Testing, testing...

Monday morning was a stress test. Working with a person who has severe depression is and can be very frustrating.

I got him up early so I could get him to take a shower.
"I can't, I have to lay down."
This is where it gets frustrating.
I put my hands on my hips and feel the anger grow. I get a bit snarky, "So why do you need to lay down? Are you dizzy, tired, out of breath..." I take his 02 levels and they are fine.
In my mind that says it is the depression talking. He needs to move, he needs to keep moving.
So I become the bad guy. "Your 02 levels are fine, your blood pressure is good. Do you need me to get the shower chair and help you? Are you dizzy, why do you need to lay down."

I can't help myself here. I am trying to get him ready for a doctor's appointment. I tried all day yesterday to get him to shower and he was too tired. Yet he could watch the streaming on the small flat screen TV for 3 hrs.

He gets angry with me, gives me the look, and goes to lay down. I stand in the bedroom door and fume. I look at the clock, he needs to shower.

That is how the mornings go with appointments at the VA. Nudge, push, push, nudge, frustration and stress at just making the appointment on time in Madison which is 89 miles away.

The stress test came back 'abnormal'. That is all the tech would say. Cardiology called yesterday morning and scheduled an echocardiogram. I wonder how abnormal is really was if the echo is scheduled nearly a month away.

As is our normal routine when not rushing to get ready for an appointment, I left hay out for Rich to feed Bob and Thor. I reminded him that I had an appointment with the manager for his mother's apartment lease.
I contacted the attorney who will be her guardian to get some guidance and told him that I'd bring him lunch back from The Corners Restaurant.

When I returned home, he had his boots on, but was sleeping. I woke him up.
I gave him his burger and fries and then asked how feeding the donkeys went.

"I was too tired," came the answer.

I was quiet for a bit while I made copies of the POA paperwork and arranged some papers for him to sign regarding his mother's paperwork for elderly housing. The lease would not have to be signed until she had the new guardian in effect. That was a huge relief.

Finally I said, "Oh. Okay. I guess that is why they brayed when I drove in. They are hungry."
I got a nasty look and he sighed. "I better go feed them since somebody wants to play psychiatrist and tell me what to do."

I stack my copies of paperwork and shrug.
He stops at the door, "Is it hot out?"
Snarky remarks want to fly past my lips...but I press them closed and then say, "Well it isn't too bad."

He feeds the donkeys and comes in with a huge sigh. "There, don't I look cured! Don't I feel awesome? Don't I want to just run up and down and be fine? Oh look I am all better!"

Picture these words with aphasia and it actually is more drawn out and difficult. But I get the jist. He is angry at being made to move against his will. He wants to just go to bed, which he does for the rest of the afternoon.

I gather up items to go to the forest and go fencing. In my back pack I throw some toys. I won't have time for it,....but you never know.

We ... he argues with me again later after I draw out a map of how I am fencing. I tell him to get on the 4 wheeler and I'll show him.
"Quit trying to be the stupid doctor, I just need meds to make my head better. If my head is better I'll be better. Just stop it."

I let him blurt it all out and listen. I want to say to him that since he has gone out to feed the donkeys daily he has improved. He has anger which is better than two weeks ago when he had no emotion. He takes it out on me of course and I sit there and want to point out the good things that are small baby steps. He won't hear any of it.

I finally tell him that I'm going out to the garden. I leave and am there until nearly dusk.
Surprisingly he does come out of the house and onto the porch. He pulls up a chair and we are friends again as we quietly snap green beans.

Oh yes.
I did have a moment or two for some silliness.
And it makes me laugh.

Toys given to me by neighbors and other kids....
why not? We all need to smile and laugh.

Testing? He tests my patience. It is a good thing I have a LOT of it.

Red Tape Increases with Veterans Admin Districts.

Or well, at least that is what I was told by the Non VA Medical Claims and Authorization Department.

"Ma'am, your husband was taken by Ambulance to a hospital that we don't have in our system for care. Because of the re-districting on January 1st, 2015 he should have gone to ....mumble mumble ... which was a 90 minute drive.

So I read to him the following:

Do I need to get approval before going to the emergency room?

No. If you are an eligible veteran, and a VA facility is not feasibly available when you believe your health or life is in immediate danger, report directly to the closest emergency room. If hospitalization is required, you, your representative or the treating facility should contact the nearest VA within 24 hours to arrange a transfer to VA care by calling the VA Transfer Center at (813) 972-7614.

And he remained stoic and explained that the Non VA Medical Claims personnel were short staffed and he himself was only seeing claims from the beginning of May.
He repeated to me that someone would have to determine whether or not his transport by ambulance was medically necessary.

I asked him to call the VA Madison number and listen to the first thing said, "Welcome to the VA, if this is a medical emergency please hang up and dial 911."

He asked if I got prior approval.  
I thought evil nasty things before I replied.

"I should tell a man who is laying naked on the floor having a stroke while I grab a phone and call for an approval?  Who are you kidding?"

I know I heard him shrug, or my mind did.
He replied the Vernon Memorial in Viroqua is not part of their district.  BUT, wait...we are in the very same state.
Nope, the state was redistricted.
I looked up the state and the district.  We are #12, the whole state, so who was he kidding?


The billing would be sent to Tomah -- even though it was addressed to Non VA Medical Claims and Authorization Department, Madison, WI.
That means that the claim was sent to Madison, who sent it to Tomah, which is not the hospital he was getting care at.
Tomah makes a determination as to whether or not it was a true emergency.

And he had no providers in Tomah.

As to the threatening letter he told me to call the Ambulance company back and tell them to be patient and that they needed to hear from the VA. They couldn't put us in collections until they heard from the VA...in fact the VA was the Federal Government and NOT and insurance company.  It was like the IRS.

He was a bit smug, but I wrote that down and told it to the Ambulance company.

So the horrid red tape continues. 
Nearest hospital ... must mean nearest secret hospital that only the VA and the secret hospital knows of.

So I forge on, building a larger file and keeping names and dates.
Thank goodness I've done this sort of thing before.