Monday, October 5, 2009

October, 5, 2009

One week and counting.....Time is racing..... D day is next Monday...... I enter the hospital on Sunday morning for a day of testing and GI tract cleansing. It really doesn't get much better that that. LOL A very expensive place to stay, and only clear liquids on the menu.

I really don't know what to say.... my emotions are all over the map, and I expect that this is normal. My plan is to endure this week, get through next week, and do the best that I can after that. Not a great plan, or even a unique plan.... it is, I think, the only plan available. I think that I have done the best that I can considering the circumstances. My doctor is one of the best in the world, the hospital is very well regarded, and, apparently, my insurance co. is going to pay this time.

I am confident that I am doing the right thing, and hoping for a good outcome. I hope that I will end up with a “neo bladder”, although I know that it is an “operating room” decision for the surgeon. The doc. will try to preserve the nerves that allow men to preform like men. Needless to say, I am hoping for success.

The next big event, after the surgery, will be the pathology report. (48 hours after the surgery) They remove the bladder, prostate, and surrounding lymph nodes, and send them off to the lab. If it is “all clear”, then 95% chance that I won't ever have to deal with this again. If not “all clear”, then chemo, and a much reduced chance of survival.

In spite of my confidence in the decision, the doctor, the facility, and the procedure, I am still anxious, scared, angry, and horrified. Part of me thinks that even the best outcome is bad, and I find myself hoping for the “least worst” result. The other part of me recognizes that I may be avoiding a slow painful death, and be able to live a near normal life, The technology available is hard to believe, imagine, making new body parts. I guess that both of these are reasonable assessments.

The Ca. Dept. of Insurance has informed me that they are very happy that I contacted them, and they encourage me to stay in touch, but are unable to help with this particular problem. They say that my dispute with Health Net is a “he said, he said”...... Nothing that they can do, and that litigation is my next step. Disappointing, but I have to agree. I am still seeking a lawyer to take this on spec. If I am unsuccessful, I guess that I will do it myself...... a bit of David and Goliath drama.....

I am spending the day preparing for the hearing on my “relief from stay” motion. Imagine me in a suit and tie...... trying to make a reasoned argument with no emotion leaking out. I have the facts, and the law, on my side, but I realize that “facts and law” may not carry the day, and that they may be able to cause more delays. I will try to present myself as “poor but honest” seeking much needed justice.

Life has gotten very complicated, and much of the time I feel like giving up..... but today, I feel like a warrior..... OK, a backed into a corner, and greatly out numbered, warrior, but still willing to engage the battle.

8 comments:

Peggy said...

John - I'm sorry you are going through this. I understand about emotions being all over the map. I wish we could be on hand to help you through this.

What good is the lousy insurance commission? One assumes that they could get hold of the tapes and then it would not be "he said....he said" now would it?

I read today that Health Net CA has lost 23,000 subscribers in the last year while some other health care insurers in CA have gained 8 or more percent more subscribers. Health Net could more accurately be termed "Health NOT".

Will someone be with you who can keep us informed after your surgery?

Anonymous said...

Hello my friend,
I will be thinking good thoughts even harder for you over the next couple of weeks. Be a strong warrior! Fight on! Kick ass and take names!
Love
Mary

Claudia said...

Wish I could have been there to see you in a suit. You're pretty dashing in your dress shirt, blue jeans, and cowboy boats. LOL.

Claudia said...

For those of you reading John's blog and want to know how he is surgery is going you can email me your email address and I'll get back to you. I'll be there with him the first few days while he is in the hospital.

JC said...

I guess that Claudia should post her e-mail address...
Thanks for all of the encouragement, It helps to know that people care.
For most of my life I have avoided suites, doctors, and lawyers.... and look at me now..... surrounded.

Barbara and Ron said...

Well, of course you're anxious, scared, angry, and horrified - who wouldn't be? But I'm betting on you!

Anonymous said...

Hi John,

So, sorry for all that is being heaped on your head. I'll be praying for you.

As for Health Net, didn't they also tell UPMC that you were covered? UPMC wouldn't have done the surgery if they didn't have some assurance that your insurance was going to cover it. If UPMC was told that it is '2 he said against he said'.

I'll e-mail Claudia with my e-mail address so we can get updates during the process.

Love you bro,

Judy

JC said...

Yup, that is what UPMC said.... My dispute with HN may fall under the ERISA laws, which do not allow bad faith, punitive, or emotional distress claims..... So, the worst that happens is that they have to pay the bill. If the ERISA laws apply, they have every reason to hold out as long as possible. I am still trying to find out which laws apply. If not ERISA, then I have a big law firm interested in my case.
In any event, it seems cruel and unusual to have to deal with all of these things at the same time.