Mental Health Update

Today is World Mental Health Day!  So I figured . . . what better day to finally come back to my blog and post an update about my mental health journey?

Overall, right now, my mental health is in a really good place.  In the time since I moved to Washington, I've gotten a psychiatrist, been diagnosed with OCD, and started on a new antidepressant.

The thing is, my mental health had been dipping quite a bit before I left AZ.  For probably the last year that I was in Flagstaff, I started developing OCD symptoms.  Now, I struggled with OCD as a child, and there's always been a small element of it with my issues, but it had never been a huge problem for me as an adult.  When Jenny and I got to WA, the OCD peaked--I'm sure the stress of the move and the transition into working from home contributed.  It got to a point where it was impacting my life: showering was a massive undertaking that took hours, I couldn't leave the house without doing multiple OCD routines, I wasn't sleeping . . . it was a nightmare.  I started seeing my psychiatrist in the summer of 2017, and at that point, the plan was just to get me re-medicated and see if that helped.  I had hopes that it would, because the OCD had been getting worse as my medication issues had gone on (remember, I didn't have a regular psychiatrist and regular prescriptions for the last year or so I was in Flagstaff).

For all of 2018 I did well with my meds, but the OCD just got worse.  So in January of 2019, I told my psychiatrist I needed something different, because I just couldn't do it anymore.  I had done a lot of research and I asked to be put on Zoloft.  Thankfully my doctor was totally on board, and he thought Zoloft was a great option for me.  So we started that, and I titrated up to a 200 mg/day dose, and . . . it has actually helped a TON!  I've eliminated or limited a bunch of routines, and even with the stuff I'm still working on, my life isn't nearly as impacted by it.  I feel SO MUCH BETTER than I used to, so much more capable of just living my life.  It's great.  And hopefully it keeps getting better, because there are definitely still some things I'm working on.

Another thing that's been really good the past year-ish has been that I've been able to really think about my issues and kind of delve into them and figure myself out.  For example, I've recognized a very specific anxiety trigger that has been with me since I was a kid, I was just never able to quantify it before.  And I recognize that my OCD gets worse in certain situations, like when I'm PMS-ing.  

My overreaction/rage issues are pretty much completely gone.  That's probably the biggest change I've noticed about myself is that I'm just calm about things that, if they happened years ago, would have made me break down.  Last fall, for example, Jenny and I went to leave the apartment to run errands one day, and the car wouldn't start.  I couldn't get it towed for a couple days, and then it took a few days to fix, and . . . it just didn't bother me.  I mean, I wasn't thrilled, because it was a very expensive annoyance, but I took the bus when I needed to go out (I was still working at home when this happened) and just . . . handled it.  As frustrating as it was, it was good to see that progress.  I'm just a lot more capable of dealing with life than I used to be.

I also have a much stronger sense of self than I used to.  That was something I struggled with for a long, long time--feeling like I didn't know myself and had no clue who I was.  And I remember stressing about weird things like not having a cohesive set of hobbies and stuff like that.  But now I'm in a place where I can just embrace and be happy with whatever I feel like doing because . . . it's all me.  (I know that's cheesy as hell but it's true!)  Some days I write, some days I sew, some days I hike, some days I play Overwatch . . . and it's all awesome and I love it.  I actually LIKE myself now and holy crap, it's a good feeling.

And of course, Jenny has been a fantastic help and support through all of this.  I truly don't know what I'd do without her.  (For the record, we're still just roommates/best friends/exes . . . and it's still easy and not weird or awkward or anything.)  

I really am happier and more content than I've ever been as an adult, and I have so much hope and optimism for the future!  I think things will only get better from here.

Deep . . . Deep . . . Deep . . . Breaths

Sooooo . . . let's talk about the gigantic cluster F that is my mental health treatment right now.

There are two parts to this story, and I really  can't remember what I've talked about here and what I haven't, so let's just start at the beginning.

The first part of this story is that I owe my doctor's office money that they can't legally collect from me.  Basically, they're trying to do what's called "balance billing"--an illegal practice that involves charging a patient for the difference between the insurance's allowed amount for a service and what the doctor's office charges for a service.  Every insurance company has what's called a fee schedule, which consists of their allowed amounts for cpt codes--in other words, every insurance company basically says, this is what we'll pay for whatever code, and this is the most our insured members can be charged for this code.  Does that make sense?

So MHC does the smart thing, and links each pt. account to their specific insurance's fee schedule, so that we're already billing the allowed amount.  That way we never have to do any weird additional adjustments on claims; it's very handy.  But some doctor's offices bill the insurance companies their cash pay rates, which is dumb and just makes more work.

So this is what happened to me.  I paid $180.40 at my visit with the crappy temp doctor.  Which was all good and fine and whatever.  Then around the beginning of the month-ish, I got a bill from his office for $219.60.  Why?  Because their charge for the cpt 99205 is $400.00, and according to them, I owed the difference between that and what I paid.

However, I work in medical billing, and not a day goes by that I don't look at the BCBS fee schedule, so I know that their allowed amount for that particular code is only about $265.  Meaning that unless BCBS says that I'm not insured by them, my doctor's office legally cannot charge me more than $265 for that visit.  I called them and left a voicemail saying I'd be glad to pay the difference of like $85 but that I wasn't paying a penny more than that.  In return they said I needed to call my insurance because they needed records from a previous provider.  Which I did, and guess what?  The provider they need records from is my old doctor . . . whose records are AT THE SAME FREAKING OFFICE AS MY NEW DOCTOR.  Effing ridiculous.  So I may be in a pre-existing condition period at this point, which is fine, because I have a high deductible anyway so I was fully anticipating paying for the visit.  But regardless of the reason that BCBS says they won't pay (unless it's for no coverage, which it won't be), I legally do not have to pay more than the allowed amount.  Again, I do this for a living and I know for a fact that I'm right.

In the same voicemail as telling them I'd only pay the allowed amount I asked what was going on with my prescriptions and was told to request a refill through my pharmacy.  I did that last week, and yesterday, upon calling the pharmacy to check the prescription status, I was told that the doctor had denied it.  Um . . . what?  The only thing I can figure is that they're denying it because of the money that I owe them, which makes me livid beyond comprehension.  I called and left a voicemail (they never answer their phone) and haven't heard back yet.  I'm now about a week off of my antidepressants and I am not feeling well.  I'm so.freaking.mad.

Tomorrow I'm going to call BCBS (at my boss's recommendation) and let them know what's going on as far as the balance billing stuff.  Insurance companies take that very seriously and they could revoke their credentialing with this particular physician if it's a regular practice.  And in AZ, losing your BCBS contract means going out of business.

I also printed out the forms to file a complaint with the AZ Medical Board, and if this isn't resolved soon, those forms will be filled out and sent to Phoenix faster than this office can say "sorry, our bad."

In the meantime, I'm trying very hard to relax and keep calm and just go about my life, but it's very difficult.  I can feel symptoms creeping back and I hate it more than I can say.  It makes me so angry that I do everything that I'm supposed to, and that ultimately this doctor would rather make an extra $140 than give his patients proper care.

What I find really upsetting is that I only caught this error because stuff like this is my job.  I wonder how many other patients who don't know anything about medical billing have just paid their balance and not thought anything of it?  Incredibly depressing.  Taking advantage of mentally ill patients is disgusting.

Anyway, I'm off to bed.

Broken Down

The past 36 hours have been a crappy day and a half mental health wise.  I've just been very anxious and down.

--I saw an old college acquaintance at work Friday night.  It was near the end of my shift; she came through my register but didn't remember me.  Which was fine, because we didn't know each other well at all.  But I recognized her, and her last name had changed on her rental account, because she's married now.  And her husband was with her, and another couple, and it just . . . well, things like that hurt.  Seeing other people who are living a life that's closer to what I want and closer to where I think I should be, if that makes sense.  It hurts more now because I feel like I got THIS close to that and failed.  And it just kind of depressed me.

--Anxiety attack because the Christmas music section is set up work.  (Aside from the anxiety I think it's a bit early . . . we should at least wait until the day after Halloween).  Normally I love Christmas and am thrilled when I start to see the signs of it everywhere but this year . . . well, this year I just want to skip all the holidays.  Fast forward to March of 2013 and let that be that.  I think the reasons are obvious.

--This was NAU's Homecoming weekend, which makes me extremely anxious for a few different reasons.  I think some of it might be too personal to get into but let me just say that I don't have a lot of fond memories of my college days.  Really, looking back on that time just stresses me out and depresses me.  And it being Homecoming is just a reminder that my life has gone completely not as expected in a lot of bad ways.  I don't have any close friends from college--I really don't.  I don't have anyone to go to Homecoming with, or a husband I can take with me to the game and introduce to my old friends.  A very small chunk of that has to do with Corey.  And it's also difficult for some other relationship related reasons--but those I know are better left for my private journal.  I just wish things had gone differently.  And I know it's harder because I'm here in Flagstaff, and that if I was in Kingman, away from the college town setting, and living a happy life with the person I love, I'd be fine with it.  Sucks.

--Anxiety attack about money.  I don't even think I need to elaborate on this one.  I know this wouldn't be as bad if I didn't know I had to get more lab work done.  I hate having these disorders that require so much attention.  Don't get me wrong, I'm glad to be better, and I want to be healthy but . . . I'm not in a position where that's an easy thing to do.  It gets stressful.

--Guilt.  I don't want to go into detail but there's something I'm feeling very guilty about right now.  I might elaborate later.

--Corey.  In three conversations at work (one Friday, two Saturday), I talked about him to co-workers.  Nothing bad or anything, and it was in a way that came naturally--it wasn't like I wanted to talk about him and forced the subject so I could.  Not at all.  And it just . . . made me miss him so much.  And I just felt lonely and combined with everything else . . . I don't know.  I'm just so sad, still, about the whole thing.  So heart broken.  I still love him and care for him so much and right now this whole thing is just so damn painful.

Right now I just feel broken.  I'm scared that I'm feeling this way, because I have been doing incredibly well with my Lithium intake--in the time since I got my prescription refilled, I have only missed one dose*.  So . . . I don't know, I guess a part of me is like, shouldn't I be fine?  But then I remind myself that I'm dealing with a lot of stress at the moment--money (totally legit stress factor), work (hours, issues with co-workers), health needs (lab work), sleep issues (I'm having bed problems at the moment).  And lack of sleep is never a good thing for my moods.  Plus I could be starting my PMDD cycle; it's the right time for it, but at the same time, last month it started a little later and was a lot milder so . . . I don't know.  Maybe I was just less stressed last month?  

Silver lining: I didn't have an actual breakdown today.  No rage, no throwing things, no wanting to pull my hair out.  I didn't even cry.  And I fully expected to; the way I felt when I left work today, my plan was get home, eat lunch, have myself a good cry, take a nap.  And I skipped the crying part which is a good thing.  So it's definitely a far cry from where I was before.

Hopefully I get to feeling better soon.  I don't like this.

*One dose=half my daily intake of Lithium.

Lowlights and Highlights

Lowlights of today:

--I'm sick.  Stuffy nose, massive sinus pressure between my eyes, itchy face, plugged ears, chest congestion, sore throat, cough.  It sucks and is very lame.
--My paycheck was tiiiiiiiny.  I seriously spent the whole thing today between treating Jerbs to lunch, buying my weekly groceries, and picking up my Lithium prescription.  (My Li prescription is the expensive one).
--I still haven't heard anything from the job; I think I'm going to give them a call tomorrow just to touch base because . . . well, because I really have a good feeling about it.
--The bus was obnoxious.  Especially the ride on route 4 to the transfer station to get home, which was held up because of people who had no idea what they were doing and took 5 minutes to get on, and had one passenger who was an overweight woman telling another passenger all about the infection she got between the folds of her skin.  (Seriously, ick.  Indoor voices!)
--Hauling groceries home on the bus just kinda isn't fun.  Especially when you're sick.

Highlights of today:

--Suit kid.  There was this kid on the bus who was no more than 11 or 12, and he was wearing a 3 piece suit and tie, and carrying a lunchbox and a briefcase.  He just kept checking his watch and it was hilarious.  Jerbs in particular was highly entertained and we imagined him thinking things like, "Today is just not my day . . . Lost the Miller account, and Mom forgot to cut the crust off my PB&J."
--Even though it's expensive it's good to have my Lithium.  And I was able to buy it myself so that's good.
--Jerbs bought me cough drop and Tylenol Cold/Cough, which seems to have helped a little.

I think that's it.  I'm gong to take some drugs and hit the sack . . . I feel like poo.