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27 April 2013
My father joined Kaiser in 1953, when I was ten years old. I have been a member of Kaiser ever since -- 60 years! Except for a brief period when I was working for Women's Health and also had Health Net coverage through that job, which allowed me to see one of the doctors in our office for my primary care physician, I have known nothing but Kaiser for my personal health care, though I have certainly worked in enough medical offices to have some sort of idea about how "the other side" works. I still think Kaiser wrote the book on managed care!
In my 60 years with Kaiser, I have loved it and hated it. I loved that each of our children only cost $60. That was the price in the 1960s for total maternity care, from diagnosis thru birth. They were bargain babies, and worth every penny.
I also hated Kaiser in those years because when I would call the advice nurse with a question or to make an appointment it was not uncommon to spend 30 minutes on line waiting. Even though you have to go through message phone hell now, it is SO much better.
I loved the care the kids got from their pediatrician (and mourned the loss of my favorite doctor when he and his family moved to an island in Canada so his draft-age son could avoid going to Vietnam).
Here in Davis I have had no real complaints. My doctor is not a people person and she has no idea about anything about my personal life, seeming to zero in more on the nuts and bolts and lab numbers of my health, but that's really all I need. When I dislocated my shoulder in 2003 and required an ambulance ride to the hospital, though I know how expensive ambulances are, it was all covered under our Kaiser plan.
I am afraid that by the end of yesterday, I was hating Kaiser's bureaucracy again. Or maybe it was just that I was a bit grumpy having made 6 trips to San Rafael in 7 days (with 2 days off because one of those days I did two round trips in one day...and actually one of those days wasn't to San Rafael, but to San Francisco, which is roughly the same distance). Also seeing my mother nearly every day is on the one hand very nice to spend time with her, on the other hand so exhausting with all the forgetfulness and the repetitions. This morning at breakfast, for example, she asked me if Walt and I took the San Francisco Chronicle and then explained that she's been reading the Chronicle ever since she married my father in 1940 and in the next sentence said "Do you subscribe to a newspaper?" But she can't help it. She doesn't know she's doing it. But it sometimes gets exhausting.
Yesterday she had an appointment with the eye doctor at 2:00 and another at 2:15. They told me she would have drops put in to dilate her eyes at 2:00 and then the doctor would see her at 2:15. I also had typed up a letter for her primary care physician attaching a form she has to fill out for Covell Gardens. I figured that while my mother's eyes were dilating, I would drop that letter off at the desk in the doctor's office upstairs.
We got to Kaiser and the parking lot (a very teeny parking lot) was full, with a whole line of cars lined up hoping to find spots. Unfortunately, since you turn a blind corner into the parking lot, you don't know that until you've entered the facility, so we waited in a line until I could get out again. I found a spot on the street half a block from the office and put in enough quarters for 2 hours time, though my mother scoffed and said that was way too much money and that surely we would be finished in less time than that.
We went to the ophthalmology department and after about 10 minutes she was taken in for her first appointment, which turned out NOT to be for drops, but for a scan of her retina, with photos taken for the doctor to look at when he saw her.
We went back out into the waiting room and waited. And waited. And waited. It was about 2:45 when she was taken to the exam room for her 2:15 appointment. Paul, the doctor's assistant, apologized for the wait and said they had "an emergency" and that things were backed up. He put the drops in her eyes and said the doctor would be in shortly.
I knew they had to wait for the pupils to dilate, so I went upstairs to drop off the letter. Only you can't just drop off something, even though the doctor's office is just two doors from where I was standing and I could have snuck in there and stuck it on her desk. No, you have to deliver it to the Medical Secretaries' office, which is in another building, in another town. I begged and pleaded, saying this was just a duplicate of a form she had filled out a week before, but the clerk was adamant. If I handed it to her, she would just have to mail it to the Medical Secretaries' office instead of giving it to the doctor and that would delay it.
As it turned out my mother had another appointment later that afternoon in the complex where the secretaries' office was, so I figured I could kill 2 birds with one stone and deliver it at that time. But no, the appointment was for 6:30 and the office closed at 5. I sighed heavily and figured I would stop by on the way home to my mother's house and drop the damn form off.
I went back to the office and the doctor still hadn't arrived. We waited and waited and waited. Finally someone else came and took us to a different office to wait. By now I was getting worried that our parking meter would expire and I finally found Paul and asked if I had time to go plunk the meter and explained about my mother's cognitive mental impairment and that it was necessary for me to be in the room with the doctor because she wouldn't understand or remember anything the doctor told her. He said that I would have enough time.
So I put another hour in the meter and went back to wait with her. FINALLY the doctor arrived, explaining that they had a detached retina to deal with before he could see his other patients. We were there because at some point in the past her doctor (now retired) had diagnosed glaucoma and had prescribed drops for her eyes. Her primary care physician noted that she had not seen an eye doctor since 2009 and had not been taking her drops for a long time and felt it should be checked out. This doctor found nothing worrisome on her films or in examining her eye and said that she should have her eyes checked out each year, but he wouldn't bother about the eye drops.
So we were, as my mother predicted, there for essentially nothing. But we had spent more than 2 hours doing it.
I was so mentally exhausted by this point. But we stopped at the Kaiser facility in Terra Linda. The Medical Secretaries' office is located by the Emergency room, which has its own parking lot (and is in a different building from the doctors' offices), but the Emergency Room parking lot, since our last visit there, had had another building adding to it, essentially wiping out ALL the parking places, except for handicapped slots, so we had to go to the other building, 2 buildings away, up a steep hill, and park in the parking lot. All I was going to do was drop off the form, so I just left my purse in the car with my mother. Oh how could I have been so stupid!
I went down the elevator two stories, and along the labyrinth of corridors until I finally found the medical secretaries' office, but I couldn't just drop off the forms and my carefully typed letter to Dr. Caron. I had to fill out a form and when I submitted it, they required personal identification from ME to let them know that I was OK to send the form I was submitting to! Gotta love those HIPPA regulations! But of course my identification was in my car which was two buildings and three levels away. I have to say when she told me that I broke down in tears. It was the straw that broke the camel's back. The woman said that I could FAX the ID in, but they would not start the process of filling out this form until they had it. And it will take nearly 2 weeks to get it sent to me after they have my ID. This could have been done SO simply if I could just have dropped the damn form off in Dr. Caron's office!!! But then I suppose if 100 of her patients came with forms to be filled out that day, it might have been a problem... Sigh. It's terrible to understand from a medical office employee standpoint, but to have to deal with it on an emotional personal level!
We went back to my mother's house until time to go BACK to Kaiser at 6:30 for the second TB test in two weeks. Covell Gardens requires two TB tests and says that it is a state requirement, though Scott at Springfield had never heard that.
At her house, she returned to hostess mode and drove me insane. At one point I yawned and she suggested that I take a nap. She suggested that several times, in fact until I finally yelled at her that I DID NOT WANT TO TAKE A NAP. (After dinner we were watching TV and if my eyes drooped or if I leaned over to rest my back for a minute, she was telling me I should go to bed -- at 8 p.m. -- and that I should try the bed instead of the couch, because it would be more comfortable, even though I have told her 1,000 times that I can't sleep in a bed because of my back!)
She also cooked dinner for me. The woman who has told me a bazillion times that she has forgotten how to cook, that she wouldn't know what to do with a steak if she had one, that the only thing she eats is from green boxes (frozen dinners) apparently cooks for Ed when he comes to her house and seems to remember how to do it quite well. She had prepared food to cook for Ed the night before, but he showed up with Chinese food, so she had her preparations left over. We had pork chops, baked potato, fresh green beans, and rolls. From the woman who can barely, she says, remember how to boil water. But nothing is too good for St. Edward. (I will admit that she cooked the life out of the pork chop and it was so tough I literally could not cut it, so she hasn't retained all of her cooking skills, but the beans, potato and biscuits were quite good.)
At 6:30 we went for the TB test and I have to take her back on Monday to have it read. She said it was a shame I had to drive all the way down there just to have someone look at her arm and that she could just go herself, but I pointed out that she'd probably forget, and if she remembered she wouldn't know where to go and when she got there she wouldn't remember why she was there in the first place. She agreed, so I'm going down again on Monday...but that's IT. Her doctor has ordered a neuropsych evaluation to assess the level of her dementia, but since she is changing doctors and since Covell Gardens has a memory wing if they determine she is getting too bad, I'm just going to skip that part of it. I'm tired of all the doctoring...and I know my mother is tired of it! She has decided she isn't going to see any doctors or dentists ever again. I don't think I'm going to let her get away with that decision,but she is at least OK for the next year when time for her next tune-up.
PHOTO OF THE DAY
A bouquet of orchids from one
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