MEDICATION SAFETY, HEALTH INSURANCE, SECOND OPINIONS

Medication safety is the theme on World Patient Safety Day, 2022.

It’s been on my mind since an event a few years back.

In those days I was dealing with a cancer diagnosis and heading for the first of three chemo dates.

My wife drove while I called the insurance company for a final approval.

One of my cancer goals was not getting railed by the insurance company.

To that end I called them about every new thing, every proposed procedure, to make sure I was in compliance.

Maybe I was overdoing things, but part of my plan was to avoid insurance problems.

The other part was to avoid traveling for care. If I was going out from cancer, I’d go locally.

My concerns were small since I kept up on communication, and have a tenacious wife.

I didn’t need to make the phone call in the car, but I did it to show her I was on top of things just like her.

She drove with the plan of dropping me off then going to her clinic.

The first chemo would be a long day.

After the phone call, it got longer.

Chemo, The Safe Medication?

Me: Hello, my name is David Gillaspie. I’m calling before heading into the infusion clinic.

Insurance: Yes, I’ll check. Mr. Gillaspie, our records show your insurance has been canceled for non-payment.

Keep in mind I’m in the passenger seat while my wife drives. I didn’t want chemo, but chemo is part of the process.

Besides, medication safety and chemo sound like strange bedfellows.

And now my insurance is canceled? On the way to a most expensive appointment?

My internal voice wondered how to tell my wife. My external voice piped up.

Wife: Who did you call?

Me: The insurance company.

Wife: Why?

Me: Last check in before I get the juice.

Wife: Haven’t you checked with them yet?

Me: Every step of the way, honey. From the ENT, to biopsy, to fine needle stuff, to today.

Wife: What did they say.

Me: They said my insurance is canceled.

(My wife takes great pride in being the most competent person I know.)

Wife: WHAT?

Me: Some clerk in an Oklahoma insurance office misfiled something, or checked the wrong box. It’s them, not us.

Wife: Canceled?

Me: For non-payment.

Wife: I paid.

Me: You’re on top of it. They’re not.

Wife: Then you can’t get chemo today.

Me: Honey, I’m on the schedule and I’m not going off. I’m getting chemo.

Wife: These are the sort of mistakes that send people into bankruptcy.

Me: And like we talked about, not getting chemo sends people to their grave like the guys we know.

Wife: You need to figure this out. I’ve got a full day of patients and won’t have time.

Me: I’ll figure it out, alright. Just drop me off.

Medication Safety To The Max

I checked into the Knight Cancer Institute on the Meridian Park Medical Center.

Before scheduling your appointment, we recommend you contact your insurance company to verify that the OHSU Health location or provider you plan to visit is included in your network. Your insurance company will also be able to inform you of any copayments, co–insurance, or deductibles that will be your responsibility. If you proceed in scheduling an appointment and your health insurance benefits do not participate with OHSU providers, your out of pocket liability may be higher. Visit the billing and insurance section of our site for more information.

My insurance had a problem, but the clinic had a green light. So did St. Vincent.

Did I know Providence insurance and Providence hospitals are separate and different companies? Do you?

To avoid problems I rescheduled chemo at the hospital on the same day.

Everyone was so nice about everything.

Clinic Nurse: We can access your chemo port here in case you get to the hospital and get postponed because they’re behind schedule.

Me: Okay. What’s that mean?

I left the clinic with no ride, so I called a taxi and waited.

Under my shirt was a big wad of bandages and tubes that made me feel like I might bleed out any second.

It’s the sort of feeling mentally strong people put in its place.

Me: I’m not fucking bleeding out here. It looks like something Ironman might have on his chest, but I believe in medication safety. Even for chemo.

2

A taxi pulled up and I fought the urge to jump in even though I knew it wasn’t my taxi.

Didn’t I have priority with an accessed chemo port hanging off my body?

Nope, not even with that. Good manners prevailed.

My taxi pulled in. The driver was depressed because Uber and Lyft were cutting into his business.

I concentrated on staying calm, hoping he didn’t crash on the way and my chemo port wouldn’t pop out.

By the way, that never happens. Chemo ports don’t pop out. But an EMT at a crash site might freakout from seeing the mess on my chest.

The driver stopped at St. Vincent and told me the charge. I paid and wished I’d taken Uber.

3

The ride to the hospital went up I-5 then cut across on 217, roads I’ve driven for years.

But never as a cancer patient with stuff hanging off them.

The hospital staff was ready when I got on the cancer floor.

They hooked me up with lunch, then the black bag of chemo.

I used my mighty brain power to stay calm while knowing I was volunteering to get poisoned.

Instead of laying in a bed and stewing, I got up and cruised the cancer floor.

The infusion clinic had an air of hope to it. From comfy blue lounge recliners to nap in, to a nice view from big windows, it felt like a medication safety place.

The hospital floor felt desperate. It was the sort of place where medicine and science and prayer combined for a better outcome.

Unfortunately for some, it was also a place with the worst outcomes. And it showed in rooms full of grieving family members.

After the harsh reality set in, I retreated to my room to think about it while the black bag drained into my chest. I made up a little song for it.

‘In with the bad shit and out with the worst,

This stuff works and I’m not the first.’

Medication Safety At The End Of The Day

I called my wife after the chemo wrap up. She was done for the day and picked me up.

Me: How was your day?

Wife: Fine. How was your day?

Me: Fine.

Wife: Our insurance isn’t canceled. It’s all straightened out.

Me: We did the right thing going to the hospital.

Wife: You liked it?

Me: No, not at all, but they’re doing the hard work in there. Those people have some bad cancer.

Wife: Just like you if you didn’t get it looked at early.

Me: You’re a life saver.

Wife: And you’re worth it.

Me: I love you.

Wife: I love you, too. We’ll beat this.

Me: We’ll do it together. Thank you, dear.

I often think of the last words in The Great Gatsby:

So we beat on, boats against the current, borne back ceaselessly into the past.

Joni Mitchell got it right in The Circle Game:

And the seasons, they go round and round
And the painted ponies go up and down
We’re captive on the carousel of time
We can’t return, we can only look
Behind, from where we came
And go round and round and round, in the circle game

You think Joni read Gatsby?

I went round and round on a painted giraffe and snagged a few rings.

Not the brass ring, but I’m not done.

Neither are you.