Rheumatoid Arthritis Support Group
Rheumatoid arthritis is a chronic, inflammatory, multisystem, autoimmune disorder. It is a disabling and painful condition which can lead to substantial loss of mobility due to pain and joint destruction. The disease is also systemic in that it often also affects many extra-articular tissues throughout the body including the skin, blood vessels, heart, lungs, and...
I am livid.....beyond livid. Tomorrow will be ugly for a few people if things don't get rolling by the end of today!
I started MTX (Methotrexate) injections 5 weeks ago for my RA. What a difference. I am at the highest does an RA patient can go to unless Rheumy wants to up it. I was on oral tablets since November 10, 2015 but eventually he started injections as I was still hurting AND being a past gastric bypass patient, Who knows how well the tablets were being absorbed, injections are safer because they bypass the stomach. He wrote me out a prescription for 4 weeks ( I take 1 ML every Tuesday morning) Best time so as not to ruin my weekend. Wednesday's I feel like I been ran over by a Mack truck.
Last Thursday the 10th I called in the refill. I had one prescription of 2 vials. Basically a months supply. My prescription bottle said I had 5 refills. So I went into the pharmacy on Monday to pick them up. They said it's on back order and should be in on Tuesday but not until between 1-4 PM. Fine. I can take it in the evening once. All they had was a 25 ML of the preservative kind that I would use once and throw the rest away. No, I wanted mine. So the boy who works there said he special ordered a 5 ML bottle, fine that's 5 weeks. But that may not be in until Wednesday. Now we're pushing it. 1 day is okay but miss longer than that you can't take it again until the following Tuesday. I also had a doctor appointment with a new PCP who I've been with while husband went. Before I went to the appointment I called the pharmacy again and vented/ranted to the pharmacist who sympathized with me because she knew what medical group I was dealing with. Then I come to find out I need a Prior Authorization as it's a specialty drug. So this tells me my Rheumy's office should have sent one in a month ago. His staff has made many mistakes, like not ordering me blood work,, xrays, making follow up appointment's etc. And guess what? My doctor is on vacation until the end of March. I call his office and the receptionist tells me he got the request from the pharmacy the night before but later weds. the nurse calls and says she didn't get a request and all along the pharmacy is saying yes they did!
So I go to my new PCP's appointment at 3:10. She is awesome. She's a young thing and as she says, very anal and thorough. I tell her about my medication I got for Pilocarpine which is for my Sjogren's syndrome (very dry mouth and eyes)another autoimmune disease which attacks salivary glands. They were making me feel real weird. I told her my Rheumy has me on 3 5 mg a day. She looked at me cross-eyed and said that is way too much. She never prescribes more than 10 mg a day. One in the AM and one in the PM. I tell her about my MTX fiasco and says she is going to send for a prior authorization because my RA doc is on vacation. Plus she ordered all this other stuff and test. I haven't had my thyroid or a full panel done in years and she is checking my hormones and sending me to a OBGYN and for a mammogram. I've had 2 periods in 14 months,. I also ask about pain meds and how my Rheumy gave me a prescription antacid to take before breakfast if I feel it's going to be a bad painful day and then after breakfast take a Advil, Aleve, etc. Again, she looks at me cross-eyed and shakes her head. NO WAY! You can't take that she tells me because of the bypass. (which I already knew) I told her I ask him about pain meds at my first appointment and he does not prescribe them. Well, Tylenol has never worked for me. It does nothing for inflammation! So she writes me a script for Tramadol which I rarely take pain meds unless I get a flare or plan on riding for a long time. Plus she gives me a pneumonia vaccine. A common cold for me can land me in the hospital with pneumonia. Hospital is the worse place to be with a suppressed immune system. Oh and lung X-rays today too because RA can mess up my lungs.
So today is Thursday and still both the medical group and the pharmacy are saying they have not received anything from either. Who's lying? Tomorrow is Friday, then the weekend when no doctors are open. Then Monday.....the day I need it! I can't go another week off it.
Tomorrow I am going full nutty patient lady! At this point, I really don't know how the health insurance system works. All I know is the staffs are lagging real bad. Do I call my insurance company? Medical group? Pharmacy? Or worse.....send my husband in person? Right now I have TWO doctor's offices working on it and nothing is getting done. WTH?
I'm ready to call Health Net and get them involved. I don't know what to do!
Since I have a prescription, can't I just go in and pay cash? According to GoodRx MTX for injections are cheap! It's not like I'm looking to buy heroin!
Where should I go from here if by 5 today nothing is done? I am at my wits end today!
I started MTX (Methotrexate) injections 5 weeks ago for my RA. What a difference. I am at the highest does an RA patient can go to unless Rheumy wants to up it. I was on oral tablets since November 10, 2015 but eventually he started injections as I was still hurting AND being a past gastric bypass patient, Who knows how well the tablets were being absorbed, injections are safer because they bypass the stomach. He wrote me out a prescription for 4 weeks ( I take 1 ML every Tuesday morning) Best time so as not to ruin my weekend. Wednesday's I feel like I been ran over by a Mack truck.
Last Thursday the 10th I called in the refill. I had one prescription of 2 vials. Basically a months supply. My prescription bottle said I had 5 refills. So I went into the pharmacy on Monday to pick them up. They said it's on back order and should be in on Tuesday but not until between 1-4 PM. Fine. I can take it in the evening once. All they had was a 25 ML of the preservative kind that I would use once and throw the rest away. No, I wanted mine. So the boy who works there said he special ordered a 5 ML bottle, fine that's 5 weeks. But that may not be in until Wednesday. Now we're pushing it. 1 day is okay but miss longer than that you can't take it again until the following Tuesday. I also had a doctor appointment with a new PCP who I've been with while husband went. Before I went to the appointment I called the pharmacy again and vented/ranted to the pharmacist who sympathized with me because she knew what medical group I was dealing with. Then I come to find out I need a Prior Authorization as it's a specialty drug. So this tells me my Rheumy's office should have sent one in a month ago. His staff has made many mistakes, like not ordering me blood work,, xrays, making follow up appointment's etc. And guess what? My doctor is on vacation until the end of March. I call his office and the receptionist tells me he got the request from the pharmacy the night before but later weds. the nurse calls and says she didn't get a request and all along the pharmacy is saying yes they did!
So I go to my new PCP's appointment at 3:10. She is awesome. She's a young thing and as she says, very anal and thorough. I tell her about my medication I got for Pilocarpine which is for my Sjogren's syndrome (very dry mouth and eyes)another autoimmune disease which attacks salivary glands. They were making me feel real weird. I told her my Rheumy has me on 3 5 mg a day. She looked at me cross-eyed and said that is way too much. She never prescribes more than 10 mg a day. One in the AM and one in the PM. I tell her about my MTX fiasco and says she is going to send for a prior authorization because my RA doc is on vacation. Plus she ordered all this other stuff and test. I haven't had my thyroid or a full panel done in years and she is checking my hormones and sending me to a OBGYN and for a mammogram. I've had 2 periods in 14 months,. I also ask about pain meds and how my Rheumy gave me a prescription antacid to take before breakfast if I feel it's going to be a bad painful day and then after breakfast take a Advil, Aleve, etc. Again, she looks at me cross-eyed and shakes her head. NO WAY! You can't take that she tells me because of the bypass. (which I already knew) I told her I ask him about pain meds at my first appointment and he does not prescribe them. Well, Tylenol has never worked for me. It does nothing for inflammation! So she writes me a script for Tramadol which I rarely take pain meds unless I get a flare or plan on riding for a long time. Plus she gives me a pneumonia vaccine. A common cold for me can land me in the hospital with pneumonia. Hospital is the worse place to be with a suppressed immune system. Oh and lung X-rays today too because RA can mess up my lungs.
So today is Thursday and still both the medical group and the pharmacy are saying they have not received anything from either. Who's lying? Tomorrow is Friday, then the weekend when no doctors are open. Then Monday.....the day I need it! I can't go another week off it.
Tomorrow I am going full nutty patient lady! At this point, I really don't know how the health insurance system works. All I know is the staffs are lagging real bad. Do I call my insurance company? Medical group? Pharmacy? Or worse.....send my husband in person? Right now I have TWO doctor's offices working on it and nothing is getting done. WTH?
I'm ready to call Health Net and get them involved. I don't know what to do!
Since I have a prescription, can't I just go in and pay cash? According to GoodRx MTX for injections are cheap! It's not like I'm looking to buy heroin!
Where should I go from here if by 5 today nothing is done? I am at my wits end today!
I do hope this got resolved and you feel much better.
But I just found out I'm the Buffoon! LOL
You know how sometimes people don't read their owners manuals? Well, my missing my dose was my own darn fault!
I've never really had many health issues until now so I never read my book the insurance sends you with the complete explanation of benefits. I never needed a PA because the MTX is cheaper than the co-payment. DUH! So member pays out of pocket. Now if it were Humira or the like....then yeah. All the pharmacy seen was it was being declined. It wasn't until I asked them the price the light bulb went off in my head.
The cash out price is $11.37 for a months supply. **face palm** But it was on back order so I wouldn't have gotten it anyway. ;) So all that stress and anger could have been avoided. ugh.
cie la vie
Oh and I feel ya on that billing issue! When we changed plans one year to the next everyone kept billing us because they were still going off the old plan. Took forever to straighten out.
Hope you are feeling better.
I actually feel pretty darn good today.
I was up until midnight last night on my laptop in bed. I never do that. And I wake up during the week at 4:45 AM....I think the MTX really does take a toll on you fatigue wise. Or I'm in some kind of remission, or the fact it's Friday! :)
Have a nice weekend get some R & R too. :)
So my pharmacy recommended another pharmacy about 30 minutes from me that one of those compounding pharmacy's and they find hard to get meds. Luckily they had 3 2ML vials so I bought all 3.
Did my injection after missing a week yesterday and today I feel normal. Good sign. Side effects are easing up.
Bad news is all those test I did the only couple of things that came back was my B-12 was too high and I showed pre diabetes. BUT...don't know if this effects it but I was suppose to be fasting for this test and I cheated that morning and had a cup of tea with sugar . I rarely eat sugars or carbs. Hmmmm....I am waiting on lung x-Rays.