I had to get my sleep tested this week because apparently I’ve been doing it incorrectly.
You would think that after nearly six decades of practicing I would have it pretty much down by now but you would be wrong.
If you’ve never done this, it’s one of those minor yet uncomfortable things that happen as you age your way through the process of medical care and it requires you to navigate the Byzantine complexity of the American healthcare system which is designed to protect the wealth of its corporate shareholders rather than anyone’s actual health. Getting useful medical results out of it is an unintended though occasionally helpful byproduct of its profiteering, but FREEDUM and this is why we can’t have nice things in the US.
Sometime over the summer I went in to see my regular doctor, which is a statement that puts me in a distinct minority in this country (see above, re: FREEDUM) so I’m grateful that I at least have this privilege. It has come in handy at times.
This is the third regular doctor I have had in the last few years as the ones I pick have a distinct tendency to retire no matter how old they are. I don’t think this is because of me since I don’t see them that often, but I cannot rule it out. The hospital where they work then asks me to pick a new one and I have no idea on what basis I would make that choice so I just take whoever has the next available appointment and since this usually gives me six to eight months to get used to the idea of seeing someone else it has worked pretty well so far. This particular new guy seems like he knows what he’s doing even if he’s not the most sociable person I’ve ever met. I’ve seen him twice now – once for the “Hi, I’m your new patient, please renew all my prescriptions” meeting that you have to have every time you switch doctors and once for this – and we have yet to have a conversation that isn’t directly connected to medicine or contains a sentence longer than seven words. But so far, so good.
He gave me the required referral for the doctor who would actually do anything connected to sleeping, and that sat on my desk for a couple of months while Life Happened. Eventually I made an appointment with the Sleep Doctor – either they’re not terribly busy or I got very lucky because that only required a wait measured in weeks rather than months – and I went to meet her and fill out more paperwork repeating all of the things that are already on file (medications, allergies, history) and then discuss the new things.
After the examination she said (in a much more professional and polite way, but this is effectively the gist of it) that I am old and fat and yeah these things will happen under those conditions so we’ll do the sleep test to get it confirmed in a way the insurance company that actually determines your medical care will accept and then figure out what to do from there.
This required me to respond to multiple texts from an equipment company confirming that I did actually want them to send me equipment. Of course I don’t read (let alone respond to) texts from numbers I don’t recognize so this took several tries before it worked out, but last week an envelope with equipment in it appeared on my front doorstep along with dire warnings that this test had to be started THAT NIGHT and the equipment returned within 48 hours or there would be CONSEQUENCES.
It would probably go on my Permanent Record.
None of that happened as far as I know. I don’t have access to my Permanent Record so that’s still an open question. But the rest of it? Not so much.
I put the equipment aside on the first day because I had a lot of grading to do and the math just didn’t work out – you have to commit to a certain amount of sleep time for this and that just wasn’t going to happen. But the next night seemed more doable.
For equipment that came in an envelope there certainly was a lot of it.
The main bit was an electronic recording unit about three inches square and maybe half an inch thick. It came with a two-inch wide elastic band that I was supposed to strap around my chest and then snap the recorder to it so that it sat right on my breastbone. It had a full complement of BlinkenLights and made me feel like Ultraman.
You would think that after nearly six decades of practicing I would have it pretty much down by now but you would be wrong.
If you’ve never done this, it’s one of those minor yet uncomfortable things that happen as you age your way through the process of medical care and it requires you to navigate the Byzantine complexity of the American healthcare system which is designed to protect the wealth of its corporate shareholders rather than anyone’s actual health. Getting useful medical results out of it is an unintended though occasionally helpful byproduct of its profiteering, but FREEDUM and this is why we can’t have nice things in the US.
Sometime over the summer I went in to see my regular doctor, which is a statement that puts me in a distinct minority in this country (see above, re: FREEDUM) so I’m grateful that I at least have this privilege. It has come in handy at times.
This is the third regular doctor I have had in the last few years as the ones I pick have a distinct tendency to retire no matter how old they are. I don’t think this is because of me since I don’t see them that often, but I cannot rule it out. The hospital where they work then asks me to pick a new one and I have no idea on what basis I would make that choice so I just take whoever has the next available appointment and since this usually gives me six to eight months to get used to the idea of seeing someone else it has worked pretty well so far. This particular new guy seems like he knows what he’s doing even if he’s not the most sociable person I’ve ever met. I’ve seen him twice now – once for the “Hi, I’m your new patient, please renew all my prescriptions” meeting that you have to have every time you switch doctors and once for this – and we have yet to have a conversation that isn’t directly connected to medicine or contains a sentence longer than seven words. But so far, so good.
He gave me the required referral for the doctor who would actually do anything connected to sleeping, and that sat on my desk for a couple of months while Life Happened. Eventually I made an appointment with the Sleep Doctor – either they’re not terribly busy or I got very lucky because that only required a wait measured in weeks rather than months – and I went to meet her and fill out more paperwork repeating all of the things that are already on file (medications, allergies, history) and then discuss the new things.
After the examination she said (in a much more professional and polite way, but this is effectively the gist of it) that I am old and fat and yeah these things will happen under those conditions so we’ll do the sleep test to get it confirmed in a way the insurance company that actually determines your medical care will accept and then figure out what to do from there.
This required me to respond to multiple texts from an equipment company confirming that I did actually want them to send me equipment. Of course I don’t read (let alone respond to) texts from numbers I don’t recognize so this took several tries before it worked out, but last week an envelope with equipment in it appeared on my front doorstep along with dire warnings that this test had to be started THAT NIGHT and the equipment returned within 48 hours or there would be CONSEQUENCES.
It would probably go on my Permanent Record.
None of that happened as far as I know. I don’t have access to my Permanent Record so that’s still an open question. But the rest of it? Not so much.
I put the equipment aside on the first day because I had a lot of grading to do and the math just didn’t work out – you have to commit to a certain amount of sleep time for this and that just wasn’t going to happen. But the next night seemed more doable.
For equipment that came in an envelope there certainly was a lot of it.
The main bit was an electronic recording unit about three inches square and maybe half an inch thick. It came with a two-inch wide elastic band that I was supposed to strap around my chest and then snap the recorder to it so that it sat right on my breastbone. It had a full complement of BlinkenLights and made me feel like Ultraman.
There was a cable that screwed into it that went to a sensor that clamped onto one of my fingers like it was trying to feed off of it and a tube that screwed into the unit somewhere else that I was supposed to loop over my ears and then shove up my nose except that my ears really don’t accommodate such things well so I had to just tighten it around my head and hope for the best.
It didn’t work the first night – the BlinkenLights swirled red at me the next morning – so I had to do it again the next night and that seemed to take.
I have no idea what it was actually measuring as I got basically no sleep either of those nights. I find anything on my face to be deeply uncomfortable and every time I tried to move all the various cables and cords would tangle together into a knot. So as far as I know this test will result in my immediate hospitalization and they will put me on a diet consisting of nothing but Ambien and vodka just to keep me unconscious for a while.
It's been 22 years since the last time I graduated from an educational institution. I thought I was done failing tests.
Joy. To the world! Or something.
ReplyDeleteI have been practicing for seven decades and still don’t do that sleep thingy right. As to having to “navigate the Byzantine complexity of the American healthcare system”, Sue and I are now covered under Medicare + AARP Supplemental + Part D which, after an initial learning curve has proven to be pretty much painless and meets our needs admirably. (To all who read these words, Medicare Advantage Plans are a scam. Don’t Fall For It.)
However, what I came in here to say was triggered by your (apparent) belief that any of the paperwork you fill out at a doctor's office actually makes it into your medical records - or, if it does, is, in any manner, shape, or form, passed on to providers that you may be referred to.
It Is Not.
My wife and I have been seeing the PCP since January. In May, he was genuinely surprised to discover that my wife has Crohn’s Disease, which was something that we spent a considerable amount of time discussing during her initial consultation four months earlier, yet somehow didn’t make it into her actual records. Kinda big miss there, I would say.
Over the last ten months, he has referred her to a half dozen specialists for various procedures, none of whom were aware of her existing medical conditions. So …
I keep three spreadsheets on my computer: first (and most importantly), a list of her medications (prescribed and OTC) which I update with every change. Second, a list of all of her past and current afflictions, surgeries & diagnoses, allergies, and family disease histories; and finally, a list of all procedures, imaging, and tests she has endured over the years*. I print out and give that to every new provider she sees, every visit, every time, because they (probably) don’t have any current records of her medical history.
I was unaware that they had DIY sleep studies available. They want Sue to undergo a sleep study at the U of U in SLC. It’s an ‘in clinic’ overnight thing. She’s holding out until they’re willing to cover the cost of a hotel room for me.
Hope all goes well for you.
Lucy
*We’ve grown weary of filling all those forms each time she sees a different provider. Now when they hand me their forms, I just write “see attached” and hand it back to them with copies of the relevant spreadsheets. They protest. I don’t care. It may not be in the form they want, but all the information is current and accurate. They can fill out their own damn forms.
And, once again, I hate the new comment page. Vigorously.
ReplyDeleteLucy
Yeah, the new comment page leaves a bit to be desired, I say with considerable restraint.
ReplyDeleteI like the spreadsheet idea. I may have to steal that for my own use as my lists get longer and longer. I once asked one of them why they ask me to fill all this out if nobody ever has access to it so I don't have to fill it out every single time and I didn't really get much of an answer. I just think they should be able to. I know they have this information. I'm not sure why they don't distribute it to the people who need it (and NOT distribute it to the people who don't, such as every medical scam troll farm with a website and a call center). But again - FREEDUM.
Ask about the in-home sleep thing - it was a nuisance but not all that bad, and much preferable to an in-patient study. It's even cheaper for them. Not sure why they haven't forced it on her, actually.
All as well as can be expected here in the depths of the semester. I hope you are doing well also, healthcare providers notwithstanding.
Oh yes, please steal the spreadsheet idea with my encouragement.
ReplyDeleteI’m taking Sue in for some tests in SLC at the end of the month. When talking to them to arrange the appointment, I asked about the records thing. A short explanation goes something like this:
IANAL, so this is just my understanding: Even though we signed forms granting permission to share the records, HIPAA privacy laws are so complex, that the provider can’t just send your records. The provider you are being referred to must request specific relevant records. That increases costs, so they don’t ask - they just have you fill out the forms, which, from all available evidence, they utterly fail to put into your records because if they need information again they can always just ask again. And again. And again.
Our doctor isn’t pushing the sleep study thing right now because Sue has other issues that are more pressing. However, I’m certainly going to ask about the in-home thing during her next appointment.
I, on the other hand, am doing well - aside from the fact that I find myself easily bored these days.
Hope your grading bit is going well.
Lucy
The idea that a law designed to help patients can be twisted to hurt them by a corporation too cheap to do what it is supposed to do should not strike me as normal but of course it does. Come the revolution, and all that. I do remember when Oliver was a toddler and we had to take him in to the ER for a severe flu while visiting my parents and I couldn't get test results out of the staff afterward. They kept insisting that they could only give them to Oliver. I pointed out - at great length and no small volume - that a) Oliver was 2, b) that I was his parent, and c) those two things combined to make me legally him for the purposes of medical records. This went on for some time before a sympathetic nurse just told me what I needed to know.
ReplyDeleteI'm in a momentary lull for grading - I've got 48 hours before the next round hits - so I'm taking the time to get ready to officiate a wedding this coming weekend. Should be fun!
I hope Sue is as well as possible. I'm glad you are well. Boredom just means you have time to figure out your next caper. ;)
Huh. The comment page has not changed for me. I feel left out.
ReplyDeleteIt seems to have a lot more white space on it, and you get a line to type on rather than a nice (expandable) box. It is not expandable anymore so you can't really see all of your comment at once if it's any length. I'm sure it won some kind of design award.
ReplyDelete