Remember way back when we had that day from hell at the hospital during my second CAKE (click here, here and here for the three-part refresher)? And the unhelpful answers (look about halfway down into this post) I got from my doctor’s office a couple days after my first CAKE treatment? Well, we spent a couple of grueling weeks sorting through issues from all that and I thought you might like to hear how it all worked out in the end.

The long and short of it is that our insurance company suddenly got stingy about giving me a particular prescription medication to help keep my post-chemo nausea under control. They wouldn’t authorize more than 9 pills at a time and then when we tried to renew the prescription in preparation for the second CAKE, they claimed it was too soon - that I had to wait a month between refills before getting 9 more measly pills. I’m sorry that my CHEMOTHERAPY for my CANCER doesn’t FIT with your freaking bureaucratic schedule of allowable benefits!!!! Grrrr! Anyway, that was one prescription that I use at home. Then there’s another anti-nausea med that I fill at the hospital and take the morning of CAKE and for three days afterwards. The insurance company got stingy with that one that same day. Somehow, (I don’t know how because I was pretty doped up and sleepy through CAKE that day) Honey worked it out and got medication #2 so that I could actually get CAKE that day and we had to pay out of pocket for just three of the medication #1. Seventeen dollars for THREE PILLS! And then a couple days later, I needed more so we paid another seventeen dollars for three more pills. Sure, they worked on the nausea but they gave me a nasty head and neckache (I have no idea how these drugs work like that!).

When you want to talk to my doctor directly about something, all you can do is either make an appointment and wait to see her face-to-face or email her. Eventually, I had acquired her cell phone number and when Honey called that, she kindly told him that the dealings with the insurance company was out of her control and that he needed to speak with her head nurse. So while we were paying an arm and a leg for six stupid pills, Honey was leaving messages for my doctor’s main nurse, Nurse Skippy. (We call people we consider dumb-asses “Skippy” instead of “Dumbass” - like bad drivers, stupid salespeople and telemarketers.) Skippy didn’t return Honey’s calls for several days. Meanwhile, Honey called our Patient Advocate at the hospital who eventually put us in touch with the individual who does, indeed, work with the insurance companies on just these sorts of issues. Honey finally got things moving and worked out with that lady, we’ll call her the Insurance Advocate, should we need to refer to her again. But Nurse Skippy didn’t call Honey back until 5 days later. Meanwhile, I’m in agony at home, nauseous and trying to take anything I possibly can to control the chaos that is my digestive system. I know I should’ve “called my doctor’s office” but if I had, I would’ve just ended up dealing with Nurse Skippy and he was already on my Shit List for ignoring Honey’s calls. I didn’t really put a lot of trust in him after his pathetic explainations to me about the sympoms I had after my first (SCARY) CAKE experience.

When he finally called, Honey just told him we had worked it all out with the Insurance Advocate and Patient Advocate. Honey’s too nice to say “So F*** OFF!” but we were both thinking it loudly in our heads!

Honey and I both have almost a decade of customer service experience under our belts. Our own good customer service skills makes us pretty reasonable customers when dealing with issues on a commercial level. I guess we just expect people in positions that deal with “customers” or, in this case, “patients” to have good customer service skills, too. Is it too much to ask to get a return phone call in a timely manner? Honey kept saying he thought he was suffering from the payback of Bad Karma for the times he didn’t call his customers back at old jobs he had!

Apparently, the Insurance Advocate had heard our complaints regarding Nurse Skippy (she had said that a lot of what she was going to do was supposed to have been done by Nurse Skippy and she wondered why he wasn’t taking care of it) and reported it to his boss. In the meantime, I get emailed requests from the Hospital’s President to fill out a satisfaction survey after each and every visit. There’s always a little box at the end of the survey for comments. You should’ve seen how I overflowed that box after that nasty CAKE visit and our issues with Skippy! A few days later, Nurse Skippy’s boss (not my doctor but the Head of Nursing) called me. She was very kind and listened to all of my complaints and concerns. Why didn’t Skippy return Honey’s call? Why wasn’t he more helpful and nicer to me when I called him, freaking out about not being able to swallow after my first CAKE treatment? I know being a nurse isn’t quite the same as selling TV’s at Best Buy but shouldn’t a nurse, above all other people in customer service, have impeccable customer service skills? They deal with sick people day in and day out…I kind of think it’s a requirement, don’t you? I mean, we all know that to be a great doctor he or she need not have a good bedside manner, just as long as he or she is great with his/her hands, medical knowledge, whathaveyou. But a nurse is an entirely different story. The nurse is the one who should pick up the lack-of-bedside-manner slack that the doctor lacks. When Honey finally got him on the phone, Nurse Skippy’s excuse was that he was terribly busy and hadn’t had time to return Monday’s call until Friday afternoon at 4pm.

Anyway, Skippy’s boss was very understanding and promised me she would talk to him as soon as he got in the next day. Which she did and he called us promptly. I waited until Honey got home so that we could both talk to him together to clear the air. We called him back that afternoon and we laid it out on the table. I told him I felt dismissed when I to him after my first infusion. I told him, “You may be very experienced and know all about the side effects, symptoms and things to expect after chemotherapy but this is my first time through it so I don’t know what to expect and I was counting on you to help explain it to me. I felt you were writing my symptoms off as trivial and silly. I didn’t know better. I was scared and confused. I didn’t feel comfortable calling you with more questions after that.” Honey told him in detail all the problems with the insurance company and those prescriptions and how eventually, when he spoke to the Insurance Advocate lady, she indicated that a lot of what needed to be done to remedy the problem should have been done by him (Skippy). Where was he? Why didn’t he take care of it? Why didn’t he call back right away? Honey and I both said to him, “We know you are busy. We are ALL busy with our lives and our jobs and our things to do. But it’s your JOB to call back and help us solve these problems isn’t it?” He said that it was and he sincerely apologized. He admitted that he had felt unusually swamped that week and he was working on the problem but he just hadn’t called to explain to us what he was doing/waiting for/the next step, etc. He thought maybe it was just a breakdown in communication between us all. He was right. So we all kissed and made up, so to speak. That was a relief.

I told my ShrinkyDink all about it. Her husband had cancer years ago and he actually had the same doctor and nurse as I do. So she was familiar with both and had already told me what to expect from my doctor. When I told her about this deal with Nurse Skippy, she said, “Don’t be surprised if he becomes your shadow and won’t leave you alone from now on. He’s probably going to take care of your every need before you even know you need anything!” BOY WAS SHE RIGHT!

Ever since we made up with Skippy, he has been one, sometimes two steps ahead of me in my coping with this cancer and the CAKE side effects. He calls me twice or more a week and asks how I’m feeling, if such-and-such medication is working to my liking, if I want to add anything else, try something new, etc. He is ALL OVER IT! He is my new be-fri! Like Friday he called and wanted to know how I was feeling because the weekend was coming up and he wouldn’t be back in until Tuesday (he and my doc are off on Mondays) and he wanted to make sure I would be comfortable between Friday and Tuesday. I told him of my persistant nausea and extreme acid reflux. He immediately called in three new prescriptions to try and told me to have a good weeekend. Then on Monday, the acid was sooooo bad that Honey got worried and wanted me to call the doctor (aka Nurse Skippy). I didn’t want to because I didn’t want another damned prescription. Well, Skippy called me yesterday to see how I was feeling again! i told him and he assured me to keep taking one of Friday’s new meds persistantly because it takes it a while to effectively heal the damage that has already been done in my stomach and esophagus from the acid. Then I asked him about how I should approach refilling a couple of my regular scripts that the doctor has doubled the dosage of — the insurance is going to give me a problem when I try to renew them too soon for their liking. He inquired about mail-order pharmacy and told me to just fax him the form I have for that and he’ll take care of the rest. He said that insurance companies usually like to fill patients’ scripts through thos mail-order pharmacies because they tend to be priced cheaper than drug or grocery store pharmacies. HA! How cool! I faxed him the paperwork immediately and he assured me he would get right on it. And I believe he will! He’ll probably call me later today to let me know the status!

So that’s how it all worked out in the end. Oh, I forgot to mention that just a couple days after we ironed everything out with him over the phone, he approached us and shook our hands while we were at the hospital for CAKE the last time. He even kept coming to check on me throughout the day and brought me samples of medications to try. He’s so cool. Like I said, my new be-fri! He’s a scrawny looking dude who’s voice sounds like George McFly in the Back to the Future movies so we’ve renamed him Nurse McFly. He’s certainly not a Skippy anymore! Maybe I’ll call him Nurse BeFri!