Saturday October 13, 2007 5:12 PM

Some things to note this week: Jim tried to eat one of those soft chewy pretzels, which I didn't think was going to be such a hot idea. He doused it with tons of mustard and got it down. About ten minutes later he comes into the family room to watch t.v. and he coughs, then I see him chewing again. I look at him and ask, "Are you re chewing what got stuck?" Yeah, he says. So gross. It's like a cow chewing a cud. Then later in the week he tries a bagel. That took about four hours to get down. Literally four hours.

I still hadn't heard from Dr. Spiegel by mid-week, so I called and talked to an idiot. Friday afternoon I spoke with the idiot again. After I hung up I dashed this letter to Speigel off and faxed it to him. I wrote it like it was coming from Jim and had him sign it, but it's all me. I think this sums everything up nicely:

Dear Dr. Spiegel:

I write this letter in a state of frustration. As you will hopefully remember, I was a patient at Lahey Clinic in Massachusetts this year and had a carotid body tumor removed, leaving much damage to my ability to swallow. Upon release from Lahey Clinic, my ENT at that hospital arranged for me to have Vital Stim therapy at Marlton Rehab Hospital in Marlton, NJ. I made much progress there. However, my insurance company, Aetna, would only cover my Vital Stim therapy for 60 days per diagnosis. One of the purposes I had in mind in becoming your patient was so that you could assist me in devising a new diagnosis code so that I could continue my Vital Stim therapy. My wife and I made this very clear in our initial meeting with you. At that time you suggested I have a manometry study done.

Dr. Rivera was unable to perform the manometry study. She attempted this three times. Dr. Rivera told us that she would report this fact to you and we should get a phone call from your office advising us what we should do next. We never received a call, so we scheduled another appointment with you to discuss how I could get more Vital Stim. At that visit you suggested a throat stretching procedure, which was done approximately a month ago. My wife reminded you of the need for Vital Stim on the phone while she was in the family waiting room after the procedure. You told her that it would be discussed at my post-op visit.

At my post-op visit you asked me if I had ever heard of something called Vital Stim. I find this very frustrating because that’s all we’ve mentioned to you in our past office visits. You suggested I go for a manometry study. I pointed out to you what happened when Dr. Rivera attempted my last manometry, but you said I would stop by your office first to get numbed up, and then go to Dr. Rivera, and someone from your office would call to make the arrangements. No one ever called about this. My wife spoke to Dr. Rivera earlier this week and Dr. Rivera told her that she had already spoken to your nurse and told her that attempting another manometry would be a waste of time. She had already numbed me and had attempted the study three times.

I got a call from someone at your office this week. My wife explained all of this to this person from start to finish. We were told that you would be calling us back. My wife just got off the phone with your office about a half hour ago and that person merely had a list of Vital Stim therapy facilities. This is not what we have been asking for. I don’t know what else to do to get what I need accomplished, as I can’t possibly have communicated what I need any more clearly. Please advise where we should go from here.



Sincerely,


James Primiani

....Nuf said.

I've been pestering Jim to draw something else for the blog. He drew the following with his Wacom drawing tablet for his p.c., whatever that is.



Tomorrow I'm off to Minnesota for another training class again. Three trips in just a few weeks. Ugh. It's killing me. I saw Dr. Barb the shrink this week and he added some Lexapro to my Trileptal to help out with the post traumatic stress shit. Jim's shrink also upped his dosage a little.