine "they seem to be increasing on my daughter, are they increasing on yours?"  Um, no, I have been diligently checking twice daily and pulling off any nits I see remaining.  I have been working very hard to wipe out this crap ASAP.

It's maddening enough that we are on "Lice Alert", constantly thinking about it, wondering if we were thorough enough, asking eachother to check scalps, etc.  But it is 10 times worse when two family members blame their infestations on us and are concrete in their assumption. 

I say, think about where you have been, there is a possibility your kids got it first and gave it to my kids.  Who knows?  That's fine, it happens.  But don't go pointing fingers at me and my kids as if we are some sort of *%#$@!>?"{}+_ lice nursery that swallowed your kids up and spit them out infested.  I'm over it.  The next time I talk to either one of them, if they start in again, I'm giving the phone to MrCooksALot, he will gladly tell them off.  Hmph!

Aug 19, 2011

Dresses, work, and kid stuff

Dresses:  I just made two in the span of two lunch breaks from yesterday and today.  I have to get one more thing done for one of them but the other I did start to finish in less than an hour.  I'm felling pretty accomplished as far as my dressmaking is concerned.

Work: Overloaded!!  stressed!!  So glad it's Friday today!

Kids: Start school on Monday, are bugging me to go shopping for a jillion items that they don't know if they even need yet in addition to those we know are yearly staples like binders, erasers, folders, etc.  While I like shopping in general, I am half dreading this shopping trip tomorrow.  I get tired of the "I want, I want, I want!"  gibberish.  I always fire back with "we're focusing on You Need, you need, you need" first!  I also really dislike navigating the mob inevitably stationed in the Back to School Zone, I just want what the kiddos absolutely need, and get out unscathed. 

Since it's going to be summer until about mid-October, I'm not concerned with getting any winter clothes until absolutely needed (aka not right now)  Shoes are a big deal.  Mousie loves shoes like her momma so is particular, and isn't always receptive to what I suggest, which is ironic since I have pretty darn good taste in shoes of all sorts.   I combine my taste in shoes with practicality too, so we don't do super trendy, dumb to have in a kid's size type shoes like high-heeled boots, jelly sandals, wedge sandals (reserved only for home/going places, not school).  SoftballGirl is easier, but still picky, and inevitably wants shoes that aren't totally necessary for school.  That's ok, I always want shoes I don't always need too.

Lord help me survive school shopping this weekend!

Aug 18, 2011

Gross, simply gross

I just got a request for some lidocaine/hydrocortisone cream for a patient.  The diagnosis wasn't just hemorrhoids, no, no.  It was so much more descriptive!  This patient has. . .. . . .wait for it. . . . . .here it comes:  hemorrhoids NOS (not otherwise specified) with necrosis.  Yep, I said necrosis.  As in: Death of a cell or group of cells as a result of injury, disease, or other pathologic state. 
(dry heave)
Her hemorrhoids are likely becoming blackened as the tissue cells are dying.  The mental pictures are more horrifying than I can explain!  All I can say is EEEEEEWWWWWWWWW!  Poor woman!  Oh, and here's the cherry on top: she's got a bun in the oven. 

Here is my minimal emesis inducing example of necrosis:

And now, I have shared.  (shudder)

Well, off to lunch now!

Aug 15, 2011

Weekend Craziness and discovery

This weekend was an "adventure".  It was a learning experience in multiple ways.  On one hand, we discovered the joy of grilled potato salad, it is so yummy!!!!  On the other hand, we learned that sometimes helping out family can be a pain, and can end up becoming way more than just helping.  This will not be happening again, we have learned our lesson. (I think) ;0) 

Potato salad is just brought up a whole 'nother level if you marinate the potatoes an hour in olive oil and whatever seasonings sound good, grill the potatoes instead of boil them, then add them to typical potato salad dressing with whatever veggies you like.  We used red potatoes instead of russet, and man were they good!  Once you go grilled, you won't want to go back.

Southern Breeze cocktails are one of my new favorites thanks to our poolside bar at the hotel we stayed at in Las Vegas.  Mr.CooksALot was smitten with this new discovery as well, declaring that we must make them once we got home.  So upon returning home, I got some sweet tea vodka, Southern Comfort, and lemonade so we could continue to enjoy our newfound drink.

We helped out a family member by hosting a party for her son's birthday, he is turning 15.  Her situation is shaky right now so we (along with my hubby's parents) said we'd help.  Plus, our house is more spacious and better equipped to host 16 for dinner.  We were the hosts, but were expected to do the menu, and all the detail planning.  She originally asked if we could do it Saturday, we said fine.  She calls us Thursday, states she's going out of town for 2 days with her kids, the party is now on Sunday.  We were puzzled, but agreed.  We made the potato salad, did all the cooking, others brought things to contribute as well.  She calls me at 1:15 yesterday, asking what time it starts (???????) and if they arrive at 4pm if that is too late.  I about lost it but politely told her 4pm was no problem, we're getting everything ready.  We reminded eachother we're doing this for her son, not for her.  The party went off really well, we cooked up a storm and all enjoyed it immensely.  Yay!  Luckily, this family member tackled the hill of dishes that was building in my sink and thanked us profusely for hosting the party for her son.

Aug 10, 2011

My Daily Daydream

I want to learn something the exact same way Trinity did in the Matrix movies; I want to learn how to MMA fight so I can use those lovely skills to clobber a certain person.  I know that kicking someone's butt isn't a reasonable solution to a problem, it isn't productive, nothing gets solved, but it does allow you to work off some stress.  (there is always an up-side to everything!) 

Snort is an idiot, I have to fix his glaringly obvious mistakes, and he needs a good ass-whoopin'.  We all overlook some information periodically by mistake, but he just does not read!  Ugh!  I inevitably get the phone calls from the pharmacy or the MD office as the result of his seemingly growing mistakes that are easily prevented if.....he.....would.....just.....READ the medication request form!!!!!!!!

He's lucky I'm not the supervisor, he'd be gone by now.  He better count his blessings and shape-up because, I'm going to verbally go postal on him if he doesn't quit it!

Aug 8, 2011

Back from my Vegas Vacation

I spent Sunday through Friday last week in Las Vegas.  I saw some things I have never seen before and you may not have experienced this yourself.

  1. On the way there, pouring rain in the desert: doesn't absorb into the earth very quickly, it puddles, creating flooded areas
  2. Also on the way, an almost completely flattened top half of a Ford Explorer that rolled several times due to bad driving in the rain!
  3. A really trashy looking woman on Fremont St. (downtown) dressed as a pirate wench, with the largest bosom (like a shelf) just barely covered at the um, "headlight" area.  Many men were drooling as they stared, I almost barfed.
  4. An extremely talented spray paint artist-he created some really amazing artwork using spray paint, a crumpled up napkin, a plastic pitcher lid, and a makeup sponge. 
  5. Innumerable women brazen enough to wear a bikini with all their rolls/jiggly bits/cellulite showing.  I have heard of this, and now I can say I witnessed it everyday by the pool. (dry heave) I even saw one woman who had laid out in the sun, complain that she had lines between her rolls that didn't tan. (should've been covered then!)
  6. Women strolling down the Strip in super high heels, barely there dresses, and complaining how their feet hurt.  Um, use your brain, get some tennies dumb ass!
Overall, we had lots of fun.  We went to the Ethel M Chocolate factory and cactus garden, Hoover Dam, Lied Children's Discovery museum, GameWorks-good food and lots of games!, hung out by the pool most afternoons, wandered through some of the hotels, ate at Hash House A-Go-Go-yummmyyyyyyyyyy, got unknowingly chased then stopped by security at one of the downtown hotels because the kids were in tow and they don't allow kids in the casino-we were only there for the 0.99 cent shrimp cocktail!

We took pictures in front of the Welcome to Las Vegas sign, practically coughed and wheezed our way through the Excalibur on our way to the Luxor, wandered the Cosmopolitan-very sparkly and had some great sculptures, went to Hard Rock hotel ate at Mr. Lucky's (great steak & shrimp special for $7.77 not listed on menu), took lots of pictures of all the music memorabilia, updated our gambling cards-but didn't gamble.  All in all, it was tons of fun and I can't wait to go back-without the kiddos.

Jul 28, 2011

MD Nonsense

I got a call from an office today that ended in a disgruntling conversation.  The Medical Assistant calls me stating the doctor wants to discuss a denial we issued on a patient.  I look up the information and lo and behold, they want a narcolepsy drug that doesn't treat ADHD for a patient with ADHD.  I don't have any idea why on earth the MD would want this drug, it doesn't make sense, and is not FDA approved for this indication.  We of course, denied it for off-label use.  If the FDA doesn't approve it, we don't either.

The MD calls back ticked off and they want to speak with the reivewer, who is (hands flying to both cheeks in shock) NOT A Medical Doctor but a Doctor of Pharmacy!!!!!!  What is the world coming to????  Apparently FunnyMan's doctorate is not good enough for Mr. MD.  Oh, well!  His pharmacological knowledge eclipses yours jackass, deal with it! 

I asked FunnyMan if he queried the doctor as to why a PharmD isn't as good as an MD.  His reply: Delusions of grandeur...why bother.

My impression: good call, good call.

Feeling Naked

Yes, it is true, I am feeling naked today.  I don't know what to do.  There is nothing for me to do until I go home at the end of my day.  How am I naked at work?  I'm not entirely naked, I am dressed properly, wearing heels, and in looking at me, one would not be able to tell unless they focused on my hands. 

I removed my wedding ring and my favorite sapphire ring that I wear daily, before I got in the shower last night.  I looked at my rings on the counter this morning while I was getting ready, but they did not end up on my fingers.  Therefore, I am naked.  I don't like being naked, it actually makes me acutely aware of their absence.  I am also aware of how obsessively I touch the bottom of my wedding ring throughout the day. 

Today, I feel my finger, not my ring.  I feel guilty.  I know I didn't do anything wrong, it was 5:00 this morning, my brain was still in a patchy fog at that time, and I didn't put them back on.  Oddly I feel like I'm misrepresenting my marital status today as the result of a mistake.

Weird, I know.

Jul 22, 2011

Love/Hate fabric stores

When it comes to sewing, I am pretty new to it.  Still learning the difference between certain fabrics so need some guidance as I go along.  Of late, I have a particular urgency when it comes to obtaining fabric that I want.  We're taking a trip to GamblingVille and I want to make a few dresses for my trip.  I got impulsive, and here's what happened:

I went to a nearby fabric store and asked an employee where to find the various types of jersey fabric (there are several so wasn't sure where to look)  I was directed to matte jersey only and was told that was the only one she was aware of.  There was only solid colors and it was too see-through for my taste.  I asked another person, who it turns out was brand-spankin' new, and knew less than I did about different fabrics.  So she asks the same lady I already talked to who of course, gave her the same answer.  Being that my trip is looming, I want fabric, I have dresses on my agenda.  So, since I wasted my whole lunch hour, I came back to work and promptly browsed, ordered my fabric, and discovered it takes up to 48 hours to ship, and 4-5 days to arrive.  Crap.  I could have driven a bit further to another fabric store the next day, gotten what I wanted, and I could've been able to begin my dresses this week.  But, I got good deals so crossed my fingers that my fabric would come fairly quickly.  Had I just gone to that store, I wouldn't be griping right now.  Grrrrrrrr.....

Yesterday, as I anxiously checked my email for a shipping confirmation, I discovered that one of my fabrics was out of stock and I had 24 hours to let them know if I wanted to substitute another or leave it off.  I called STAT, waited on hold for a good 15 minutes to have a 3 minute conversation which ended with the rep telling me my fabric would ship out Friday (today).  I told her that I was really needing it ASAP but that did me no good, she wasn't handling it personally. 

So, here I am anxiously awaiting my package that likely won't get here until next Thursday, which leaves me 3 days (during/after work only) to make 3 dresses, and pack for 3 people.  Maybe I will dial-down my ambition and just do what I can.  Imagine that!  We'll see what happens.

Jul 18, 2011

Weekend Whining/Grumbling

We hosted a birthday party this weekend for one of our girls and inevitably some drama took place.  I have one sibling-in-law that cannot mind their manners and makes scenes over stupid crap.  True to form, a mini-scene was performed in the dining room for everyone to see, and the climax occurred in the middle of the street for all the neighbors to see. 

(sigh, shaking head) 

It's a child's birthday party, can't you just mind your manners you insensitive yet overly sensitive, self-absorbed, negativity driven, overly critical, big-mouth person?  A simple request made of every parent who was there is not a stab at you or your children.  We love your kids, we always have and will.  It wasn't specific to you, but your world doesn't work like that I guess.  All I can say is thank God you left and decided not to return, you spared us and the rest of the guests your needless, childish, reactionary bullshit.

Stupid ass. (a quote from my mother-in-law)

Jul 13, 2011

Can I inflict bodily injury?

Snort is making me crazy!  I am "rescuing" him by fixing errors, making things right, and I'm done.  I snapped at him earlier because he intercepted a request I was personally handling, didn't do it right, and I could not find what I was looking for.  This request had a special process I needed to follow and when I asked if anyone had seen it, nobody knew about one but he said he saw something like that earlier.  I brought it up on my screen and asked if that was the one and he said yes. 

Two Words: So Done/Choke Him/Don't Touch!!!!!!!

(sigh of relief now that I've vented)

Jul 8, 2011

Don't you dare call me. . . . . . . .. . .

Any of the following names when we are on the phone discussing a patient or if you are the patient and I'm answering your questions.

Hon-Sorry, not your hon.

Honey-unless you are my mom, but she works in finance so doesn't fit the above description

Sweetie-unless you're one of my parents, neither of whom work in health care

Sugar-don't even dare

Babe or Baby-unless you're Mr.CooksALot

Love(y)-prepare to forfeit your ear, I will rip it off over the phone if you call me this!

Missy-I will inflict bodily injury over the phone if you use this

Child-I don't know you, I am not your child!

I recently was speaking with a patient about her prior authorization and I almost completely lost it as she repeatedly called me Honey and Hon.  I let it slide when the voice (or DOB if a patient) indicates someone who is much older than I am.  This was a 23 year-old calling me this.  I about told her off, but didn't as I need my paycheck.  It is actually exponentially worse when these terms of endearment come from a man, unless as previously stated, he is of advanced age and doesn't sound creepy or shady.  I will ask them to stop calling me by those terms and cross my fingers they don't get off subject in our conversation.  This happens rarely, as I can be a chicken and try to keep my professionalism to a maximum at all times.  It has however, happened. 

For the record, to the creepy, sleazy sounding pharmacy owner in New Jersey: NO, I WILL NOT take a trip to your state soon, you will not, I repeat will not call me babydoll, and I WILL NOT be calling you to show me around.  EVER.  The fact that you told me I sound very beautiful and like an amazingly interesting woman didn't help either.  You really freaked me out and I am now thoroughly weirded out.  Thanks a lot.

Jul 5, 2011

Chewing while on the phone

Happy belated 4th of July!  I hope all enjoyed the 3-day weekend.  I did, but it went entirely too fast!  Late nights watching fireworks don't make for wonderful (let alone easy) early mornings where one must wake up to be at work by 6am or earlier.
On to business: my first call of the day was a doctor who wanted to speak with one of the reviewers on an acne medication denial.  I answered the phone and while I'm stating my name, department, then ask how I can help, all I can hear is chewing and smacking loud and clear in my ear.  Dr. then states his name and doesn't seem to be able to get through a sentence without punctuating pauses with smacking and/or chewing followed by the occasional gulping of a mystery drink.  Now, I know a lot of us can be pressed for time and need to try to get a bite in when we can, but does it have to happen while you're talking to me? 

As I have stated in previous posts, I have a very vivid imagination. While I hear these gross sounds coming from his mouth, my imagination is kicked into gear with all sorts of unsavory images.  This morning, I imagined pints of spit flowing from his chomping jaws as he chewed and smacked away on what I imagine to be either peanut butter right of a spoon or a giant sandwich oozing condiments.  Bluto from the Popeye cartoons came to mind as well although this MD didn't sound like him at all.  I also imagined the gulping was not of water, but a giant mug of soda or beer.  Why?  I don't know, but the sounds fueled my imagination and that's what I came up with.  Supremely disgusting, I know.  I did do a couple impressions as I told co-workers about the experience...and then I got grossed out all over again.  Blech.

(tongue sticking out of mouth in disgust)

This leads me to the general question: Why would someone do this while on the phone?  How does it not occur to someone that this is supremely rude and could render someone nauseated?  I must admit later on this morning, I got caught with a bite of granola bar in my mouth and had to answer my phone.  I have the decency to at least do my very best to hide the fact I'm talking with food in my mouth and sound like my normal PA Honeybee self.  (Patting myself of the back) Ha! Ha!

Jul 1, 2011

You want what? Ummmmm......NO

I got a call today from Customer Service on the other side of the wall from me, and they had a patient on the line asking if we could issue an emergency supply of Expensiva, a costly injectible medication for arthritis, psoriasis, Crohn's Disease.  I asked if we had received a Prior Authorization request and she stated that the MD office is closed for the holiday and won't be in until Tuesday so has not submitted it yet.  The patient is pleading that we give them an emergency supply, there is a major flare occurring, they are bleeding, and in much pain.  Based on the diagnosis I knew this was a lost cause, but, being the thorough person I am, I asked RedBull if we could accommodate the patient. 

Here's how that went:

RedBull: have they had it before?

Honeybee: According to our records, nope.

RedBull: Was there previously a grandfathered PA even?

Honeybee: nope

RedBull: So, they want us to issue an emergency supply for a new start of Expensiva which costs thousands of dollars, you cannot break the box, and must fill the whole kit for a non-life-threatening diagnosis?

Honeybee: That's what it sounds like to me unless they got it under another insurance coverage which explains why we don't have claims history.

RedBull: That's a possibility. The emergency supply is not gonna happen.

Honeybee: that's what I thought but I just had to make it "official" by checking with you. My inclination is to recommend some Polysporin and bandages for the bleeding & to have them call the MD on call to see if they could do some oral steroids to help get the inflammation down & stop the bleeding, but that's just me.  Steroids will kick in fast, Expensiva needs to build up in your system, it isn't going to provide instant relief for anyone.

RedBull: good call, you need a significant raise

Callous and heartless as our exchange seems, this is reality in PA Land.  If you haven't begun therapy on a drug in the recent past, we're not going to issue an emergency supply (unless we're talking a drug for a life-threatening condition) without a Prior Authorization request.  Sorry!

Jun 28, 2011

Out of the mouths of kids

I post my monthly schedule on the fridge so my family knows what shifts I work at any given time during the month.  SoftballGirl looked at the schedule and said, "Mommy, I don't like Snort!"  I asked her why, as she hasn't met him before.  "He gets the good shift, you have to leave before we wake up, and it isn't fair!"   Of course, Mousie hears this and chimes in too, "I don't like him either, he's mean!"  I just smiled and told them that since I work early, that means I'm off early, so we get to play Mario Cart, ride bikes, go places, or play games together before dinnertime and we don't get that opportunity if I work the shift that primarily is Snort's.  I also reassured them, that once school starts again, I will be on a rotating schedule so I get to work that shift and take them to school.

I think that means my kids love me and miss me in the mornings. 

Jun 27, 2011

I'm dreading this day (if it comes)

Sometime in the fairly near future, three people from a health plan I deal with will be coming to visit so I can train them on a process I do for them daily so they can take it over. (YAY to taking it over!  I hate this task)   I am however dreading meeting one of the three people because this person is so very oblivious to so much! 

I become rather irritated as a result of some email exchanges where apparently the brain is elsewhere in the universe while the hands type amazingly stupid statements or questions.  Sometimes I am accused of being a liar in a roundabout way.  The word itself doesn't get used, thank God, because a funeral would need to be planned for this person because I will not take that crap from anyone!  As it is, I feel like I may need a medicinal intervention as prophylaxis so I don't flip out during conversations with this person and inadvertently unleash my pent up frustrations, getting myself in trouble.

This trip may not occur (I hope, I hope, I hope!) and I may be spared direct contact after all, or not.  I am a very professional person, but this individual may negate this quality in me, or, I may excel and never let on how much stress, anger, and desire to bash the empty cranium against the wall I have felt up to that point.

My reaction to the email communication with this person has continually entertained my co-workers who just laugh when I vent my frustration to them. (I'm a talker when I'm ticked off)  Maybe there will jsut be more fodder for amusement, I don't know, but, I'm dreading this training session more than I can express.

Jun 23, 2011

Descriptions of symptoms

I love it when I get a Prior Authorization with detailed information.  It is of course helpful when trying to determine whether authorization for whatever is being requested is justified.  I just did one where the patient is experiencing menstrual blood clots the size of golf balls.  YIKES!  and thank you for that descriptive information, I now have vivid mental images floating around in my head of giant blood clots being hit with a golf club on a pristinely green golf course. :0P

Jun 22, 2011

Things that drive me nuts

I was catching up on some local news via my beloved Yahoo! homepage this morning when I found an article about 4 idiots who decided to go rafting without life jackets, they overturned, and were clinging to a tree in hopes they would not drown.  Some bystanders had to call EMS to rescue them, they were all rescued, and walked off unharmed.  Here's where I want to scream because anyone with a brain in their head would realize the following:
  1. We had some unusually large amounts of snowfall in the mountains this winter 
  2. now the snow is melting, feeding the rivers 
  3. melting snow is still cold, therefore, the river is colder=more deadly
  4. rafting on an unusually swollen, exponentially swifter river may not be a good idea=bad idea, likely deadly
  5. we have no life jackets=bad idea!!!!!!!
The stupidity of people never ceases to amaze me.  Now, these idiots will (likely) be telling their story to family, friends, etc. and still may not realize just how lucky they are to be alive.  Or maybe they will.  In any case, it pissed me off.

Jun 20, 2011

Vacation Summary

Today is my first day back to work after my vacation-or I guess it was a staycation as I didn't travel anywhere out of town.  My tests came back as normal, with no indication of cancer or a cyst.  Yay!  Here are the things I did while away from the madness of the cubicle jungle:

Went to a minor league baseball game: the nieces and nephews irritated the people in front of us from start to finish.  How you ask?  They cheered.  That's it.  My thought was this, "if you are attending a baseball game, people yell, people cheer, it gets loud, this is to be expected.  We are not in a library, we're at an outdoor baseball game.  If you don't like my nieces, nephews, and my kids yelling move to other seats.

Picked raspberries every morning in my backyard: yummy

Stayed up late watching interesting shows like River Monsters, Prophets of Doom, and various movies such as: Harry Potter and the Deathly Hallows, High Fidelity, and Letters to Juliet.

Slept in until (gasp) 7:30ish daily, sometimes 8am!: not usually a frequent occurrence, I'm usually up 2 hours before that.  I loved it!

Made two batches of limoncello: lots of lemon peeling but our efforts will pay off.  MrCooksALot did one batch that steeps for 8 days, and my batch takes 40 days.  I will be happy to report the outcome after it steeps.  The countdown is at 5 days and 38 days to go.

Made strawberry lemonade: If you have 18 lemons that have been liberated of their yellow peel, you have lots of lemons to use, so what better use than lemonade?  I made just under a gallon of fresh squeezed lemonade and added chopped strawberries to it.  The kids went nuts over it on Father's Day.  Luckily, I had enough presence of mind to hide the second half gallon jar so it wasn't gone in less than 10 minutes.

Helped Mr.CooksALot make smoked salmon: it came out a bit salty, but the slab of salmon we had was on the thinner side.  It was sooooooo good with eggs and Crystal hot sauce!  We also used it to fill portabella mushroom caps along with onions, celery, garlic, breadcrumbs, and manchego cheese.  YUM!!!!

Finally went to the Farmer's Market:  we bought peaches, cucumbers, 8lbs of oranges, locally made cheese, Thai basil, baby bok choy, squash, celery, and decided that organic eggs were not for us since a dozen costs about $5 and that's absurd when I can get 24 eggs at Costco for about half that amount.  I have been wanting to go to Farmer's Market for years but we just haven't been able to make it.  Now that we've gone, we're hooked and will be back weekly if we can swing it.

Made Cinnamon Rolls and Cherry Cobbler: double yum!

I did finish my knitting project but didn't touch the pajamas so I will work on them little by little this week.  I must say, I really had a nice week away from work.  I didn't want to come back & if it wasn't for the fact that I get a paycheck, I would have stayed home.

Vacation from PA Land

I am taking a week off; once I step out the door this afternoon, I am on vacation!  I get to be home with the hubby and kids now that they're out of school and I am looking forward to it.  But, Monday is my one cloud in this vacation.  I have an appointment for a diagnostic test that has me a little worried, but I'm trying to stay optimistic.  My thoughts are bouncing back and forth from optimism to worry.   Cancer is scary. . . . . but it might not be cancer, it could be a cyst that will be aspirated!  Within my family at present, I have two people diagnosed with cancer within the last year, so I am fervently hoping I am not number three. 

(sigh) If it is what I'm hoping it isn't, at least we can begin treatment to prevent disease progression.

On a brighter note, I will be able to get some stuff done, maybe attend a baseball game with the family, get in some much needed cooking, knitting, sewing done.  Poor SoftballGirl has been waiting a month for me to finish her summer pajamas because I got caught up in my new addiction: loom knitting.  I'll be able to devote more time to getting some exercise in (theoretically anyway), get reaquainted with my Bowflex, and possibly start on my half marathon training.  I'm talking about walking, not running. (at first)

Jun 10, 2011

Questions-A Rant

Where does the sense of entitlement come from with some Medicaid patients?  If you are indigent, out of work, down on your luck, I understand.  Times are tough, jobs are scarce, money is tight, people need help.  I get it, really.  If you appreciate what you have, and don't abuse what you are given, great.  This taxpayer appreciates your appreciation for what you have.  However, it is the ones who don't try too hard to get a job, are content to be lazy, and don't realize how fortunate they are to live in a country that has Medicaid programs that seem to take medical care for granted. They are here, instead of a third-world country, they are blessed.  (I am talking about all people, not only immigrants) 

I never cease to be appalled when I speak with these patients.  I do my very best to be informative, helping them understand the process for Prior Authorizations, but all they seem to hear is this: YOU CANNOT HAVE YOUR MEDS, I KNOW BETTER THAN YOUR MD DOES.  These words never, never, ever come out of my mouth. 

I  have been threatened with lawsuits countless times and I never take it seriously.  You see, they can threaten me all they want, the bottom line is this: we are not refusing you all medication to treat your condition, only a certain one which requires additional information on previous meds tried. (this statement does come out of my mouth)  Yes, cost is an issue.  We cover many drugs that have been used for years successfully, are generic, lower cost, and we just need to know if you tried one, whether it helped or not.  Just because a drug is new on the market, is Brand only, and is expensive doesn't mean it will work for you.  It only means just what the description states.  Why not try a drug that has been around for years and has worked on thousands of people?  To me, this is good prescribing sense however, drug reps are pimping medication to every MD in the U.S. so that has an influence in varying degrees depending on the MD.

If your MD doesn't want to submit a PA, fine, have them change the medication.  I CANNOT MAKE YOUR MD SUBMIT A PA!!!!  If you want them to do so, please bug them-incessantly if they are not receptive.

Final Statement: Treating a patient's chronic condition is usually a process of trial and error. Period.  There are very few "Cookie Cutter" treatments available.

Jun 8, 2011

Do Your Job yourself!

Snort just looked over at me and said, "Get this, we got an (insanely expensive antibiotic) request and the MD office wrote on the form that we need to contact the patient's case manager for the Culture and Sensitivity Report which outlines what medications the bacteria is susceptible to.  Um, that is the provider's job, not ours.  If asking for a Prior Authorization, you must provide the documentation required! 

I don't care who has it, get it, and fax it along with your request so we can determine whether this drug is unquestionably appropriate, or if other cheaper drugs would treat the patient's infection.  I don't want to hear that soft tissue infections cannot be cultured, I know that is a line of BS and you are wasting our time!

On an unrelated note, don't call me to ask if I will call the pharmacy, you could have called them yourself.  But instead of calling them, you called me, to call them.  Does this sound productive?  I didn't think so.

Jun 7, 2011

Things to Ponder

I recently got an email that asked some good questions about random things regarding terminology for things/people.  Here are a couple examples from the email and I added some of my own:

If people from Poland are called Poles, why aren't people from Holland called Holes? 
Why are people who ride bikes called cyclists/bicyclists but those who race cars are not racists? 
The plural for mouse is mice but the plural for house isn't hice, it's houses, so why can't we say mouses?
Then, there is moose and goose.  They aren't pluralized the same either, what gives?
Underwear, why is the term a pair when it is one item? 
I think jeans/shorts are a pair due to the existence of legs, but I'm not sure. 

Who came up with these inconsistencies anyway?  I demand to know. Now!  Hello?!  Bueller, Bueller, Bueller?

**This has been a public service of PA Honeybee on gin and Fanta Toronja that lost its fizz** (NO, I'm not working today, so put your mind at ease.  No drinking on the job for me)

Jun 2, 2011

Um, what?

I just received a PA request for budesonide respules for nebulization for an adult patient.  This is an asthma medication that is usually reserved for pediatric patients who cannot use an inhaler on their own, however, this office wants it for a runny nose.  Across the top of the form in large print is the following message: Please expedite, patient not expected to live much longer.  So, he is on his deathbed but must not have a runny nose...(?)  This is an asthma medication, what exactly are they trying to accomplish?  I had CatWoman look at it and she was a bit confused as well.  So, we denied it due to the need for a more logical rationale as it makes no sense on multiple levels. 

I feel bad that this man hasn't had a long life at all (in his 20's), but, this MD office needs to make sensible statements if they want us to approve a non-urgent medication for a man on his deathbed.  Right?


As of Tuesday, I feel miserable.  It all started in the middle of Pirates of the Carribbean on Stranger Tides.  I was enjoying the movie next to Mr.CooksALot when it nose began to run.  My throat had been scratchy the previous few days and that was going away apparently so my nose and sinuses could torture me.  So, I have been blowing my nose, thereby inducing a lovely red glow on my nostrils,  dabbing at my ever watering eyes which periodically burn and ache, and enduring throbbing sinuses since Tuesday night.  This nonsense is wearing me out! 

My trusty cetirizine and hydroxyzine are not rescuing me, the allergens are too powerful.  Worst of all, I can hardly taste food and I LOVE FOOD, it isn't enjoyable unless you can taste it!  I did try to see if eating jalapeno bread would help but alas, it did not.  All I got out of it was a slight burn in my mouth-but I couldn't taste the hot jalapeno goodness.  The only thing I have been able to taste today is vanilla yogurt and 2 spoonfuls of peanut butter at 5:18am this morning.  This is very disappointing.  I may have to seek out some Pho later to help my plight.  I won't hold my breath that I'll be able to taste it either. :0(

Jun 1, 2011

A Rant on our Server/Tips

I just wanted to take this time to give my opinion as a hungry, paying customer.  When I go out to eat with Mr.CooksALot, I'd like to have a relatively non-irritating experience free of odd mannerisms, horrific smelling perfume/cologne, and a feeling of being rushed.  The preceding information may not come as a surprise to you, however, when we went out to lunch yesterday, our server was very abrupt, she was wearing a vomitous smelling perfume or lotion, and she really seemed a bit "off". 

Upon asking what we'd like to drink, we both asnwered we wanted to start with water.  Mr.CooksALot asked me if I wanted an appetizer while she was still standing there and as soon as I said, "um", she took off like a shot before I even got out another word.  I looked across teh table and was confused.  It did turn out that we didn't want an appetizer after all, but it was the principle of the action that bugged me.  She came back with our waters, asking if we were ready to order.  We told her what we wanted and she walked away.  Mr.CooksALot pointed out the sweet potato fries with Szechuan chili spiked ketchup which sounded oh so delicious to me, so he walked over to the computer she was punching our order into and asked if she would add that to our order.  You would swear by her reaction that he jumped out of nowhere and tried to grab her like a kidnapper.  She was even turned slightly toward him so he had to have been in her peripheral vision.

Every time she walked past or up to our table, I got a whiff of her nasty, vomitous scented perfume or whatever she was wearing and I tried to lean away from her so as not to show my distaste in her choice of scents. (I CANNOT hide my impressions/feelings, my face tells on me all the time)  She also smiled a lot (good) with her eyes wide open making her look a bit deranged (bad!!!).

Another server brought out our food and literally, right as she walked away, our server came up to our table asking if everything tasted good.  I seriously wanted to ask her if she had any observation skills, because our forks were still wrapped up in our napkins, WE   DON'T   KNOW  YET!!!!!!!!  Instead, we told her it looked good and as she walked away, Mr.CooksALot and I just looked at each other confused.

Once we had finished, she came by asking if we wanted to order dessert.  I told her maybe and she mentioned there were some "lighter options" toward the bottom of the menu.  As I am trying to be conscious of what I put in my mouth, and how many calories it contains, I took a look at the menu and to my disgust the lowest calorie Mini Delight listed was 840 calories-what???????  I looked at these choices and wondered, what is going into these MIni Delights to make them such huge calorie bombs?  I showed Mr.CooksALot and he was shocked as well.

For us, going out to eat together is a big deal, it doesn't happen too often as we usually cook at home.  I know your birthday is a time to splurge, (yes, it was my birthday Monday)but when the menu item doesn't look like it's worth it, I say forget it and move on.  We went to see Pirates of the Carribbean on Stranger Tides afterwards, and I got my dessert.  Reese's Pieces.  Yum!

May 31, 2011

A Bit of Irony

I began work this morning at 6am.  Every Monday morning, there is catch-up work to be done since we are closed on weekends but we continue to receive handfuls of Prior Auth requests from a few offices, Urgent Care, and ER departments.  Of course this week, we were closed Memorial Day, so there was 3 days of work to do when I came in this morning.  I was working away on Saturday's requests when I came across an URGENT antibiotic request with no patient information, the rest of the form filled out in detail, and a lab report with just the patient's name which upon searching I discovered about 30 patient records, but without a DOB-sorry, I cannot begin to assume who this was for!  If it was sooooo URGENT, why not give me all the patient's information!!!!??????  Just asking.

May 27, 2011

Birthday Wishlist

Just in case anyone is wondering, the following list has been compiled to answer the question I hear yearly (I hope): What would you like for your birthday?

  1. An amazingly indulgent, rich, joy-inducing cake or cupcakes
  2. A gift certificate for a pedicure-really!
  3. YARN!!!!!!!! To continue my knitting education by trying my hand at hats next
  4. Time to finish SoftballGirl's pajamas before summer gets here
  5. Bookshelves to house our growing collection of books and college textbooks
  6. A magic cancer-curing pill for all affected by the disease in its many forms
On a less than serious note, here is my "Fantasy Wishlist" for my less than realistic wishes
  1. A vacation house in Monterey
  2. An Audi A6 3.0
  3. The winning Lottery ticket for the next Mega Million jackpot
  4. My very own beautiful Friesian-I have always wanted one (it's a horse)
  5. An Electra Bike; Please see my previous post for my faves
  6. Anonymous benefactor who funds my sewing, knitting, home decorating/outfitting, and horse interests. . . . .or see #3
  7. Mediterranean Vacation on a cruiseship

May 25, 2011

New Obsession

We had a yard sale three weeks ago, and one of my neighbors cruised by on her Rat Pink cruiser bike (Remember Rat Fink? this was the girl version).  I am not a pink person, but it was a really cool looking bike.  I also observed a few other women on their cruiser bikes that day as they checked out my stuff.  Seeing the different cruiser bikes planted a seed in my mind and now, I really, really, really, want one of my very own.  I have a bike, it's a nice Trek mountain bike that I got for my 15th birthday, but it has some things that need to be done to it and I cannot ride it until it is fixed.  So I'm thinking we spiff it up, sell it, and I can get my cruiser bike!!!!! maybe?

I have done some research to determine what I would want in a bike when (if) I get one.  As is Murphy's Law, of course the brand of bicycle I want is on the more expensive end of the price range.  I think I am completely, utterly, unabashedly in love with Electra cruiser bicycles!!!!!  I cannot however narrow down which one I want.  They are all so beautiful and if/when the opportunity arises, I know I'm going to agonize over which one is perfect for me. 
Take a look for yourself:
Some of my faves:

Electra Butterfly in Yellow
Electra Blanc et Noir
Electra Orbit in Buttermilk
Electra Peacock
Electra Cherie 7i Damen, schwarz
Electra Cherie

May 24, 2011

FDA, what do they know?

FunnyMan just had a conversation with an MD regarding Zyprexa, (an atypical antipsychotic) denial.  He brought the interesting nature of his conversation to my attention. 

Here are his edited notes:
MD does not care what FDA says (in regards to being told of the FDA indicated age).  Told her to appeal (Expedited, as she deemed the situation urgent).  No changes at this time. 
Of Note: The abundant use of the word "bull****" was present and phrases such as "I couldn't care what the FDA says", "I know what works", "I am tired of spending 4 hours everyday on Prior Authorization bull****" (to which I apologized for her frustration and again reinforced the Appeals avenue) and other expressive statements were issued from the provider during the conversation.  The provider also issued the usual statement that the member will be hospitalized if Zyprexa was not approved.

May 23, 2011

Waxing Mishap = Lesson Learned

Two weeks ago, I thought it would be a great idea to start waxing my underarms myself  instead of shaving them (which I hate!)  I went to Target on my lunch hour, picked out some wax strips, then patiently waited while the hair grew to the right length to wax. (gross I know)  Saturday, I got out of the shower and decided it was *time* so I followed the directions, applied the strip to my underarm, and yanked.  Let me just say, "OOOOOOWWWWWWWWWWWW" and not all the hair came off.  I did however get some hair, skin, and drew blood.  Great....and OUCH!  Determined person that I am, I kept reapplying the strip to the unwaxed areas in an attempt to be successful. 

I even enlisted the help of Mr.CooksALot who took one look at me, winced, agreed to pull it off me, and counted to three before he yanked.  This only worked partially.  He then declared I needed to forget the wax, get my razor, and do it the painless way.  I stood there with one slightly fuzzy/waxed/bleeding armpit and contemplated having to shave off what was left of that one and do the other unscathed one fully.  I shaved off what was left and decided my lesson has been learned.  I WILL NEVER DO THIS AGAIN!  I may however try to see how the results are and get it done professionally.  Hopefully, my esthetician fares much better than I did.  If not, I guess I'm stuck shaving.  Crap.

May 20, 2011

5 Dangers of Excess Sugar By Catherine Guthrie, Experience Life

This is a reminder to myself as well as to others (if you're out there) that sugar is delicious but comsumption comes with a cost.  In light of my recent loss of control, I need to be more mindful of this information.

As kids, we were taught that too much sugar would rot our teeth, but today we know that the ramifications of a lifelong sugar splurge are scarier than a finger-wagging dentist. Yes, sugar can cause cavities, but of much greater concern is the sweet stuff’s link to bodywide inflammation.
Sugar can contribute to cellular inflammation, which is like a continuing series of paper cuts that compromise cell function. Deep inside the body, these microscopic wounds fester below the pain threshold. Because many of us don’t see or feel the damage, there is little incentive to cut back on the inflammatory diet that is causing this constant cellular damage, so the party continues.
That is, until the body blows a gasket. Left unchecked, inflammation can unleash dozens of different diseases.
Here are just a few of the malfunctions related to a lifetime of sweet indulgence.
Heart Disease
Results of a 2010 study published in the Journal of the American Medical Association showed that people who got at least 25 percent of their daily calories from added sugars were 3.1 times more likely to have low levels of HDL (good) cholesterol than people who got less than 5 percent of their calories from sweets. People on the high end of the sugar spectrum were also more likely to have dangerously high levels of blood fats called triglycerides.

Scientists have long known that cancer cells love glucose. A common scan used to detect cancer in the body, called a PET, starts with a person downing a sugary solution. After the sugar is absorbed into the bloodstream, the scan identifies possible malignancies by highlighting areas that gobble up the most sugar. “Data supports the general hypothesis that cancer cells are addicted to glucose and that, by restricting glucose metabolism, one can stop their growth,” says Don Ayer, PhD, a cancer researcher at the University of Utah and the Huntsman Cancer Institute in Salt Lake City.

Type 2 diabetes, a deadly disease that can cause blindness and nerve damage, and can lead to amputations of digits and limbs, is perhaps the most direct and serious repercussion of excess sugar in the diet. In the United States, nearly 24 million people have been diagnosed with diabetes and another 57 million suffer from insulin resistance or prediabetes. Some experts estimate that by 2050 one in three Americans will have the disease.

In the early stages of type 2 diabetes, cells stop responding to insulin. Unable to enter the cells, glucose builds up in the blood, triggering inflammatory health conditions. Left untreated, insulin resistance often escalates into type 2 diabetes. But long before that diagnosis, the inflammation associated with prediabetes (sometimes called metabolic syndrome) wreaks havoc on the body, setting the stage for heart disease and cancer, among other serious problems.
Yeast is a natural inhabitant of the gut. Healthy bacteria help keep yeast levels in check. But when antibiotics, illness or chronic stress kill off healthy bacteria, yeast can run amok. Sugar compounds the problem by feeding yeast growth. “Sugar enables yeast to go from a budding stage to a tissue invasion stage,” says Carolyn Dean, MD. Yeast overgrowth can cause problems ranging from yeast and fungal infections to rashes, thrush and leaky gut syndrome.

Immune System Snafus
Because a diet laden with sugar creates body-wide biochemical stress and inflammation, it can overstress and thereby weaken the immune system in a variety of ways. One way, as noted before, is by triggering leaky gut syndrome, which leads to undigested food molecules getting into the bloodstream. When that happens, the immune system has to finish the digestive process, an overwhelming and distracting effort. “In short, our defense forces get exhausted by the sugar,” says Teitelbaum, “so that when real trouble comes down the pike, the immune system can’t respond.” A leaky gut can also underlie disorders characterized by an overactive immune system, such as rheumatoid arthritis, lupus and psoriasis.

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