Hooray! The de-Borging has (hopefully) officially begun!

[Adam]

So, my nurse just left. We were able to remove the silly extension line for the picc line, which has been most annying for the last eight weeks or so. When I had surgery, they removed the IJ (intra-jugular) picc line and moved it to my bicep instead. Great! I no longer have this thing poking out of my neck. But when I got home and had to start doing injections, I discovered a problem: the business end of the line where I connect the syringes is basically right at the inside of my right elbow. Go ahead: try to touch the inside of your right elbow with your right hand. Also, never put anything in your ear bigger than your elbow.

Thus necessitated an extension, basically a hose about 14" long in order for me to be able to reach it with both hands as needed for injections. This thing just flops around all over the place and you have to be REALLY careful not to let it hang up on anything lest it yank out the picc setting, which would mean a real pain in the ass going back to the hospital, removing fully the old line, getting shot up with The Devil's Hot Poker, better known to some as lidocaine, and then they have to go about putting in another line, probably in an even more inconvenient place on my body. There are a number of ways to try to contain the extension, most of them essentially based upon the idea of a sock with the toe removed to hold everything in place, but that's pretty annoying, too: go put a sock on from your wrist to your elbow and see if that doesn't drive you bonkers after wearing it 24/7 for a few days.

Alternatively, it can simply be taped down, but that has its own problems. I have hair, for one thing. And, one thing I've definitely learned from this whole horrid experience is that the adhesives used for this stuff is essentially a form of slow torture that violates the Geneva Conventions. My skin breaks out in all sorts of rash with these things. After discovering this with the initial "regular" picc line dressing, we moved to using the IV-3000 dressing, which is marginally better, but still makes me itch like crazy. Infuriating.

BUT, this afternoon, I am to report to the infectious disease department at VUMC and if all goes according to plan, they'll pull this hose out of my arm entirely and I won't have any dressing to deal with at all. I'll probably have to take a belt sander to the site once the dressing is gone in order to clean up all of the skin irritation, but I'll happily soak my arm in a vat of phisoderm for a week if it means I can be rid of this thing.

So, one less Borg-like pipe coming out of my body. I'll still be stuck with the VacuuSuck 10,000 for another week and a half or so, but my surgeon and my nurse both feel like my surgical wound is healing well enough that by October 11, they should be able to transition to a wet-to-dry wound dressing. That sounds a little complicated, but it's essentially just a traditional wound dressing: gauze soaked in saline packing the internal part of the wound, then covered by a dry dressing on the outside. That will still have to be changed regularly, but at least I won't have a couple of quarter-inch hoses coming out of my chest and I won't have to put up with a noisy, tempermental machine to drag around everywhere. And that means that I should be able to get a good night's sleep without encumbrance for the first time since mid-June. Oh, happy day!


picc 1.jpg picc 2.jpg



Goodbye, you piece of shit. I won't miss you in the least.

[scott]

Man!

I'm so glad you're doing better. You should be commended at keeping your flowery wordsmithing and sense of humor.



I hope and pray it's nothing but more good news onward.

[phillygirl]

Congrats!! And boy, just from the arm picture I can see your weight loss!

[80zephyr]

Were you able to hold a job thru all this?

Mark

[Adam]

There we go: 42 cm of picc line now gone from my body.

[Adam]

Were you able to hold a job thru all this?

Mark

No, I haven't really had anything one would call steady employment since the liver diagnosis.

Fortunately, since my brother has me living at his house, I don't have that expense, and that long-term disability insurance that I've been paying into for decades is finally paying off. So this year, I'm guessing that BCBST and MetLife are both sorry that they ever even heard my name.

[scott]

No, I haven't really had anything one would call steady employment since the liver diagnosis.

Fortunately, since my brother has me living at his house, I don't have that expense, and that long-term disability insurance that I've been paying into for decades is finally paying off. So this year, I'm guessing that BCBST and MetLife are both sorry that they ever even heard my name.

Very happy to hear that. It sucks, but at least it's not welfare.

Although, shouldn't you be eligible for SSDI soon? You've been paying into THAT for decades as well. I would be hard pressed to think that your massive health issues don't qualify you for that. I know you aren't one for handouts but this is NOT A HANDOUT. We all pay taxes to take care of people like you.

[Celeste Chalfonte]

There we go: 42 cm of picc line now gone from my body.

[Novaheart]

Glad to hear it, Adam. Also glad to hear (but not your suffering) that I am not the only one who can't stand that plastic patch and adhesive.

[Adam]

Very happy to hear that. It sucks, but at least it's not welfare.

Although, shouldn't you be eligible for SSDI soon? You've been paying into THAT for decades as well. I would be hard pressed to think that your massive health issues don't qualify you for that. I know you aren't one for handouts but this is NOT A HANDOUT. We all pay taxes to take care of people like you.

This has the potential of taking a decidedly un-loungy turn, so please: no one take what I'm about to say as some sort of license to spiral off into political hectoring or preening. I'm in too much of a celebratory mood for that.


By means of explanation:

When I was growing up, from my mid-teens on, we (meaning everyone I knew in my age group) were told that Social Security wouldn't be there when we need it, so we had best make other arrangements on our own. I don't know if you were told the same, but given that we're about the same age, I would have to assume that someone must have said that to you in your younger, more carefree years. That was to include SSDI, just as much as the retirement end of things, because the whole system would wind up imploding, and none of it would be reliable. So, I did that. starting in my early 20s: someone with MetLife was offering an LTD plan that was pretty cheap, flat-rated (based upon tiers according to income), and, rather importantly these days, unlimited. Ergo, with my plan, I paid something like $8/month when I was first starting out working, and unlike a lot of LTD plans, this one will provide income to me for as long as I'm alive, should I need that. I get 75% of the average of my income over the five years prior to the disability. That's not living large (who wants to take a 25% pay cut?), but it means that even without living rent-free, I could still at least manage to live somewhat like the lifestyle to which I have become accustomed. There's another rider in there for profound disability (think drooling in a wheelchair) to cover health insurance deductibles (but not premiums) over time as well, should that be needed. There are income tiers and there are caps involved (Jeff Bezos does not get to have 75% of his income replaced; the top-out is something like $75K), but it was a security that I certainly hoped that I'd never use, but now I'm glad that I have it. Just like a gun or car insurance, you hope that you never have to use it, but if you need it, you're very glad that it's there.

I'll still be surprised if there's anything left of the tire fire that is Social Security for me in 17 years when I first become eligible, but who knows: that's been limping along for so long that maybe they can manage to give it another botox injection and keep it alive for ten or twenty years after that. But I'm sure as hell not counting on it, for retirement or for disability.

Now, in this particular case I will certainly say that I never, ever expected to be unable to do a regular job for this long of a period of time. When I took out the policy, I had essentially two things in mind:

1. Some event that would keep me out of work for 6-8 weeks, e.g. some sort of broken spine or something like that, and;
2. getting run over by a cement truck and never being able to live independently, much less work, ever again.

What has come true is in fact closer to the latter than the former: I've basically not had a steady job for almost a year, and pretty much can't right now just because of different doctor's appointments, dragging this machine around, etc.

As for SSDI, in this roundabout way of explanation, there are a couple of concerns on my end. First, as I understand it, it's just damned near impossible to get on it without many months, sometimes years, of paperwork, qualifications studies, the usual misunderstandings of a bureaucracy, etc. I'm reasonably certain that Celeste can attest to this, and in fact it's pretty much the only sort of "insurance" that I can think of where beneficiaries almost always have to hire an attorney in order to wade through the governmental morass to get to the end. Certainly that happens some of the time with other insurance policies, but it's definitely nowhere near almost every single case. Even without having to drive a minivan through red-tape hell to get there, if everything goes "perfectly," it's almost always months and months before someone actually sees a dime out of SSDI.

By contrast, I was able to file a claim and have all of the paperwork and documentation done with MetLife in an afternoon, and had a check (later to be direct deposit) in about three days. When I had my heel incident, which was the first time I ever considered that I would be physically unable to do any work, I was released from VUMC about 10:30 in the morning, came home, and wiith two phone calls and some faxes/emails, had everything in play in time to have dinner. So obviously the reactivity was immeasurably better there, but I'm preaching to the choir on that. But at that time, I was expecting to be off my feet (literally) for about six weeks, not what's going on eight months now. It seemed pointless to even bother trying with SSDI, since I was always planning to get back to work as soon as I could anyway. That this has stretched on now really has no bearing, because barring some other catastrauphic event, I have every intention of getting back out there and working as soon as I can get these pipes out of my chest. The liver stuff doesn't really prevent me from living and working a daily life now that I have that generally stabilized. The initial diagnosis meant a months-long whirlwind of different doctors and tests, practically daily, but that's behind me now. I'll still have routine tests and appointments, but it really won't be much different from every other healthy person out there who goes to the GP/PCP a couple of times a year, the dentist a couple of times a year, in the case of women sees a gyno every year, people who have to go to the eye doctor to check eyes and update glasses, etc. These things happen, and every sane employer understands this and adjusts schedules to accommodate. That my case is about my liver in particular shouldn't really have any bearing, particularly with jobs aplenty around here right now.

Also, as I understand it, SSDI is based upon events, and I don't have a single event. Bill is in a car crash (we'll leave the auto insurance aspect out of this for the sake of simplicty) and is in a coma for six weeks; when Bill wakes up, he can't walk or speak. Bill gets SSDI based upon the event of the car crash. I didn't (and hope I never) have that; I've just had a run of really shitty luck that has resulted in a series of events, not a single one. Bill is in a car crash, but this time it breaks both of his legs in three places and no coma. Bill is in traction for a couple of weeks and then spends six weeks learning how to walk again. Bill can work, so on the way to his first job interview after the wreck, he falls down a manhole and breaks his back. Bill is back in traction, and he'll have another ten weeks of recovery after that, but he'll be able to work once it's over with. Bill doesn't qualify for SSDI even though he's going to be out of work for three months all together, at a bare minimum.



Anyway, to make a short story long, I just haven't bothered with the headache of trying to pursue SSDI since I didn't think it would even be an issue when all of this started, and there's not much sense in trying to pursue it now

[Celeste Chalfonte]

This has the potential of taking a decidedly un-loungy turn, so please: no one take what I'm about to say as some sort of license to spiral off into political hectoring or preening. I'm in too much of a celebratory mood for that.


By means of explanation:

When I was growing up, from my mid-teens on, we (meaning everyone I knew in my age group) were told that Social Security wouldn't be there when we need it, so we had best make other arrangements on our own. I don't know if you were told the same, but given that we're about the same age, I would have to assume that someone must have said that to you in your younger, more carefree years. That was to include SSDI, just as much as the retirement end of things, because the whole system would wind up imploding, and none of it would be reliable. So, I did that. starting in my early 20s: someone with MetLife was offering an LTD plan that was pretty cheap, flat-rated (based upon tiers according to income), and, rather importantly these days, unlimited. Ergo, with my plan, I paid something like $8/month when I was first starting out working, and unlike a lot of LTD plans, this one will provide income to me for as long as I'm alive, should I need that. I get 75% of the average of my income over the five years prior to the disability. That's not living large (who wants to take a 25% pay cut?), but it means that even without living rent-free, I could still at least manage to live somewhat like the lifestyle to which I have become accustomed. There's another rider in there for profound disability (think drooling in a wheelchair) to cover health insurance deductibles (but not premiums) over time as well, should that be needed. There are income tiers and there are caps involved (Jeff Bezos does not get to have 75% of his income replaced; the top-out is something like $75K), but it was a security that I certainly hoped that I'd never use, but now I'm glad that I have it. Just like a gun or car insurance, you hope that you never have to use it, but if you need it, you're very glad that it's there.

I'll still be surprised if there's anything left of the tire fire that is Social Security for me in 17 years when I first become eligible, but who knows: that's been limping along for so long that maybe they can manage to give it another botox injection and keep it alive for ten or twenty years after that. But I'm sure as hell not counting on it, for retirement or for disability.

Now, in this particular case I will certainly say that I never, ever expected to be unable to do a regular job for this long of a period of time. When I took out the policy, I had essentially two things in mind:

1. Some event that would keep me out of work for 6-8 weeks, e.g. some sort of broken spine or something like that, and;
2. getting run over by a cement truck and never being able to live independently, much less work, ever again.

What has come true is in fact closer to the latter than the former: I've basically not had a steady job for almost a year, and pretty much can't right now just because of different doctor's appointments, dragging this machine around, etc.

As for SSDI, in this roundabout way of explanation, there are a couple of concerns on my end. First, as I understand it, it's just damned near impossible to get on it without many months, sometimes years, of paperwork, qualifications studies, the usual misunderstandings of a bureaucracy, etc. I'm reasonably certain that Celeste can attest to this, and in fact it's pretty much the only sort of "insurance" that I can think of where beneficiaries almost always have to hire an attorney in order to wade through the governmental morass to get to the end. Certainly that happens some of the time with other insurance policies, but it's definitely nowhere near almost every single case. Even without having to drive a minivan through red-tape hell to get there, if everything goes "perfectly," it's almost always months and months before someone actually sees a dime out of SSDI.

By contrast, I was able to file a claim and have all of the paperwork and documentation done with MetLife in an afternoon, and had a check (later to be direct deposit) in about three days. When I had my heel incident, which was the first time I ever considered that I would be physically unable to do any work, I was released from VUMC about 10:30 in the morning, came home, and wiith two phone calls and some faxes/emails, had everything in play in time to have dinner. So obviously the reactivity was immeasurably better there, but I'm preaching to the choir on that. But at that time, I was expecting to be off my feet (literally) for about six weeks, not what's going on eight months now. It seemed pointless to even bother trying with SSDI, since I was always planning to get back to work as soon as I could anyway. That this has stretched on now really has no bearing, because barring some other catastrauphic event, I have every intention of getting back out there and working as soon as I can get these pipes out of my chest. The liver stuff doesn't really prevent me from living and working a daily life now that I have that generally stabilized. The initial diagnosis meant a months-long whirlwind of different doctors and tests, practically daily, but that's behind me now. I'll still have routine tests and appointments, but it really won't be much different from every other healthy person out there who goes to the GP/PCP a couple of times a year, the dentist a couple of times a year, in the case of women sees a gyno every year, people who have to go to the eye doctor to check eyes and update glasses, etc. These things happen, and every sane employer understands this and adjusts schedules to accommodate. That my case is about my liver in particular shouldn't really have any bearing, particularly with jobs aplenty around here right now.

Also, as I understand it, SSDI is based upon events, and I don't have a single event. Bill is in a car crash (we'll leave the auto insurance aspect out of this for the sake of simplicty) and is in a coma for six weeks; when Bill wakes up, he can't walk or speak. Bill gets SSDI based upon the event of the car crash. I didn't (and hope I never) have that; I've just had a run of really shitty luck that has resulted in a series of events, not a single one. Bill is in a car crash, but this time it breaks both of his legs in three places and no coma. Bill is in traction for a couple of weeks and then spends six weeks learning how to walk again. Bill can work, so on the way to his first job interview after the wreck, he falls down a manhole and breaks his back. Bill is back in traction, and he'll have another ten weeks of recovery after that, but he'll be able to work once it's over with. Bill doesn't qualify for SSDI even though he's going to be out of work for three months all together, at a bare minimum.



Anyway, to make a short story long, I just haven't bothered with the headache of trying to pursue SSDI since I didn't think it would even be an issue when all of this started, and there's not much sense in trying to pursue it now

Since you asked for me by name, I assume you're OK with me responding directly.

Your understanding of SSDI is deeply flawed. There is no "incident" required, just a medical diagnosis (if there's a stumbling block, it's often this) and onset of total disability that has lasted or is reasonably expected to last 12 months or more. There is a waiting period, which I believe is 5 months, IIRC. Squishy disabilities, like bad backs, are usually denied and require an attorney to appeal. Serious, objectively verifiable disabilities like end stage renal disease, blindness, liver failure, and some others are often a slam dunk, assuming your doctor is marginally communicative. If the claim is denied, almost all legit (and some not so) disabilities result in an award of benefits within a year, in my somewhat remote experience. Vague collections of symptoms without definitive test results and diagnosis are the problem cases, and frankly, that's often because they're a smokescreen for alcohol or drug dependency, which, at least when I was working in the field, were not covered medical conditions.

I'm actually surprised that your LTD carrier didn't require you to apply for SSDI as a condition of paying benefits. Most policies (even really old ones) have an offset for SSDI and you're required to apply before they'll pay anything. You don't have to qualify; if you don't have enough recent quarters or meet the policy's definition of disability ("own occupation" policies, like mine, for example) but not SSA's, they'll still pay, but you almost always must apply.

Social Security fraud pisses me off precisely because, your (pardon the pun) jaundiced view notwithstanding, when people use it honestly and as intended, it does a very good job as it was created to do.

[Adam]

Since you asked for me by name, I assume you're OK with me responding directly.

Your understanding of SSDI is deeply flawed. There is no "incident" required, just a medical diagnosis (if there's a stumbling block, it's often this) and onset of total disability that has lasted or is reasonably expected to last 12 months or more. There is a waiting period, which I believe is 5 months, IIRC. Squishy disabilities, like bad backs, are usually denied and require an attorney to appeal. Serious, objectively verifiable disabilities like end stage renal disease, blindness, liver failure, and some others are often a slam dunk, assuming your doctor is marginally communicative. If the claim is denied, almost all legit (and some not so) disabilities result in an award of benefits within a year, in my somewhat remote experience. Vague collections of symptoms without definitive test results and diagnosis are the problem cases, and frankly, that's often because they're a smokescreen for alcohol or drug dependency, which, at least when I was working in the field, were not covered medical conditions.

I'm actually surprised that your LTD carrier didn't require you to apply for SSDI as a condition of paying benefits. Most policies (even really old ones) have an offset for SSDI and you're required to apply before they'll pay anything. You don't have to qualify; if you don't have enough recent quarters or meet the policy's definition of disability ("own occupation" policies, like mine, for example) but not SSA's, they'll still pay, but you almost always must apply.

Social Security fraud pisses me off precisely because, your (pardon the pun) jaundiced view notwithstanding, when people use it honestly and as intended, it does a very good job as it was created to do.

I'll certainly bow to your much greater expertise in the matter than mine. Having never been directly involved in the process, I can only speak to what others I have known have experienced, and that's probably about a dozen different people who all seemed to relay the same message. Without a doubt, it's entirely possible that I've simply encountered a subset of the whole who have questionable diagnoses and/or used "dial-a-doc" to worm themselves a way into the system. I never really got that impression, but I'm always a little squeamish about burrowing into someone else's health issues. That's between you, your family (if you so choose), your doctor, and God/Yahweh/Allah/FSM/Gaia/that weird dude on the corner of Fifth and Main who shouts all the time. Bring it to me and I'll be happy to help, but I'm not going to come to you and demand that you tell me your medical history.

That having been said, five months is a long time to wait for assistance for a lot of people, and in a way reiterates my point: I never expected to have this last for anywhere near this long, and at this point it's pretty much moot to try to start the process.

I'd have to go back and re-read my policy word-for-word, but AFAIK, the only concern in the policy about SSDI was in regards to the payment cap. IOW, if the payment cap is $1000/month, and the policyholder qualifies for $200/month, then they say you have to go through SSDI and they'll only pay $800/month once SSDI actually kicks in. Those are low numbers for the sake of simple math, and I'm nowhere near the cap, so it's not really a concern in my case.

The big selling point of the policy in my case was that I wouldn't have to wait for any sand-filled government gearbox to turn, specifically because five months is a long time to try to figure out how to fend off the landlord and get groceries and keep the lights on. I would guess that maybe at some point down the road they might try to demand that I get whatever SSDI to offset their payout, but it's still a non-issue in my case since I'll be back among the land of the living in short order, and the entire point of the policy was/is to be completely independent of other programs.

One way or another, though, I have every hope to be one who is paying into that system, not taking out of it, in just a matter of weeks. There certainly ARE people who genuinely need that help, and I'm glad to do my part to help provide it for them.

[Celeste Chalfonte]

I'll certainly bow to your much greater expertise in the matter than mine. Having never been directly involved in the process, I can only speak to what others I have known have experienced, and that's probably about a dozen different people who all seemed to relay the same message. Without a doubt, it's entirely possible that I've simply encountered a subset of the whole who have questionable diagnoses and/or used "dial-a-doc" to worm themselves a way into the system. I never really got that impression, but I'm always a little squeamish about burrowing into someone else's health issues. That's between you, your family (if you so choose), your doctor, and God/Yahweh/Allah/FSM/Gaia/that weird dude on the corner of Fifth and Main who shouts all the time. Bring it to me and I'll be happy to help, but I'm not going to come to you and demand that you tell me your medical history.

That having been said, five months is a long time to wait for assistance for a lot of people, and in a way reiterates my point: I never expected to have this last for anywhere near this long, and at this point it's pretty much moot to try to start the process.

I'd have to go back and re-read my policy word-for-word, but AFAIK, the only concern in the policy about SSDI was in regards to the payment cap. IOW, if the payment cap is $1000/month, and the policyholder qualifies for $200/month, then they say you have to go through SSDI and they'll only pay $800/month once SSDI actually kicks in. Those are low numbers for the sake of simple math, and I'm nowhere near the cap, so it's not really a concern in my case.

The big selling point of the policy in my case was that I wouldn't have to wait for any sand-filled government gearbox to turn, specifically because five months is a long time to try to figure out how to fend off the landlord and get groceries and keep the lights on. I would guess that maybe at some point down the road they might try to demand that I get whatever SSDI to offset their payout, but it's still a non-issue in my case since I'll be back among the land of the living in short order, and the entire point of the policy was/is to be completely independent of other programs.

One way or another, though, I have every hope to be one who is paying into that system, not taking out of it, in just a matter of weeks. There certainly ARE people who genuinely need that help, and I'm glad to do my part to help provide it for them.

Well, as Scott and Frostbit are always saying, the ideal is to have at least 6 months' worth of expenses in savings, which would dovetail nicely with the 5-month wait. For those who can't accrue such a cushion (and I have been among them at times), there are sometimes other sources, especially if they are low earners. In CA, we have State Disability Insurance, a system most workers pay into, which pays up to a year of short-term disability at 2/3 of the person's average weekly wage, up to a maximum of about $1300/week. If the disability is due to a work injury, workers' comp pays up to 2 years, at roughly the same rates/maximums as State Disability. These programs and rates vary by state of course.

For those who don't qualify for anything else, there's SSI, which is a federal welfare program. It won't actually keep you in your home unless you're on Sec. 8, but it does provide some income while you recover, if you can find a place to lay your head.

You have a good policy, and I recommend you keep it at all costs, because I'm pretty sure you can't replace it.

Incidentally, I wasn't saying that everyone who has trouble getting SSDI is a faker. It's just that, if you're unfortunate enough to be disabled by one of the ailments that is commonly faked or exaggerated, the scrutiny is closer and more prolonged.

[Newman]

Well, as Scott and Frostbit are always saying, the ideal is to have at least 6 months' worth of expenses in savings, which would dovetail nicely with the 5-month wait. For those who can't accrue such a cushion (and I have been among them at times), there are sometimes other sources, especially if they are low earners. In CA, we have State Disability Insurance, a system most workers pay into, which pays up to a year of short-term disability at 2/3 of the person's average weekly wage, up to a maximum of about $1300/week. If the disability is due to a work injury, workers' comp pays up to 2 years, at roughly the same rates/maximums as State Disability. These programs and rates vary by state of course.

For those who don't qualify for anything else, there's SSI, which is a federal welfare program. It won't actually keep you in your home unless you're on Sec. 8, but it does provide some income while you recover, if you can find a place to lay your head.

You have a good policy, and I recommend you keep it at all costs, because I'm pretty sure you can't replace it.

Incidentally, I wasn't saying that everyone who has trouble getting SSDI is a faker. It's just that, if you're unfortunate enough to be disabled by one of the ailments that is commonly faked or exaggerated, the scrutiny is closer and more prolonged.

I always regarded that advice as a joke, akin to the idea that your mortgage should cost about 20-25% of your monthly income.

[Celeste Chalfonte]

I always regarded that advice as a joke, akin to the idea that your mortgage should cost about 20-25% of your monthly income.

These days, I can usually manage 3 months reliably, but I also have an income replacement policy that kicks in at 90 days, and a ton of saved vacation and sick leave. That's another prudent policy: don't use your sick leave up as fast as you earn it. Some people take a "mental health day" every time they accrue a day of sick leave. I only took off 4 weeks for major back surgery, and I had enough sick leave accrued (even in a private firm) to receive my full pay for the whole 4 weeks. When I returned half-time, CA State Disability Insurance made up the difference between my half-time pay and my full pay. Since I paid into that for over 20 years without ever drawing a dime, it didn't bother me at all to make that claim; I earned it.