It’s a long one. Sorry. Kind of. But a fat old lady’s gotta vent, ya know.

I’m trying.  Really trying hard, to get my knee surgery scheduled.

The prerequisites seemed deceptively simple. 

1)            Get a bunch of blood work done;

2)            Schedule MRI;

3)            Get clearance from my oncologist/hematologist;

and

4)            Get clearance from my primary care physician

Item 1 – got it done the day after my appointment.  Easy peasy.  Well, easy peasy if you don’t count siphoning 6 vials of blood out of my poor arm that has already been poked for my annual physical, and gets poked on a weekly basis to keep track of my platelets.  (I remind myself to just be grateful that my one and only good vein has not decided to take a dive and hide under the fat like the other veins in my body.)

Item 2 – First try to schedule, the order had not gone out yet. 

Second try – success!  Only to have that appointment canceled because my insurance had not yet authorized the MRI.  Phone calls and messages exchanged, advised to make another appointment.

Third try – success!  Only now, my insurance carrier has denied coverage for an MRI.  (Fuck.). 

The guidelines are beyond stupid.  Get this:  My carrier will not allow an MRI for use in robot assisted surgery UNLESS you have deformities in your tibia or fibula (well, I do have bone spurs on my tibia – so suck on that Blue Cross/Blue Shield) AND (that’s AND not OR, mind you) you have hardware in your knee from previous surgery!  That’s right folks, you can only get the MRI to assist in your knee replacement surgery if you’ve already had knee surgery that includes hardware in the knee!!!! 

Well, I have to admit, they’ve got me there – I’m trying to get knee surgery, so I haven’t already had knee surgery.  Well played Blue Cross/Blue Shield – how can anyone argue with logic like that?

In order to avoid any delay in getting this surgery, we decide we’ll pay for the fucking MRI and argue (i.e. appeal) later.

So I call the doctor and leave a message letting them know that I will be paying for the MRI myself, and appealing the denial after the fact; and then send a follow-up message saying the same because the call back I received did not deal with the MRI but whether insurance will now cover the robot assisted surgery at all and that they still don’t have clearance from my primary physician (say what?).

Now my phone and messages blow up – they know all about the denial and thought I had gotten a call.  Nope.  No call here.  Would have been nice, but that didn’t happen. 

Now  the scheduling department calls to cancel the MRI appointment because the insurance denied it.  I told her, I’m going to just pay for it.  She tells me (a) the doctor now says he doesn’t need it (news to me) because he’ll do a conventional manual total knee replacement (also, news to me); and (b) I would have to pre-pay for it but that will take a phone call from someone else.  I say, I’m not willing to cancel this appointment until I actually talk with my doctor’s office because at that moment (as I tell this young lady who has called me) I’m at the Y, in the locker room, sitting in my underwear (enjoy that image) and all of this is news to me. So she says she’ll have someone from finance call me.  I get dressed, get to my car and finally look at my phone; and listen to the message one of the nurses at my surgeon’s office left for me. 

Okay.  Fine.  No MRI needed – when I got home, I went online and canceled the appointment (and hopefully, that will show up in the system and I won’t get a call from someone from Finance, but I’m not counting on it.)

Item 3 – as far as I know, there is no problem with this and has been taken care of.

Item 4 – NOW, WTSF.  I spoke with my primary in May when I had my annual physical and he said he saw no reason why clearance for surgery would be a problem.  So, again, WTSF?

I send a message through the patient portal.  His nurse messages me back, asking for the date of the surgery because usually EKGs and lab work have to be ordered.  (I can feel the grrrrrr rumbling deep inside me.)  I message her back – the surgeon’s office will not set the date of the surgery UNTIL they have the clearance. 

She messages me back, “I have you scheduled for Wednesday 6/25 at 1pm.” 

I message her “Scheduled for what?”  and “I have my weekly blood draw on 6/25 at 1 pm.”

Yeah, you wouldn’t want to check with the fat old lady with various medical issues (and even, at times, a life, thank you very much) to see if she has anything else on her calendar – just go ahead and make that appointment.  (Can you hear that Grrrrrrr getting louder?)

The nurse messages that the appointment is for surgical clearance.

Since, my priority is the knee surgery, I tell her I will cancel or reschedule the blood draw and will keep the appointment.

(GRRRRRRRRR.)

I can’t imagine there is any more blood work that anyone could possibly need.  Between my primary’s annual bloodwork, the surgeon’s office bloodwork, and my weekly bloodwork I may have the most worked of blood in the region. 

However, I KNOW they don’t do EKGs at my doctor’s office.  Please all that is bright and beautiful in this world, do not let me go to this appointment only to have more tests ordered (and therefore, more delay).  There may be blood shed.  And it won’t be for lab work.