dropped the cat off for surgery; COBRA
Jul. 30th, 2009 08:23 am![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
verushka70So, last week when I brought my dog in for his ear infection*, I told the vet about the pea-shaped mobile little cyst in my littlest cat Kako's armpit that I discovered about a month ago, which has gotten bigger and was starting to frighten me. So we made an appointment for this past Tuesday to bring her in so he could look at it. And I brought her in Tuesday and he looked at it.
Now, I trust this guy. When the wet-behind-the-ears new grad vet at an expensive emergency clinic in a wealthy neighboring suburb wanted to do repeat barium studies (to the tune of, minimum, $450!!) on my dog because he was obstructed by eating (ewww) a used tampon of mine (I mean, ewwwww -- but my old dog, Riffraff, did the same frakkin' thing like 20 years ago, dammit! what is it with dogs and menstrual products! ick!) --
I called up this vet, who's an old guy, with white hair, and he told me to go out and get plain, unflavored Metamucil or the store brand equivalent, and put two heaping tablespoons in Linus' food, and the fiber would "push through" the tampon and accumulated feces within the next 24-36 hours. I did what he said, and sure enough: within 36 hours Linus had crapped out all of his obstructions and was no longer straining to poo without pooing. All with like $6 of Metamucil. I have nothing against modern veterinary technology, but not when it's not frakkin' necessary and the dog would be unnecessarily exposed to radiation and the problem can be solved with a nice, safe, non-risky, old-fashioned solution that works.
So ever since then, I trust this guy. Plus, he told me he just was at a big veterinary conference in Seattle (which was the AVMA convention July 11-14, a couple weeks ago), so I know he's also staying up to date on the latest veterinary medicine info. So that's cool.
But when I brought Kako in Tuesday to have him look at her cyst thing, which grew from pea-sized to about acorn sized (after I finally noticed it) in like a month, I could tell the vet was not happy. Furthermore, when I said, "Look, you've seen a lot of pets, you must have seen this kind of thing before. What do you think it is?" he responded "I'm not gonna speculate, we'll send it out for biopsy." I'm thinking, well, either he really doesn't want to speculate, or he has seen this before, knows it's bad, or metastatic, or whatever, but wants to wait until that's confirmed by biopsy before delivering the bad news to me.
I had been hoping -- since it was in Kako's armput, not near any nipples, and since it was a movable cyst-like thing, rather than attached to the chest wall -- that it was most likely just a benign growth of some kind. People get them all the time; I see it in a lot of elderly patients and nursing home patients that come through our ER. They have skin tags and moles that have turned into pea-sized attachments to their torso. I'm familiar with these, they were in our nursing textbooks, they're benign. So I was really hoping that's what it was in Kako's case.
But now, based on the vet's reaction, I am worried that isn't the case.
So I just dropped her off at 07:30am this morning to have the lump removed. The vet said he will do the surgery between 10am-12pm and she should be out of the sedation by 4:30pm if I want to call and check on her. Then I pick her up tomorrow AM.
I have an appointment at 1pm to meet with my mom's attorney to officially begin the probate process for her estate. I have to give him an official copy of her death certificate and a retainer check for $500. (But we just got her life insurance check so that's covered.) I hope I will be done with the attorney by 4:30pm so I can check on my baby cat.
She's not a baby, of course; she's like 12 years old. The vet said he was not going to put her under general anaesthesia "because of her age" -- he was going to sedate her and then use a local anaesthetic as well. I just call her my baby cat because she always was the youngest and she's the littlest. What she lacks in stature she makes up for in fur...
I am trying to be optimistic but (1) that doesn't run in my gene pool and (2) a month after my mother died, I'm just not capable of it. I thought nothing worse could happen than my mom dying a month ago. After all, I'd already had my dad go in 2005, and my step-dad in 2007, fast, when the metastatic lesions in his liver took him over; so then my mom died, suddenly, but not unexpectedly 6/26/09, and I figured, this is as bad as it can get, right?
Well. Turns out, maybe not.
So I'm just kind of quietly freaking out, wondering if I'll be burying yet another loved one in the next few days/weeks and praying it isn't something metastatic. Plus hoping when I get Kako home Friday AM she doesn't go berserk and rip out her stitches or something.
*Which has required twice daily ear antibiotic gel and oral antibiotics -- good thing he's super well trained, or this would be a huge problem... because Linus is like 70 lbs. and big enough to rest his nose on the table without standing on his hind legs. You get the idea. Big. I am all about the big dogs. Well, big-ish... I've never had a Great Dane or an Irish Wolfhound or anything that big. Yet.
And I have my hands full with my happy-happy-joy-joy black lab Linus now, anyway. He's actually pretty much the only reason I get out of bed; he's the only one that gets let out (the cats would be killed if I let them outside; I live 1/2 block from a busy intersection and have seen many flattened stray cats, possums and squirrels here over the years... no, no, no; they are indoors-only cats). Plus it's kind of hard to be completely depressed when you've got a 70 lb adult dog that wags his whole body like a puppy when you get home from even the slightest absence from your home.
I always feel guilty if I don't give him a ball throwing session. I swear this dog would retrieve things until he dropped dead. Of course, his breed was bred to do that, so it makes sense. But he's like a machine. Seriously. No matter how many times, or how far, or into what -- tall grass, water, mud (not intentionally; that was an accident at a forest preserve, where there was standing water lurking in what I thought was merely wet grass from rain the night before!) -- you throw his ball, he will keep bringing it right back and drop it at your feet and expect you to throw it again. The net effect is good for both of us; forces me to get out of the house, too. Especially now.
My COBRA papers finally arrived so I can continue my health and dental insurance until I get another FT RN job with benefits. I am considering not doing that if I can get in as registry (temp pool) for $41-42/hr at one of the nearby hospitals. The hospital where I still work PT is... such a shithole. But I digress.
So my COBRA? $517/month. I can pre-pay $1500+ to stay insured up to Oct. 1, '09.
Looks like I will really, seriously, have to do the math on this and calculate how much it would cost me out of pocket to pay for my health care -- uninsured, in cash -- vs. how much COBRA is costing me.
I had a near heart attack a month+ ago when I refilled my antidepressant RX. It's for Budeprion XL, which is an extended release form of bupropion (generic Wellbutrin). The pharmacy receipt said something like "You saved $454 !!" and when I read this in detail at home, I thought, That can't be right! So I called the pharmacy up and said, I didn't really save $454.00, did I?" and he told me, yes, actually I had. Turns out the XL form is not generic, it's proprietary... so they can charge whatever they want.
But I've taken the non-XL generic form before, so I don't think I need it. I don't mind taking pills twice a day if it would save me $450. I can get the non-XL generic bupropion for like $10/month.
So part of me wants to just dump the COBRA and not have any insurance at all, if the only RX I actually need is the Singulair for my asthma. I don't have diabetes or high blood pressure or any cardiac risk factors (my cholesterol is fantastic, though most MDs would never believe it, just looking at me; I'm a fat girl).
What I have is depression with a seasonal component (which was why I was dosing down, until my mom died) for which I take the Budeprion XL, asthma (Singulair 10mg/day, albuterol HFA inhaler as needed, almost never needed), allergies (ragweed, tree & grass pollens, and molds) (for which I take OTC loratidine/Claritin and cetirizine/Zyrtec daily and NasalCrom for extra coverage if I'm getting itchy eyes/sneezing), myofascial pain syndrome (when it flares up, I take 4-8mg tizanidine/Zanaflex, &/or 25-50mg Topamax --not available generically -- and OTC ibuprofen, but none of these are necessarily daily), and RSI (for which I'll take whatever works -- usually OTC ibuprofen, naproxen/Aleve, aspirin, and use icepacks &/or Epsom salt wraps or soaks). My normal daily intake of meds these days is RX Budeprion 150mg/day, RX Singular 10mg/day, OTC loratidine/Claritin 10mg/day, OTC cetirizine/Zyrtec 10mg/day... that's it.
I refilled my Singulair this past Saturday and it was $143. So it would appear that paying $517/month for COBRA might be a good idea just to get the RX co-pay benefit. How the fuck senior citizens don't starve to death, I don't know.
But two of my sisters are telling me to just pay the COBRA because what if I have a gallstone attack, like my mom did the summer she was unemployed, which left her with a $12,000 hospital bill. Which, they're right, that could happen. In theory. So could any number of other potential emergencies. And it isn't like I don't have the money; I could actually pay the $1500+ from money I still have left from my father's estate. I just ...don't want to. I was going to use that for tuition money. And keep saving it for, I don't know, relocation expense money for when I can get the hell out of Chicago, after I finish my BSN and my bf does his MBA. Or a down payment on a house. Or something. Not... fritter it away on COBRA.
The obvious solution, of course, would be to just get another FT job. I just don't feel mentally up to it, though, and I still have to clean out 40 years of stuff from my mom's apartment and basement and garage so that we can rent her apartment and generate enough money to pay the taxes and utilities on the house. It's not like it's going to sell in this market. Sigh. Plus, I went PT so I could do the RN-to-BSN program. I missed the deadline to register for the next class when my mom died. But I'm due to start up again at the end of August.
I'm not usually great at decision-making. But lately, I'm even worse at it. I just waver and waver and waffle and don't decide anything. Sigh. So, go back to work FT? Get another job? Quit or finish the school thing? I can't make up my mind. And until I do, I will need the COBRA, I guess. At least, that's what my sibs are saying. My friends? 1/2 of them say dump it, it's too expensive, and I don't get sick much and I can pay out of pocket/sliding scale to see the psychiatrist (once every 3 months) and my MD if I need to. 1/2 of them say keep it because you never know what will happen and you don't want to be socked with tens of thousands of $$ in hospital bills.
The last argument is, I think, the strongest.
Now, I trust this guy. When the wet-behind-the-ears new grad vet at an expensive emergency clinic in a wealthy neighboring suburb wanted to do repeat barium studies (to the tune of, minimum, $450!!) on my dog because he was obstructed by eating (ewww) a used tampon of mine (I mean, ewwwww -- but my old dog, Riffraff, did the same frakkin' thing like 20 years ago, dammit! what is it with dogs and menstrual products! ick!) --
I called up this vet, who's an old guy, with white hair, and he told me to go out and get plain, unflavored Metamucil or the store brand equivalent, and put two heaping tablespoons in Linus' food, and the fiber would "push through" the tampon and accumulated feces within the next 24-36 hours. I did what he said, and sure enough: within 36 hours Linus had crapped out all of his obstructions and was no longer straining to poo without pooing. All with like $6 of Metamucil. I have nothing against modern veterinary technology, but not when it's not frakkin' necessary and the dog would be unnecessarily exposed to radiation and the problem can be solved with a nice, safe, non-risky, old-fashioned solution that works.
So ever since then, I trust this guy. Plus, he told me he just was at a big veterinary conference in Seattle (which was the AVMA convention July 11-14, a couple weeks ago), so I know he's also staying up to date on the latest veterinary medicine info. So that's cool.
But when I brought Kako in Tuesday to have him look at her cyst thing, which grew from pea-sized to about acorn sized (after I finally noticed it) in like a month, I could tell the vet was not happy. Furthermore, when I said, "Look, you've seen a lot of pets, you must have seen this kind of thing before. What do you think it is?" he responded "I'm not gonna speculate, we'll send it out for biopsy." I'm thinking, well, either he really doesn't want to speculate, or he has seen this before, knows it's bad, or metastatic, or whatever, but wants to wait until that's confirmed by biopsy before delivering the bad news to me.
I had been hoping -- since it was in Kako's armput, not near any nipples, and since it was a movable cyst-like thing, rather than attached to the chest wall -- that it was most likely just a benign growth of some kind. People get them all the time; I see it in a lot of elderly patients and nursing home patients that come through our ER. They have skin tags and moles that have turned into pea-sized attachments to their torso. I'm familiar with these, they were in our nursing textbooks, they're benign. So I was really hoping that's what it was in Kako's case.
But now, based on the vet's reaction, I am worried that isn't the case.
So I just dropped her off at 07:30am this morning to have the lump removed. The vet said he will do the surgery between 10am-12pm and she should be out of the sedation by 4:30pm if I want to call and check on her. Then I pick her up tomorrow AM.
I have an appointment at 1pm to meet with my mom's attorney to officially begin the probate process for her estate. I have to give him an official copy of her death certificate and a retainer check for $500. (But we just got her life insurance check so that's covered.) I hope I will be done with the attorney by 4:30pm so I can check on my baby cat.
She's not a baby, of course; she's like 12 years old. The vet said he was not going to put her under general anaesthesia "because of her age" -- he was going to sedate her and then use a local anaesthetic as well. I just call her my baby cat because she always was the youngest and she's the littlest. What she lacks in stature she makes up for in fur...
I am trying to be optimistic but (1) that doesn't run in my gene pool and (2) a month after my mother died, I'm just not capable of it. I thought nothing worse could happen than my mom dying a month ago. After all, I'd already had my dad go in 2005, and my step-dad in 2007, fast, when the metastatic lesions in his liver took him over; so then my mom died, suddenly, but not unexpectedly 6/26/09, and I figured, this is as bad as it can get, right?
Well. Turns out, maybe not.
So I'm just kind of quietly freaking out, wondering if I'll be burying yet another loved one in the next few days/weeks and praying it isn't something metastatic. Plus hoping when I get Kako home Friday AM she doesn't go berserk and rip out her stitches or something.
*Which has required twice daily ear antibiotic gel and oral antibiotics -- good thing he's super well trained, or this would be a huge problem... because Linus is like 70 lbs. and big enough to rest his nose on the table without standing on his hind legs. You get the idea. Big. I am all about the big dogs. Well, big-ish... I've never had a Great Dane or an Irish Wolfhound or anything that big. Yet.
And I have my hands full with my happy-happy-joy-joy black lab Linus now, anyway. He's actually pretty much the only reason I get out of bed; he's the only one that gets let out (the cats would be killed if I let them outside; I live 1/2 block from a busy intersection and have seen many flattened stray cats, possums and squirrels here over the years... no, no, no; they are indoors-only cats). Plus it's kind of hard to be completely depressed when you've got a 70 lb adult dog that wags his whole body like a puppy when you get home from even the slightest absence from your home.
I always feel guilty if I don't give him a ball throwing session. I swear this dog would retrieve things until he dropped dead. Of course, his breed was bred to do that, so it makes sense. But he's like a machine. Seriously. No matter how many times, or how far, or into what -- tall grass, water, mud (not intentionally; that was an accident at a forest preserve, where there was standing water lurking in what I thought was merely wet grass from rain the night before!) -- you throw his ball, he will keep bringing it right back and drop it at your feet and expect you to throw it again. The net effect is good for both of us; forces me to get out of the house, too. Especially now.
My COBRA papers finally arrived so I can continue my health and dental insurance until I get another FT RN job with benefits. I am considering not doing that if I can get in as registry (temp pool) for $41-42/hr at one of the nearby hospitals. The hospital where I still work PT is... such a shithole. But I digress.
So my COBRA? $517/month. I can pre-pay $1500+ to stay insured up to Oct. 1, '09.
Looks like I will really, seriously, have to do the math on this and calculate how much it would cost me out of pocket to pay for my health care -- uninsured, in cash -- vs. how much COBRA is costing me.
I had a near heart attack a month+ ago when I refilled my antidepressant RX. It's for Budeprion XL, which is an extended release form of bupropion (generic Wellbutrin). The pharmacy receipt said something like "You saved $454 !!" and when I read this in detail at home, I thought, That can't be right! So I called the pharmacy up and said, I didn't really save $454.00, did I?" and he told me, yes, actually I had. Turns out the XL form is not generic, it's proprietary... so they can charge whatever they want.
But I've taken the non-XL generic form before, so I don't think I need it. I don't mind taking pills twice a day if it would save me $450. I can get the non-XL generic bupropion for like $10/month.
So part of me wants to just dump the COBRA and not have any insurance at all, if the only RX I actually need is the Singulair for my asthma. I don't have diabetes or high blood pressure or any cardiac risk factors (my cholesterol is fantastic, though most MDs would never believe it, just looking at me; I'm a fat girl).
What I have is depression with a seasonal component (which was why I was dosing down, until my mom died) for which I take the Budeprion XL, asthma (Singulair 10mg/day, albuterol HFA inhaler as needed, almost never needed), allergies (ragweed, tree & grass pollens, and molds) (for which I take OTC loratidine/Claritin and cetirizine/Zyrtec daily and NasalCrom for extra coverage if I'm getting itchy eyes/sneezing), myofascial pain syndrome (when it flares up, I take 4-8mg tizanidine/Zanaflex, &/or 25-50mg Topamax --not available generically -- and OTC ibuprofen, but none of these are necessarily daily), and RSI (for which I'll take whatever works -- usually OTC ibuprofen, naproxen/Aleve, aspirin, and use icepacks &/or Epsom salt wraps or soaks). My normal daily intake of meds these days is RX Budeprion 150mg/day, RX Singular 10mg/day, OTC loratidine/Claritin 10mg/day, OTC cetirizine/Zyrtec 10mg/day... that's it.
I refilled my Singulair this past Saturday and it was $143. So it would appear that paying $517/month for COBRA might be a good idea just to get the RX co-pay benefit. How the fuck senior citizens don't starve to death, I don't know.
But two of my sisters are telling me to just pay the COBRA because what if I have a gallstone attack, like my mom did the summer she was unemployed, which left her with a $12,000 hospital bill. Which, they're right, that could happen. In theory. So could any number of other potential emergencies. And it isn't like I don't have the money; I could actually pay the $1500+ from money I still have left from my father's estate. I just ...don't want to. I was going to use that for tuition money. And keep saving it for, I don't know, relocation expense money for when I can get the hell out of Chicago, after I finish my BSN and my bf does his MBA. Or a down payment on a house. Or something. Not... fritter it away on COBRA.
The obvious solution, of course, would be to just get another FT job. I just don't feel mentally up to it, though, and I still have to clean out 40 years of stuff from my mom's apartment and basement and garage so that we can rent her apartment and generate enough money to pay the taxes and utilities on the house. It's not like it's going to sell in this market. Sigh. Plus, I went PT so I could do the RN-to-BSN program. I missed the deadline to register for the next class when my mom died. But I'm due to start up again at the end of August.
I'm not usually great at decision-making. But lately, I'm even worse at it. I just waver and waver and waffle and don't decide anything. Sigh. So, go back to work FT? Get another job? Quit or finish the school thing? I can't make up my mind. And until I do, I will need the COBRA, I guess. At least, that's what my sibs are saying. My friends? 1/2 of them say dump it, it's too expensive, and I don't get sick much and I can pay out of pocket/sliding scale to see the psychiatrist (once every 3 months) and my MD if I need to. 1/2 of them say keep it because you never know what will happen and you don't want to be socked with tens of thousands of $$ in hospital bills.
The last argument is, I think, the strongest.
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no subject
Date: 2009-07-30 02:39 pm (UTC)Dogs are life savers. Without mine, I'd probably stay in bed a lot more than I do. They keep me in the world, you know?
As for Cobra, check to see if there's a way to pay less. With the economy the way it is, I was thinking they made some kind of concession about making it a lot less for the first 18 months of unemployment. I'm not sure if that's applicable if you left voluntarily or if you're fired, but I'd sure look into it.
But whether it's cheaper or so damn high, you really can't afford to be without it.
50% of all bankruptcies in the country are because of medical expenses. Anything could happen and you'd have thousands in debt that would keep you in the hole for years.
I keep hoping they'll pass a real healthcare plan for people so they don't have to pay that kind of money for care whether it's medicine, doctor visits, or hospital care.
no subject
Date: 2009-07-30 09:10 pm (UTC)Actually my bf saw something on either Frontline or some other PBS show last year that said over 60% of bankruptcies are because of medical debt. So you're definitely right; it's something to consider.
All these frakkin' politicians who got campaign money from managed care companies are so busy trying to fight it and water it down, it makes me sick.
Well, maybe I'll just bite the bullet and do the COBRA. Better safe than sorry. Things are kind of scary now. Who knows how much worse it might get? I deliberately chose health care as a field because (1) it interested me and (2) I knew it had a future: people aren't going to stop aging and getting sicker. But that's not true for a lot of people... and they're hoping our consumerism is going to prop up the economy, when there are so many people without jobs, there IS no consuming.
My bf works as a housing counselor, trying to help people who are about to be foreclosed on or headed in that direction... but what he is hearing more and more is "No, I don't need to refi, I need a job -- can you find me a job?" Because without a job, no matter how low the monthly mortgage payment or interest rate, they're going to lose their homes anyway. And this isn't, he tells me, the people who were stupid. These are people who did everything right, and who've already been out of work so long they've cashed in their 401Ks and used up other retirement savings -- often even paying the IRS penalties for early withdrawal -- prior to coming to the housing counseling center.
It's frakkin' tragic. And it seems unstoppable.
no subject
Date: 2009-07-30 11:13 pm (UTC)The news peeople would like to make it seem like it's only those who were over extended and stupid losing their homes but it's not. With unemployment so high, it's a side effect. You can't pay what you don't have.
no subject
Date: 2009-07-30 05:15 pm (UTC)I'm no insurance expert, but could you maybe drop COBRA, but get some kind of catastrophic coverage? COBRA is insanely expensive. I was paying $350, and then dropped it in favor of catastrophic insurance and that was $70 a month. I forget what the deductible was.
no subject
Date: 2009-07-30 09:13 pm (UTC)The thing is, a couple people have pointed out that if you lose your insurance for more than 60 days, any new insurance can exclude pre-existing conditions for up to 12 months of your new coverage. Since I have depression and asthma (and breathing is not really an option), it would be nice not to have those excluded. . . I'm leaning towards the COBRA. I know it's insanely expensive, but my mom's gallbladder surgery while she was unemployed and uninsured (to the tune of $12,000 in medical bills) is kind of looming large in my mind right now. . .
no subject
Date: 2009-07-30 05:32 pm (UTC)I'm going through a nightmare with (lack of) health insurance now, and my two cents would be to keep the COBRA. If your insurance lapses and you end up trying to get individual coverage (if you end up self-employed, or if your new job doesn't offer adequate insurance), you can be denied for any preexisting conditions -- seriously, anything. (There are I think five states that don't allow individual underwriting; if you live in one of them, this may not apply.)
So it's not just the short-term risk of something happening while you're uninsured, it's that if you fall out of the nest (the magical land of People Who Have Health Insurance), you may not be able to get back.
There are insurance agents who do health insurance. You could talk with someone about your options -- maybe you could get an individual policy that would cost a lot less than COBRA but still cover the essentials. But I would advise not letting coverage lapse entirely.
no subject
Date: 2009-07-30 09:20 pm (UTC)(Why, why did I ever waste money on a BFA in 1992? I never did a thing with it... just went straight into computers anyway. Sigh. But since I already have one bachelor's, I'm not eligible for financial aid... so I really need the tuition money...)
Sigh.