Kit's Healthcare Thread: Help Wanted

SO! I did that Very Stupid Thing again last fall/this early winter where depression/anxiety/panic and some truly horrible living situations made me drop all of my (extremely tentative and insufficient) healthcare connections and appointments. Again. (I know from experience that most neurotypical people I've talked to find this baffling, but... apparently other people experience it too?)

Anyway, we have medical insurance, we even have an HSA full of funds that can cover copays at least for a while, and I have a whole cluster of mental and physical health issues that need taken care of, but I am sandwiched between shame at failing to take care of myself, phone anxiety + audio processing issues, some by-now earned fear of the medical industry in general, and an actual shortage of healthcare (especially mental healthcare) in my region.

I just. Get overwhelmed and depressed any time I even try to start thinking about where to start with this. Advice and, later on when I even have tasks figured out, gentle nudging reminders to complete tasks would be super duper welcome.

Health Problems that Probably Need Fixing:

• previous gynecologist diagnosed me with PCOS - I was on birth control pills for a while to regulate my cycle, and it's stayed relatively regular once I went off of them, but I might still have thyroid or insulin resistance issues that need monitored and/or medicated
• repetitive stress injuries in hands - I actually feel like I have my day-to-day care of this on lockdown, but it would be... nice to have access to physical therapy if I accidentally do a Big Injure to them again sometime? my hand history is complicated.
• depression - super root of lots of my issues. Should definitely be on antidepressants, as they REALLY HELP... but when I went on hormonal birth control for the PCOS, it was like taking a sugar pill instead of my antidepressant, and I got really discouraged, and then life snowballed on my and I said "fuck it" and stopped doing anything, basically.
• PTSD? - I have no official diagnosis for this, but it's pretty damn clear by now that this is a thing I'm dealing with, probably complex-type, between the two disparate sources of a series of abusive relationships in the past five years AND two severe car accidents. I should. Be getting some kind of treatment? I think?
• GI issues - Not sure what the root of this is, but we have a family history of a lot of varying kinds of GI issues. I didn't used to have problems at all, but back when I was getting regular healthcare two-ish years ago they had me on multiple medications that all had GI issues as a side effect... and the issues didn't go away when I stopped medications. Partially manageable with diet experimentation at home, but still frustrating and mildly concerning.
• teeth - aaaaaaa. I haven't been to a dentist in. Forever. And I only in the past six months or so, with lots of patience from my wife, have started developing even reasonable oral hygeine habits, as toothbrushing is very near Ultimate Sensory Nope for me. I've got the habits in good progress now, but I know my teeth are kind of fucked up and need cleaned and... probably some work done? But a dentist is the one kind of medical professional I have literally never found on my own as an adult. I don't even know how dental care works vs healthcare and what I have to do to make sure insurance is doing insurance things. I am completely beyond overwhelmed by this.
• eyes - This is probably the easiest! I'm about six months overdue for an eye exam, but I know the doctor I used before, and I like him, and they even do online scheduling. the ONLY downside is that my wife seems to remember us having to pay a significant money out of pocket for my lenses and/or frames last time, and I don't remember why, and that is something that isn't covered by our HSA by our memory/understanding, so we'll have to plan that around having wiggle room in the budget. (And, honestly, prioritize her getting glasses, since she hasn't had new ones in years).

Not an issue that I necessarily NEED healthcare for, but one that informs all of this - I am super-strongly suspected autistic, but not diagnosed. The autism explains quite a few of my medical history decisions, may inform some comorbidities, and will ABSOLUTELY affect how I experience the medical care industry... but I don't know if seeking diagnosis is a thing I want to do right now? And holding things up for that process regardless doesn't seem healthy.

This got very rambly, and I'm sorry. I will super duper incredibly appreciate anyone's help, advice, or even just hugs. This all sucks, but I REALLY WANT to be good and start trying to take care of myself again.

 

i recommend going online to their website or contacting your insurance company directly to find out what clinics/offices/doctors near you are in network. if a place/doctor is in network it should be mostly covered with a reasonable copay.

then, pick one and shoot an email to tell them you have X insurance and would like to scheduale an appointment for Y (ex: teeth cleaning). then wait for response, and then hopefully pick a date and time. that's my experience, anyway, if it goes well.

re: teeth. recently when i've gone to the dentist they offered me topical numbing stuff on my teeth/gums, which has helped tremendously. the first minute is bad because it doesn't taste good, but after that it's so much better because i don't have to worry about pokes or the water being too cold (my teeth are suuuuper temperture sensitive). i dunno if this is avalible everywhere but i recomend at least asking if it's a possibility.

re: eyes. i recently got new glasses and when i picked them out, i had to be careful because insurnce would only cover frames up to a certain amount of money, and they wouldnt cover any extra (anti-glare, or transition lenses). the eye doctor had frames that ranged from totally covered to extremely expensive, but they didn't make a big distinction between those frames so i had to be careful and pick ones that were cheap enough to he totally covered. possibly this kinda thing is why you had to pay a lot last time? i don't know, but yeah.

 

I can just... email offices?

That would be so much easier.

Granted, my insurance company's website the last time I remember having to use it sets new bars for complete dysfunctionality, but I can give it a shot. If all else fails, I can probably sort of reverse-search it by pulling up the websites of my local doctors' offices (of which there are few enough that this is a feasible task) and seeing which insurance companies they accept.

Juuuust... gotta do it now.

(Gonna try insurance website first.)

Edit to add: For glasses, I think my wife insisted on getting me scratch resistant lenses last time. Which, whatever, that's very nice, but I don't actually live a super active running-into-shit lifestyle. Maybe we could get glasses almost completely covered that would be cool.

 

Progress: I didn't forget my insurance website login! And the website didn't lock up and insist my session had timed out when I tried to log in!

Hahahahaha my last claim listed was from June of last year. Wooooooops. I. Really kinda failed at this whole healthcare thing.

 

phone calls will usually get faster action, but yeah i usually email offices if possible. if an office has a website or a facebook page or something it usually lists an email address to contact. bonus, you now have a paper trail! (well, email trail) which can be very helpful.

and yeah i know my insurance company considers scratch resistant to be extra, so.

good luck!!

 

Mmmkay. Website is still kind of kind of annoying - trying to backspace back to my doctor search logged me out somehow - but I'm trying to look at local providers.

Just thinking out loud here - I guess I should look for a GP/Family Practice doctor first? And then have them refer me if needed to specialists. It'd be really nice if I could find a family practice doc who was also certified for ob/gyn, though, since I know that will be a need I will have and I will be less stressed if I have less appointments and medical relationships to juggle.

(thanks so much for the advice and the luck-wishing, @raybot - it's helping to know someone's seeing this, even if half of it is just me thinking out loud somewhere where I have a 'paper trail' to refer back to)

 

a GP makes sense, yeah, but in my experience eye/teeth things are pretty seperate from other general medically things? so the GP can refer you to people for GI/ob/gyn stuff but i would just reach out to eye and teeth doctors without waiting for GP input.

(you're welcome! :D)

 

Okay, so, progress update!

I actually managed to narrow things down to a single GP I would like to try. Her clinical interests listed on her profile include Family Medicine, Obstetrics/Gynecology, Obstetrical Care including deliveries, Women’s Health, Comprehensive Preventative Care, Pediatrics, Chronic Disease Management... which just about perfectly fits my current and (hopeful future) needs. She's part of a large practice - an American Health Network building. I do know someone who had a bad experience with that practice, but to be fair their family is kind of Ultimate Failure Mode at managing communication, logistics, and appointments, so I'm taking their complaint that the office staff was "difficult to work with" with a grain of salt.

...this office doesn't have any kind of email address listed, though.

Gotta call.

*teakettle noises of anxiety*

It is too late to call today, but for tomorrow... would anyone be able to help me come up with phone scripts for talking to the New Patient Coordinator I have a phone number for? I very specifically want this one doctor at their practice, and I'm not sure how hard that will be to arrange. I also just super wow extremely suck at audio processing, and won't have anyone around who's any better at audio processing than me during their office hours.

 

Decided to look up dentists while I am waiting for my wife to get home so I can fill her in on my progress.

According to my insurance website, the closest in-network dentist is an hour and a half a way.

Can that even actually be right holy shit.
I have to be doing something wrong... right?

 

I can maybe help? I don't know how useful I'll be able to be, but I'm happy to try to help.

Also, regarding dentist: that does seem extreme! Is it sensing your location automatically, or did you enter an address/location manually? Sometimes the automatic location thing can be weird and give wrong locations.

 

I have a problem with really overexplaining when I get nervous, and my medical history is complicated and v weird looking, so that gets bad fast in person, never mind on the phone. Help with figuring out the exact amount of things I need to communicate to set up an appointment would be much appreciated :) like, what do I need to tell them?

For the dentist thing - I entered my zipcode for my location. Double checked, and it looks like dental is in fact listed under my medical benefits under this company, not as a separate plan (which I remember my parents' insurance doing at one point.) It's searching based on the specific healthcare plan we have under this company. Part of me is like "yes, this is exactly what my area's super shitty healthcare is like, I had to drive almost that far to see an ethical/competent psych a couple of years ago why am I surprised" but - it could also be the website glitching. Anthem's website is infamously glitchy.

 

I tried to write a script. Dunno if it's what you're looking for, but hopefully it helps.

"Hi, my name is [name]. I'm looking for a new primary care physician and I'd like to be a patient of [physician] if possible."

-> responses
a) Ok, she currently is accepting new patients. Can we get some information about you and then set up an appointment?
b) Sorry, she's not accepting new patients at this time. Would you like to work with another doctor from our facility?

IF a), info you'll be asked for will probably be things like name, address, phone number, maybe previous doctor. Probably not medical history, and if they do ask, you can say, "I don't feel comfortable explaining it over the phone" or "I'd prefer to explain it to [physician] in person." Probably insurance info, so have that ready when you call.

IF b), "I really would prefer [physician]. I have some complicated medical history, and would feel most comfortable with a physician with appropriate background."
-> you'll probably be asked what about [physician]'s background you want. I'd recommend answering this honestly, they might have someone else who's close enough to work. If you do end up in this fork of the conversation, a concern will be not just accepting whichever doctor they suggest just so you can get off the phone. Maybe having a written list of criteria you can refer to will help with this? E.G. "I have a chronic disease and some women's health concerns and I'd like a doctor who's knowledgeable in those areas."

If they suggest someone who isn't what you want, polite refusal dialogue: "I'm sorry, I just don't think that [other Dr] will fit my needs."

(edit: added examples of criteria)

 

that is actually so super helpful omg thank you thank you thank you

 

Definitely seconding Vierran's advice, really spot-on!

 

you're not necessarily doing something wrong. sometimes this happens. my insurance recently decided to drop all local providers. now i have to drive to another city for physical therapy. i have no idea why this is a thing that they do but???????? *inner wailing* ahem but yes. this is a thing that happens, for some reason.

luckily ime dentist things tend to be standardized like once a year-ish, maybe once every two years, unless you need dental fixes (and even then you get it fixed, and then go back yearly visits). so you shouldn't have to make the trip all that often

 

I CALLED THE GP OFFICE

they directed me to fill out the new patient packet (available on their website) and go ahead and send it to them

Now for the weirdly fun part - I actually get an odd if mildly frustrating glee out of filling forms like this. Is frustrated glee a thing? It should be a thing. I like to cheerfully curse at the parts where I don't fit neatly into boxes, and I just genuinely like forms. Things have places! There's an order!

Now I have to make an eye appointment, and figure out the dentist thing >.<

 

Yay to finding a GP :D

I know next to nothing about the American health care system, but in the Dutch system you have to have a GP, because they refer you to specialists, and also determine when to refer you to specialists. (95% of complaints that people go to their GPs for can be solved by the GP).
Dutch GPs also generally have patients' complete medical history in their files. They get all letters from specialists and hospital stays. This means they also have an overview of things that have been tried and have failed in the past. I love this about our system.

Here's to getting health issues sorted out! (I really should do some of that myself...)

 

A note on glasses, in case it's relevant to you - one of the things that is super expensive out-of-pocket for me for glasses is getting specially-made thinner lenses, because my prescription is super high and thus the lenses tend to be very thick (and fall down my face) without it.

This might have been something that was expensive for you, or it might not - but if it was, it's worth thinking about whether it's worth saving up for that in your personal circumstances, because the super thick lenses can be enough of a problem that it can be worth waiting a while until you can afford thinner ones.

(I realise this is super specific and may not apply to you at all! It was just the thing that caught me out most last time.)

 

Very delayed update!

Because I am bad at executive function, it took me nearly a month to get the forms for the GP I was talking about earlier - and in the meantime, some family conversations about healthcare have possibly shifted my priorities somewhat in terms of what I want out of healthcare.

To cut a very long story short, I've got some good reasons for considering getting my primary care through a Certified Nurse Midwife. There's even one within a reasonable driving distance of here who 1) specializes in my exact medical needs, 2) takes it as a personal mission to be good with chronic illness patients, and 3) comes supremely highly recommended.

Their office doesn't do insurance billing, though - they are frequently covered by insurance, but we would have to handle the billing for reinbursement ourselves.

This sets off all my brainbugs about being "worth the effort," but - is it worth the effort? I don't know.

 

holy crap

I just called the midwifery clinic, and not only are they accepting new patients, and not only can I cover my initial expenses with my HSA while we figure out insurance billing, they could schedule me for an appointment next week.

I live in the USA. I live in the midwest, in Indiana, in an area of staggeringly terrible healthcare availability. And I just got a non-emergency appointment in a week. I've had friends have to schedule out six months ahead to see a GP.

HOLY CRAP THIS IS AWESOME.