Medicaid Services: Too Little, Too Late

We spent two or three months trying to get a care manager from Health Homes, “we” being me and Dr. Katherine (Kate) Lewis, a psychologist with Psychological Health Care. He—Leonardo Sanchez—finally showed up at Sunnyside Care Center last Thursday morning. A case manager at last!

He left my room to find out how I was supposed to get the walker with which I was to be discharged, and swearing that he would call me back that afternoon. We both understood that his office was closed on Friday for Independence Day and that he would talk to Kate and then meet with Kate and me at my apartment on Monday. Leo did not call me back.

On Friday I was discharged with no food and a prescription for a walker that I had no way to fill. My pain level was down to two Tylenol a day. I wheeled to a Chinese place and got Egg Foo Yung.

On Saturday, at home, I discovered on MyChart that somebody had made an appointment with Dr. Nanavati for me without telling me. It was for 8:00 a.m. Monday. Morning is my absolutely worst time. My aide, Robin-the-magnificent, doesn’t get to work until 8:00 a.m. I was terribly sick and absolutely had to see the doctor. Impossible. Impossible. Robin and I went to the university shopping area and got juice.

I had lost eight pounds in a week. I was weak and wobbly and frequently lost my balance. I slept or not, ate what I could carry without a walker or tray. Moved from bed to recliner and back, terrified with each step, hit my head and wept. I stank from sweat, a catheter and no perianal care, thrush and no dental care. On Sunday, Robin and I got me some kind of shower, at high risk for falling.

On Monday, Robin got up around 5:00 a.m. and took the bus to my place. Arrived around 7:00 a.m. Fed me breakfast and got me dressed. I was at Dr. Nanavati’s by 8:00 a.m., sobbing in pain from a muscle twitching in my big toe. The receptionist asked if I was all right. I said I was in pain. She said “oh” and left me sitting in the waiting room.

My vital signs were all normal. Dr. Nanavati hugged me and I wept. He adjusted the wheelchair so I could lay back. He said that first we had to deal with the pain, which—consequent to having to take care of myself—was now up to two narcotics every four hours. He talked about an orthopedist, increased services, talking to Dr. Ghaly, looking—not in medical services but in the community—for help. Kate and Leo were meeting with me at noon, and he wanted to talk to them.

I went home. Robin put me back to bed. I took two more painkillers, and slept.

Kate arrived. Meals on Wheels had been left outside the door. Leo did not show up. We spent half an hour trying to find him. He had said he would be here at 12:15 p.m. He wasn’t. Then he said he wasn’t my case manager; he was an intake worker. Then he said he would come on Friday to meet with Kate.

Kate knew I couldn’t possibly last that long. She said she would call Dr. Nanavati, and I knew she would do it. Whether, together, they can save me I do not know.

I can’t even turn over in bed. My catheter bag is full and I cannot empty it.

I have done everything I was told to do. I have complied with the system.

It will be the death of me. This is what your taxes pay for: too little, too late. You pay for a boondoggle that does not provide essential services. When are you going to stop paying for Medicaid when it doesn’t work?

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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