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Over the past week, stage IV esophageal cancer combatant Diann Pearson has lost more sleep to pains in the backside from Molina/Univita healthcare than to pains in her chest and back from EC and her stent – and I mean that quite literally:
For Diann’s enteral feeding order last month, Univita sent a pump and pole we didn’t need, feed bags we couldn’t use, and the wrong amount of formula, so we refused the entire order and made them get it right. This month, on Tuesday 04/28 they delivered the right bags, but when we opened the formula cases we found Boost Plus™ instead of Ensure Plus™ as prescribed. When we called Univita to complain, some stock-clerk-turned-nutrition-expert said the prescription gave him the right to make substitutions. I informed him that both brands having the word “Plus” in them did NOT make them interchangeable, that Boost Plus gave Diann diarrhea much more so than Ensure Plus, and that he could either send me his dietitian’s credentials or send a driver to pick up the Boost Plus. He promised to send a driver – but never did. Anyway…
On Wednesday 04/29 I sent a fax to Diann’s Jackson Memorial Hospital (JMH) oncologist Amrita Desai informing her that Diann was only benefitting from 2 of the 12 medications and services a D-List discharge doctor prescribed for her the previous Friday. I also copied nurse Stephanie Echeverria to keep her primary care physician Francis Aquino in the loop. Stephanie noted that a nebulizer was among the items prescribed but never ordered, and took the initiative to order it herself from Molina/Univita, Diann’s Florida MMA (Mismanaged Medicaid Administrators) on paper and the DME (Delayed Medical Equipment) providers who do all their dirty work.
Later that afternoon, Diann was awakened from a recuperative slumber by a phone call from Univita saying they’d deliver the nebulizer that evening. I told them to have the driver pick up the Boost Plus when he delivered the nebulizer. They agreed – but their driver never showed. Instead, Univita called and woke up Diann again, this time to say they’d deliver it the next day. We told them we had a doctor’s appointment in the morning, so they agreed to make their delivery between 2 and 5.
The next morning – Thursday 04/30 – our friend from NC Linda Seagle drove us to JMH for a 9:30-ish appointment with Dr. Desai. We reported that (a) Diann’s esophageal stent was effectively alleviating her cough, but (b) beyond that so far serving little purpose other than “recreational deglutition” (swallowing for pleasure), and that (c) her primary source of nutrition and hydration was still our enteral feeding pump, with which we were (d) struggling to maintain her weight at 140 pounds. We also reminded her that Diann was suffering from pains in her neck, chest and back that none of her medications were relieving. The young doctor responded with a prescription for liquid morphine it took the JMH pharmacy two hours to fill, then sent us on our way with a promise to resume chemotherapy next week.
We got home around 1:30pm. Diann was exhausted, so she unplugged her landline and went to sleep. I did some work and waited for Univita to deliver the nebulizer “between 2 and 5.” 5:00pm came and went – but Univita never did.
The next morning – Friday 05/01 – I emailed nurse Stephanie and told her Diann still had no nebulizer. She later called to say that, after spending 30 minutes on hold, Univita told her they’d attempted delivery on both Wednesday and Thursday and would not attempt again until we called them. I assured Stephanie that was not the case, but there was little else to do but call Univita at 888-914-2201 extension 1454 as they insisted. I did. And after waiting 33 minutes on hold, I got to speak to “Brian.” Brian said according to their driver on both days the front door to Diann’s building was locked, so he could not enter and deliver the nebulizer. I told Brian that was a lie, because if the driver had actually come to the front door of her building (and could read English) he would’ve seen a sign on the door instructing all deliveries be made through the north-side Delivery entrance. I later took pictures of the sign on the front door and the Delivery entrance and faxed them both to Molina, Univita and Stephanie to destroy any doubts about Univita’s duplicity.
On Friday afternoon, a Univita driver with nebulizer in hand finally showed up at Diann’s door. He refused to pick up the Boost Plus as Univita promised he would, so I refused to accept the nebulizer until they did. Later that evening, Diann’s rest was disturbed by a Univita “courtesy call” asking why we’d refused the nebulizer. I explained, and the caller said the Univita computer showed the Boost Plus had been already been picked up. I assured her that was not the case, then she assured me Univita would “send someone” that evening. An hour later some highly-stressed, tenor-voiced delivery supervisor called and claimed that someone would arrive before 9:00pm. Then finally at 9:40pm, Univita driver Santiago Leon showed up, signed for the Boost Plus, and hauled it away.
Diann still has no nebulizer – and perhaps you are wondering why we refused something that might give her relief. We did so because being forced to use the Boost Plus might have meant 30 days of diarrhea, and that’s a high price to pay for a few days of relief from what is now a minor cough. Besides, all Univita was providing was the nebulizer. We’d still have to get the nebulizer solution prescription filled on our own, and we decided to deal with that another day.
Pray for Diann,
P.S. After weeks of serving cheerfully as our unpaid chauffeur, our friend Linda Seagle had to return to North Carolina yesterday. We can’t thank her enough for being there when we needed her!