Archive for July, 2014

I’m about an hour away from my son driving me to the hospital. 

July 25th, 2014

The interesting thing about time is that it can go by in a wink, like life, or it can drag on like some form of ancient water torture, one drop at a time.  I’ve decided to spend this time with you.  Some of you may know that I’ve had a few weeks to think about my life.  Two and a half weeks ago, I experienced some discomfort in my chest that was NOT normal.  The problem with chest discomfort is that, sometimes it’s just that.  Unfortunately, heart symptoms and digestive indicators can mask each other.  So, I joke a lot about the magic question,  ”Will I burp, or will I die?”  This time, however, with three previous CATH experiences, I knew that the latter one was more likely than the former.  After trying one day of home remedies, I acquiesced to the “adult DVD” inside my brain, and went in for a check-up.   All the while I was hoping that my instincts were misguided, but knew deep down that they were not.  In fact, when the cardiologist recommended a CATH, it was like the proverbial Déjà vu all over again.

The drill is well known to me, but the outcomes never are.

This time, nine years after my previous CATH, I utilized something that was not part of my earlier support network, FACEBOOK.   For those of us who mainline connectivity, social networking can be a very powerful and meaningful thing.  In fact, I used to speak all over the United States about blogging, texting, and You Tube long before Facebook was in vogue.   Well, of my designated FRIENDS on Facebook, over 200 took the time to respond to my announcement of impending medical attention.  The result was an unbelievable level of love that poured out in these comments from my FRIENDS.

Today, I truly do feel surrounded and bathed in love, and it’s a very interesting cascade of love, because it’s crosses six decades of my life.  I’ve been touched by childhood friends, high school and college friends, associates, former students, and former employees and co-workers from almost every job I’ve ever held.  I’ve been touched by good wishes and warm thoughts from all over the globe.

This will be a good day no matter what the outcome because I leave here confirming that there are far more good hearted and caring people in this world than there are destructive ones, and I do believe that we will eventually prevail.

As I look out of my office window today, I see a sky that is so blue, so perfect and reminiscent of why I have loved living in this State, in this country, on this planet.   I take a deep breath and remember today’s blue sky, tepid weather, and amazing ever changing seasons, and I appreciate my life on all levels; the students that I’ve nurtured, the amazing  jobs that I’ve been privileged to have had, and most of all,  the beautiful, caring, family that has given me love, light and hope for the past 40 plus years.

One healer reminded me to embrace today the memory of the touch from the little hands of my grandchildren; another reminded me of how I vaccinated his soul with positive energy as a young student.  Regardless of the sentiment, it’s been so fulfilling that all of those people are holding me in their hearts just like I’ve held them in mine all of these years.

My mother’s favorite saying was from John Wesley, ““Do all the good you can. By all the means you can. In all the ways you can. In all the places you can. At all the times you can. To all the people you can. As long as ever you can.”

I’ve embraced those words, and know that many of you do as well.  Hold onto love. It’s the source of our energy and strength.


ICD10 – Struck by a DUCK!

July 20th, 2014

For several years something called ICD-9s dominated the healthcare providers’ reimbursement landscape.  It’s how they get paid for treating their patients.  There were 13,000 different categories of ICD-9s that were always up for individual interpretation.   Well, as only they can do, the federal government has simplified the decision-making process by complicating things exponentially.  Now, instead of the traditional 13,000 choices, there will be something called ICD-10s with 68,000 billing codes.  Over five times more obscure, yet descriptive, billing selections for the already confused healthcare workers to decipher.

The implementation of these expansive diagnostic code changes will take place in October, 2015.  Katie Bo Williams of Healthcare DIVE News wrote a wonderful description of the  most absurd codes that will be a part of the ICD-10 list, and some of them were stupid enough to have some fun with here.

A few years ago, when the codes were beginning to appear in writing for the first time, I was working in Florida and was having lunch with a group of very Southern individuals.  I jokingly said, “You know there will be a billing code for getting hurt while riding on the back of a hog.”  One woman looked almost indigently at me and said, “You’re obviously not from the South.  Our hog races are very important to us.” To this day, I’ve never seen hog jockeys!  (Bucket list.)

W55.41XA:  Bitten by a pig, initial encounter.    Let me be perfectly clear.  This code absolutely is referring to a farm-related injury.   Because my farming experience has been pretty much limited to geese who bite and cows with limited denture capabilities for significant biting, I can’t personally respond as to how risky pigs can be if aggravated.  I think it’s interesting, however, that I already have two pig references and we still have several hundred more words to go.  Does this imply that, not unlike our schools, airports, and other public buildings, we’re going to have to have armed guards to protect us in our pig pens?

One of the fantastic code descriptions that Katie writes about is V9733XD:  Sucked into a jet engine, subsequent encounter.    It took a minute for this one to sink in because I read it as, “If you happened to have been sucked into a jet engine and lived and then were sucked in again, there was now a code for it.”  In the vernacular of the times, that would really suck.  She went on to explain, however, that it meant subsequent encounter with a physician, not a jet engine.

Z63.1: Problems in relationship with in-laws.   Truthfully, I can’t believe they didn’t have this one in the first 13,000 codes.  If you’re a fan of “Sons of Anarchy” it’s certainly clear why this needs to be a code.  Who hasn’t had this challenge?

Two or three years ago, one of my doctor buddies used this next one in a speech he was giving regarding reimbursements and what was coming our way.  Y93.D: V91.07XD:   Burn due to water-skis on fire, subsequent encounter.  A person has to ask, “What could you possibly have done to even get your water skis to catch on fire?  Did you soak them in a flammable liquid for two days?  Did you jump through a burning hoop on skis?”  In that case there should be a code for flaming Speedos.

12.Z99.89: Dependence on enabling machines and devices, not elsewhere classified.   This one obviously refers to a physician having to counsel us because of our addictions to electronic communication devices.   As Katie says, “There’s just no substitute for a Crackberry.”

Finally, my very favorite one is W61.62XD: Struck by a duck, subsequent encounter.    It’s my favorite for reasons that I can’t really write about here relating to a really old joke, but it is one of the only codes that rhymes.  He was struck by a duck!   Get him to the ER. STAT!