Monday, April 6, 2015

Paging Dr. Feelbad. PT. 1 (What's Behind the Green, Kapoor?)



"When the doctor said I had diabetes, I conjured images of languishing on a chaise lounge nibbling chocolates. I have no idea why I thought this." - Mary Tyler Moore

Hello Blogiteers!

Diabetes can be a real bitch.
No... I take that back.

Diabetes is the bitch.

Sure, my claws are sharp, but they might as well be made out of papier-mâché in defense against  the wellspring of pure evil that Diabetes can call to arms at a moment's whim. If I didn't know better, I'd say that this disease is seriously trying to kill me.

I know, I know... it sounds completely paranoid, but I'm starting to think that I might just be right.

Over the last few months, I've suffered a puzzlingly random escalation in my blood sugar numbers, an almost crippling bout of peripheral neuropathy, which in turn, has led to a painfully heightened skin sensitivity that makes accomplishing even the smallest of tasks exceedingly difficult at the best of times.

The best analogy I can think of to describe this sensation is that of a T-Rex with a bad sunburn trying to make a bed that's full of hyperactive kittens... while standing in a lava pit.

For those of you who are unaware what peripheral neuropathy entails, here's the rough definition:

"Peripheral neuropathy, is a result of damage to peripheral nerves, and often causes weakness, numbness and pain, usually in the hands and feet. It can also affect other areas of the body.

The pain associated with peripheral neuropathy is generally described as stabbing or burning. Often, there's tingling."

Ah, yes... tingling. That would be a definitive up-sweep in joy if that were only the sole symptom I was currently experiencing. For sake of clarity, imagine vengeful demons repeatedly stabbing you with red-hot knitting needles as you try to tie your shoes with your legs, arms and hands sheathed in fire, and you'll get a much clearer understanding of what I've been going through recently.

And yet... I'm still feeling fairly optimistic about this, the relatively new year of 2015. Sure, I could easily give in to my obvious discomfort, but I'm the Artbitch. I dispense pain, I don't suffer from it.

In fact, it's currently a quarter after midnight as I write this newest screed, and while it's true that the only reason I'm up this late is because my bed-sheets feel like barbed wire on my skin, I'd like to call attention to the fact that I'm taking this particularly sour batch of razor-lemons and making 100 proof hard lemonade out of them.

If I have to be up half the night, I might as well be productive, and despite the fact that I've had to fire two doctors for refusing to follow their sworn duty to the basic tenets of the Hippocratic Oath*, I'm still soldering on. Throw in all the medical marijuana recipes that I've received from friends wanting to help ease my pain, and I'm pretty sure that I could open my own cannabis-based bakery.

The wonders of modern science. It's so much more than just Velcro and Shrinky-Dinks.

[*Seriously. Avoid Dr. Jatin B. Daas of Arizona Primary Care like the freaking plague. He won't return messages, doesn't "believe" in prescribing medication that you've been taking for over three years, won't follow your pre-established protocol, has quite possibly the worst magazine selection that I've ever seen in a physician's waiting room, and as an added bonus: possesses (in my opinion) the bedside manner of Dr. Mengele at a B'ani B'rith pot-luck*. [*Allegedly.]

And while we're on the subject, I'd recommend that the office of Dr. Smita Kapoor at Internal Medicine Health Center at St. Joseph's is also best avoided as well. Taking care of, and listening to, their patients isn't seemingly something that interests them, so do yourself a favor and just visit a voodoo priestess instead.



That way you know they'll be some tasty bomb-ass chicken soup waiting for you in the end, and let's be honest here- who doesn't love themselves some tasty bomb-ass chicken soup?



Pasty-faced Vegans, that's who. More on her operation in a bit.]

Minus my ongoing pain issues, it's been relatively low-key here at the Lair of Snarkitude- the day gig framing art for galleries and their clients is humming along, my social life is fine, and I was tapped to write a small article for PHOENIX Magazine which should see publication sometime in the next few weeks, as well as being assigned two additional Q&A commentaries- overall, it's shaping up to be an interesting year, to say the very least.

What hasn't been interesting or fun has been the amazing amount of hoops I've had to jump through recently in regards to my medical care and the ongoing maintenance of my health, which as you may have already surmised- has been exceedingly problematic as of late.

Some context.

Being a diabetic is a lot of work- you're constantly micro-managing every bite you eat, endlessly testing your blood sugar, and let's face it, constantly whining about the travails of being a diabetic  is known to consume up more than it's fair share of energy as well.

You just can't win.

If all goes well, hopefully one dies of old age before this disease kills you in all sorts of interesting, yet terrifying, ways. Heart attack/strokes. Liver failure. Low blood sugar. Kidney failure. Retinal failure. Circulatory system failure leading to the amputation of fingers, toes, and even your legs.

Good times.

Let me tell you something from my unique point of view- if you have to pick a disease to be cursed with, get one that they write operas about. Granted, tuberculosis is always a solid choice, but I'm also highly partial to the route of wasting away via alcohol as well. Sure, it's tragic, but at least it's singable. In fact, I'm in the midst of writing one myself.

Working title: "Sweetblood, or hey- I'd love to have a Ding Dong, but... you know."
The dancing Snickers bar dream sequence by the way, will be the show stopper, hands down.

All creative diversions aside, the majority of my free time these days seems to be focused on battling my disease, and that, at times, can be just downright exhausting, both physically and mentally. I sometimes get panic attacks when I see a white lab coat, which to be honest. has really put a heckuva kink in those times when my GF Ashley and I like to play "naughty scientist and pizza delivery guy".

One of the other irritants of being a diabetic is trying to find a doctor that actually understands the complexities of Diabetes, and all that condition pertains to, as most GP's (general practitioners) don't have the background knowledge to make a viable difference in your health, and when it comes to dealing with specialists who do know, AKA: Endocrinologists, it's been my sad experience that they don't really earn the over-inflated fees that they charge.

Don't take this the wrong way, but if I'm paying $250.00 for ten minutes of someone's time, it at least better be with an Asian dominatrix wearing thigh-high boots who gives an amazing lap-dance while  letting me know that I've been a very bad boy and need to be punished.

What can I say... I'm a simple man who enjoys simple pleasures.

Fortunately, at one point I did have such a doctor- the aforementioned Dr. Smita Kapoor. I started seeing her several years ago after my previous physician started cracking jokes to my girlfriend about me "milking" my neuropathy pain for sympathy, rather than performing the job he was being paid an exorbitant amount to do.

Like all relationships, it was great in the beginning- my pain levels went way down, I was on top of my condition for once, and as an added bonus, she was easy on the eyes. Granted, that sounds incredibly sexist, but if you have to be poked, prodded, and examined constantly by a stranger, it might as well be an attractive one.

But all things eventually come to an end, whether we like it or not. I lost my medical coverage, which led to my not seeing her for over a year, mainly due to the cost of the office visits- this in turn, led to the failure of my health, resulting in my most recent and unwilling hospital stay, where I once again discovered that the ICU ward at John C. Lincoln has some dope-ass vanilla pudding.

Seriously. You have no idea how freaking good that stuff is. It's like creamed crack. On steroids.

So when I finally got back on my feet, I decided that it was time to bite the financial bullet and start getting back to seeing my doctor on a monthly basis as a way to wrest control of my life back from the fiery grip of Diabetes.

That was the plan, anyway.

Sadly, when I contacted my doctors office, I discovered that she was in the process of leaving the group practice, and any further details as to where she was going to wind up were not forthcoming.

Son. Of. A. Bitch.

Chagrined, I decided that since I couldn't do anything at that time, I'd just accept the physician who took on my now former doctor's patients- that being the aforementioned Dr. Jatin Daas. Going in, I wasn't worried, as there was a multi-year treatment history for him to reference, and being the eternal optimist that I am, I naively assumed that he would just follow the pre-established protocol.

One day, I have to really apologize to my gut for not listening to him like I should. I'm not sure in which manner this will occur, but I'm definitely going to have to get him something nice for all of his attempts at keeping me from being a complete idiot.

When I finally get to meet my new doctor, he takes all of eight minutes to establish our new working relationship, and proceeds to re-up my prescriptions, one of which is a fairly low-dosage of the narcotic known as Oxycodone. Currently, I take the following drugs daily for control of my Diabetes and neuropathy:

Novolog (fast-acting insulin taken by injection)
Lantus (slow-release insulin taken by injection)
Pregabalin AKA Lyrica (for nerve pain)
Oxycodone (pain control)
Amitryptyline (a non-addictive sleeping agent)


Now, when it comes to the Oxy, it's essentially a back-up medication to take the edge off my pain when the Lyrica isn't cutting it, which is rare- in other words, I normally can make a 30 day supply typically last three months. But as of recent that hasn't been the case, due to the hellish bout of neuropathy I've been battling.

Unfortunately, it's been trying to become an essential part of my daily routine, and since my day gig involves the handling of expensive art while using sharp and stabby tools that can take your hands off if you're not careful, I can't allow myself to be too doped up either.

Therefore, I generally "tough it out" and take the Oxy at night, as a means to help me stave off the ever-present pain, which if timed right, lets me grab two to four hours of sleep before the fire in my skin wakes me up again. Even sleeping naked can be too much where my skin sensitivity issue is concerned, and if my GF happens to move, accidentally dragging the top-sheet across any part of my body, it's a sure bet she'll find me hanging from the ceiling, man-bat style come the dawn of the new morning.

So, as I leave my new doctor's office, I make the follow up appointment for a month later, and I go about my day, running errands, accomplishing tasks, and occasionally killing the random circus clown here and there.

You know... like you do?

Granted, I was still in a lot of pain, but I did have the Oxy, and after all, I was going to talk to him about upping my dose of Lyrica during the next visit anyway. See, I have a theory- after five years of taking this drug, I'm convinced my body has become acclimated, and that the dosage needs to be "tweaked" a few milligrams upward in order for it to continue working as effectively as it has been.

But there upon the sunny My Pretty Pony horizon, a spanner in the works was thrown.

Roughly a week and a half before my appointment was to occur, I discovered to my horror that I was going to run out of the one medication that kept me from peeling the skin off my own face by seven days- that of course, being the Oxy, a drug that I had been taking without incident for the past half-decade. So, like any responsible adult, I called his office and left a message explaining the critical situation... and didn't hear anything back for three days.

Thus began a game of phone tag that would make the Gods of Olympus themselves weep. Despite the fact that I had a well-documented medical history of neuropathic pain going back five years, Dr. Daas seemingly couldn't care less about the discomfort that I was going through, or the hellish pain that I was on the cusp of experiencing.

Let me be clear- at no time whatsoever, did he even bother to return any of my messages personally, leaving that sensitive task to his head nurse, who to her credit, became more and more agitated by his unethical refusal to render any sort of aid regarding my situation.

Not once did he offer to move up my appointment or recommend an alternative pain killer, but he did let me know (via his nurse) that he wasn't "comfortable" prescribing narcotics, a small but important fact that I feel should have been told to me when we first met. Forgoing an actual solution, he offered up (via his nurse again) the name of a pain specialist who charged $250.00 for the first office visit, couldn't see me for three months, and then, to top it all off, didn't actually treat diabetic neuropathy...

AT ALL.

In fact, their practice was based on what their receptionist referred to as "Erector-Set" pain- the analogy being that if you were more metal than flesh due to an accident, then they were your go-to guys for said treatment in regards to the same. While she was truly sympathetic, there wasn't really anything that they could do to help me whether it was in the short or the long term.

I tells ya- sometimes, I really wish that I was a jazz musician, so that I could go do some heroin without anyone giving me real grief for it.

But as my circumstances seemingly became bleaker, there was a flash of white light on the horizon, a joyous trumpet-call from over the hills, the sound of a crash between a truck full of chocolate and a truck full of peanut butter- my GF Ashley using all of her redheaded Google ninja skills had found my old doctor, the one and only Smita Kapoor!

(CUE UPBEAT 80's MOVIE MONTAGE THEME MUSIC, WHILE SHOWING ME DANCING IN MY BATMAN UNDERWEAR PLAYING AIR GUITAR IN A ROOM FULL OF POP CULTURE POSTERS!)

God, what an amazing feeling that was- not only did I have my old doctor back, I was able to get an appointment on the very same day that I was supposed to see the schmuck that was refusing to follow my treatment protocol- certainly, this was Fate dealing me it's finest hand.

It's closely akin to an old high school buddy calling you up and saying: "Dude... my parents let me move back into the basement- so come on over and let's get that wicked surf-punk ska house-mix Def Leppard cover band project going, and we'll make some rock and roll myths happen!"

So, after setting up my new appointment with my old go-to girl, I then called up Dr. Daas and proceeded to fire him as my physician- granted, I had to do this via his head nurse, but she
seemed more than happy copying down my thoughts on his inability to follow the tenets of his chosen career.

And as an aside, she did this with an inordinate amount of personal glee, I'm happy to report.

You think that I'm a bitch on the pixilated page when you piss me off? You should really hear me on the phone [or see me in person] when I get going, as I've made Teamsters weep for their mamas, and yes...

I AM that good.

As for his difficulties in following my pre-established care, I'd normally state that "It ain't rocket science", but it might as well have been, since reading what was in my file was apparently a parallel to NASA being able to land the Space Shuttle on top of one of Neil deGrasse Tyson's lawn gnomes.

But no matter, for I was about to get back on track while wearing black, and I was looking forward to it- picture a Christmas morning inside the Willy Wonka Factory while all around you the gathered Oompa-Loompas dance in their native and festive garb, and you'll be close to the joy I was feeling at just the mere thought of getting my pain issues finally settled.

And when the blessed day finally arived, it went great. She seemed genuinely thrilled to see me, and even re-upped my pain meds, all the while chatting about how "we" were going to get back on top of my condition. Who-hoo. Yipee. Yowza.

Sure, there was one small issue- that being I was told the office charge was going to be $100.00, and it turned out to be $151.00 instead, but at least I was getting to see the person most responsible for my continued health, so that seemed to be a small price to pay in the long run overall.

[Side note: this practice of adding additional fees after the fact for a standard office visit seems to be the newest way the medical profession attempts to gouge it's hostage client base- I would love to see if any other business could get way with this, wouldn't you?

"Yes, normally it's two-seventy-nine for that Big Mac, but our counter-person did have to hand you a receipt, so now it's four-fifty-five."]

But back to my narrative.

When I came in for the follow-up appointment a mere two weeks later, that breezy attitude had been replaced with the countenance of someone who had previously dated me and had the misfortune of seeing me naked. Clinical. Calculating. In a word, just plain frigid. As I describe how bad my pain is, she seems distracted, and I observe that she and her nurse (a bottled-blonde named Shaun) are taking subtle glances at their watches as if they had somewhere else to be.

Cutting me off in mid-sentence, Dr. Kapoor informs me that she wants me to get my blood drawn for a series of tests- one will be a full blood work-up panel (over $300.00) a urine/drug test ($200.00) and then she wants to see me in another two weeks for another visit. ($100.00-150.00) For those of you keeping score, I haven't had any real cessation in my pain levels, plus that's at least $650.00 at the bare minimum, and I don't have any health insurance.

Not because I'm irresponsible or anything along those lines, I'm just still working my way through the tepidly bureaucratic mess that is the Affordable Healthcare Act- and while I can't speak for you, I generally don't have that kind of cash on hand at any given point, a detail which I made particularly clear to Dr. Kapoor.

Several times, in fact.

Brushing that aside, she informs me that I will need to find a way to raise the funds, as she cannot (and will not) re-up my pain meds without a current urine test, and as to my request for "tweaking" my Lyrica dosage, she states rather haughtily that she is, and I quote: "not in her comfort zone" for doing that either.

Let me clarify. She wouldn't prescribe me the low-dose narcotic that she originally approved as a side drug to ease my pain, nor will she alter the dosage of the non-narcotic drug that is obviously not working like it used to.

And for this, I get to pay her $150.00? I would have been way better off giving that money to the aforementioned dominatrix- if I have to be in severe pain, I'd rather that it be served to me while it's wearing a black leather corset. Once again, I'm a simple man with simple appetites.

Excusing herself, she gathers up her laptop and exits the room with Shaun, leaving me sitting there... for 45 minutes.

Interesting side note: when you're stuck in a room with no magazines save for Good Housekeeping, [Happily, I did learn how to make cookies that are moist and delicious- the secret is butter.] and your phone only has 50% of it's battery left, you'll find it's truly amazing what you can make out of tongue depressors when you're tragically bored beyond belief.

Ladies and Gentlemen, I present to you, the Leaning Tower of Pisa!

All kidding aside, I cannot even begin to tell you how infuriating it is to hear someone mewlingly complain that their "comfort zone" is being compromised when all your zones (and I do mean all) are in sheer f**king agony. Aww... poor baby- you feel uncomfortable.

Well, guess what, you self-absorbed bitch, when I wake up in the morning, my goddamn eyelashes hurt. So f**k your comfort zone, and f**k you as well.

And as an aside, here's a heads up: when a patient of yours is diabetic and you abandon him in a room for 45 minutes and he hasn't had a chance to eat yet, he's apt to have his blood sugar drop, so next time please make sure to leave him a glass of OJ or a peanut butter sandwich before you decide to go see the other six patients that you all cleverly scheduled for the same time.

Once again, I'd love to see any other profession that does this: "Hi, I'm from the cable company and I see you have a one o' clock appointment, so I'm also going to be installing the other five houses on your block at the same time- this could take a while." That's right- I experienced a "low" when I was there, due to having to wait so long for them to get back.

Fortunately, I always carry sugar pills and fast-acting glucose gel to stave off such an event. Thank the Lord, that I do, because when Shaun returns, she dismisses what could have been a very bad thing and doesn't even once to think to check my blood sugar*- instead, she just blathers on about how Dr. Kapoor will "return soon", because as I think I've established by now, I obviously have nothing but time on my hands.

*[When we did check it almost 30 minutes later, it was 114- which means I probably dropped into the low 60's. That's pretty bad, and could have led to my passing out.]


Granted, this is all occurring on my day off- what better way to spend my excess time than being trapped in a beige room with nothing but cotton balls, six month old magazines, and tongue depressors to amuse myself? If I only had access to a roll of bubble wrap and a box of packing peanuts... I could have kept my inner child amused for days.

Attempting to make the most of the down time, I at that point handed Shaun the other reason why I was there, that being my medical aid paperwork. The drugs that I require to function and stay upright, (namely the Lyrica and my two Insulins) are bloody expensive, and because of their prohibitive cost and the fact that I'm uninsured, I'm more or less forced to be on aid programs to receive them free of charge.

Each box of Insulin pens and a 30 day supply of Lyrica runs about $268.00 each, a price that has only been rising since the new insurance laws went into effect. Mind you, I don't blame the AHA, I blame the drug manufacturers who saw it as a golden opportunity to gouge it's client base. For instance, a vial of Lantus used to be around $90.00- not cheap, but also not break-the bank expensive either.

Heck, even without insurance, I could afford that. But now?

Try $250.00 for a drug that I could buy from Mexico or Canada for less than twenty, the only difference being the zip code it's located in. That's what I love about this country- if you're rich, you'll be just fine, but if not- well, just pick out what suit you'd like to be buried in and what song you'd like to be played at your service.

[By and by, my choice would be Frank Sinatra's "My Way" as covered by Sid Vicious- it is a train wreck full of awesome.]

Overall, the process for receiving this medical assistance isn't that complicated- it typically requires filling out a one page application, providing proof of your financial status, and per the federal requirement, your doctor's office faxes the whole shebang, along with a prescription for whatever drug you're applying for, directly to the company who manufactures said drug.

Normally, a five minute procedure at worst- two if you're firing on all eight cylinders.

Now as a rule, I tend to keep things highly organized where personal paperwork is concerned, as it's a combination OCD and German thing, and this was no different. Each application was individually binder-clipped together, and the areas that my doctor needed to fill out were highlighted with one of those neon yellow marker thingamajigs- in short, a masterwork of neurotic compulsiveness that even Helen Keller could have easily followed.

With her hands tied.

So naturally of course, it got all shades of bolloxed up. Shaun exits the room once more, paperwork in hand, and when she returns almost 45 minutes later... none of the paperwork is filled out, which for some reason, she did not notice. Mind you, I could see this from across the room, but apparently, when it comes to the fine details, Shaun is far-sighted.

[For those of you keeping track of the time, we're close to almost TWO hours for what should have been a half-hour visit at worst.]

Giggling, (I kid you not) she suggests that I should leave, and states that "they'll take care of it"- not to worry. Note to self: whenever anyone offers to do this in the future, remember this day, and how badly they screwed the metaphorical pooch with a sandpaper condom.

After I reluctantly depart, I call Shaun's direct line and leave a message reminding her not to forget to send the financial info for all three forms- granted, it says to do so right underneath the fax number printed on each application, but since she had already shown me signs that she was possibly three beans short of a burrito, I felt I should hedge my bets, and make sure, nonetheless.

Speaking of burritos, it seems that now would be a good time for me to take a pause from my tale and go microwave one, and then hit the sack. And when I come back...

I get a Dear John letter, have a showdown with Marshall Dillon's incompetent sister, dance a tango with a nice (but scripted) St. Joseph's patient relation flack, and show the bitches who I be, using nothing but the power of positive thinking and my melodic voice.

"I don't trust doctors. It's not to say there ain't some good ones, but on a general level, no, I wouldn't trust 'em at all."- Keith Richards

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