Tag Archive: Ulcerative Colitis

Caremark “Congratulates” Us for Having Lots of Medical Debt

family out of pocketCaremark, the online drug service owned by pharmacy giant CVS, handles part of the drug benefit for Polly’s group health insurance plan. Caremark tracks insurance-approved medical expenditures with a graphic on their website. This graphic shows how much money you have paid in a particular year for out-of-pocket medical expenses. This year, the maximum out-of-pocket is $6,750.

The company Polly works for pays about $18,000 a year per employee to provide each employee with medical insurance. On top of that, married employees with children pay $3,900 a year for insurance — $150 every two weeks. This means that if an employee reaches the maximum out-of-pocket this year, the total cost of health insurance is almost $29,000.

The past fifteen months have been a medical nightmare for Polly. And we are not done. She now has serious bladder pain, and is getting up in the night numerous times to use the bathroom. She’s up more often than I am during the night, and that’s tough to do since my prostate/bladder just love making life miserable for me. In previous years, I have had my own medical nightmares, leading to exorbitant medical expenditures. Over the past decade, we have met the maximum out-of-pocket five times; all while trying to make ends meet on Polly’s income. (That’s why me being able to draw Social Security beginning in June will be a big help to us.)

Polly’s insurance provider finally paid the last of her bills from her January hospitalization for acute ulcerative colitis. This put us over the maximum out-of-pocket for the year. Woo hoo! right? The good news is that everything is FREE — to us anyway — the rest of the year. The bad news is that we have accumulated $6,750 of new medical debt over the first ten weeks of 2019. On top of that is the $50 a month we have to pay for Lialda, a drug Polly will be on the rest of her life. When the gastroenterologist first prescribed Lialda, we took the script to the local Meijer Pharmacy, only to find out it would cost $890 a month. Well, that sure as hell wasn’t going to happen, regardless of its benefit to my suffering wife. We simply couldn’t afford it without being forced to sleep in our car. Fortunately, we found a service that works with lower income families to provide expensive drugs for them at a reduced cost. Prescription Hope was able to procure the drug for $50 a month. Since the cost of the drug is not run through insurance, we will have to the monthly cost regardless of meeting our maximum out-of-pocket for the year. I plan to contact the insurance about being reimbursed for the $50 a month cost. We do have a tax-free HSA account. Polly’s employer kicks in $138.47 every two weeks and we set aside another $100.

As the above graphic shows, Caremark congratulated us for reaching our maximum out-of-pocket. This, evidently, is what Caremark is congratulating us for: in 2019, 30 percent of our net income will go towards medical costs. That’s the “prize” for reaching the maximum out-of-pocket finish line. And this doesn’t include dental costs.

I look towards the future and ask myself, how will we manage? I don’t have an answer. I told my counselor that I had finally figured out how to get our medical costs under control: death. I am grateful that we can still keep our head above water financially, but if medical costs continue to increase (and they have increased every year over the past decade), it leaves me wondering how in the hell we are going to make it. Of course, the answer is single-payer insurance/socialized medicine. While there are a handful of champions of this cause in Congress, Republicans and many Democrats are in the pockets of insurance, medical, and pharmaceutical corporations. Our political leaders actively work against our best interests, health-wise. This leaves the rest of us scrambling to figure out how to pay the price for living.

About Bruce Gerencser

Bruce Gerencser, 61, lives in rural Northwest Ohio with his wife of 40 years. He and his wife have six grown children and twelve grandchildren. Bruce pastored Evangelical churches for twenty-five years in Ohio, Texas, and Michigan. Bruce left the ministry in 2005, and in 2008 he left Christianity. Bruce is now a humanist and an atheist. For more information about Bruce, please read the About page.

Bruce is a local photography business owner, operating Defiance County Photo out of his home. If you live in Northwest Ohio and would like to hire Bruce, please email him.

Thank you for reading this post. Please share your thoughts in the comment section. If you are a first-time commenter, please read the commenting policy before wowing readers with your words. All first-time comments are moderated. If you would like to contact Bruce directly, please use the contact form to do so.

Donations are always appreciated. Donations on a monthly basis can be made through Patreon. One-time donations can be made through PayPal.

Life Sucks — Sometimes

life sucks

In a few months I will draw my first social security check. My oldest son will turn forty in May, the same week my oldest granddaughter graduates from high school. Illusions of youthfulness no longer cover the reality that I am officially old, a curmudgeon whose best days are in the rear-view mirror. If I live to age seventy, six-sevenths of my life is gone, and if I live to eighty — not likely — three-fourths of my life has wafted away as steam rising from a radiator heater — the steam that used to entertain me fifty years ago as I stared out the school window, hoping for spring’s soon appearance. I am a pessimist by nature, choosing to see things as they are. My counselor and I were talking about people who love to point to spry, healthy, all-jacked-up-on-Mountain-Dew people in their eighties and nineties as examples of what any of us could attain if we would but do ___________ (fill in the blank with the latest, greatest health/fitness/lifestyle tip). While such people are well-intentioned, they are, in fact, delusional. The human race is a pyramid, with the Jack LaLannes of the world standing on the pinnacle. Most of us will not have such lives, and will, instead, face a variety of health problems as we age. And for some of us, our health problems will have begun long before we got old. In my case, I was fifteen.

At the age of forty, I was diagnosed with Fibromyalgia, and over the last two decades osteoarthritis has attacked my spine, neck, shoulders, hands, and feet. My orthopedic doctor says arthritis is like a wildfire spreading through my body. Throw in high blood pressure, diabetes, nerve pain, a torn meniscus, and a torn shoulder labrum, and, well, life sucks. Tonight, I photographed a local high school’s junior varsity and varsity basketball games. This required me to stand on my feet for an extended period of time. It was not long before the years-old ritual began: pain in my lower back, pain in my shoulders, pain in my feet — even with orthotics — culminating in burning numbness in my thighs and face. At half time, I sat down as I have done countless times before, rocking forward and back, relieving the pressure on L5 in my lower back. The pain subsides and the numbness dissipates, that is, until the buzzer sounds, telling me it is time to stand once again, camera in hand, ready to photograph young, athletic men who remind me of myself forty-five years ago.

I am sure some of you are thinking, if photographing the games cause so much pain, why do it? Simple. Yes, life sucks, but I have two choices. I can either rot away in my recliner watching M*A*S*H reruns, or I can force myself to get out of the house, knowing that the price of admission is pain. I choose the latter, having no desire to spend my days mindlessly watching TV. I take narcotic pain medications, NSAID’s, and muscle relaxers, hoping they reduce the pain enough that I can gut out whatever it is I want/need to do. This is not me whining or complaining. I don’t seek your sympathy. But I do have a point I want to make . . .

My wife, Polly, was, until last year, destined to be one of those eighty-somethings standing of the pinnacle of life. She rarely got sick, and the only time she was in the hospital was to give birth. Polly has worked at Sauder Woodworking for twenty years. Up until recently, she had never missed a day of work. Never, not one day. Polly expected to live a healthy life all the way to the finish line. Naive? Perhaps, but past experiences suggested she had “good health” genes. One early morning, however, everything changed. Polly woke up me up, saying her heart was racing. Sure enough her pulse rate and blood pressure were quite high. Off to the emergency room we went, and hours later it was determined Polly had AFib. Two months later, Polly started bleeding internally, requiring two outpatient surgical procedures. A month or two after that, Polly broke a molar. The dentist could not fix the tooth, so it had to be surgically removed. A few months after that, Polly had to have surgery for a deviated septum. By then, both of us were singing the LIFE SUCKS tune. Surely, better days lie ahead, we thought. Unfortunately, the worst was yet to come. In January, Polly began having severe bowel problems. This eventually landed her in the hospital. Numerous tests later, it was determined Polly has ulcerative colitis — a diagnosis that explains some of the problems she has had in recent years. Six days later, Polly left the hospital, her life changed forever. Life sucks.

And then, our water heater quit working. A small thing, to be sure, but I thought, doesn’t the shit ever stop flowing our way? I want to think that better days lie ahead, but I don’t know what tomorrow might bring. All I know to do is to endure, believing that there will be moments and days when life doesn’t suck. Sometimes you have to look really hard to find them, but they do exist. I remember a particularly painful day last summer when the family was over for dinner. Quite frankly, I just wanted to be left alone, but this event had been scheduled for a long time so I put on my weary fake smile and endured. But there came a moment when I was sitting in my lawn chair outside watching my younger grandchildren play. So full of life, filled with energy and silliness. I found myself, in that moment, enjoying life; a brief respite from pain and suffering. It was a reminder to me that, yes, life sucks, but there are the joys of life, the reasons for which you continue to get up, breathe deeply, and live.

Earlier this week, I attended band concerts for my fifth-grade grandson and my seventh-grade granddaughter. The fifth-grade concert was, well, good job, kids. Keep practicing! The seventh-grade concert, however, was phenomenal. My granddaughter plays in the jazz band, and I was quite impressed with their skill level. She has come a long way — talent-wise — in three years. I sat on the front row. This made me an easy target for thoughtless, careless people. Three times, people plowed into me. One teenager knocked my cane out of my hands. I wanted to scream, I am a big man! Can’t you people see me? I said nothing, choosing instead to endure their punishment. And it was worth it. Once the music began, I found myself in one of those “life is good” moments. I have the privilege of watching my grandchildren grow into teenagers and young adults. My dad died at age forty-nine and my mom committed suicide at age fifty-four. None of my children or grandchildren ever got to know my dad. He was dead by the time they were born. My oldest two sons remember my mom, but that’s it. I have often wondered what my mom would have thought of my redheaded daughters or my grandkids. Alas, heart disease and mental illness ended my parents’ lives on a “life sucks” note. I wish it could have been different. I wish my children and grandchildren had the opportunity to know my parents. But all the wishes in the world won’t bring them back from the dead. All I can do is try to keep their memories alive through stories and photographs.

Yes, life sucks, but I am grateful for those moments in time when it doesn’t. I am blessed to have a wonderful wife and family. And even though the pain is unrelenting, I continue to try to look for those times when I am reminded that life is good; that even in the midst of suffering, there are moments of joy. All I know to do to is get up each day and hope for the best. I don’t know what any one day might bring, but I remain hopeful that in the midst of stormy weather, the rain will cease and the sun will shine — that is until a meteor wipes me (and you) off the face of the earth. 🙂

About Bruce Gerencser

Bruce Gerencser, 61, lives in rural Northwest Ohio with his wife of 40 years. He and his wife have six grown children and twelve grandchildren. Bruce pastored Evangelical churches for twenty-five years in Ohio, Texas, and Michigan. Bruce left the ministry in 2005, and in 2008 he left Christianity. Bruce is now a humanist and an atheist. For more information about Bruce, please read the About page.

Bruce is a local photography business owner, operating Defiance County Photo out of his home. If you live in Northwest Ohio and would like to hire Bruce, please email him.

Thank you for reading this post. Please share your thoughts in the comment section. If you are a first-time commenter, please read the commenting policy before wowing readers with your words. All first-time comments are moderated. If you would like to contact Bruce directly, please use the contact form to do so.

Donations are always appreciated. Donations on a monthly basis can be made through Patreon. One-time donations can be made through PayPal.

Update on Polly

blogging

I want to thank everyone for their kind words and thoughts. Polly and I appreciate your support.

Five doctors, a CT scan, a MRI, colonoscopy, endoscopy, and countless blood tests later, two doctors — the surgeon and the gastroenterologist — believe she has ulcerative colitis and the hospitalist believes she has Crohn’s disease. It was interesting to hear each side argue their diagnosis. Biopsies, which are outstanding, will provide a definitive diagnosis. Either way, the initial treatment is the same.

Polly also has a liver/bile duct issue which remains unresolved. We should know more on that issue tomorrow. It may have been exacerbated by the widespread inflammation in her bowel.

As things stand tonight, Polly should be released on Sunday. When she was admitted on Tuesday, I feared she was dying; and left untreated she would have died. Thankfully, the ER doctor quickly narrowed down Polly’s symptoms and determined she needed to be admitted. Her other doctors have provided first-rate care, and, at times, comic relief. The change in Polly’s condition over the past thirty-six hours has been remarkable thanks to modern drugs, especially steroids and antibiotics. I’m grateful we live in a day when such things exist.

Thanks again for your wonderful support.

Bruce