Blair's Medical Blog

SNAP filed, CHEST ct-scan

June 2 Tue 9 pm

SNAP Food stamp EBT card should be in the mail in "2 or 3" days. 1&1/2 hour online application dss.virginia.gov. The caseworker called me a couple hours later. She said, now I need to do the same thing for social security disability online. Medicaid was approved May 13 & reapply by April 30, 2021.
CT-scan of chest at UVA Imaging on Fontaine.
Consultation with Dr. Domson Jun 17 Wed 8:20 am UVA Fontaine.
Jul 3. Second injection of Lupron 3-monthly Testosterone blocker. This treatment should be paid by the pharmaceutical Lupron. Financial application completed May 8 at doctor's office. First treatment April 10 paid by Free Clinic, reimbursed by Medicaid. Follow-up with Dr. Struble. New blood test to check PSA.
July or August start radiation treatment 9 weeks 5 days per week. First appointment is surgery to implant 2 pieces of metal into my prostate & gel to protect rectum.
My Chart at Sentara & UVA are active. I have not activated the Gastroenterology portal or the Urological Associates.

Medicaid Approved - Right Shoulder

May 13 Wed 1 pm

Medicaid was approved.
To Medicaid Office, Charlottesville Social Services, so Medicaid can reimburse Free Clinic. Into dropbox I left for Carrie (a) paystubs (b) handwritten statement that it's my total income.
Medicaid paid for the SUPREP laxative for May 20 Wed colonoscopy 12 pm at SMJH Dr. Gomez. I declined the $128 which was discounted Tue morning to $113. I picked it up Tue evening. Still needed for colonoscopy (a) Corona Virus test 5 days prior (b) EKG (c) no longer iron deficient.
Right Shoulder MRI looks like Lytic Lesion from Lung Cancer. Dr. Domson recommends a biopsy. Blood sample. UVA Orthopedics on Fontaine May 13 Wed. Medicaid paid for the visit. UVA also has a My Chart.
Appt Radiologist Dr. Hendrix May 14 Thu 9:30 am at SMJH Cancer Center 2nd floor.
July 3 next treatment & follow-up with Oncologist Dr. Struble.

Colonoscopy May 20

(May 9 Sat 5 pm)

May 8 Fri 9:30 am. Consultation for Colonoscopy. Gastroenterology Associates. Donna Smith.
- Scheduled for May 20 Wed 12 pm arrival at SMJH. Rescheduled from July 22.
- SUPREP laxative drink at CVS Pharmacy. (Prescription ready. Robocall Sunday 10 am.)
- Corona Virus test is ordered for 5 days prior to colonoscopy.
- EKG is ordered.
- Blood tests ordered for the afternoon.
  - BMP Fasting (Basic Metabolic Profile).
  - CBC w/ auto diff. platelet.
May 8 Fri 3 pm SMJH Cancer Center. Blood tests include PSA & Gastroenterology requests. Signed the paperwork authorizing MedAssist representative Christina to complete the Lupron (testosterone blocker shot per 3 months) pharmaceutical aid application.
May 11 Mon 3:40 pm Follow-up with Dr. Struble at SMJH Cancer Center. Learn lab results. Refill prescription for muscle relaxer.
To be mailed May 11 midday.
- Phase 2 of Sentara aid application. Sign MedAssist authorization. Phase 1 was Apr 21 packet (last 2 bank statements, last 1040 tax year, last 3 paystubs with Year-To-Date).
- $291 Sentara bill. My payment method is Charlottesville Free Clinic. My understanding is May 5 all parties have DocuSigned the Medicaid application. When approved, Medicaid will become my insurer & reimburse the Free Clinic & other fees.
May 13 Wed 9:10 am. Orthopedics UVA on Fontaine Bldg 545.
My Chart Sentara Reports.
- MRI Right Shoulder Without & With IV Contrast (Apr 17).
  1. Abnormal marrow replacement within the glenoid/lateral aspect of the scapula as well as adjacent paraosseous soft tissues. This would be an atypical appearance for cancer given its ill-defined lytic appearance on radiographs. No discernible matrix associated with this lesion on radiographs. Primary differential considerations include lytic metastatic disease, myeloma, or primary aggressive appearing bone tumor (including sarcoma and lymphoma). CT-guided biopsy may be useful for further evaluation this patient.
  2. Tendinosis/mild partial thickness tears of rotator cuff tendons.
  3. Elongated dissecting presumed paralabral cyst along the junction of anterior and superior labrum and inferior to coracoid process.
  
  Early report communicated directly by me to referring clinician at 1425 hours.
  
  Signed By: Jay C Fertile, MD on 4/17/2020 2:40 PM
- X-ray of Right Shoulder (Apr 10)
  Ill-defined RIGHT glenoid lucency, which is concerning; RIGHT shoulder MRI is recommended in continued investigation.
  
  Signed By: V Colt Peyton, MD on 4/10/2020 10:58 AM

Orthopedics Scheduled

(May 7 Thu 11 am)

May 8 Fri 9:30 am. Colonoscopy consultation to determine if I need a colonoscopy. See Donna Smith.
May 8 Fri 3 pm. Blood test at SMJH cancer center. "Quick Infusion" is a department name.
May 11 Mon 3:40 pm. SMJH Dr. Struble follow-up consultation. Has PSA dropped? Renew prescription for muscle relaxer. Create a plan. Ask about the $291 bill.
May 13 Wed 9:10 am. Orthopedics UVA in Bldg 545 on Fontaine. 434.924.2663. They had been calling a wrong number. Referred by Dr. Struble. "Large lytic lesion" on right shoulder.

Sentara + Medicaid + SNAP

(May 5 Tue)

On Monday, for hospital financial aid, I called a friend to print some documents for me to pick up in the afternoon. I attached the PDFs as email. Hope to copy the tax form Tue at UPS store & mail it. I have stamps.
- Last 2 bank statements
- Last 3 paystubs with Year-To-Date
- Last 1040 tax year
Followup with SMJH caseworker Anne. She called Demetria while I was on the phone. My email was received late Friday & she's working on it now. She can also apply on my behalf to SNAP food stamps with same information. 30-day processing. If I receive a Medicaid account number, I should inform Anne for billing.
Tue 11:30 all parties have signed Medicaid application. I signed in a touch-screen box. Thank you MedAssist Demetria.
PATIENT.SENTARA.COM My Chart account is activated after couple hours of restarts. Then the app doesn't work on my phone. But I was able to access on computer.
Colonoscopy Fri 9:30. Need to call for special instructions.

Medicaid Expedite

(Entry May 2 Sat 2 pm)

Call Friday 3:30 pm May 1 from Demetria of Sentara 434.654.8151. Emailed my paystub PDF to dajacqu1@sentara.com. No response. I sent myself a copy to document I sent it & spelled the addressee correctly.

Also I sent a reply & a message to Sentara to resend My Chart activation. Expired 24 hours after April 22. I will try to check my email every day for a while.

Medical Timeline May 1, 2020

Administrative Process

Prostate Cancer Metastatic to Intra Pelvic Lymph Node

Diagnosed April 10, 2020. Biopsy of Prostate April 3. All 6 samples are cancerous. First treatment April 10.

Biopsy of right shoulder for April 24 to investigate possible lytic lesion is cancelled. Orthopedic specialist to be scheduled. Is it cancer or recurrence of Perthes Disease, which appears the same on x-rays, first shown in 1910? Or something else?

In early January 2019 I stopped the monthly auto-pay after finishing out the 12 months of $50 per month. Total $600 for the 2 visits. I highly recommend Ivy Family Medicine . If my circumstances change, I would go back and try to pay the $600 all at once. Total adding my hernia was less than $3,000. My health insurance had changed so the deductible was $5,000. So it was cheaper not to have insurance.

JP Morgan EZ-Pass I-66/I-495 don't honor Martin Luther King Holiday. I was the only car on the toll road. On return trip 2 days later, I stayed with the heavy traffic.

Day 6. Healing as expected. Inguinal hernia surgery on Tue. Jan. 16. Pain/discomfort now only when I move around. If my job were sedentary, I would go back to work today. If my job were physical, like stocking grocery shelves, I would stay out another week or two. Not because I'm milking the system.

I want to thank Dr. Kravitz. The first person who called me from Maryland on Dec. 15 was the same person who performed the surgery. Everyone was cordial and professional, not fake. The patient paid the medical bill completely. So this was the highest quality / most affordable medical treatment available. Worst thing I can say about the trip was I got turned around in traffic.

If you read below, you can see how UVA Hospital scheduled an appointment for 10 weeks in the future when their website says 3 business days. That's the double-standard between quality care and "poor service". It's not just my memory of how poverty charities work, but studies show Meidicaid has same outcomes as no doctor.

Luckily I found a doctor I could pay directly. Two weeks and 2 appointments later, everything has been taken care of. That's the high quality care I'm talking about. If someone else were paying for me (Insurance, Medicare, Medicaid), I'm sure I'd still be waiting for an appointment.

My mother will be my Angel and drive from surgery back to the motel for 2-night stay.

Moles removed. Prostate exam. Blood lab results. Wednesday December 6, 2017.

Successful doctor's appointment. (1) Hotspot on face is frozen off. (2) Hernia is confirmed. I can live with it but surgery is recommended. Will order the hernia belt from Amazon. Was referred to Northridge for blood work to include Hep C and test for prostate cancer. Price $50 to $75 to be billed to my new primary physician – Ivy Family Medicine – chosen because they had actual prices listed online.

Next appointment 12-6-2017 to discuss blood results. To have 2 tags removed – mole under left arm pit and right groin where skin rubs...included in the $60 per month for 12-month obligation.

To discuss hernia surgery possibilities. Doctor mentioned nearby option for $3,500. Would have to confirm validity of the $1,900 Rockville, MD clinic. More research and other options.

I still need to cancel the appointment at UVA Dermatology made Oct. 3 for Dec. 18. (Cancelled Dec. 5. Phone 434-243-3675. uvahealth.com/appointments)

UPDATE Medical. Hotspot on Face + Hernia. Monday November 27, 2017. (Comment)

Skin Hotspot on face the size of dime to freeze off with liquid nitrogen. A 30-second procedure conducted twice in 7 years at UVA Primary Care Dermatology. The first of total 3 visits involved my feet described below. When I was a UVA employee and had insurance, they made the appointment for the next day. As a regular person, the clinic made the latest appointment for 10 weeks in the future for Dec. 18. I'm paying out-of-pocket and hope to find an alternative referral.

Pictures below are from 7 years ago. Current conditions are minor but persisting much longer, don't show up well in photos. This page is to document my story and serve as a link to photos and resources. And maybe inspire others to seek a screening. If the clinic is a scam and not really helping people, I will let my readers know.