Want a Quarter Pounder with That?

Every now and again, I get a bee in my bonnet. I've got one now. I've been complaining to the folks at my local Brookshire's food store for a while now. I finally broke down and sent them an email. (It's been over a week without a response, so I'm not going to hold my breath.)

I've long had an issue with the pork they sell. It's all "enhanced". Enhanced means that it's injected with an "all natural" solution of water and God knows what else to "enhance" the flavor. What this really does is make it weigh more. Then they sell it to me by the pound. Really? How dumb do they think I am? They do the same with the chicken but they do have an additive-free option for chicken. It costs more, but since it doesn't all turn to water when you cook it or thaw it out, it's really a better value.  But there is no alternative for pork.

But here's my beef with the beef: It no longer comes in one pound or half pound increments. If I want to buy a pound of beef, I am forced to buy one and one quarter pounds of beef. It doesn't seem to matter whether it's ground beef or steak. One and a quarter pounds up to something like one and a third pounds is just how it comes. If you want two pounds, just plan to buy two and a half. That's  how it comes.

One of the managers told me that's how it's shipped from the distribution center. But if you look in the back of the store you can see a machine that looks like it packages the meat. Maybe that's just for show. Although one of the cashiers indicated that I could probably get one of those guys back there in the meat department to do me up a package in the size I want. (If you can find "one of those guys in the back!!") Another cashier told me that they had frozen ground beef in one and two pound packages. But I've never been impressed with the quality of that frozen meat and much prefer fresh. The younger cashiers think the whole thing is funny. I suspect they think I'm just a cranky old woman with nothing better to do than complain about the way they package the meat.

And maybe they're right. But let's consider that the premium ground beef costs $6.99 per pound. That means that if I buy an extra quarter pound, it adds $1.75 to the price of the package. Wow! That means that Brookshire's gets an extra $1.75 off everyone who wants a pound of ground beef. Granted, they are selling them the extra weight. It's not that kind of rip-off. Just saying that some of us don't want to buy the extra quarter pound.

Spending extra money for meat I really don't want is irritating. But what is infuriating is that those extra calories are going into the meatloaf/spaghetti/shepherd's pie or whatever it is I'm cooking. That's like throwing in a spare quarter pounder. Let's say that there are a thousand calories in a pound of ground beef. An extra quarter pound of meat adds an additional 250 calories to the dish. Let's be serious here, who is going to measure that extra weight and remove it from the recipe? Not me (and I'm fairly obsessive). Not you. Who? So instead of having a meatloaf that has a calorie count of 268 per serving, you now have a meatloaf with a calorie count of 330 per serving. An argument could be made that you now have a five serving meatloaf rather than a four serving meatloaf. It's a bad argument. My meatloaf pan is still the same size and it's not so much bigger that I'm going to invite an extra person over for dinner. It's just got an extra 63 calories per serving. I don't want those extra calories any more than I want to shell out the extra $1.75.

In the interest of eliminating this as an issue in my life, I'll probably have to start driving the extra 10 miles down to Market Street in Frisco. They'll even sell you a half a pound - if that's all you want.

The Secret Codes

When we got back from our trip in September, I phoned American Express Traveler's Medical Insurance to find out how to file the claim. They indicated that in addition to the bills and a copy of our itinerary, they would also need a copy of the EOB (Explanation of Benefits) from our primary insurer. They also told me that most Medicare plans cover emergencies when you are traveling. Losing enough blood to require five transfusions seems like an emergency to me. It certainly wasn't part of our master vacation plan.

I phoned Humana and the lady I spoke with told me they wouldn't pay anything. I told her that I still needed to file the claim because my supplementary insurer needed to see the EOB before they would pay the claim. I waited a month (the mail can be a bit slow here in the country). I assumed the claim form was not coming so I filed the claim for Mark's Parisian hospital stay with American Express Traveler's Medical Insurance along with a note that said I'd spoken with Humana and they'd indicated that they would not pay.

The response back from AmEx indicated that they absolutely had to have the EOB to process the claim. Not wanting to wait another month for a claim form that Humana wasn't actually going to mail to me, I decided to go to their website to find it.

I clicked on Medicare. Made sense, that's the plan Mark is on. The only claim form there was for pharmacy claims. Since it was Sunday afternoon, I assumed that no one would be answering the customer service phone. I opted for email. I would have an answer on Monday morning and could get the claim form completed and in the mail that afternoon.

When there was still no response by Tuesday, I opted to try their online chat feature. At least they were able to help me find the claim form. The link I had to click to get the form was "Insurance through Your Employer". Well. That's not some place I would have intuitively looked. Even though I think it's somewhat stupid to think that the only people who will ever need a claim form are people who have insurance through their employers, I didn't bother asking the customer service rep why this form couldn't be accessed from the "Medicare" tab. She didn't design the website so how would she know? It's likely that the people who did design the website don't know, either.

At any rate, I got the claim form and started filling it out. It was fine until I got to "CPT Code/Service Description" and "Diagnosis Code". I don't know what the codes are. They weren't on the bill because they don't use these codes in Europe. They may be consistent throughout the United States but they are NOT universal. I called Humana's customer service department to ask what to do. She had one mantra - "We can't process the claim without the codes".

"Where am I supposed to get these codes? Are they on the internet somewhere?"

"You need to call the doctor."

"The doctor is in France. She primarily speaks French. Their automated answering system is in French and I don't even know what number to press to reach anybody at all, much less that particular doctor. There is not a "press 2 for English" option. And since they don't use those codes, it's not likely they're going to be able to help me with that."

"We can't process the claim without the codes."

This conversation was going in a circular motion. I decided to see if Mark's local doctor's staff could help. I left a message for the person who does the billing. It's been three days and I have no response.

My next step was to call the nice folks at AmEx and see if they could give me some help with these codes. After being transferred to several different departments, the last young lady I spoke with offered to transfer me back to the department I started out with. Reluctantly, I said okay. Then she came back on the line to tell me that it would be about a 20 minute wait and asked if that was "okay". Actually, it wasn't okay. I did have other things to do yesterday. I thanked her and told her that I didn't have time to wait that long and told her I'd just make up a code and get on with it.

An internet search gave me some Diagnosis Codes. I picked the one that seemed most closely associated with the problem and wrote it in the appropriate box on the claim form. But the CPT code remained a mystery. Seems these "belong" to the American Medical Association.  Operative word being "American". I'm not even sure the Canadians use them, but most certainly the French do not.

So I'm sending it on to Humana. I'm sending copies of the bills and the doctor's diagnostic report AND I'm including a letter explaining the problem. I needed to send a letter anyway just to make sure they realize the bills are in Euros. I'm guessing that the folks in the claims department are under the impression that the whole world uses US dollars.

End of Story

I received a check from British Airways - not for the "lost" luggage, but for the items I had to buy to survive a three week journey without my "stuff".

I'm okay with that. Since I eventually got my bag back and everything in it was in tact I am happy to be reimbursed for what I affectionately call "the Eurotrash" I was forced to buy. (Quite frankly, of the stuff that I bought, I only REALLY like one top that I bought in Manchester and one top that I bought in Switzerland. The rest of it was bought because I needed "something" to wear. That being said, I'm quite happy with the Marks and Spencer underwear!)

However, I was told on two separate occasions by two different British Airways employees that after 21 days, I would be reimbursed for the contents of the bag as well as the things I had to buy. (Our trip was 21 days and my bag didn't arrive until over a week after I got home.) Which is why I spent several days doing the research on what I'd paid for the items in the bag. (Glad I got it back because as I was unpacking it I realized that there were four items I'd failed to include in my inventory.)

So I was only reimbursed for the items I bought. No reimbursement for the numerous phone calls trying to track the bag, no remuneration for the time spent (days) completing the claim form for stuff they had no intention of paying for, and no compensation for pain, suffering or mental anguish.

But I can't say I'm surprised. Based on my experience with British Airways, the thing they do best is tell lies.

If I'm ever on a British Airways flight again, it will be because all other airlines have stopped flying to London. End of story.

No Other Options?

Hydrocodone makes me violently ill. I'm told it's not an allergy but a "sensitivity". Call it whatever you like - I don't want to take it. It makes me sick. In the past, when I indicated that I was "sensitive", I was still prescribed hydrocodone along with an anti-nausea drug. I don't really know what happened to the drugs that didn't make me sick, like Darvon and Percodan - although I did look them up and it seems that Darvon isn't effective (could have fooled me) and Percodan is no longer suitable for me because I take an anti-coagulant. And it's very possible that over the years I may have developed an intolerance for them, as well. I was so pleased to learn about Tramadol. As I understand it, Tramadol is what is prescribed for people who are "sensitive" to hydrocodone.

The instructions were to take one tramadol tablet before I went to bed. Who would have thought I'd wake up sick? Violently ill would have been an improvement. At least it would have been over with quickly. With tramadol I woke up nauseous and stayed that way until I was forced to get out of bed for 15 minutes which resulted in being ill (aka vomiting, puking, tossing cookies - choose your euphemism.) After that, I started to feel better.

In some ways this was worse than hydrocodone. With hydrocodone, I typically throw up within 30 minutes of ingesting it.With this stuff, I was green around the gills all day.

I had to let the doctor know that we needed to try something else. Fortunately since this doctor is thoroughly modern, I'm set up on his web-based system and all it took was a quick message to let him know that it made me sick and that we'd need to try another option.

But then the message came back that there were no other drug options. He told me my best only option was an orthopedic surgeon. Surgeon?? Surgeons have knives!

I've long been a believer in "better living through chemistry" and now chemistry was going to let me down. But to say that my ONLY option is an orthopedic surgeon? He doesn't know me. I will try diet and exercise. I will try acupuncture. I will try massage. I will try chiropractic. I will try dancing around the fire with a mask. Only when all other options have failed will I seek the assistance of a surgeon.

Marcus Welby vs. Doogie Howser

Remember Marcus Welby? This show ran from 1969 to 1976. What bothered me about it at the time was that no doctor actually got that involved with a patient's care. House calls?? No way! But other than that, Marcus Welby was just what I expected in a doctor. This can be summed up as "older than me".

Then in 1989 television doctors got a new look. Doogie Howser. This one ran from 1989 until 1993. At the time I thought that a doctor who looked like he was twelve was fairly preposterous. (I think in Doogie's case, he actually was twelve.) But these days a younger look seems to be the norm.

Let's talk about my doctors for a minute. I like my cardiologist. He has a lot of experience and I believe he's older than me. At least he looks older than me. I like my dermatologist. He was able to quickly diagnose a problem and prescribe a solution for a condition that a younger doctor had missed even though I'd visited three times with the same problem. I'm pretty sure my dermatologist is older than me. My OB-Gyn may not be older than me, but I've been seeing this same doctor for close to 25 years and his hair is turning gray now. Let's face it, I'd be upset if he started looking younger.

My friend's husband had cardiovascular surgery a couple of weeks ago. I waited with her and when the doctor came out to talk to her about the surgery I would have sworn he must have just graduated from high school in the spring.  (By the way, this is a worldwide issue - one of Mark's doctors in Paris appeared to be about 16.) So I wasn't completely surprised when the rheumatologist I saw last week looked like he was barely 20.

So maybe it was a generation gap issue that caused me and this new doctor to get off to an awkward start. He asked me what brought me to see him that day. (A reasonable question - even though I assume my complaint was written on the chart somewhere.) I also mentioned that I'd had a test for lupus back in June and that I assumed it wasn't a problem since my doctor hadn't phoned me to tell me that it was.

Then he told me that I needn't have wasted my time with that test because lupus strikes young black women between the ages of 15 and 30 and I was neither black nor between the ages of 15 and 30. I told him my mother had suffered from lupus.

Then he told me that she would have had it since her thirties and that since I was in my sixties, I needn't worry.

"My mother may have had it in her thirties but she wasn't diagnosed until she was in her sixties."

He gave me a quizzical look and then "implied" that her doctor probably didn't know what he was talking about because he may have been a GP instead of a rheumatologist. Indeed! Her doctor was a rheumatologist on staff at University Hospital in Cleveland - Case Western Reserve University. Well that shut his mouth and we moved on to why I was actually there, which was to see about my knee, not argue the particulars of my mother's case. He conceded that there are sometimes exceptions. I smiled and nodded but he needs to realize that there are ALWAYS exceptions. ALWAYS.

I could see from the x-ray (something that the doctor I saw back in March didn't share with me) that I'm missing a bit of cartilage. To make it stop hurting I got a cortisone shot, an exercise plan, lidocaine ointment, instructions to buy a knee brace for golf, and a prescription for tramadol.

I should be good to go!
  

More Difficult Than It Should Be

My knee hurt. (It still does, just not as bad as it did last week.) I needed to see a doctor. I thought about shooting myself in the knee and going to the ER, but it was only a thought. I was confused about what type of doctor to see. I saw an orthopedic surgeon last spring who told me I had garden variety (aka "not special") arthritis but that it was not serious and I did not need any type of surgery or medication. But it was hurting a lot more than it had last spring.

Could things have changed in six months time? (Of course!) Should I go back to that doctor? (Maybe, but he's a specialist and I might have to wait a month or longer and he's in a really inconvenient location.) Should I go to the ER - (without the gunshot wound)? An urgent care facility? Should I see a different doctor? What kind? Another orthopedic doctor? A rheumatologist? I wasn't sure. I decided to call the nurse consultant provided by my insurance company. I'm going to assume that she really is a nurse even though it was fairly obvious that she had a list of pre-scripted questions. (And there's nothing wrong with that - job aids can help a novice perform like an expert in a short amount of time.) After we went through her list of questions, she recommended that I see a rheumatologist. Then she helped me find the three that are in my network within a 35-mile radius.

Only three. One in Frisco, one in Plano and one in Sherman. Basically, 15 miles, 20 miles and 35 miles. I really wasn't willing to drive farther than that.

I called the one in Frisco. Was I being referred by another doctor? No? Had I seen a doctor for this condition before? I made the mistake of mentioning the x-ray and doctor visit in March. They would have to have the x-ray sent to them before they could schedule an appointment. No problem. I had time to go get it and walk it over since they didn't have any appointments available until December. I said I'd look into getting the x-ray call and get back to them. (Sure I will. As long as I sign a release form, why can't they exchange this information amongst themselves?)

I called the one in Plano. What was my date of birth? Really? They wanted to know my date of birth before my name? Maybe they wanted to make sure I wasn't on Medicare. Who knows? They wanted to know if I'd seen a doctor for this condition before. I wasn't going to make the mistake of mentioning the garden variety arthritis again. After all, it could have all changed and any x-ray should be redone. So I said "no". Then she told me that I had to have a referral from my doctor. I indicated that I had been referred by my insurance company. Let me tell you, she was not impressed.

"We only make appointments for people who are referred by other doctors. We have to have a referral form from a doctor and a copy of all your medical records."

"I'm over 60 - I have a lot of medical records - most of which are not relative to this condition."

"We don't need them all. We only need what is pertinent to your condition."

"If I haven't been seen for this condition before, how would any of them be pertinent?"

"Just have your GP write up a referral and..."

I interrupted, "I don't have a GP since I changed insurance companies last year. My GP thought he was in network, but he isn't."

"I'm sure he'll still write you a referral. I'll need that referral and the office notes from your last two office visits."

"I'm not sure how knowing that I had a flu shot helps you here, but if it makes you happy, I'll see what I can do. Do we make the appointment now?"

"No. We don't make any appointments until we have the physician's referral and the medical information. Then someone will review it and we'll call you back to make an appointment."

"How long does that take?"

"Usually we review it within three days of getting it and then we call you to make the appointment."

This looked like a lot more work for me and no guarantee that they'd even bother to call me back when my last two office visits pertained to a flu shot and a sinus infection. Besides, their first available appointment was November 23rd. My pain was more immediate.

I was starting to get really frustrated. It should not be that hard to make a doctor's appointment. I called the doctor in Sherman. Again, we start off with the date of birth, even before the name. Seriously people - this may be efficient, but it is just rude to ask someone when they were born before you even ask what their name is.

But at any rate, I did make an appointment - for the following week. (Not November or December.) No medical history required. No referral required. And I even got a call an hour later informing me that there had been a cancellation and if I'd like to come in the following day, that would be fine.

Yes. I would like that very much. 

So Where Was it Really?

I guess my bag did have a vacation of its own. I've removed and examined the baggage tags. Here's where it's been:

Dallas to Houston and Houston to Heathrow - August 27
Heathrow to Manchester - August 31
Cleared security in Manchester - September 9 (Really??)
Heathrow to Zurich - September 10
(I have no idea how or when it got from Zurich to Rome - there are no stickers - maybe it went by courier or by train.) 
Rome to Heathrow - September 30 
Heathrow to Dallas - October 1
Sent on October 2 to me via Fed Ex 2 day ground and arrived on October 6, which is right since FedEx only counts business days.

There are date stamps and little stickers that indicate that it may not have left Houston on August 27th. I'm not really familiar with all of these stickers and what the numbers mean, but there is one sticker that indicates it probably left Houston on the 28th. Why it sat at Heathrow for 3 days is anyone's guess.

My bag arrived in Manchester the day before I left and since I left first thing in the morning, there is no way they could have delivered it to me. However, if they had sent it immediately to Switzerland instead of keeping it in Manchester until September 9th, I might have received it there. I was in Switzerland from September 7th thru the 12th. Although I have to wonder why it took them five days to contact me after the bag arrived in Zurich. It arrived on the 10th but no one phoned me regarding delivery until the 15th - five days later and three days after I'd left for Italy.

I suppose when they figured that I'd gone home and didn't "need" it that there was just no rush because the bag didn't leave Rome until September 30th. (I left Rome on September 17th and arrived back home in Dallas, via Heathrow, on September 18th. But once the bag got back in the US, it didn't take long at all. It arrived in Dallas on October 1 and was shipped back to me on October 2.

I noted that it was NEVER in Paris, even though this was a popular BA response. Really, there's only so much you can blame on the French. And with all the stickers and barcodes, it is amazing that BA was never really able to tell me EXACTLY where it was.

The Apple logo decal was still in tact. The name tag with my name, address, and phone number was still in tact. Every single sticker says RUSH and EXPEDITE on it. I can only conclude that those folks in Europe have no idea what RUSH or EXPEDITE mean. (I can forgive the Italians for not knowing English words - but what's up with the British and the Swiss?) Thank goodness here in the USA, we know what good customer service is! May it ever be so.