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. 

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.

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

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.

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)

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.

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.

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)

Just Had to Post this!

Please check this out  http://nottotallyrad.blogspot.com/2009/11/waking-up-is-hard-to-do.html

These are the singing anesthesiologists, they are a crack-up!

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?

Misery

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 began.....my 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(

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!