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I betcha that  bcbsnc would be just as furious about what happened today at the pharmacy as Humana is.
I've been posting about my pain medication saga on this blog and my other blog, for the last couple of days now, and had found a pharmacy with the very last of the generic medication in stock, all of the way down in North Port today.

So my friends drove me down to the pharmacy in North Port this afternoon in a massive thunderstorm and heavy rain that lasted the entire drive down there, and half of the way back home, in order for me to get the last remaining stock of the generic Oxycontin HCL 40mg ER, which is Oxycodone HCL 40mg ER.
The pharmacy that I found it at didn't have my full prescription of 90 pills, but they did have 80 of them, close enough.
So I went for it because my doc had said because of that whole mess, that he was not going to write me a new script until he figured out what would work best for me because I am allergic to the equivalent med which is morphine sulfate, (MS Contin) and I am severely allergic to morphine, and also because Fentanyl patches don't work, and the Fentanyl injections are too dangerous and I refused them.

I went into the pharmacy and handed over my script and the pharmacist filled it, ran my insurance for it, and my co-pay was going to be $2.40, and that's when the pharmacist told me that she was losing money because of the insurance.
"What?" I asked.
"Because I am accepting your insurance for this medication," the female Indian pharmacist said, "I am losing money on it."
"What does that mean?" I asked.
"Let me explain. I pay $40 for the medication, Humana is only going to pay me $20 for it, you are only going to pay me $2.40 for it, so I am losing $20.00 by accepting your insurance and giving you this medication" she said.
"Ok, what does that mean for me?" I asked.
"It means that unless you pay me $20.00 for the medication, I cannot let you have this prescription" she said.
"Uh, ok, um, I haven't gotten paid yet, let me go see if I can borrow it from one of my friends" I said, and I went out to the truck to ask Deb and Nic if I could borrow $20 until I got paid Friday night.
Nic let me borrow it but told me I was being yanked.
I said that I knew that and would deal with it later, but right now this was the last pharmacy in the whole damn state with my med, I needed to get it and would report the theft and insurance fraud when I got home.
I went back in and instead of paying the legal amount of $2.40, I paid the theft price of $22.40, got my med, and we drove back home to Sarasota.

What the pharmacist did is called price gouging for one, theft for another, and insurance fraud for a solid third.
It is against the law to accept and charge an insurance company for the medication, actually charge the patient the real co-pay amount, and ask the patient to pay another price on top of that.
I know by going to the Humana website and logging in to my account, that I can see how much the medicine costs, my co-pay amount, and how much Humana pays the pharmacy when they submit the claim to Humana.
The medication costs $670.62, my co-pay is $2.40, and then Humana pays the pharmacy $668.22.
 
That is actually what it says on the My Humana page for today's (Friday October 16th, 2009) prescription fill at the pharmacy I went to today.
At my usual pharmacy that I had been getting it at for a full year before this whole Purdue lawsuit mess, the price of the med was $789.95, because they were getting the generic version from a different pharmaceutical company than the one I got today.
My regular pharmacy was getting them from Watson Pharmaceutical, and they were round and orange-ish-yellow.
Today's pills were manufactured by Dava Pharmaceutical, the pills are round and purple.  
The different pharmaceutical companies all make their pills look different, and they charge different prices for them.

But that's really neither here nor there, what this pharmacy did was illegal.
And she knew it too.
It is an independently owned pharmacy, the husband and wife own it together, she's the pharmacist, he's the cashier, 1 cash register, 1 tiny little store.
She so totally knew that what she was doing was illegal, and she took steps to prevent being caught.
On the patient medication print-outs, there is always a strip at the top that says the name, address, and phone number of the pharmacy, it says the medication name, how much it costs, and how much the co-pay is.
This little strip is perforated to be torn off for the patients use.
The pharmacist tore it off so that I wouldn't have access to the truth.
She made 1 mistake though, she let me keep my cash register receipt that clearly says that I paid $22.40 for 1 prescription, and the receipt has the name, address, phone number, and the name of the pharmacist right at the top.

When I got home, I immediately called my insurance company to report what had happened.
The Humana rep was aghast at what I was telling her, she placed me on hold while she got a supervisor and asked what she was supposed to do for this kind of thing, and then she told me that they had all of the pharmacy's information in the system already because the pharmacist had submitted the claim, I really did pay the legal co-pay amount of $2.40, and she told me that they were sending me a form to fill out, that I would need to photocopy all of the paper work that I did have, like the receipt and the patient print out showing that she tore the patient use information strip off, and that I would need to explain exactly what happened, what the pharmacist told me, and then she told me that I needed to report it to my state's price gouging hot-line, and the police in North Port, which I did.
I left a voice mail for the hot-line in Tallahassee because that's what you're supposed to do, and I spoke to a detective at the North Port police department who told me that I would need to go back to NP and file a report and bring the evidence and my witnesses with me.
Both Deb and Nic said that they would be happy to go to NP with me and fill out the report, especially Nic because she's the one who loaned me the $20.00 to pay for it, and was just as shocked as I was that the pharmacist did that.
All 3 of us were in shock that she ripped me off for $20.00 when she had submitted the claim to Humana for the full price of $668.22, claiming that she was going to lose $20.00 by accepting my insurance.

Can you freaking believe the week I have had just trying to get my freaking medication?!?
Totally unreal right?
I mean, who the hell else would have this kind of luck?
This is the kind of stuff that happens to me all. of. the. time, and this pharmacist knew that she was the last pharmacy to have the medication, she knew that I had to have it, so she totally took advantage of those facts and she stole $20.00 from me, lied to me, submitted the claim to the insurance, so that's fraud, and she totally, illegally, price-gouged me!!
Seriously people, this kind of crap only happens to me.

Because I don't want any other person in the south west Florida area to be ripped off, I am telling everyone right here on my blog, to never, ever, go to D & A Pharmacy in North Port Florida, located at 3015 Bobcat Village Center Rd. in the Bobcat Village Shopping Plaza.
This is a picture of their store front happily provided by the pharmacy to be listed on Google.

Never go there folks.
Ever.

As I posted on Tuesday, I was having to wait for my insurance, Humana, and my doc's office to agree on either paying for my pain medicine or forcing my doc to write a new script.
Well, neither happened.
It seems that Purdue Pharma won in federal court, to be the ONLY manufacturer of Oxycontin HCL 40mg ER.
Actually, Purdue Pharma now has the patent on ALL controlled-release oxycontin until April 16, 2013.
That's right, they fought and won the right to be the only maker of all controlled release oxycontin until 2013.
That's total crap.
I was taking the generic, oxycodone HCL 40mg ER, but seeing as only the brand name is being produced, my insurance refuses to cover it because of how expensive it is.
Because the only equivalent alternative medication is morphine sulfate, my doctor did not write me a new script for medication.
He was going to write me a script for Fentanyl, either the patches or the injections, but I refused based on the fact that patches do not work for me, I have damaged nerve endings in my back still, I cannot even feel it when being touched by a hand, stung by a bee, anything on my back, so without nerve endings, the medication in the patches would never be absorbed and be able to work.
I also declined it based on the horror stories of that medication that I have heard about and seen on tv programs like Dateline and 20/20.
People suck on the Fentanyl pain patches and have a heroin like experience, and it is also highly addictive because of how strong it is when used in the liquid injection form.
I do not need a highly addictive heroin-like medication in this house.
I am already physically addicted to some of my pain meds, I don't want to be emotionally addicted to something like that, I've never done heroin, and I certainly don't want to take a medication that is like heroin.

So anyway, I do not have my regular medicines, and I am in quite a bit of pain.
It is amazing just how bad the pain is without my usual regiment of medications, all I want to do is stay curled up in a ball on the couch, every single part of my body aches, all of my joints ache like crazy.
Just doing the grocery shopping this evening was a test of sheer will power to make my body walk there, walk the aisles, and walk home.
As soon as I got home, I put everything away and curled myself up like I was sitting in an egg chair.
Curling up is the most comfortable position right now, my other pain meds are not even touching the arthritis pain that I have, it's horrible right now.
My ankles, knees, hips, pelvis, lower back, and my neck, are just throbbing in pain.
We're heading into a cold spell, well cold for Florida, and I am so feeling it.
I'm really kind of ticked off at my doctor for not trying to find an alternative medication that I can take.
I also can't believe he wanted me to take 100mg of Fentanyl, that stuff is like heroin man, I don't want that crap.
I don't want to take it, I don't want it in my house, I don't want anything at all to do with it, but he thought it was a good alternative.
I think I'm going to call Purdue Pharma tomorrow and ask them for help.
I cannot get my insurance to cover the medication, and I cannot afford to get my script filled for their name brand product.
It would take me 2 months of SSDI payments to pay for just 90 pills, it's very expensive like I said on Tuesday.
It can't hurt to ask them for help seeing as their little war over a patent has caused me to be without my meds right?
Their greed has caused me to be in pain since Tuesday, maybe, just maybe, they will help me and cover the cost of it or send me some.
I've heard stories about some of the pharmaceutical companies helping people that way, maybe they will help me.

The whole process will kill you.
Or at least make you want to choke someone.
A friend of mine is currently going through the disability appeal process right now, for the 2nd time, and she is not happy.
Applying for disability and going through the whole process is a really rough time, it's hard.
You go to doctor after doctor, get test after test, you can have 20 doctors all saying that you are permanently disabled, and if just one of the governments approved doctors says that you're not disabled, then that's it, you get denied for disability.
I swear the absolute best way to even apply the first time, is to get an attorney.
Just get a lawyer right from the start, they know how it works, they do it for a living, trying to do it on your own is nearly impossible.
I tried telling my friend Nicci this, she didn't think she would need one, now she is desperately looking for one to help her.
The paperwork is just overwhelming, the whole thing is really, you need professional help to apply and get approved.

I was so sick yesterday and last night, most of this morning, and I'm just finally starting to feel better.
I don't know what it was, but man, my stomach was just wrecked, I was throwing up, cramping up, in tons of pain, and my feet that were swollen and had gone down, had started to swell again.
I managed to pull myself together to go to my new pain doctor appointment, and went for my 3:15.

It's a very strict office I'll tell ya.
They make you pay your co-pay or self pay before they see you, and there was this one guy who was $10 short of his $350.00 fee, and they turned him away, told him he had to reschedule it, they don't mess around man.
I had enough to pay my co-pay and for my scripts, but I was 2 days too early for my insurance to fill them, so I have to go back to the pharmacy tomorrow morning and pick them up before I go to my surgeon appointment at 2pm.

But anyway, the new doc is very strict but also very nice.
He took a look at my records, my CT scans from the 19th, and my blood test results, and we started there.
He said, "So you had spine fusion in 2006 from T3 to S1, wow, that's really big."
I said, "Yeah, but I just had another one, I'm now fused from C1 to S1, the whole spine."
He said, "Wow, you are the biggest spine fusion I have ever personally seen. Did you say that you're having another surgery?"
I said, "Yeah, I see my surgeon on Wednesday, and hopefully he'll have a date and a plan for what and when we're going to do. C1 and C2 collapsed after the surgery in September, my head is stuck down, I don't have much movement at all in my neck, muscle spasms in my back and legs, sometimes the spasms are so severe that if I'm sitting at my desk with my feet up and my keyboard on my lap, the spasms actually throw my keyboard clear off my lap and knock over my foot stool. But C1 and C2 were congenitally fused from birth, there's no disc space there at all, so I have no idea how he's going to fix me."
He said, "Yeah, I'm looking at your CT scan and I honestly don't know how he's going to do it, I'm not a surgeon, so I really don't know, but I can now understand why Doc R. sent you to me. You are much more complicated than the patients he usually deals with. He's a rehab pain manager, he helps people get better and get off medication, and honestly, I know you probably don't want to hear this, but I don't see you coming off of medication for another 5-8 years, maybe the rest of your life based on what I'm reading in your records. You not only have had major spine fusion and another one going to happen soon, but you have arthritis, stenosis, nerve impingement, and a lot of disc damage. It could be years before anyone even thinks of taking you off of medication, or never at all. I'm sorry."
I said, "That's ok, I already knew I was bad off."

So he wrote out my scripts, added a muscle relaxer, which I hate taking because they make me sleep for anywhere from 6-8 hours, so taking those 4 times per day, I'd be sleeping all of the time, and he added Lyrica , which is for neuropathic pain.
I didn't get to pick that one up because it needed like pre-authorization or something, and I may not pick it up at all because as of right now, the Walgreen's website says it's $82.46 for just 30 pills.
That's crazy!
I refuse to pay that much for a medication that I have no idea if it will even work for me yet.
Maybe it hasn't been processed through my Humana insurance yet, but if it has and that's how much it costs, I may not pick it up at all, or I may wait until I get my tax refund back on Thursday.
I don't know yet, have to wait and see, but as of right now, it's still not ready for me to pick up anyway.
Apparently, they still don't have the authorization for it.

So tomorrow morning, I'll go pick up my pain meds, come home, and then get ready for the long ride to Safety Harbor to see the surgeon with my sister.
I'm giving Mindy the day off...LoL
Mindy does so much for me already, and she's been working hard at her cleaning business, taking care of her family, and other things, she's exhausted, so Wednesday is her only scheduled day off, so now it's really a day off for her.
I personally think she needs a nice long vacation somewhere really nice, like maybe go out to California all by herself, stay at a nice San Diego hotel, go see a few sites, and get some much needed rest.
She works way too hard and needs a good, long break.

I've made some really decent new friends over the last few weeks.
It happened sorta by accident, I met Dustin and his girlfriend Stacey through another friend, and they have just been really awesome.
They are like totally blown away by the amount of titanium I have, Dustin calls it the 'chainsaw back' because when you look at a front view of the xrays, it looks like a chainsaw blade.
But anyway, they are both just really sweet, Dustin helped me get to my doc appointment yesterday and to the pharmacy, and today, they both just stopped by to see how I was doing.
Stacey said that after my next surgery, she'll come by anytime I need help, help clean the house, help me take showers, shave my legs, brush my hair, stuff like that, because with the halo brace on, it's going to be very difficult to do things by myself.
I had been telling Dustin yesterday while sitting in the waiting room at the docs, about how awesome my teens are and have been after my surgeries, they helped me in and out of bed, in and out of the bathroom, they have even shaved my legs, brushed my hair, they do all of the grocery shopping, cooking, cleaning, and so he told Stacey, and she was like well hell, this single mama needs help sometimes so let's help her.
I thought that was really sweet of them to even offer, and who knows, I may take them up on it sometimes if I'm having a wicked rough time after surgery.

Oh, Sebastian just went out and got the mail, and in today's mail was my settlement check from the Airborne class action lawsuit.
I got a check for $34.95.
Nice!

I went for my daily walk just a bit ago, all the way up to the corner store and back, I needed to get a loaf of bread anyway, and I was craving chocolate, so I grabbed a snickers too.
Yum.

When I got back, I checked the mail box, which amazingly, has not been hit by a car again in a good long while, (knock on wood) and in today's mail, I got our new Netflix movies, Hancock and Repo! The Genetic Opera.
The teens want to see Hancock, and I want to see Repo!
It looks sorta interesting and it's got good reviews on Netflix.
I also got my dvd that I ordered with my Buy.com gift certificate from a shopping mix-up, the Poltergeist (25th Anniversary Edition).
I have always loved that movie, it's been digitally remastered, and it's just a classic, plus, I had to spend the rest of the gc, it was only $6.00, so I said why not.

Then I saw it.
A jury duty summons.
I can't serve jury duty.
A) I can't get all the way to Venice every day, no car, no driver's license, and B) medically, I'm just in no shape to do it.
I take heavy duty pain meds 24/7, I have doctor's appointments up the wazoo all of the time, and I cannot sit in the same spot for hours on end every day.
I am constantly having to get up, walk around, lay down etc, so yeah, I cannot serve jury duty.
I'm all about doing my civic duty and all of that, but I can't do jury duty, not right now, it's physically impossible for me to get there and sit there all of the hours that would be needed.

On November 4th, I will be voting No on question 2, the Florida marriage amendment to our states constitution.
What does this amendment say?

"Inasmuch as marriage is the legal union of only one man and one woman as husband and wife, no other legal union that is treated as marriage or the substantial equivalent thereof shall be valid or recognized."

In Florida, gay marriage is already illegal, we do not need an amendment to our state constitution to say it again.
Let me say that again,
Gay Marriage is already illegal in the state of Florida.
It's already against the law 4 times, so why do we need an amendment to say it again?
Read about the consequences that have happened in other states because of the same type of amendments.

"Every unmarried Floridian will be impacted by this amendment - especially divorced or widowed seniors and public employees who, under existing programs, can share some benefits such as hospital visitation privileges and health care coverage without being married."
 
This amendment would effect domestic partnership agreements, not just homosexual couples.
This amendment would take away domestic partnership couples rights to be covered on their insurance, to visit each other in the hospital ICU department because they are not married.
It would take away existing couples benefits, it would force senior couples to choose between health care and government benefits.
The government has no right to be involved in Floridians relationships, and it would force current domestic partners to have expensive legal papers drawn up to protect the rights they already have, and have been protected by for years.

Domestic partners are not just gays, they are couples who have either lived together for years, or senior couples who have chosen not to marry at their age, young couples who chose not to marry but have lived together, had children together etc etc.
These couples need to be protected, the rights they already have are going to be changed if amendment 2 passes.

There are only 13 days left until we go to the polls to choose our next president, our local reps, and vote on other important local and state issues, and this is one of them that every Floridian needs to read up on and choose the right thing for all unmarried people in our state.
I urge all Floridians to read up on this issue and vote No on 2.

...You are about to participate in a great adventure. You are about to experience the awe and mystery which reaches from the inner mind to... The Outer Banks, er, Outer Limits....

It's almost 9am on Sunday morning, I've been awake all night again.
Insomnia really sucks.
It's like a form of anxiety insomnia.
Like if I know that I have to be somewhere, do something really important, i won't sleep at all no matter how hard I try.

I know I'll be fine though, I tend to get second and third gusts of wind right when I need them.
Then when we get back home, I'm hoping that I'll be able to sleep for at least a few hours (probably not) because I have some important medical stuff to deal with on Monday morning.
I have some pre-surgery phone calls to answer questions, like have I gained or lost any significant amount of weight in the last 6 months, when was the last time I had a blood test, donated blood, have I discovered any new allergies to medications, food, or latex/plastic/tape products.
I've answered all these questions before, no big deal.

Then I need to call and set up an appointment to have both my will and DNR verified again, notarized, signed, stamped, sound mind and body, yadda yadda, and I have some questions I need to discuss too.
I have a lot going on, not only is the surgery like a big medical jumbo brain frazzle, it's legal too.
Sign this, cross these Ts, dot those Is, on every page with an 'X', please initial on the line provided, sign and date the bottom of each page.
I know the routine, so while I'm initialing and crossing, and dotting, I'll be able to ask my other questions and discuss my other concerns.
I just don't want a big battle on anyone's hands should anything at all go wrong.

Time is fluid. The waters of forever close -- and passage may not be completed. The present and the future are for a moment united. And the Enemy, half-today, half-tomorrow, is locked between...