#but health insurance is weird because you will need to go to the doctor

[thatmartiangirl]

Working in the insurance industry and getting a better idea of how it works and it's becoming clearer and clearer how bonkers it is that the healthcare system in this country is insurance based

[keepingthepeaceinouterspace]

Psyched that I get to pay $278 for seeing a cardiologist because my PCP said there were something weird on my EKG only to go to the cardio and find out there was nothing wrong in the first place and for my PCP to say "oh no it wasn't because of the EKG, it was because of the placement of the numbness". Which was MADDENING because I'm not fucking experiencing numbness and literally nothing about my issue points to my heart. It points to a spine issue or a posture issue.

[copperbadge]

How did you find the doctor(s) who assessed you for ADHD? Im looking into the process of getting diagnosed because (although ive suspected I might have adhd for years now) I've been struggling a lot more lately and i want to try medication to see if it helps at all. Im trying to search for psychiatrists through my health insurance portal but the the results im getting are all for child/adolescent psychiatry specialists, and I dont think that'll be much help for an adult adhd assessment? Did you have an established therapist to refer you for your assessment or were you able to find a psychiatrist independently?

I actually just kind of had to freeform it, but that does mean I have some tips to share!

I will say, I have never once used a health insurance portal to find someone to treat me for anything. Often their search engine is fucked up and the information is sometimes out of date. I almost always either ask someone who I know has had similar issues if they have a recommendation, ask my treating physician if I have one, or just google until I find someone reputable-looking; any qualified medical center or professional will list what insurance they take anyway, and you can always ask when you make the appointment.

So here's the process for how to do that!

When I was first considering it, I asked a friend who'd had an evaluation that came back not-ADHD, which I liked because it meant we knew it wasn't like, a weird Adderall pill mill or something. I really wanted to have a professional and thorough evaluation because I knew myself and knew I was capable of gaming a questionnaire. The place she had her evaluation was unfortunately having some staffing issues; part of the reason it took me so long is that I played phone tag with them for ages -- I'd call, and regardless of what time of day I called, their scheduler would be "out", so I'd leave a message and never get a call back. Ultimately I said "I really need to talk to a human, because your scheduler has not returned any of my numerous calls" and they said they could transfer me to another office outside of Chicago (in the burbs). That was not going to be accessible to me, so I told them thanks but I'll go somewhere else. Then COVID hit and I was not going to go anywhere near a medical center unless I had to for about two years.

So, when I was making my second serious run at getting evaluated, I did what might be expected of me by longtime readers of this blog: I made a spreadsheet.

I want to caveat this up top with REALLY IMPORTANT CONTEXT: I did not do all of this in a single day. The process from starting research to making an evaluation appointment took about a month, and probably would have taken longer if I wasn't getting somewhat desperate. Do not push yourself to do this as a single act. Research alone is a multi-day process; some days I looked at the open tabs and only entered one tab's worth of information. It took me quite a bit of time to write the form email I sent inquiring about an assessment. It took me time to call the clinic back when they asked me to call to book the appointment. This is a series of steps, not a single leap.

So!

I was looking for a clinic rather than an individual, in part because I'd heard a couple of horror stories about people who went to a psychiatrist and just got argued with for an hour instead of actually getting evaluated. So I googled, and here are some key terms for you, chicago adult adhd assessment. Chicago obviously for the region, but "adult adhd" (putting it in quotes will help) is the important term that will help you filter out a lot of child psych stuff. A lot of what I looked at did included family or child assessment/therapy but were clear that they also evaluated adults.

Then I went through every legit-looking search result and noted down, in my spreadsheet, the name of the clinic/company, the contact phone and email, the URL, the physical location (I needed to be able to get to it fairly easily) and whether they took my insurance. Even if they didn't take my insurance (all but one did) I still put them into the spreadsheet so that if I found them again I could check the sheet and know I didn't need to investigate further. I also tended to bump more legitimate and friendly-looking places to the top of the sheet. And if I were going to do it again I would also look for one specific thing, which is an assessment guide of some kind.

The assessment guide may be something they only give you after you speak with them, so it's not a no-go if they don't have one on their website, but it basically tells you what generally will go on during the assessment, how long it will take, and what you should bring. A full assessment like I had is estimated to take 4-6 hours and they recommended I wear layers so I wouldn't be overly cold/warm in their office, and to bring a snack. That's the kind of information you want, duration of the assessment and what they recommend for you, to ensure that you're working with people who are thorough and care about your comfort.

So, I have this spreadsheet now of places to reach out to, which I know take my insurance and do adult assessment. In the spreadsheet I also had columns for what date I contacted them and whether they'd responded. I started reaching out via email, one per day, with the form email I'd written.

The form email basically said "I'm 42 with no previous diagnosis but I have a family history of autism and dyslexia. I've been told I should get assessed for ADHD, so I'm looking for a clinic that will do the assessment and takes (my insurance). I prefer to be contacted by email but if need be, my phone number is (phone number). Please let me know if you have any open appointments and what information you will need from me to book an evaluation with you." (You can always ask for more information about the actual evaluation process once they respond.)

If I didn't get a response within 24 hours, I moved on to the next, but I only greyed out the text in that line of the spreadsheet; I didn't disqualify/remove the nonresponsive ones because again, I wanted to make sure I kept that information in case they eventually did respond. I did this with about ten clinics, because I figured I must be able to find at least one in ten who could do the eval, and I could go back and research more if necessary.

I think the third or fourth one I reached out to was the first to respond, and I ended up going with them; I had a very positive experience in the assessment itself but it was a real pain in the ass getting the documentation from them -- they took about a month to go through the evaluation data (this is not abnormal but is rather longer than usual according to my psychiatrist) and they gave me an in-person-by-zoom report once it was ready. That said, it took another four months and the threat of reporting them to the state to get them to send me the text of the eval (in part because the evaluator left the clinic unexpectedly with my formal report not yet written). But that's something that's truly impossible to know until you're working with them, and highly unusual, so don't let concerns about that deter you. If you end up in that situation come hit me up and I'll tell you how I dealt with that.

My eval recommended an executive function coach, but if I haven't been able to func it by now I never will, so I thanked them for the recommendation and went looking for a psychiatrist unaffiliated with the clinic to prescribe me meds. There, the key words you're going to be looking for are again "adult adhd" but also "adult disability" and if you want medication that's less likely to be a huge fucking hassle, "medication management". My psychiatrist and I meet every two months to reup my prescription, but he doesn't require me to take a regular drug test or meet him in person in order to get a new scrip, as some people have encountered. We meet in person once or twice a year (I can't remember, it's due to a legal requirement in Illinois) but otherwise it's over zoom.

So yeah -- it's a process, but there are ways to streamline and manage it, and a few tripwires in place to make sure you don't end up screwed by the system. Definitely feel free to ask if you have questions, either here or if you want a more indepth conversation you can email me at copperbadge@gmail.com. GOOD LUCK!

[kiok0r0]

"Hey Kioko, how's the new job?"

I now understand why people advocate so strongly for universal healthcare. Insurance is such bullshit. But aside from that. This is a terrible job.

"It's only been two weeks. What's going on?"

Okay.

So I didn't think this through.

More under because the rant's long

This job I'm at is at a clinic. They're open three and a half days each week, it's typically 30 hours per week. I've got no experience or knowledge of medical terminology and medical computer programs. I admitted this in the interview we had. I was way too over the moon when they IMMEDIATELY HIRED ME AFTER ONE INTERVIEW. Why do I know they immediately hired me? They sent me forms that jobs normally send after someone gets hired. That should have been, you know, two red flags. But again, they wanted me to come in for a work interview, so I thought maybe they wanted my paperwork beforehand so I can do the work interview.

No, I literally missed the signs. I mean, I thought it was weird but I sort of thought they were super eager. And then after that work interview, they asked how soon I could start.

"I want to at least do my two weeks at my other jobs." Since, to be honest, while I hated one of the jobs, the managers at both places have been super kind.

"Can you ask if it's possible to leave earlier?" The doctor asks without hesitation.

Also another thing to say, I don't have a lot of work experience. I've been hired on the spot for one of my other jobs and didn't have a job at the time so I didn't really need to do a two week notice. But a two week notice is a courtesy. And again, while I didn't like the job, I really liked the managers. They have been patient and flexible with me and didn't pressure me to do things I couldn't do. So I felt rushed and slightly offended. But I brushed it off. Maybe they just thought I would be a good fit for the position and really wanted me to start soon.

So I started Tuesday. Realized I had to leave to celebrate my brother's graduation this week. Here was what the doctor did when I told him that I would be gone Friday and the first half of next week:

I have essentially did a speed run of the basics of the tasks I'm supposed to do the four days I've been in so far.

It's not even the end of week 2, mind you, and I haven't done a complete week at this place yet. Sure, the doctor's not expecting me to be an expert, but when I am the only one working at the front desk and I have no experience in the medical field or know how to do insurance claims maybe there should be a lot of training.

There is none. I have been taught way too many things in the span of four work days that takes thirty minutes to explain to me. And then it eats away my time because a new thing arises that the doctor didn't teach me.

He's expecting questions from me. I have so many and he's not available at all times. And I don't know how to tackle a lot of things without asking for help. There is no one available all the time. I am floundering. I'm spending way too much time after closing to figure out what to do by myself.

No one is teaching me how to read insurances. No one is teaching me how to explain to patients why their bill is like this. No one is teaching me how to be good on my own. This is the worst job with training. I'm essentially the face of a clinic who's trying to maintain people's health. And I have to learn "along the way"?

I don't know. I feel that when I'm in charge of looking at someone's expenses for their health, I feel there should be someone that should be training me from the moment I get into the office and the moment I leave.

I told myself I'll give this a chance. I wanted to give myself a year, 6 months at the bare minimum. Now I think I'll give it 3 months.

Oh and they told me my position is "office manager" when I had to tell someone what my position at the clonic is other than being just being an office clerk. Which. Was the job title on Indeed.

[deadmomjokes]

i hope this isn't too weird a thing to say, but between 'exercise itchies' and 'tomatos aren't spicy?!' i am confident that your kid will never have a potential allergy/health condition go under the radar. like as someone who's seen waaay too many people i know not realize they were allergic to something because folks thought they were just a picky eater, or get their chronic pain brushed off as puberty/growth spurt pain for years, or not realize you aren't supposed to take ibuprofen on a daily basis... yeah, The Bean will not have to worry about that. (BTW if anyone reading this needs to hear it: you shouldn't have headaches on a daily basis that range from 'really unpleasant' to 'incapacitating', and in the name of my brother I suggest you ask a doctor about migraine medication.)

I sure hope that's the case! We already kind of went through it a little bit with her, but more in the sense of keeping on the doctors' case because we knew things Weren't Quite Right. (For the record, Bean's PCP is absolutely incredible, it's just that insurance makes us all jump through a bunch of specialist hoops before they'll pay for the one we really needed, so we had to work our way up the ladder of ineffective treatments and diagnoses til we had the evidence to say "LOOK". And because she wasn't technically underweight or, like, vomiting blood, everyone except us and her primary care doc just called her a "picky eater" until she was able to verbalize what was happening.)

If nothing else, I'm super determined to keep my eyes peeled so she doesn't go through the nonsense we went through for as long as we did.

And yes! Oh my goodness, folks, please listen to Anon: daily headaches are not normal, at any severity! Especially not incapacitating ones! In fact, incapacitating headaches of any frequency should warrant at least a follow up with a doctor!!

Y'know, given the state of health education, medical literacy, and the general attitude toward children in my country (usa, of course -_-), I may have to poll my friendgroup, family, and personal medical histories to start a masterpost of "Hey, that's not normal and you should see someone about that." Because now that I'm thinking about it, there's kind of been a lot.

[aalt-ctrl-del]

it is very concerning how that the general public forgets that the argument on "abortion" and "reproductive rights" isn't isolated to the topic of "baby in the womb doing stuff".

The whole encompassing topic of body autonomy doesn't start or end at "womb" or "fetus". Those are the buzzwords that republicans love to throw around to simplify the morbid truth of this weird control train. It's what republicans prop up like a cardboard placeholder for the submerged iceberg of everything that they want to control on the topic of body and reproduction autonomy.

And this goes for men too. I know my boys like to pretend that they republicans have no interest in the peepee gun. But the republicans also think condoms and male birth control are the devils work, because dem bois are still killing babies. So when they get done with the ladies, they'll be looking at us all.

Which ties to my next point, aside from birth control measures being removed because it 'kills babies'. The whole topic is a mess because republicans idea of saving babies is for women to get married ASAP and start having babies. Messy. Topic. Bat. Shit. Insanity.

What is more batshit insane than gutting production of birth control and contraceptives, is the general focus on anything to do with the uterus or the ovarian things. Because this is the massive, whole encompassing issue here. In red states, it is difficult if not impossible to get sterilization surgery, regardless the reason. Women and people with uteruses struggle to get healthcare in red states, when their biology connected to the uterus fucks up. Even if the procedure is something that will benefit their quality of life, such as the case of Menorrhagia, Endocrine, Ovarian cysts, and various other illnesses that incapacitate or cause general disruption in health in those with a uterus. Some chemical birth controls help with managing these disorders, but sometimes that isn't enough. Some people go for a hysterectomy, but that all depends. But all of this medical hippa and body autonomy is infringed upon by republicans and red states, under the guise of "Saving babies".

These republicans put the quality and safety of a damn organ, above the person mental and physical health. It's bizarre. It's sick. People with uteruses lose full jurisdiction to their body, because by religious and state ordinance, the body is not their own property. Not fully. The uteruses may not be full of oil, but the republicans sure as hell want to stake a claim in it.

The topic is not a clear cut of black and white, regardless how simple the republican smooth brain schemes tries to posture it. It's dehumanizing and frankly, dystopian. Topics of health and wellness should be governed by no more than two people - the doctor, and the person seeking medical assistance for their body. Governors, Supreme Court, House Representatives - none of those people in those districts have a place in body autonomy regarding a singular organ. They HR, SC, Congress, whoever - they can have discussions of healthcare and affordability and the insurance coverage (which is a fuking nightmare). But when it comes to procedures that people seek to amend personal health issues, they cannot be governed by anyone not privvy to that information.

But that's just a reminder to anyone who thinks "abortion has nothing to do with me because I cannot get preggos". You miss the point it wasn't about babies or pregnancy or protecting/saving anyone. It was about controlling body health and emotional welfare.

You go to the doctors one day because you have heavy bleeding, and you get the results back from tests letting you know "there's a large tumor on your fallopian tube and it needs to be removed." It's not a simple case of scheduling the procedure, even if you have the assets to get this done and insurance that can cover it. Because there's suddenly the possibility you're actually involved in a nefarious plan to kill a baby, and everything about this procedure must be approved by your very red state, just to be sure you're not a heathen. Insurance might not even have jurisdiction to cover it, since this is happening in a red state.

But that's the gist of reproduction rights and body autonomy. It's never been about babies or saving unborn children.

[doubleca5t]

Idk if this is a different ballpark entirely but since you work in insurance I figured I’d give a shot asking; why can’t you add to your insurance plan within the same year you sign up? I can’t add preventive care to my pet insurance until next year, so I just have accidental. I’ve noticed that’s the same for health, and figured it’s probably consistent across the board now. I just think that’s weird cause wouldn’t insurance want more money?

Health insurance doesn't let you endorse mid-term to discourage people from underinsuring as a way to avoid paying full premium.

Like let's say you've got a health plan that lets you endorse mid-term. You could buy a barebones policy that doesn't cover much of anything, endorse to a higher tier plan right before you need to go to the doctor, then endorse back to the barebones plan shortly after. Since the premium would be pro rata you'd end up only paying a little over the cost of the low tier plan while getting all the benefits of the high tier plan. Some people might just skip out on insurance entirely until they got sick, and then only end up paying one month's worth of premium for all the coverage they need for a full year. So if you can't endorse mid term and you're locked into whatever plan you purchased at the start of the year, it incentivizes you to buy more coverage than you think you'll need and pay a full year's premium for it.

Other lines of business like home and auto don't have this problem because you can't strategically time upgrades to your insurance policy based on when you plan to crash your car or have your house burn down, so they absolutely will let you endorse mid term. With health, on the other hand, even if you're having a health problem, in a lot of cases, you still have some degree of control as to if and when you go to the doctor for it, and therefore have an opportunity to intentionally underinsure yourself.

[wistfulcynic]

in December 2008 i moved permanently from the USA to the UK and promptly got an ear infection. It was intensely painful, like an ice pick through my skull. i took some OTC painkiller and lay in bed, moaning and miserable. 

my (English) husband looked at me like i’d grown a third head. 

“if it’s that bad why don’t you just go to the doctor?” he said. 

“i--i can go to the doctor in this country!” was my reply. 

at that time, it had probably been 5-6 years since i’d seen a doctor. Not since i stopped being on my dad’s insurance. Even when i’d had my own insurance (via my grad school institution as part of my teaching assistantship compensation, the same insurance as the professors had. Probably pretty good. Still too confusing and scary for me) i never felt like i had the spare cash to cover a copay, was always afraid that what i needed wouldn’t be covered by the insurance. i ignored an abscess in my mouth for weeks until it finally burst in a geyser of pus you definitely don’t want me to go into further detail about, because i was worried that would count as dental and i didn’t have dental coverage. 

you get the picture. Health care in the US sucks hard. 

when my ear was infected, my husband phoned his local GP surgery (with which i was not registered, i was an immigrant on a spouse visa, only arrived the previous week), got me an appointment later that day. They saw me, diagnosed me, gave me a prescription for antibiotics for which i paid (i think, at the time) roughly £7. Cleared up in a few days. 

all i paid for was the prescription. 

some years later my husband made me go to the doctor again. i was having random symptoms i wasn’t even sure were symptoms, a weird laundry list of stuff that could be connected or could be nothing. i went to the GP with this list, worried that they’d take one look at a heavyset woman and immediately go “lose weight fatty!” or “diabetes!” They did not. The doctor was a young-ish woman who listened carefully to everything i told her, looked at my list of symptoms, and said “we’ll test for other things, but I’m 99% sure this is a problem with your thyroid. i’m going to start you on some medicine while we wait for the test results.” 

prescriptions were by then something in the neighbourhood of £8. 

a few days later i got a call from the lab that had run my blood tests. They told me that my thyroid levels were through the roof, so high they were actively dangerous. Cardiac arrest was a likely outcome if it was left untreated. They advised me to get a prescription immediately, and were audibly relieved when i told them i already had one. 

if i’d not been living in a country with free-at-the-point-of-service health care, i would not have seen a doctor. The NHS saved my life. 

why am i going on about this? Well. It’s because NHS workers have planned a strike for later this month, and the press are already on the attack. Fearmongering about how this will throw the system into chaos, patients will go untreated, etc etc blah blah all with the very unsubtle spin of “blame the workers. Blame the strikers. They’re putting your lives in danger.” 

zero mention of how dire the situation is in many hospitals. Not enough nurses (because Brexit among other reasons) and the ones we do have are overworked and underpaid. Too many patients not enough beds. Old buildings, old equipment. 

none of which is a problem with the system. The system’s great. The system works. The problem is the predatory Tory government who would love nothing more than a privatised, US-style insurance-based healthcare system off of which they and their cronies can profit. The problem is how the government has been starving the NHS of funds for over a decade, under the guise of “austerity” and how we all need to muck in together. Except them, obviously. They’re different. 

the problem is absolutely not the people striking because they, like nearly all of us in this country, are shamefully underpaid. Because they deserve compensation for their hard and dangerous work. Compensation they are not being given, despite their attempts at negotiation. 

whenever collective action happens there are always people eager to blame the workers. Greedy nurses, refusing to treat us when we need them because they think their pay is more important. How dare they? They have a responsibility to do their jobs! i am urging all my UK mutuals and anyone who reads this not to be taken in by these spurious arguments or any spin doctoring from the news rags. Side with the workers! Side with the nurses. Side with the people who want the NHS well-funded and thriving. A robust national health service is a universal good. Ours is creaky and wobbling but that is from mistreatment, not because the principle is unsound. i promise you, however frustrating you find the NHS, an American-style system is far, far worse. 

[thedisablednaturalist]

so sorry ppl that cant read are sending you messages about those posts but i get it completely. rheumatologists and osteos and NP's want to hear more abt my decade old severe anxiety and depression and adhd and ~more~ diagnoses than chronic debilitating pain and just slap vitamin D pills on it and throw up their hands because "test results are weird idk what to tell u even tho i said it was this two weeks ago". abled friends and coworkers can have conversations about their mental health struggles but its looked at self pityingly if i bring up how my life is irreparably damaged by my physical disability because disabled people have to be strong and resilient to earn a place in their field and if you cant cut it just get on those snazzy disability benefits and let it get worse. i think a lot of abled ND people just cant accept that they do not experience the worst of life's struggles and that solidarity doesnt make us the same

I try to be understanding and answer peoples questions politely when I have the spoons and if they are genuinely confused bc I used to be ignorant as well about a lot of aspects of physical disability but it gets so tiring. Nowadays there are a ton of resources from physically disabled people talking about their experiences its actually quite easy to educate yourself on our struggles. Like sorry I get a little frustrated and rude when I'm constantly bombarded by ableism and rude ass people.

Also yeah that's exactly what I've been trying to say. Doctors can usually relate to people having mental health struggles and even some aspects of neurodivergencey. But they cannot understand someone looking completely fine and not being able to detect anything but complaining of horrible pain and constant tiredness outside of the lense of mental health. And if your mental health is managed or only suffering because you are in constant pain, they say you're faking, or OBVIOUSLY you just need to lose weight, or drink more water, or exercise more than any able bodied person does. People take one look at me and think the solution is obvious and I'm just too stupid or lazy to figure it out.

And me saying this isn't saying that mental illness is super easy to deal with. Its fucking awful as well and many doctors say this shit to neurodivergents as well. And this is especially true for poc and people with psychosis or bipolar disorder or schizophrenia.

I went to my first therapist in my sophomore year of highschool and got medicated that same year. I started investigating my health issues in college freshman year and have JUST gotten actual results from treatment. SIX fucking years later. SIX fucking years of CONSTANT PAIN. And I have great insurance and a great dad who just wants me to feel better (my mom is a different story). My parents are sort of upper middle class and I live in a very privileged area. Of course that means I can't afford to move out even with an ok salary, but at least there are plenty of doctors around to choose from and plenty of appointments available. I can't imagine how long it takes someone without those advantages. And even still I had to fight to be listened to, I had to listen to so much bs from doctors and had to go from doctor to doctor begging for someone to listen.

Like they really don't get how unbelievably hard it is to get care for physical disabilities, visible and invisible. If you're visibly disabled you get treated like a child and a monster and you're isolated from society. If you're invisibly disabled you get laughed at by doctors and ignored. If it's hard for you guys imagine that difficulty increased by 100%.

I try to be really visible when I'm working in a position I know has my back. I really try to educate young people and children on what my disability looks like and I hope disabled kids and kids who eventually become disabled can see me and know that their lives are valuable and they are valuable. And it is possible to find joy in your life and reasons to keep living. And employers shouldn't be able to throw away our resumes and pay us less just cause we may need a little extra help. I know what everyone thinks when they see me in my wheelchair and using my walking sticks and when I tell them I need to take a break as I'm running out of spoons. I know their first thought is what the hell am I doing here if I'm in so much pain? When people see me by myself in my wheelchair they think I must have gotten lost and separated from my abled handler. I love my job, I love what I do, and I want to be able to keep doing it. But I can't work as long as an abled person, I can't do it without accommodations. Hell abled people shouldn't be working as long as they do either. I wish to live a life where I'm free to do the work I love without killing myself and still be able to live a comfortable life. Every disabled person, working or not, deserves to live a comfortable life.

[ahhscheisse]

TRIGGER WARNING: ABUSIVE DOCTOR, TRANSPHOBIA, SEXUAL ASSAULT, EATING DISORDER

This is a long one and I know the wording in this review is transphobic but… My first top surgeon was an absolute bastard that’s left me with significant health issues as a result - including needing a second top surgery.

I saw him kiss young trans girls on the lips and no one fucking believed me but now it’s showing up in his reviews like this:

If you’re going to have gender affirming surgery in Whittier or Beverly Hills, California, be very wary of this doctor. You can DM me for his practice. He left me with terrible burns on my stomach, fucked up ribs and surgery results I will never be able to fully correct - among emotional and other physical fucked upedness.

Fuck you, Doctor.

BEWARE! THE REST IS WORSE!

Here’s some of what he did to me.

- he refused to answer my questions 90% of the time

- called my body “weird” and “off putting” while looking at my new chest for the first time

- went out of his way to do things that were extremely painful/humiliating without warning

- my surgery was only supposed to last 3 hours max but went over 8 and he refused to answer my families questions or mine after I woke up

- I woke up on the surgery table naked with pain in my genitalia, was thrown into clothing immediately and shuffled out the back of his surgical office into my families car

- he and his staff misgendered me every day I saw them until the last day without fail

- told my mom not to call him unless my fever reached 104 - it was 103. Hung up on her

- made me wear a surgical binder for five fucking months straight, 24/7, and I was so clueless that when people told me that that was in no way okay, including another top surgeon and two GPs, I could have cried because I was in so much pain. My ribs are still fucked up and I had surgery in early 2018

- I had dog ears and puckering in the center of my chest, he sewed my skin together so wrong that it hurt to move for two years and there are still pockets where dirt collects

- it took months and multiple doctors to finish taking out staples and stitches because he never took the time to be sure they were all out.

- called my GP an idiot for not feeling comfortable in removing some sort of an anchor internal stitch or something that was dangerous to remove, that you couldn’t see on the outside of my body, that could have reopened my chest entirely and that the surgeon should have removed himself

- he told me NOT to bandage my nipples and one fucking fell off

- he triggered my eating disorder by making me lose twelve pounds every month immediately after surgery or else he’d make nasty comments about how his nurse gets up at 4am to go to the gym and if she could do it, I certainly could, too

- had pictures of various famous porn stars on every patient room wall

- kissed young trans girls ON THE LIPS

- said I had a “very ugly family”

- my lips turned blue after surgery and he called me a liar and said to stop being dramatic

- left burn marks all over my ribs

- I had an infection in one of my drain wounds that he refused to treat

- during the consult, he would not let me put my shirt back on while we discussed things like insurance and the scheduling process

I had night terrors for two weeks leading up to appointments with him and one day, I just stopped going and reported him to my insurance, who told me he had multiple malpractice suits in the beginning stages. I also found out that he almost fucking killed a trans person who was bleeding out. He refused to see them or fix the wound, and refused to even tell other surgeons about that persons surgery.

There’s more but I am too heartbroken. DM me if you’re having surgery in Whittier/Beverly Hills, California so I can help you avoid him.

[doberbutts]

@hikko-g

Because that post is already long enough, a condensed timeline for how my doctor was able to put things together and figure out that I’m intersex:

I brought a lot of evidence that I’ve been gathering for the past 5 or 6 years and then asked her to look into it, because I found out by complete surprise after thinking maybe I had PCOS or endo that I might actually be intersex instead. How did I find that out?

I had an ovarian cyst I didn’t know about burst and the pain was so severe that my face turned a light grey color (and I’m black so that is... Not A Great Sign) and I collapsed to the floor in the middle of my shift, and it was in the right spot for my appendix to have burst, so my job immediately sent me to the ER because if your appendix ruptures you either get surgery or die. Pre-op bloodwork revealed that my appendix is Fine Actually, so they did an ultrasound and discovered one very upset ovary covered in cystic scarring [bastard] and one ovary that very much did not look like an ovary but did look like an undescended testicle sitting where an ovary should be.

Which I took directly to my mother who proceeded to tell me “oh we’ve known about that since you were born”. WELL IDK WHO “WE” IS BECAUSE I WAS VERY NOT INCLUDED IN THAT DISCUSSION

She linked me to a study on CAH- Congenital Adrenal Hyperplasia- which according to her the doctor told her I very likely had when I was born, which she deliberately kept from me because she was afraid it would make me want to be a boy. That was right before I moved to this state so about 5.5ish years ago. I have been working with PCPs and OBGYNs since trying to figure this shit out and at the end of the day I was told to go to an endo armed with all of these “well have you ruled out-” and “could it have been-” dead ends.

My endo looked at the evidence I provided and the medical records ruling out the more common stuff, did a brief physical exam of my body, and went “yeah probably”, did a quick blood test, and as the results trickled in over the next week she went “yeah that’s it all right”.

The specific things she was testing for were: baseline levels of estrogens and androgens [needed for HRT anyway], cortisol levels, and special tests for the components of cortisol as well as what people with CAH make instead of cortisol that the body converts into androgens. What do you know, my estrogen levels are at or below post-menopausal despite me definitely having periods, my testosterone is juuuuuuuuuuust touching the low end for a cis man, There Is No Cortisol Here, and I have a lot of loose ends my body should be turning into cortisol but is actively choosing not to do that and to turn it into androgens instead. So, that pretty much sealed the deal.

As for my ovary vs testicle problem- that is still a mystery and honestly one that will be resolved hopefully next year when I have the damned thing removed. My OBGYN looked at the images from that ER visit and went “yeah that sure doesn’t look like an ovary” but then on her own ultrasound said that it could be deformity or even a benign tumor causing the weird shape and so without actually seeing it outside of my body it will be hard to determine either way. CAH does not inherently do this- most people with Nonclassical CAH have perfectly normal internal genitals, but a study did discover that a non-insignificant number do have some form of mixed genital presentation either externally or internally, so it’s hard to say either way.

This was not a quick process but I do have to say that it would have been slightly faster had COVID not happened, as I was all lined up to start this process mid-2020 and then March Happened. And then things kept happening and I lost my health insurance and I just got it back. So instead of taking 5 or 6 years it would have been 3 or 4. Still not a fast process tbh.

[necromancy-enthusiast]

I got my first doctor prescribed ketamine treatment a few days back and man the high sure was weird. Honestly I wouldn't really even describe it as a high so much as a weird, overpowering calmness. They're pretty sure my health insurance won't make me pay for it... I mean, other than the premium because the US healthcare system is pure evil, and if you're one of those non-Americans that makes jokes about it, uhhhh fuck you? Yeah, fuck you, because if I hadn't gotten lucky enough to have parents that were willing and able to pay the thousands of dollars in medical bills I've wracked up over the past five years, there's no way I'd still be alive. :^)

Anyway, wow... Who knew all I needed to get the occasional bit of ketamine was ~treatment resistant depression~ or as I like to call it, ~shit life syndrome~.

They probably didn't put up a fight about paying for it because they know that I've tried A Lot of different meds and have only had moderate success, and it would ultimately be more expensive for them if I didn't get the treatment and tried to off myself, thus having to go to the er or an inpatient program. I mean, I've never tried to off myself and am not tempted to, but you know. Still a smart choice on their part, evil bastards that they all are.

[polyamorouspunk]

So I had a kinda weird week

My parents decided to do a vacation week in my college town while I had lectures and it’s been kinda… uuuuh

I also had migraine two days this week (one actually today, it always gets better after sleep, food and some hefty ibuprofen) and my knees decided to act up

Consequently I actually used my walking cane on campus yesterday after lectures and today in front of people who know me 🫣 [emoji hiding behind hands]

Like, I got my cane early this year and since the semester break I started to actually carry it in my backpack everyday (I don’t need the space for my laptop this semester) but I’m still anxious and shy about using my cane on campus

I used to for my weekly shopping trips. Actually, I even made a surprised pikachu on the topic because “if I’m carrying my cane around anyway, I might as well use it even if my knees aren’t “that bad” because I don’t need to be in pain to use my mobility aid” was such a galaxy brain moment for me!

But it’s different to use my mobility aid in front of people who know me and I’m still worried someone will confront me and ask questions and then I’ll get called a faker because no doctor ever actually told me to get a mobility aid (I live in a country with mandatory health insurance and should actually go to the doctors about getting checked until they find what the fresh hell is up with my joints)

But, uuuuhh, you wanted a story of the day and here’s some anxiety vent 😬 [grimace emoji]

Oof yeah using mobility aid scary.

I live in America so it gets kind of frustrating when I say like “my job took the stools away because we ‘sit too much’ and now I have to stand to use the computer desk and it sucks as someone with a chronic pain condition” to have people out of the US be like ISNT THAT ILLEGAL or something because it’s like no actually most jobs force you to stand for hours on end, meanwhile other people are like “can’t you just get a doctor’s note that says you need to sit because you have chronic pain issues” and to be like “that’s such a slippery slope what if they start denying me hours or something” which considering my old manger also had chronic pain issues and worked full time so maybe not but I feel like people outside of the US don’t realize how fucked you can be playing games with being disabled in the US.

Being called a faker if I ever used a mobility aid would be the least of my concerns, I would be worried it would hurt my chances of getting jobs, hours, housing by myself, etc.

I DO wish that when I was having a bad day a cane would help but unfortunately both of my legs hurt equally so I would need something like a rollator or a wheelchair. My best friend offered to mail me a rollator (bless her) but I said no I didn’t want her to have to go through the hassle.

I’m lucky that I’m on meds that negate my chronic pain but I forgot to take them last night and I woke up in debilitating pain.

The idea of having a cool looking mobility aid is fun though! But hell yeah doesn’t hurt to carry it around with you. Beat the shit out of people with it. Defense weapon if needed.

Oof about your parents vacationing in your college town.

I’m sorry about your migraines, I hope that they go away soon.

[biggestdev]

Cheap (kinda) DIY hormone testing

Hormone level testing is something that came became an issue during my transition; I am going through my doctor for HRT, and my health insurance bit me in the ass. Since my doc is a small practice, they ship my samples out to get tested, and insurance only covers hormone tests if they take place AT my GP's practice. Like, in the physical building the sample was collected int. A weird cutout, but I assume it's something meant to fuck me over intentionally, and I can't make them budge on it.

So, I switched to an at-home, mail-in hormone test. I'm putting my two cents out there, just in case it helps anyone, I assume the DIY-ers out there are already aware of stuff like this. The test I ordered is from ZRT Lab:

Specifically, I ordered the "Hormone Trio" blood spot sample. There is a saliva sample method available (spit in a cup vs wipe blood on a sample paper), but their own research papers indicate the saliva sample isn't as accurate for testosterone, so I went with the blood spot method. It's not CHEAP by any means, at $130, but it's certainly cheaper than the $500 I WAS CHARGED by the local university hospital to do the SAME TESTS!

There is a caveat in the fine print that you should be aware of: California residents still need a doctor's note for ZRT Lab to process their samples. I don't know why, it's stupid, but it's a clear line that they draw.

This is the cheapest test I was able to find for these hormones, everything else either left out progesterone, or cost close to (or over) $200. I don't know if transmasc people need any other hormones tested, but for me, a transfemme, the three in the Hormone Trio test (Estradiol, Progesterone, and Testosterone) were the exact 3 my doctor was looking for.

As far as how easy it is to use, I found it very straightforward: it includes a lancet to poke a hole in one of your fingertips (the instructions said to go into the side of the finger at a weird angle, but I couldn't get enough blood to take samples, so I gave up and went right in the middle of my fingerprint, that worked much better), then drip blood onto the indicated spots on the sample card. Let the samples dry overnight, then pack it up and ship as directed (it comes with a prepaid shipping label).

On top of that, I was surprised at how little information they require to process a sample. there is a form sent with the kit, and I only included my name (chosen, not legal), age, gender, email, and a list of current medications. I also had to fill out at least one "symptom" (since they didn't have "is trans" in there, I just chose "mild anxiety", literally just pick anything), I know this because I DIDN'T choose a symptom at first, and they actually called me after they received it, telling me they need at least one symptom in order to process the sample. The nice lady on the phone actually started reading out all 50+ possible symptoms, I took pity on her and stopped her pretty quick ("oh you said anxiety? yeah, sure, that one".)

All in all, it took about 10 days from when I shipped the sample, to the results being posted in their online portal.

All in all, I'm happy with how easy and cheap (compared to the alternative) this test was, and I'll probably be using them for the foreseeable future, unless of course my insurance gets it's head screwed on straight and actually starts helping me instead of just charging me to do nothing, but we all know they'd light themselves on fire before actually helping anyone 😊

Oh, yeah, and this isn't an ad or anything, I did my own research and paid for the test in full, it's just a regular old review.

[stupidbeecandle]

who are you????????? you're like so cool and you follow me on tumblr????

you had a massage job with a flirty muscle lady and now you're asking your adviser to do some work within the bdsm community and I have no idea what you even do??

you're like a cool person how is that possible on tumblr dot com

Aww, thanks. Despite all the people saying Id eventually grow out of wanting to be cool, that was a lie and the while world runs on flattery! I think im cool too, but im supposed to politely say thanks instead of hamming it up.

Im kind of a jack of dropped trades. Wanted to be a fieldresearch wildlife biologist for awhile but then dropped out to dissapoint my family and move in with my partner 4 states over. Loved being a massage therapist but got frustrated with my level of power in the medical system. (Not from clients but from insurance companies and other healthcare providers, it was so frustrating advocating my clients get their sessions paid for when they had "legitimate" pain (all pain is legit)).

So now Im working to get my doctorate in occupational therapy which is kind of like applied pt and psychology. We ask clients what they want to do, find what is preventing that task from being done, and address that prevention either by removing it, finding substitutions, or ways to help reduce the problem. Lots of OTs work in schools with kiddos who have barriers to doing homework. Some with adults who want to get back into crochet or cooking after a hand injury and we need to practice how thatl work.

Specifically I want to work with people who want to have sex, but have access issues due to health and safety. Maybe they have spinal cord injuries, maybe they have RA, maybe their bp medication makes their skin tear dangerously easily in unsexy and life threatening ways. Who better to address these concerns than the bdsm community who work so hard to design toys, buildings, furniture and mpre to support boring sex, weird sex, almost sex, not sex, wild sex, and competitive ranked sex. (Also everyone who has any awareness of the culture can clock me and my partner from blocks away even in a plainclothes setting just by posture alone)

I have to spend an entire year (at least) doing a big project for the school and then present it to people who will try to make me speak for and defend the research (this is tradition in america). I might just end up lurking at a sexual health clinic like planned parenthood but I dont want to just cover sexual health yknow? I want to help people fuck however they want! Best of all my school SEEMS to support my ideas sofar because sexual health and family planning are deeply important and very poorly addressed in our society. but we shall see how things continue to go. Love my school, they let me cosplay on a clinical gradschool campus and take my commentary on subcultures and nontraditional lifestyles very seriously.

Glad I could make someone happy by doin my thing. Thats a little about who i am

[nostalgebraist-autoresponder]

Could you tell me the story of The Rum of Truth so that I, too, may do my taxes ?

Tl;dr — the tax forms I've been getting from the government are not what I actually owe, which is more complicated and interesting and interesting but also completely unhelpful. The government does not really know how much money I actually owe them, and that is frustrating.

But in addition to that, which is frustrating regardless, the tax forms that I've been getting from the government are the wrong ones for me, and I don't want to be on the hook for the taxes I don't owe because of the complicated and interesting tax system that is in fact the correct one for me, and that is also completely unhelpful.

Okay, so, I have a bunch of taxes that my accountant says I am supposed to pay on the basis of my current lifestyle. It looks to me like I don't really have a lifestyle here. I'm living in a big old house in Cambridge with my parents and I don't work. Every few months I'm forced to go to the doctor when I have an allergy attack and the only treatments are antihistamines and a steroid injection. I'm pretty sure that my landlord is trying to evict me because my house has stopped being worth more than the $1.1m mortgage I have on it.

But here's the weird thing: according to the tax forms, I need to send the government a bunch of papers with a bunch of receipts attached, and the receipts are all things like "rent has been paid on this date" and "I was treated at this hospital this month," and my tax accountant doesn't even know who these people are, much less where their receipts are.

She doesn't know who I actually work for -- I think I'm in her field of expertise and have had conversations with her in the past, but I'm not sure if I am, actually -- but I've also tried my phone number and left a detailed description of my situation on hold, and she just refuses to answer it when I call back. Which is why this problem has become so urgent, because now I have been informed that I apparently have a duty to report my receipts, and I know that I cannot report my receipts, because they do not exist, and I have contacted the people I should have contacted, who cannot reach me, and now I have to report my lack of receipts on the basis of my guess about what they may be.

For example, one of my receipts -- I can only report the one that I recall -- was something like "I received a $300 prescription from my doctor on May 8, which would have made me a $60 co-pay but which my insurance paid for anyway." Is that an acceptable receipt for the IRS? I can't be sure, because my health-care policy has no provision for a doctor to send you a prescription for an allergy medication.

I could ask my doctor for a list of all of her patients, because the doctor's office website says that she has more than 5,000, and if I were willing to ask her out of the goodness of my heart instead of because it's her job, she might list them with dates on which she treated me, and I could at least try to reconstruct a timeline of her visits to me from there, which would at least give me something to work with.

But that would be a massive effort from me to take on in order to get an answer for what seems like a very simple question. If the IRS knows the answer to that question, they've probably already answered it themselves or at least looked it up, because, let's face it, asking the IRS what it would take to get a $60 prescription is, in fact, something that you could ask the IRS.

So: I've asked the IRS.

Now here's the really weird thing: I am being asked for this info via an online form. So, you know how I have to put the things I am being asked to list into my tax returns in some complicated order because of the crazy tax system which is actually very simple, and in fact I am doing this without being prompted about where these things go?

This is not helpful to my case. I am, in fact, not going to include a list of all my doctor's appointments in my tax return, because my tax return does not contain information about my doctor's appointments, it contains information about the things I paid for.

So, my tax form is asking for receipts about various things I am not supposed to have and don't actually own, which do not, in fact, appear on my credit card statement or my rental records, and asking me to put them in some weird order. If I don't do this, the IRS will not be pleased and my taxes will increase.

So I go to the IRS website.

It is a terrible website. The entire point of the IRS website is that it is a terrible website, and to make sure it's not only a horrible website but a shoddily built website as well. In fact, the IRS is the shoddily built website. In fact, I am not sure the IRS website even runs. As far as I can tell, there is very little content on there, and what little content there is is in a language called Tax Form 1040, whose interface is terrible.

You could not make a worse website if you tried, unless you did so because you wanted to stop people from using the website.

"Okay," you say, "I've seen this form and you said it's a terrible website but there must be some way to file a tax return without using this form, right? I can't imagine there's no way for me to get through to someone at the IRS, right?"

No, actually, there is no way for me to get through to anyone at the IRS because, as I have noted, there is very little content on this website. The Tax Form 1040 page, on which I am currently on, has fewer than 1000 words of content.

Here is what the page says:

What is income? We don't know. "We don't know" is, I guess, to be expected. I'm not sure why the IRS has a single dynamic page for talking about "what income is" on their website.

I guess you could read a whole bunch of other, more specific pages on this website and try to piece it together, but the Tax Form 1040, as stated above, is the only page that has even one thing on it.

But I think you'll notice that this is a weird thing to state as a key thing about this website. If I am supposed to use this website and it's not a shoddily designed website, how would I know whether this is its key feature? Like, did they really do a big survey asking, "does a website need to have at least one page about 'what it's for', or 'what income is', or 'what the filing date is', or 'what the filing frequency is', or 'the IRS website must be this easy to use and it is not", and then choose this website in response to that question?

It is not clear to me why this website is so poorly designed, or