We have enjoyed this summer so much compared to last year at this time. Dale was in and out of the hospital for a large part of the summer and the rest of the year he was making the long climb back. We recently went to Dallas to have a procedure done and before we left we were presented with a bill that was from last year.

When we got home I called the insurance company to see what happened. Medicare had paid their part but our private insurance was denying the claim. They initially said that it was because the hospital didn’t precertify. Dale of course didn’t call them because he was half dead from infection and hallucinating due to the pain medication (given to him by a hospital I won’t name since they recently showed a desire to frighten anyone who publishes negative opinions about them by suing them).

Next they claimed that the hospital didn’t provide enough information to convince them that the procedures in the list of charges were necessary. I proceeded to explain exactly what the procedures were and why they were done and you can trust me when I say they were not elective. The customer service person I was speaking to said the only thing I could do would be to request the records from the hospital and send them with a letter asking for an appeal to the insurance appeal department. I had already given permission for the hospital to file an appeal on my behalf about 8 months ago. We have requested records from the hospital for ourselves over a month ago and still haven’t received them so this put us in an interesting situation.

I explained to the person on the phone that this was not going to be a workable option and that I needed to speak to someone in the appeals department. She replied that the appeals department doesn’t speak to the people who file claims. You have to communicate with them in writing. I asked to speak to someone who could help me. She told me (in a rather sarcastic tone) that I could speak to someone else in her department and they would tell me the same thing she was telling me. I asked to speak to a supervisor and was put on hold for fifteen minutes (I timed it and the elevator music wasn’t lousy) before someone answered.

This new person checked back and found that the hospital had sent records – 131 pages to be exact. The reason the claim was being denied was because the doctor’s notes were not legible. We now have three completely different reasons why the claim has been denied and I still haven’t been granted an audience with the great and powerful grand pooba of appeals. I have also patiently explained to each person I have spoken to, what was done and why.
I called the office of the admitting doctor and the person who deals with insurance there got out the notes and found she couldn’t read them either. The ball is in their court now.

I wonder if Michael Moore will be doing a sequel – “Sicko II” – I may have a story for him.

Thanks for all the good wishes and prayers. We made it through the first round of tests and we are waiting for them to schedule the stress test. We were given a lot if information to digest and we were both exhausted last night. The side effects of anti-rejection drugs are pretty scary and I know Dale is kind of trying to balance it all out in his mind. It would free him up from the dialysis and the diet would be better but the medications come with a chance of diabetes, nausea, lymphoma, melanoma, infection, and a host of other not so nice things. They have to be taken for the rest of your life or you lose the kidney. The actual surgery is the least scary part for him.

The traffic was terrible and at one point we actually managed to drive 8 miles in 45 minutes. It started pouring between Greenvile and Rockwall and my windshield wipers staged a protest and just quit for about 15 minutes. I was thankful for the mini-van in front of me that gave me tail-lights to follow till the wipers started working again. They have done this off and on for awhile and also refuse to turn off sometimes. They have NEVER done it when I have been near a mechanic of course. Mechanics and medicine – I’ll stick with computers.

A year ago today Dale was in the hospital at the beginning of the worst summer of our lives. Tomorrow we go for his first round of tests for kidney transplant which means we are back where we started a year ago. He is stronger and in better shape that I would have ever thought he would be after the peritonitis. His spirit and his sheer hardheadedness is amazing. Our first appointment is at 8:20 in the morning which means we will leave the house at about 5:30. The last appointment is at 3:20 and we have to go to a total of three different facilities during the course of the day. They are predicting rain and I am hoping the worst of it will pass us – I’m not terribly comfortable driving in Dallas (especially when I am going to places I have never had to find before) and I’m definitely not comfortable driving in storms so I’m keeping my fingers and toes crossed.

I shouldn’t complain at all – I’m not the one who will be poked, prodded, and x-rayed all day. We will spend part of the day in a transplant education class so I’ll be moving to the next chapter of everything you never wanted to know about kidney failure and were afraid to ask. I’m praying for no bad surprises. If he is told he cannot have a transplant it means a life sentence of dialysis which means for him 4 hours a day three days a week being hooked to a machine that filters your blood. It means feeling really crappy those days. It means having to be on a very strict diet, being more susceptible to all kinds of serious illness. If that is the verdict we’ll deal. If he gets the green light the next step will be having his sisters tested to see if one of them can be a donor. If not we get on the list and stay prepared for a phone call.

We will appreciate prayers – we’ve been blessed throughout all of this and part of me knows that those blessings will continue, The other part of me is weak and worries and gets very cranky and stressed. I wish I could be that person that everyone admires for their strength and grace. Unfortunately I happen to be a big bundle of crybaby nerves instead, who takes it out on the kids, or tries to stay busy to try to outrun it.

Okay – enough whining. We will do this just like you eat an elephant – one bite at a time. I’m turning in early – that alarm clock is not going to be my friend tomorrow!

We are home. We hope to stay home this time but I’m still taking it one day at a time. It was wonderful to sleep in my own bed, take a shower in my own bathroom, and cook food that Dale can have on a renal diet that actually has some taste and that he likes. Things I hated were Dale being in pain and having to go through so much physically, being alternately hopeful and terrified, leaving my kids here on their own, sleeping on a pull-out chair, having no privacy, having sleep constantly interrupted, missing work and the seniors graduation, being afraid that no matter what I did – it wouldn’t be enough. Things I am so very thankful for are Dale while still being very weak physically is now more like his old self and feeling more positive, for my kids being able to keep things together and finish school without us here, for meeting folks that were often in much worse condition than we were and finding that we could all pray for each other and hold each other up, for doctors and nurses that cared, for finding that I can drive in Dallas, for Robert at Hicks who scotch-taped my air conditioner together to keep it working for a little longer, for the prayers and concern and calls and emails from all the people who love us and who we dearly love, for Jack at the dialysis center who paid attention and realized that Dale had something else going on and needed to get back to the hospital, for all the people at the dialysis center who called us in Dallas to check on us and who gathered around to welcome Dale back tonight and probably much much more. I’m still running on adrenaline and I think I will probably crash and burn this weekend. I’m planning on a long Saturday afternoon nap with the kids here to look after their dad and maybe a long soak in the tub.

They are now telling us we will be here through Monday. I counted up yesterday and as far as I can tell we will have had 25 days total in hospital, 7 procedures, 4 antibiotics, 5 CT scans, 5 trips to dialysis and I have no idea how many docs. I can find my way to Target and back and my list of hints if you are ever at Baylor is as follows:

Laundry can be done on the 12th floor of the Wadley Building – carry quarters for detergent and softener sheets – the machines are free

Computers are available in the Health Science Library but no one tells you this – you have to ask. Just go to the Truett Lobby and go down the hall towards the chapel. Turn left just before you get there and go through the double glass doors. Go to the end of the hall and turn right and you are there. They tell me the reason they don’t have a program with laptops for patients is because they haven’t figured out the wireless thing yet. (maybe you should hire yourself out for a huge consultation fee Tony!)

Parking is insanely expensive, but for five dollars you can purchase a package of five parking passes. This means a dollar each time no matter how long you are parked there and ordinarily it would cost you $3.50 a day.

Go to Target if you need personal items like excedrin or toothpaste – the pharmacy here is outrageous. You can get on Washington and go straight to it and come back on the same street which is wonderful since so much of the streets here are one way and you can go in circles for awhile seeing Baylor but not being able to get to it!

If you know someone is going to be here and the family members will be around a lot, a gift certificate from Starbucks might be a nice thing since there is one located next to the Truett cafe. They also have loadable cards in the gift shop for the Atrium Cafe and probably Truett as well.

The gift shop has prepaid phone cards and for ten bucks you can get 250 minutes. Cell phone service is iffy in some parts of the hospital and my little trac phone is worthless but the phone card has been very helpful.

That is my list of things to remember if I ever know ahead of time that someone is going to be coming here. I think it would be a great thing if Baylor had a little welcome packet available for people that had this info in it but at this point all I care about is coming HOME.

Yesterday my daughter said she cleaned out the refridgerator while my somn was gone to debate practice. Eveidently she did a great job because he had to do the dishes when he got home because she was at bible study and he was not to happy about it. I bet when we get a new dishwasher they will pay close attention to instructions on the operation and care of it. They have never been without a dishwasher before and this has been a learning experience. They both seem to managing the laundry thing okay as well and I plan to let that continue when we get home. I am planning on working and I think their laundry can be something they can continue to handle. Maybe some of this experience will end up being a good thing as far as their ability to cope on their own. My usual way of handling everything is to yell and complain and then do it myself. That has come to an end. I am letting go of some control!

We are ready to come home – sit on the back porch with the ceiling fan on and a glass of tea, turn on the sprinkler and watch the grass grow!