Well, that was interesting...

 

I had an 'interesting' week. Most of the week felt like it was a half a bubble off. Ever have one of those weeks?

Some good things happened and so did some very bizarre things. 

We all understand about CareGiver Stress, well, perhaps everyone doesn't. However last week during a meeting with our CareGiver social worker via the VA's version of Zoom, the social worker referred me to a counselor to help deal with some of the things I've been dealing with this winter.

The VA now offers counseling to CareGivers one on one in their own homes. Before this, I would have to seek out counseling in my home town. There is the stigma of admitting that you have stress while caring for someone along with trying to find one place that would actually take the insurance offered by Medicare and ChampVA is an incredible challenge in itself.

I said YES, please! This winter has been difficult.

I try not to share my 'difficulties' here. So I really won't go into it. However I recognize the symptoms of it all. I want to be Snarky every time I'm asked to help him, is not a good feeling. I get riled at the least little thing and want to yell and immediately feel guilty because it really is NOT his fault!

Wednesday was awesome. I went with a friend on a nice easy hike along the paved section of old hwy 131 on the Kickapoo Valley Reserve.
 

I was surprised that the ponds were still frozen. We just walked and she talked, I listened. Her mom is in Hospice and has been for 2 months now. It weighs on my friend's mind. She is trying to balance her feelings about quality of life and also has a new grand child which makes her full of joy. Balancing Joy and Sadness is hard.

Part of the way through the hike I started to have dark brown floaters in my one eye. The 'good' eye. I've had this before in 2021 in the opposite eye. It is freaky. Think about dropping food coloring into a glass and watching the dye float about in the water. Then think about that being what you see in your vision. 

When I looked at the sky around me, I could clearly see the floaters and knew it was from a Vitreous Hemorrhage. That sounds terrifying. However, I was told that sometimes the Vitreous has a little pull on it in older eyes and there is a tiny bleed. The eye doctor told me NOT to go to the ER, but to call they eye clinic and get in. ER's don't call in eye doctors or have the equipment to look into your retina.

Thankfully, I did get an appointment for the next morning.

I had the exam and this eye doctor was hilarious. He looked deep into the eye to check to see if I had a tear in my retina or a detachment. 

His commentary was hilarious. "Ohhhhh Ahhhh Nice! You did a great job! This tiny tear is in the Best Spot! Right next to the Optic Nerve! I think we need to take a picture of that so you can see it!"

What causes it? It can be age. It can be because I've had eye surgeries before, it can be possible that I sneezed and did it...or it just happened on its own. 

What does it look like? I tried looking all over the internet and no good examples came up. So I went into a program and created what I see right now. Speckles and floaters that never stay still and sometimes interfere with what I am trying to read. They wiggle around every single time you look at something.

This is perhaps like just a few molecules of seepage from the little tiny blood vessel in my eye. The molecules will reabsorb like they did in 2021. It takes time but is very annoying.

The big scientific words for what happened sound very scary: Posterior Vitreous Detachment. I will be seen in two weeks to have another look at it to see if it is healing up.

So this week, photography hasn't really been much fun nor has reading. However, I've gone about my daily business and am continuing to keep busy.

Typing this was a bit of a challenge, but now I am used to patterns floating through my vision. My brain says it is no big deal and so I am treating it that way.

Walking in the forest is nice because of all the brown colors the floaters are not bothersome and I can ignore them.

Onward to new adventures despite the coffee thingies in my vision!

Disturbing phone calls and scams

The Message went like this:

Urgent! Return your absentee ballot today! Did you know that whether you voted is public information?
Your neighbors will know if you voted!
Don't let your neighbors know you didn't vote.

IF you don't vote in the November 2022 General Elections, You're telling your neighbors that:...

[yadda, yadda, yadda, propaganda stuff...]

Your neighbors will know!

The next day we got a flyer with the same message.

Both parties are calling like nimrods and leaving dire messages on our landline.

Another disturbing phone call is the Amazon Scam. Not done by Amazon, but by scammers who repeat the calls every 15 minutes telling us that Amazon has gotten a suspicious charge on your account, in the amount of --- choose your amount --- please call 1-888-XXX-XXX and press one to talk to an account service rep.
I had to unplug our phone to stop the repeated calls. 

Yes, we have a land line because my cell doesn't have any bars in our house. I have to walk outside and away from the house to make or receive a call.

Then I got an email saying that I had a suspicious charge on my PayPal account. Yeah, that was pretty funny. Paypal has an expired card on file. No worries. I only used PayPal 7 years ago...once. Since I never used it I deleted the account and had them remove my data.

I can easily check any charges pending on my charge card and those that have been posted. If the credit card company gets an odd charge they will notify me in a way I won't explain here. However, it works and is very efficient. Charges above my norm or in a place that is not usually used by us are flagged.

There is also a very easy way to dispute charges which has been very successful.

I do wonder how many people fall for the scams that are via phone or email? 

Speaking of that, on another note. 
I had to do some investigating on an insurance claim for hubby.

He is a Veteran with Community Care that is local. His ER visit was billed to the VA and not Community Care. The VA said the claim could not be processed as it was to go to the CCN [Community Care Network]. The Hospital instead billed Medicare -- WRONG! -- I called them on it and explained the process to the billing department.

A month went by and the Hospital Billing Department said 'It just wouldn't go through'.

Which to me translated to: We won't make the effort to rebill the proper Insurance.

Today while waiting for an oil change I called the CCN folks at the Madison VA and found out that payment through the CCN Insurance had been authorized in July the day after the ER visit.

So I used Secure Messaging to pass that on to the Billing Dept and the specific person who told me I was wrong. Note this, Secure Messaging becomes a part of a patient file, no hiding by saying -- I didn't get the message!

I provided the Auth number and suggested they pay Medicare back and bill Optimum UHC. It would be considered fraud to bill the wrong insurance and get paid. Even worse when it is Authorized Care for a Veteran, he/she should NOT be billed.

So I often wonder, how do some of our elderly deal with these issues? The world is scary and invasive. Rotten phone calls that feel like threats. Scam phone calls that are confusing.

Hospital billings that are incorrect.

And I wonder.
How on earth can we stop it?

Last note.

A few years ago the VA system offered me a job as a Patient Advocate. You know what? That would be a great job. However, right now I have my hands full advocating for my own Veteran.

Well now

No Slime Today

Aren't you relieved?

I believe this is a purple finch. Hubby has been spotting them and I am usually too late with the camera to catch them.

Catching it in flight was completely an accident.
 

Most of the afternoon I hung out on the porch and did weeding and watering those plants that don't get much moisture because they are so close to the porch that the eaves keep the rain off them.

I was awaiting a return phone call after being shuffled around by the VA Community Care People. 30 minutes after being transferred 3 times, I got voice mail.

Community Care is sometimes frustrating. Communications between a non VA provider and the VA itself is tenuous a best. A medication was ordered for hubby two months ago. He still had a 'rescue' inhaler so it wasn't a vital medication.

However, the non VA provider followed her instructions that the VA provided and ordered the medication. It went 'somewhere'. I followed up by contacting several people and finally landed on a person who said she'd handle it.

That was 4 weeks ago. So I looked up hubby's info in MyChart and noted that the CC gal had called the local doctors office and gave the clinic the info for faxing or calling in meds.

The local doctor's office used HER name in ordering the medication. The VA pharmacy said no one by that name worked in that pharmacy. And that is where it was dropped.

So there was miscommunication between CC, the pharmacy, and the local doctor's nurse.

I need to draw them a chart on how to order meds, I think. 

Today I made more phone calls.

The solution was simple, whoever wrote down the fax number for sending in medications, wrote one digit off. A 1 instead of a 7. Or perhaps the handwriting was sloppy? Who knows?

Well now.

So it goes. 

Navigating Health care sure takes a good deal of effort on any person's part.

Wild Hot Wednesday

Ok. Not Wild, but surely HOT!

As the Caregiver for my husband, I am now taking an online class regarding 'Caregiving' with the Veteran's Administration. I sort of dreaded the first class. Apprehension is pretty common when you aren't sure what you are getting into. 
[It isn't much different than the class called Building Better Caregivers]

I realized that I was not alone. I am not the only person caring for someone. 
I also realized that in some ways I have it much easier than other Caregivers. My husband actually sleeps at night. Imagine caring for someone who wanders 24 hrs a day?

Well. Enough of that.

~~~~~~

The mules are in the woods. They can walk around in the Buckthorn section of the woods and find patches of nice grass. It will be a bit before they can go into the larger section of woods. I want to figure out a way to keep them off the meadow for a while longer. The meadow suffered last year with it being so dry.

To say the least, being in the woods has taught my equine to deal with obstacles. They rarely twitch an ear to large logs or difficult trails.

~~~~~~~~
Against the other half's wishes I bought another hummingbird feeder and a little thistle feeder for the goldfinches.

Funny that adding a second feeder and attracting the goldfinches has caused someone to watch out the window and give me a running commentary on what kind of birds have come to the feeders!

Truth is, he is enjoying bird watching.

The hummingbird fights are something to see! If our military could build planes as agile as these birds that would be something wouldn't it?

Hummers are very territorial!

The female Grosebeak is also very territorial. -- Not a good shot -- but here she is defending a piece of an orange in the grass from a male Oriole.

I think the goldfinches are incredible in their color too. 

Enough of the birds right? I have yet to upload the photos from today where those golden beauties are hanging out in the Hickory Tree.

When I woke up this morning the fog was incredibly thick and it was muggy out. I fired up the 'Ru and went up to the ridge to see if the sky would provide a colorful sunrise.

I am in love with this area. The land is not flat, and the morning mists roll along on humid mornings creating an incredible landscape. The view never gets boring.

We accomplished some mowing today but won't be doing the rest of it until it cools off a bit.

Tomorrow it is supposed to get to 93 degrees. 

What bizarre weather. From using the heat last week and frosty mornings, too using the AC.

Oh boy! 

Bird alert! We saw Indigo Buntings today! They are so stunning in their bright blue feathers.

The Turn of Events Or Two Tests

This is an update to the previous post and I hope to give some folks some hope.

The Rapid Test was Negative.
Rich's classic symptoms screamed Covid. So much so that the doctors felt the test was wrong and asked for another more complicated test. Covid protocol came into effect. Of course now most every hospital I think practices some very strict PPE. 

However they did treat him as an infected person and therefore I was an infected person most likely.

I had to return to the hospital twice for things they needed. The CPAP and then a list of medications. Yeah ... this is why the person who is the CareGiver should be present.

Also they should know how to use the VA's 'Veteran's Health Information Exchange' to look up his meds and current health notes. I will not judge them for these two issues because I know our tiny hospital is over run. So I printed out a copy from his Pharmacy list and took it to them with how he should take the meds. 

The nurse called me later in the afternoon as they are very busy. She said 'We are going to remove the Propranolol from his meds and cut back on another med.'

I said to her that Propranolol was removed by his PCP a year ago because of adverse side effects, it drops his heart rate severely. This too exists in the VHIE [electronic health records].

She said 'Well it was prescribed in the ER.' 

OK. One more reason to have someone who does CareGiving there for the patient. 

Again, not really the nurse's fault, but a fault of the overburdened system right now. They probably thought it was prudent at the time. I told the nurse of my husband's health history. The Cliff Note version. 

I discussed the pain med that they were withholding. It was prescribed for his Major Depressive Disorder or MDD. 

She told me that Rich never could tell her exactly what hurts but everything hurt so bad. I said Bingo! MDD! You have a patient with severe depression and by withholding that med it causes him pain AND withdrawal pain.

See me visually smacking my head with one hand while trying not to get angry.

Test #2 finally came back. He is not Covid-19 positive. But he is a perplexing case. Wonky heart rate -- so much pain, not able to get enough 02, and some other things. 
She remarked that he had asked for a DNR order and it was noted. 

I told her I wanted a clear picture of what was his diagnosis. They get a bit hesitant with that stuff so I told her to look at the HIPPA Consent form under Richard's Living Will paperwork she had on file [in his chart].

I wanted to know if he was stable enough to come home even if he had to stay in bed. Did he need an IV for fluids? Were his lungs clear? 

She made notes. She couldn't give me an answer.

I was polite and professional. The poor woman started her rounds in our little hospital at 7AM. She got her break to call me at 2PM.

Humans are odd creatures. My husband is one such creature. I've been his personal health advocate for 24 years. I even have a degree in Billing and Coding and nearly switched over to Pharmacology. I have a background in commercial and health insurance, billing, and coding. I am very serious about taking care of my husband at a hospital that is really not equipped for what he needs. Again, not their fault. I do believe it is an excellent facility.

It is not staffed with people who understand veterans with Mental Health issues. The best place for him is to be surrounded by vet nurses and veteran staff, but that hospital is full.

My course of action is to hope that a bed opens up for him soon or he becomes stable enough to come home.

The nurse said he was pleasant and she really liked him. 

About 15 minutes later she called me back. She had the pharmacist with her and needed to go over a few things with me. I pulled up my chart and read off the answers for her.

So in conclusion, they are treating him for symptoms that parallel Covid symptoms. But don't have a clear picture of what is going on. His fever is gone.

At first yes Covid, then not Covid, then similar to Covid.

The only good thing to know after all of this ... is that all my extreme precautions have been working. 

Another observation. When I brought his CPAP and later his meds to the hospital, I did wear a mask and tell the person in reception that I came from a home of a suspected Covid-19 patient.
That poor girl's eyes went deer in the headlight white and she went back for gloves and a Bio Hazard bag to put my chart in.

I was a Witching Pariah, or something to that effect.

We are living in a very strange world right now. 

Last but not least I am starting a Suck Box. More on that later.

The FB Portal

Gosh, there sure isn't much to talk about these days.
We received something called Facebook Portal through the Red Cross for Veterans that are pretty much stuck at home. I learned about it from the VA's Vantage Point Blog.

I was very leery of anything 'free' so I called the Caregivers folks and they said yes indeed the items were free and the promotion was free to the first 7,400 veterans that applied. I applied and then forgot about it.

I got an email from the Red Cross notifying me of a delivery date via FedEx and lo and behold, this was delivered.

It works by using contacts through Messenger on FB [yeah I don't like FB that much, but I have it]. When set up you can activate the voice and camera and ask it to call someone on your contact list.

So we talked with his daughter on Friday with the grandkids using the Portal. There is a 'smart' camera that detects motion so if one walks out of the room and back the camera sort of follows.
The sound is good and the video is excellent.

On Saturday Rich wanted to talk with Kristi from Missouri and see the boys. Kristi is like a second daughter to him. The kids showed Rich all of the lego stuff, talked about their Advent Calendar and Rich was able to see everyone.

On Sunday he wanted to do a Portal call to my oldest son. Again, lots of waving and laughter, checking out Covid Hairdos and holding up dogs to the camera.

The Portal has a slider to put over the camera to shut it off or you can manually shut it off. It will show a slide show of photos and you can connect it to Alexa through Amazon to play music or ask for the weather. 

I use it once in a while to play music while I am in the kitchen doing things. Otherwise I just unplug it and stick it off to the side.
All in all it really put a huge smile on Rich's face to be able to SEE and interact with those he loved. 

The premise behind the Red Cross effort with the VA was to put isolated veterans in touch with their friends and family. Sure most people can use zoom or a smart phone or duo...or they can be like Rich and not have a smart phone or computer. This is perfect for him.

Last night I loaded photos from my FB feed onto the Portal and let it cycle through while we ate supper. Rich enjoyed looking at the photos of old hound dogs, Morris, mules that had passed on, and the grands when they were little. 

After we 'hung' up with Eddie, he leaned back and smiled. "Boy that was fun, I sure like that a lot!"

I have read mixed reviews about the Portal and some people hate it. All I know is that it is making one Veteran very happy. And that is good enough for me.

Now hear this...

 

Yesterday was a really really long long day. So Charlie and I headed out to the Rock Fort to sit a spell and listen to the woods. I was dressed in Blaze Orange but most of the weekend hunters had left the area to go back to where ever they came from. The bottom photo is of my crochet project. I am making a new rag rug and crocheting it. I don't have a loom but I do have balls and balls of material my Grandmother painstakingly put together from old shirts and sheets. Thus...a new rag rug!

~~~~

The morning hours were spent in a long 'intake' interview. 'Intake' is what the VA calls it. Rich and I were interviewed by a gal named Jennifer via secure video connection. It was not painful or difficult, she asked questions of Rich and then asked questions of me without Rich. He was happy to go watch TV in the other room. The program is called VA Family Caregiver Assistance. 

The VA feels it may be cheaper to pay a family caregiver to care for a veteran who needs assistance in all aspects of his daily life....or Activities of Daily Living.... than find a place in a nursing home for him/her. 

I just need to say this. I care for him because I do care. I quit a very well paying job so I could be with him and take care of him. Leaving him home alone every day for hours on end was not an option. There are about 5 more steps with an exam with a nurse, and exam with an Occupational Therapist, more social workers, and even a virtual home visit I think. It takes time and I am not terribly worried. 

One of the benefits that a caregiver can get is access to ChampVA insurance along with respite care and in home assistance. Mental Health access to deal with stress is also available. 

I told Jennifer that it would be amazing to be able to talk to someone from MH just to blow off steam. Okay, I know I have friends, but truly, who wants me to ring them up and complain about how frustrating it is when the person I care for is doing things that drive me crazy? I know he can't help it because of 'brain injury' but yet... somedays having an adult toddler is insane. 

Add a Pandemic to the mix and what have you got? Rhetorical question there. 

Anyway, it was really NICE to talk with another human, even it was a social worker doing an 'intake' interview.

The latest townie news is this. Our 25 bed hospital is nearly full, there is NO more room. The ER is full most of the time. They are treating some patients that need higher quality of care but have no place to transfer them to. That is unless beds open up with deaths or discharge to a lesser unit.

The Doctors made a plea via our local paper and radio stations to PLEASE please wear masks, wash hands, and socially distance...and please do not bring people outside of your household in for Thanksgiving. 
Many of our folk really are trying hard. Others think it is still a hoax or they just don't need to follow the guidelines.

And I know in my heart that if my husband suffers a Medical Emergency, it could be the very last time I see him. 

This really got to me yesterday and that is why Charlie and I went to The Rock Fort and sat while I crocheted. Fresh air, sunlight, birds, and a kind dog helps a lot.

So this morning I decided NOT to read the news. 

I went into distraction mode and created art with Mandebulb 3D, Incendia, and Corel PaintShopPro [a program cheaper but similar to Photoshop which I cannot afford!].

Viking Terminator!

Sleeping Dragon

Have a good day. Stay safe. I'm going out to enjoy the  new snowfall.

Plan B

My neighbor and friend Bill planned on working out at the Wellness Center this morning. He was not aware that they had closed the gym with no plans at this time of reopening....well, until I texted him early this morning.

He just texted back:
He said "I need to go to plan B. Wait, I don't have a plan B."
I texted him back and said, "Home workouts, raking, bicycle, light jogging, fresh air, creative ways to do upper body weights..."

Next text: Can we do a really hard hike this week?
My answer: Sure. I have a 3 mile killer hike. We can start at my driveway and it will take us through two valleys.

I'll be looking up workouts to keep up my current upper body strength.

Next text from Bill: Will I get hurt on your hard hike?
My answer: Of course not! Hard in the way that there are two valleys and lots of steep hills but the trails are good and I've taken kids on them.

I thought that was funny sort of. If he wanted a hard fast hike, I'd give it to him for the leg burn.

There is plenty of space for us to hike and stay separate. However that may come to a swift end soon if positives are found in the county.

But anyway.

Plan B for exercise? Well I am still working on Plan A for staying home.
I have one more errand tomorrow and that is to pick up the taxes.
I dropped into Walmart [eeks !] to grab some coffee.
I needed some seeds also.
The garden and hardware sections were void of people. The food isles were full of people. NO toilet paper, no napkins, no paper towels, and two boxes of Kleenex were left.

I told Rich we were going to go back to cloth for napkins and wiping up messes.

I'm all done in for right now. The Patient Advocate for the VA says she is getting the run around on the claim I've been trying to work on for 18 months. She told me to call the White House Hot Line. Um. Okay?

Bam.
The oncologist we were going to see tomorrow called. He asked to be on speaker phone so he could talk with the both of us.
[I moved that appointment assuming it was just a 15 minute consult and congrats on being clean for almost 5 years]


Um. No. He wanted a Nuclear Medicine Bone Scan. Rich's CT scan from last month showed 'something' a bit out of the ordinary. Then he mentioned the C word and my heart stopped. He went on to downplay it but to tell us he was scheduling a scan as soon as he could.
He said not to be concerned over this, it was probably nothing, but if it was cancer it might just be prostrate or bone or...well, when we saw the Urologist we could be better informed for .... options.

[Did he say that? I don't know, somehow my brain sort of had a disconnect when he said cancer.]
I thought NO.
No...no no.

He then assured us that this was normal operating procedure and he'd put the consult in right away for the bone scan.
He hung up after wishing us a nice day.
Hey, this guy is nice...but hmm.

Rich was unconcerned. He shrugged and then patted my hand and told me not to worry. He smiled and said "But of course you will! YOU won't sleep for weeks now!"

He turned back to his Western and pushed play.

Plan A & B had just changed.


Hey. Why not address Pandemics and Cancer all in the same day, right?

We will see what happens.

I need a Plan C.

Knees, Appts, Creativity.

So.

The knee has not resolved itself at all. I just figured I'd get out and 'walk it off'. I went to CrossFit a few times last week and even did the 22WOD. Eh. That may have been a mistake but I was careful. It felt great to do it with my good friend and partner. She is awesome and strong!

The swelling in the knee is gone. For the first time in my life I can really understand what it feels like to have knee pain. See, I didn't want to acknowledge the injury and just figured it would go away like the other time I smashed it against a boulder.
I'm mad at my knee. It should have gotten better. Really.
If I go outside and pull my pants down and yell at it, will it help?

Okay, bad image, right?

Today is going to be one of 'those' days. Calling the VA Community Care folks to see where the claim from 2018 still stands. The hospital just sent a nasty letter which is normal for them. They are a huge conglomerate and of course all phone calls are handled by a person who is 'not' in charge and 'doesn't' know anything.
These phone calls require at least 20 minutes on hold and many transfers.
I think I need an office assistant just for dealing with appointments and care.

Rich is doing mildly better so that bump is resolved for the moment.

~~~~~~~~~~~~~~~~~~
Some fun with editing photos.
Since I am not out hiking at the moment...
I am studying some funky photo effects and editing.

Dispersion Effect:
I really want to nail this down as I think it would be fun. I think instead of 'chunks' of dispersion, I like the birds more. Using bat brushes would be fun too.

Double exposure ~ done in camera:
I need much more experimenting, but it is sort .. of neat!

Pencil sketching skulls:
This is part of my skull collection. I like it, but dislike the white edges that Painter does.

Pencil sketching mixed with the original photo:
I really like this one a...lot. 

Well, off to work. The mules want to eat!

February thaw and?

What a difference a day makes!

and...
Sunday...

I know, slightly different views, but there you are!

and then...

I didn't go very far yesterday, my knee is troubling me. I know I probably shouldn't have done the 22 WOD on Saturday, but it was for a good cause and it was a lot of fun. We had a great turn out at the gym.
I have a bruise of the patella and it makes certain hiking movements a bit difficult in deep snow and ice.
I don't think it is more than that, but we'll see.

Charlie was a champ and hung around close by while I did some long exposure photography.

Friday was another day spent at an ER, but at least we had some more answers than last Friday.
MDD or Major Depression Disorder are the initials of the month. MDD can manifest itself in so many ways.
However we may have come up with another temporary and mild 'fix' for a while.
I must say that the VA nurses and doctors are much more understanding of a veteran who has mental health issues as well as physical issues. Our local ER and doctors are not quite as well versed in this area. Rich's psych doctor was also on hand.

That said, I am spending more time inside right now just doing my monitoring 'thing' for Dr. Schiffman. And I can say there is a slight improvement.

So this is my favorite shot from yesterday. Mossy rocks kissed by a bit of sunlight ... with a little bit of ice on the moss that had not yet melted.

Buggin

Early mornings are my best times.

This morning I went out and started to 'dead' head the marigolds to keep them blossoming. I picked seeds from the 4 o'clocks and zinnias to have for next year. I clipped most of the yellow cosmos and had gathered enough of their seeds to plant an acre of them.

I nearly put my hand over a bumble bee when plucking marigolds. So I went in and grabbed my camera.

The early morning sunlight highlighted the Bumble! After I downloaded the photos, I noticed the little beetle below the Bumble.

I slowly walked around and looked at the flowers more carefully.

If I am right this butterfly is called a Skipper? I don't know but it was cool. The Skipper stayed there for quite a while and I was able to try more than one angle.

I moved around to the front of the porch and found this interesting tiny bee below a tiny orange marigold.

It was dead, probably killed by a spider?
Hanging by a mere thread.

Bug Drama.

I dig insects.
~~~~~~~
Monday I have to dive back into the billing saga of the utterly discombobulated way the Gundersen and the VA work or don't work together.

Neither entity it seems wants to actually pick up the phone and make real communications.
Gundersen won't recognize disabled veterans right to have emergencies billed to the VA per CMS guidelines. Won't? Can't?
The VA keeps asking for proper billing and paperwork or notes.

And Gundersen just told me last month to just pay them and then I could talk with the VA.

Someone at Gundersen doens't know very well how to handle veteran claims when the veteran is admitted in an emergency. As the gal in billing said, "It is awful hard to do unless we have an authorization number!"
Amazing comment coming from someone who handles billings for such a large health care system.

Stuck indoors

The winds were absolutely wicked and the snow is like concrete in places. I shot these turkeys out through the front door in the wide open summer pasture.

I was bored inside. I wanted to go hiking but Rich said he was feeling a bit off, so I stuck myself to inside the house.

I just purchased a Infrared converted digital camera that is a pocket camera. Look forward to some wildly creative shots after I get it!

Meanwhile I got out my Olympus which is on it's last legs and fitted the IR lens filter I had for it.
Now IR is really meant for warm sunny days, not cold winter days.

But I don't believe in rules...so I started to play.

Infrared shot of the sky out the back door...the green on the pines do reflect white..

Edit to black and white from the Infrared filtered shot.
The pine needs are white as well as the bark which reflects the heat.
Cool huh?

And then I decided to play around with Rich's old torn up gloves and a wrench thingy I found in the shed.

I like the white one better and I used a 'paint effect' on it too. PSP's Painter Essentials 6. A pretty easy program. I let the program paint the photo and then saved it. There can be a bit more to it, but I didn't work super hard on it.

Pink Whisperly Dreams.
I shot this with the infrared filter on too. Just experimenting with colors and different stuff.

Lastly the Nisse that was hand made for me with a mini bottle of wild grapvine curls.

The raw winds continued to blow outside on Monday and it just felt bitter. I kept busy indoors. Vacuum, dust, and balancing the books. I think for sure that balancing the books is the worst job ever.

Yesterday was appointments day. PT at the VA and other appointments which led to more appointments.

Well that is the way it goes sometimes right?
We came home to a slew of messages on the answering machine. One was from
the VA Fiduciary Field Examiner, she wanted to set up a meeting.

Well.
Now let me be clear. I am glad that the VA does protect its veterans that are incapable of handling their finances by their system. There is a potential for abuse. But it is a bit intimidating too.
I don't know anyone who has done this, but I am reading up on it.

I've been keeping spreadsheets on our expenses and handling our accounts for quite a while ... so ... well. I'm nervous.
Time to go do some more reading.

Welcome to the VA...or not.

When you call a provider at the Veteran's Administration you hear: "Welcome to the VA..." the voice continues to tell you, "If this is an emergency please hang up and dial 911..."

Then comes the menus to take you to different areas of the VA. It started innocently enough. I called the social worker that had been in contact with us to ask a rather simple question.

Had the VA approved or authorized the follow up appointments with Neuroscience and the Neurologist that had treated my husband on May 6th?
She didn't know, but "How were things going?"

So I told her that Rich had is up days and down days. That we had done language exercises and found that some words were beyond his ability to spell or write down. I didn't know if this was new or not, I don't think he'd been asked to do any writing since his stroke.

She said she'd get back to me.
The phone rang a bit later as we were packing up the car to go fishing.

It was a case nurse from the VA. The writing issue concerned her and she wanted us to drive to the ED in Madison right away. I explained to the case nurse that I didn't think the writing issue warranted a 90 mile drive. Rich did not have stroke symptoms that were an emergency. She sounded rather displeased and said she'd put a note in that he was to see the ED [Emergency Dept] after speech therapy. She wanted a CAT scan done. She'd also notify his provider to get a consult from Neurology and ask for his records from GLHP.
I asked why no one had followed up with GLHP yet.
She had no answer.

We went fishing.

At our appointment with the Speech Therapist, Elizabeth asked us how things were going. I saw that she had printout in front of her. She knew about yesterday's call and the follow up notes that strongly suggested we come to the ED.
We were able to establish through some testing that Rich did indeed have Agraphia along with Aphasia. Both were mild but extremely frustrating to Rich.

Was this new? Probably not. We were given exercises to practice at home to challenge the writing and speaking. We left with a lot of thank yous. We'd see Elizabeth in a bit less than two weeks. She had felt that Rich had improved since last week. We left and were reminded to go see the ED.

Oh yeah. The nurses took his BP and asked a few questions. "Why were we there?" I explained because the case nurse demanded we come when I spoke with her yesterday."
The nurses left the room and then walked us to another waiting room.

I checked the clock. Shift change time.
We sat down and waited.

A man with a white coat opened up the waiting room door and asked for Richard. We stood up.
"Why are you here?" he asked Rich. So...my first thought was dislike of this doctor's manner. It was an aggressive manner and his face was closed not open. If you watch people, you would understand what I mean.
Rich tried to answer.
The doctor tilted his head a bit, then interrupted Rich.

I was able to begin to explain what was going on when the doctor held up his hand and said, "Just go to Gundersen and get all of the notes and records. Get the imaging and physically hand carry it here. I'll make a consult note to Neurology. They will call and set up an appointment. Bring them the materials."

This conversation happened as we stood in the waiting room. This person who called himself a doctor was not interested in the patient before him. He was interested in 'getting rid' of him so as not to have to deal with it.

However, the doctor was right. The VA was pretty bad about getting information from another treating facility. Their in house records were fantastic. But the method of getting other records was archaic and next to impossible.

Two days later? I still don't have an answer to an approval for a follow up appointment to see neuroscience. True to VA fashion, they would rather keep his treatment in house so to speak.

I see I will need to call the social worker again. She is going to hate me.
All I wanted was an answer to how the follow up appointments were to be handled.

Welcome to the VA.