The IPRO Appeal (Part I)

Dr. Stephen Wechsler, my Power of Attorney, has advised me that we should appeal the decision.  I’m not entirely sure who made what decision but I think Medicare made the decision not to pay Crouse Hospital for my time spent here.  Neither Crouse Hospital nor I did anything wrong, and there are no current options, so I think Crouse should get paid for taking care of me.

Please note that I am writing this under the influence of chronic hyperglycemia.  My fasting glucose this morning was 429.  I don’t think as clearly as I used to.  In decades past, I was poisoned by a doctor prescribing lithium without monitoring it.  The result is “immune dysfunction, type unknown, resulting in hypersensitivity to medications.”  In fact, I have had three trials of insulin and cannot tolerate it.  This is the beginning of the story.

On June 27, Crouse Hospital discharged me to the Iroquois Nursing Home in Jamesville, New York, with Dr. Richard Lockwood attending.

To the best of my knowledge, NYS Dept. of Health regulations require the attending physician to do a physical examination and medical assessment within twenty-four hours of the patient being admitted to a nursing home.

Dr. Lockwood did neither.

On June 27, he came in with Nurse Manager (?) Krista (?), shook my hand, and said he’d have me out of there in no time.  I was not there for rehab so I replied, “I’m here for palliative care.”  Lockwood then stated that he had not read my hospital discharge summary, then left the room.

I did not see Lockwood again for the next twelve days, despite asking to see him virtually every day (omitting weekends and the Fourth of July, when I was told he would not visit the Iroquois).

A nurse told me that doctors at the Iroquois don’t necessarily see the patient; sometimes they just review the medical records.  The nurse acted as if this is so common that they think of it as routine.

Much has been made of my mental status.  Let the record show clearly that I do not have any mental illness.  I took antidepressants every day from 1974 until 2001, and was diagnosed with everything in the book—suicidal depression, borderline personality, paranoid schizophrenia, narcissism, obsessive compulsive, bipolar, etc.  What I had was a reaction to antidepressants.

In 2001, I stopped taking antidepressants, and therefore also stopped attempting suicide, stopped being hospitalized, stopped seeing a therapist and stopped being depressed.  I continued to see the psychiatrist because he treated my medical ills with acupuncture.  Around 2008, I had a battery of psychological tests administered by Dr. Kevin Antshel at Upstate Medical Center which established that I had no psychopathology:  I was a mentally and emotionally healthy person.

Dr. Lockwood and others, in the medical records, have dwelt on my psychiatric history.  In fact, I was psychiatrically perfectly healthy until the hyperglycemia set in about two years ago when the diabetes mellitus no longer could be controlled by diet.

Chronic hyperglycemia causes loss of cognition, despair/depression and irritability/anxiety.  Dr. Lockwood, et al, from Iroquois Nursing Home now are trying to pass off the symptomatology of hyperglycemia as psychiatric illness.  It is not.  At the Iroquois, I was sometimes very agitated and distressed.  I repeatedly asked for Lockwood so we could discuss the immune system problem and intolerance of medication issues, and figure out how we could relieve my pain.

In twelve days, Lockwood did not come to see me once, even though it appears that he did write at least one medication order for me (as recommended by the last psychiatrist who saw me, Dr. Nasri Ghaly).

Following the directions in the Iroquois handbook, on Monday, July 8, I called the NYS DOH nursing home hotline.  On Tuesday I had a return phone call from the Case Resolution Unit and was told that they would call the Iroquois that day.  On Wednesday morning, Dr. Lockwood came to see me.  He was abrupt, uncooperative and would not listen to me when I tried to talk about the medication problems.  Lockwood spent about six minutes in my room, then walked out.  After he left, I said loudly, “Lockwood is damned asshole!” or words to that effect.

A couple hours later, Nursing Supervisor Sue Greer entered my room and said they were sending me back to Crouse Hospital because they “couldn’t meet [my] needs.”  I said they were meeting my needs just fine, except for the doctor, and I did not want to leave the Iroquois.  Greer then left the room and called POA Steve Wechsler.

About annecwoodlen

I am a tenth generation American, descended from a family that has been working a farm that was deeded to us by William Penn. The country has changed around us but we have held true. I stand in my grandmother’s kitchen, look down the valley to her brother’s farm and see my great-great-great-great-great-grandmother Hannah standing on the porch. She is holding the baby, surrounded by four other children, and saying goodbye to her husband and oldest son who are going off to fight in the Revolutionary War. The war is twenty miles away and her husband will die fighting. We are not the Daughters of the American Revolution; we were its mothers. My father, Milton C. Woodlen, got his doctorate from Temple University in the 1940’s when—in his words—“a doctorate still meant something.” He became an education professor at West Chester State Teachers College, where my mother, Elizabeth Hope Copeland, had graduated. My mother raised four girls and one boy, of which I am the middle child. My parents are deceased and my siblings are estranged. My fiancé, Robert H. Dobrow, was a fighter pilot in the Marine Corps. In 1974, his plane crashed, his parachute did not open, and we buried him in a cemetery on Long Island. I could say a great deal about him, or nothing; there is no middle ground. I have loved other men; Bob was my soul mate. The single greatest determinate of who I am and what my life has been is that I inherited my father’s gene for bipolar disorder, type II. Associated with all bipolar disorders is executive dysfunction, a learning disability that interferes with the ability to sort and organize. Despite an I.Q. of 139, I failed twelve subjects and got expelled from high school and prep school. I attended Syracuse University and Onondaga Community College and got an associate’s degree after twenty-five years. I am nothing if not tenacious. Gifted with intelligence, constrained by disability, and compromised by depression, my employment was limited to entry level jobs. Being female in the 1960’s meant that I did office work—billing at the university library, calling out telegrams at Western Union, and filing papers at a law firm. During one decade, I worked at about a hundred different places as a temporary secretary. I worked for hospitals, banks, manufacturers and others, including the county government. I quit the District Attorney’s Office to manage a gas station; it was more honest work. After Bob’s death, I started taking antidepressants. Following doctor’s orders, I took them every day for twenty-six years. During that time, I attempted%2
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