Rx Insurance

It was bound to happen sooner or later.  My “specialty” meds can no longer be filled at my local drug store.  Instead, for my “convenience,” I’ll have to drive 22 miles to Walgreens, instead of 3 miles to my local pharmacy.  How the &*!%$ is that convenient?!

RxLetter

Methotrexate and Cimzia are both on the list.

Now, I realize that one option is to get prescriptions through the mail, but I have heard so many horror stories about the incompetence of mail-order pharmacies that I don’t see that as a very good solution.

Furthermore, one doesn’t have to read very many pharmacy blogs to be aware that Walgreens is one of those pharmacies that have a truly horrible reputation for pushing pharmacists to do more and more work in less and less time, without enough manpower to ensure patient safety.  I guess I can be relieved that my particular meds affected by this are ones that just require slapping a label on the box.

Any suggestions?

Physical Therapy

PT & OT. What’s the difference?  Does it matter?

Even physical therapists and occupational therapists can have a hard time explaining the distinction between the two fields because there is significant overlap.  When asked, professionals who have been able to formulate any sort of response have explained:

  • PT tends to work on large joints (knees, hips, shoulders); OT tends to work on small joints (hands & wrists)
  • PTs tend to prescribe formal exercises; OTs are more likely to learn about your daily life and find things you can fit into your normal routine to exercise the joints involved (an OT will tell you that knitting and piano playing are excellent hand exercises).

However, PTs can work on the hands.  In fact, they can earn extra “hand” certification.  I discovered this (and many other interesting things) because my daughter has decided that her career goal is to become a physical therapist.  She has been learning what hoops she’ll need to jump through to make that happen, and one requirement is a certain number of observation hours in a variety of PT settings.  Two local PT offices have graciously allowed my daughter to observe in their clinics, so she has been able to compare not just different therapists in a single location, but the differences between how two different clinics are run.

One of the PT clinics where she’s observing is a large chain.  An advantage to large chains is that they employ floaters who act like a substitute teacher, travelling from one clinic to another to cover for those who call in sick.  Patients can set up a therapy schedule and be confident that they won’t be cancelled if their therapist becomes ill.  One disadvantage is that the PTs there are extremely clock-conscious, and ignore the patient part of the time because they’re doing documentation.  In case you haven’t discovered it yet, ignoring patients to do documentation means that the therapist doesn’t notice when patients are doing their exercises wrong.

The other place is a small, privately owned clinic.  They do not watch the clock as strictly, and tend to be more focused on accomplishing specific goals for each patient each day.  If that requires an extra ten minutes, it isn’t a problem.  On the down side, if someone is out sick, either another therapist has to pick up extra patients all day, or patients have to be rescheduled.

Schooling

In the past, PT was an undergrad degree.  That has changed, however, and new physical therapists enter the field with a doctorate in physical therapy.1  DPT school is every bit as competitive to enter as medical school, and has stringent entrance requirements:  at least one year each of college level biology, human anatomy & physiology, chemistry, physics, and psychology, with a number of other “strongly recommended” courses, as well.

Benefits

Anyone with RA (or another type of autoimmune arthritis) can benefit from consulting a physical therapist.  PTs can test to determine which muscles need to be strengthened, and can then teach the least painful way to strengthen muscles so that joints work as efficiently as possible.  The more I learn, I believe there is value in shopping for a PT like we shop for a physician.

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1Occupational therapists enter the field with a masters degree, which honestly makes no sense to me, since it takes about the amount of time to earn as a DPT.

This Crazy Whirlwind of Life

Honestly, those of you with kids in public school, I don’t know how you manage.  My son made the basketball team, so I have had to drive him to the school for either practices or games every day.  Then I have to go back and pick him up.  If there’s a game, I stay and watch.  It is exhausting to arrange my schedule around someone else’s — I’m accustomed to setting my own schedule.  And this is only for basketball season; I can’t imagine doing it all year long.

This has been going on since mid-November, and I’m beat.  The only day they don’t practice/play is Sunday (oh, they also got Thanksgiving, Christmas, and New Year’s off).  The season is almost over, but there’s no rest for the weary.  Now that the high-school aged son is nearly done with basketball, the youngest son has begun to play.  I had to quit teaching swimming lessons so that I can transport my basketball players.  Now that I think about it, cessation of swimming probably contributed to the return of my shoulder and hip issues.

Even knitting has become painful.  I drag my knitting bag along to all the basketball games.  All that time I would have wasted, just sitting there waiting for the game to start, has added up to two pair of socks, three hats, and a pair of mittens.  It’s nice to have something to show for all that sitting-around time.  Unfortunately, for the past few days, my shoulders have hurt even while resting my elbows at my sides — that’s worse than usual.

Wouldn’t it be nice to treat ourselves sometimes?  When my animals are sick, I can go to the feed store to buy medicine. Just today I gave a cow two shots s of LA-200.  In the spring I give vaccines to our horses. When they’re injured, I can clean them up and apply bandages. We have a stomach tube for calves that won’t eat.  Yet for some reason, there is no way for me to say, “Look, I’ve had this problem with my shoulders and hips off-and-on for six years.  Can’t I just cut out the middle man and treat it the same way it’s been treated every other time?”  No.  Instead, I have to phone my doctor’s office, make an appointment, spend two hours on the road for a short visit with the doctor who will do the same exam he always does and recommend the same treatment as usual.  Wouldn’t it be nice if I could go online, do the point-and-click thing, and a few days later have a bottle of kenalog show up in my mailbox?  No travelling. No time lost.  Not that I don’t like my doctor.  I do.  It’s just so overwhelming to think about going to see him yet again, that it’s easier to just stay home and deal with the pain.

This is why I haven’t been blogging.  Life has been even busier than usual, and the bursitis & tendonitis have been waging war.  My computer is upstairs, and I’ve been mostly staying downstairs.  I’ve even been sleeping in a recliner in the living room since November (instead of climbing the stairs to torture my hips and shoulders by squishing them against a mattress).  Something needs to change.

Miscellaneous other stuff, since I haven’t posted in ages:

Last month I finally took dear daughter to see her rheumy in Seattle.  The doctor saw why I’d been phoning and pestering her to treat this more aggressively. DD is now on a DMARD instead of just NSAIDs.  She’s also getting some pretty intense physical therapy.  More about that another time.

Both my college kids came home for Christmas break.  It was great to see them and hug their necks.  Our son is planning a service-project trip for spring break, and is applying for an internship over the summer, so I guess that means he’s all grown up and on his own, and we’ll see him again next Christmas unless we go to visit him in Texas (which we are considering).  Our daughter, however, plans to be home both for spring break and over the summer; we are thrilled.  My husband and I are both the oldest child in our families, and really had no idea how hard it is on the younger kids when older siblings grow up and move away.

In other news, totally unrelated to RA (but I could make a case following the RA/food allergy thread), my ducks molted.  Molting means that their feathers fall out and they quit laying eggs.  Not good, since the people in this house without a Y chromosome do not tolerate chicken eggs.  We eat duck eggs.  I finally threatened the ducks, and said that if they didn’t produce, they’d go in the soup pot.  Two started laying.  I should’ve threatened them sooner.  1-2 eggs a day isn’t really enough, so I increased my flock.  Unfortunately, the new ducks are all white, which means that they are much easier than brown ducks for owls to see in the dark.  It’s been most frustrating, but I started shutting the ducks inside at night and haven’t lost any more heads.

AND… if you just skimmed:  IFAA is doing some great chats with blog leaders on the Facebook page.  I am signed up, but don’t even have a date scheduled yet — because, seriously, nobody wants to do a chat at midnight, and I feel like I’ve been running from first thing in the morning until the rest of the household is asleep at night.  That seems to be the only time I’m not committed to doing stuff.  Basketball won’t last forever, though.  Meanwhile, please check out the Facebook page and participate in the chats!

Wishing you painless days!