9 April 2021
Yesterday we spent the morning unraveling the mysteries of durable medical equipment, also known as supplies. Joyce's plan (well, mine too) covers 80 percent of the cost of these essentials. In her case (at the moment) they're large Mediplex bandages, abdominal pads, rolls of gauze, Dakin's Solution and Vashe.
Byram is the company that delivers this stuff when Dr. Tong orders them (and her staff of elves places the order through Medicare to Byram). And a few weeks ago we got a flyer from Byram suggesting we set up an account so we could reorder supplies.
But when we finally ran out of the Kerlix gauze rolls, we were prohibited from reordering.
Which was not as simple as it sounded, of course.
There was already an account set up for Joyce by Dr. Tong's staff but we had to get access to it, as we detailed in Once More With Feeling. But in March we were able to order a few supplies after that and they did arrive after a few days. Yippee.
But when we finally ran out of the Kerlix gauze rolls, we were prohibited from reordering. Why? Because Joyce had three past due invoices from February. About $350 worth. Surprise.
I started another online chat but was told to call the office where a nice lady explained Joyce was only covered for 80 percent of the cost of the supplies. Yeah but why are all the other orders listed as $0.00? And how could some gauze cost $350?
No idea.
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MEANWHILE WE WERE RUNNING OUT OF KERLIX. I stretched it by using one roll cut in half for two dressing changes. Salwa the LVN had told me I only had to be "clean" with the wound, not "sterile." I'd shown her the open box abdominal pads that I was reluctant to use, but she said they were fine.
So yesterday morning (finally back to the beginning of this story), Joyce and I called Byram again. She had to participate since it involved her finances.
Leslie wasn't able to answer those questions either but she had her supervisor call back a few minutes later and she could answer them.
Leslie wasn't able to answer those questions either but she had her supervisor call back a few minutes later and she could answer them.
Those zeroes are not real zeroes. They are pending bills. After Medicare pays, they'll let us know what the damage is. We don't see a total cost, so we can't estimate it ourselves (or comparison shop, for that matter). We just get the bill.
Well, what about all the supplies we got that we can't use. You can return anything within 15 days of receipt, she says. After that, you are in the second-hand durable medical equipment business, apparently.
She offered to flag our account so that any orders must be approved by us. Going forward.
And she offered to send a hardship application because, she said, these costs are going to skyrocket as Medicare pays its share of them and they bill us for the rest.
And, no, she did not have Cat the PA's Kerlix order from last week. But she put one in for us. A 30-day supply of 60 rolls. Which I could drag out for three months. She said she'd have them here today.
But what was I thinking? Three more months?
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NOT ONE TO TRUST estimated delivery dates, I went to Plan B. When we returned to the clinic yesterday for a debriding, I propped my cardboard sign up on my knees in the waiting room, "Will Work For Kerlix."
Alex gave me a sack of Kerlix that should last a week. Then she asked if there was anything else I need. Well, sure, but. I decided to hold my cards close to my vest for the time being.
Dr. Tong popped out for a minute to offer to order the Codeine Joyce had requested for pickup today at the pharmacy on the next block. Perfect, I said, because we're going over there for the Dakin's Solution and Lidocaine (neither of which they had when we went there Tuesday).
Codeine? Where did that come from. It had been Oxycodone or Tylenol.
Codeine? Where did that come from. It had been Oxycodone (or Tylenol). The Tylenol did not cut it earlier when I put the Lidocaine on the wound just before we went to the clinic. Joyce screamed and cried and screamed and cried as I applied the cream to the wound. We got out of the house before the police arrived.
So I told Joyce to ask her for Codeine. I was thinking of Oxycodone but remembering my mother's Tylenol with Codeine. And Dr. Tong took my "advice."
(I can report it worked wonders last night. Joyce was in agony in bed after dinner until she took one. Then she slept like a log all through the night.)
After she'd finished the debriding, Dr. Tong briefed me on the situation. She suggested we skip a week. Or not, up to me. Well, it's actually up to her, of course. She pointed out she had very little to cut away today. The Dakin's/Vashe treatment is working.
So, in consultation with Joyce (who held the tie-breaking vote), we decided to skip next week.
No need for the Codeine or the Lidocaine, ha. And even more amusing, I had planned to pop over to the lab to do my annual blood tests next week (since I'm past the two-week second-vaccination window) instead of hanging around the waiting room. I may just wait one more week.
Dr. Tong also said Joyce could go back on the Wound VAC with black foam any time now. The wound is pink and ready for it. "But she's not emotionally ready," Dr. Tong admitted.
So maybe in, say, 10 days when we return to the clinic, there still won't be much to debride and Dr. Tong will convince Joyce to go back on the wound VAC.
Which means we won't need three months of Kerlix after all. But it will be within the 15 days of receipt (assuming it ever gets here) to return the order.
"OK, so take next week off," Dr. Tong said, smiling behind her mask and face shield. "We have to give Mike a break!"