2023-02-15 - 3:02 p.m.

PEEPS

I have ranted much about how all should get the gardisal vaccine as most cervical cancer is PREVENTABLE
when the #1 cause is the HPV virus, which is fucking common.

Literally

common

and most often passed by fucking

There you go.

My bestie called today and I said to her something must have made someone "pissed"

She responded
"Remember your audience"

and said "You are a lady, talk like a lady. I don't like hearing profanity or crude language-- it is just not necessary."

I got the reprimand from the nanny.

I apprechiated the reminder that it makes her uncomfortable

she further said "you are leading by example"
"Although I have tried to teach this by modeling for my kid, but she apparently wants to be defiant
and it is going to become a habit
so even if she doesn't want to talk like that
it might be hard to stop as is so ingrained"

I said "Times have changed I think"

True

I think the world has become more comfortable with crude langauge. I have become more comfortable with crudity
Something happend that shifted

I suppose just being around RAW and those with no filter long enough make it seem more normal.

I don't think that a good thing overall

but at times and in certain respects I feel like it is ok. For example, I am perfectly content being complete stream of consious in my WRITING
or when talking to bestie
and venting
letting out the ugly words

in a vent

BUT in every day life I totally agree with her. Profanity makes folks highly uncomfortable
USUALLY

THAT IS THE POINT in fact
USUALLY

All this to say

Next step in my healthcare journey was tracking down the Women's hospital in the area at which the surgon has admission privaleges - a surgon in the practice my ob/gyn FIRST referred me to.

I called to see if they would be able to let me know if the hospital could do the procedure with a doctor with admission privaleges, when BOTH are providers in the network of my insurance
bypassing the private office the surgon ALSO works at where they don't take my insurance.
I said I get it that it may be up to the DOCTOR
but I had the name of the doctor (that IS in network although her office is not. That is the crazy thing- sometimes a facility is not but an individual is only when working on site and out of a local hospital but not their own office!)

The lady at the hospital once found the actual womens hospital and dept where they specialize in what I need - chased the question for me up to management

who said YES
BUT...
they just need it to be sceduled and by a physicial referral .

They said CALL BACK if your ob/gyn is giving a hard time getting that done.

I didn't feel like it was them giving a hard time scheduling- I felt like they just somehow did not know the process?I mean they refer folks to the private practice which honestly most around her have insuance that is taken. I don't think they necessarily had to hit this particular hurdle before and I think the office manager DID TRY TO HELP but got stuck
like I did...
I mean my ob/gyn office manager did call the health insurance company, did get names of referrals of surgons IN NETWORK- and I (and she!) followed up with calls and she faxed records etc... then that office (in Winchester ) told me
"We are not taking new Medicaid patients" AND THEN
"Oh this Doctor doesn't do THAT.... he just does pelvic floor surgury" ( you know when ladies want to stop peeing every time they sneeze cause their muscles just are not as conditioned,in shape, and TIGHT as before......

So back to square one which is why I called the hospital direct once I found after calling the insuance company AGAIN that a doctor at the FIRST place referred actually DOES have admitting privaleges at a hospital in network with my insurer and the doc herself is on thier in network list!

SO after all the back and forth, the Doctor FIRST referred to is in fact hopefully the same one I can end up with

AFTER going through the Right process.

THIS is the stupid part.

My ob/gyn someone never called the surgon to see if she could see me for a pre-op then scheduling at the hospital as I requested. ( I did call my Dr, office and aske dif they could just schedule me at the hospital Hosptial stays have ZERO copay for me and I think outpatient procedures likewise will have ZERO co pay when deemed medically necessary and done in the hospital.

SO I called the # the kind lady advised. as after she consulted with her management (at the hospital) said I have to have the referral and call this # to scheudl PRe op. and get on the schedule.

SO I call the # given and it is for a primary physicana visit. I am confused, thought it was for scheduling surgury. The nice lady who answere that call was so patient as it was a lengthy conversation of me explaining what I need, and how I got here...

and she basically said that I reached the # to schedule a physical and establish relationship with a primary physican in their medical group. ( A whole different medical SYSTEM That non of the doctors seen of late are in! BUT the surgon I want IS a part of!)

THEN the physican will order baseline tests and do a preop workup and THEY can refer me to the surgon.

OK then.

I said "Does the surgon ONLY Take referrals from someone in the same medical group OR is is FINE for ANOTHER Doctor, say my primary, or my existing GYN who ALREADY did the groundwork and testing and ...I mean I can't see anyone starting over to re-do everthing they already have done, call the surgon to request me see her for a per op consult? "

SURE she could

But getting the # is the challenge. This lady could not give me a number said " They would have to contact the surgon at their office"
I asked "Is there ANY WAY To get a message via the hospital?"
"No; just their office"

Which.. does not take my insurance. So any business done via that office I will have tio pay for out of pocket and that is imaginary money just now- don't have the REAL money to cover that...so not feasible...

She said "Well if you ahve a referrala nd it is approved"
I mean it was like talking in circles with no more clairty on if there is a FUNCTIONAL actual way for Dr. Not in their system to refer a patient.

It was odd to me.

BUT- she was saying she could help as could set me up with an appointment with a primary doctor as the start would after seeing me COULD order the consult.

OH joy...

Just seems odd to me. That my Ob/GYN could not just simply refer me to the surgon AT The hospital on an out patient basis.

But that can't happen it seems. I left a message asking for such if possible. No call back

SO I did schedule a general phyical to start with a Nurse Practitioner right in my town, part of the medical system, who does take my insurance and who apparently will have an easier time referring me to a surgon in the ob/gyn group that works with privaleges at my local hospital ( as well as the dedicated Women's hospital 45 min away- not too far and that seems good idea); apparently easier than the other doctors seen thus far?

I was told to get all records to her, schedule a physical, and she can run labs and the pre op physical to be sure I am ok for surgury and then refer me to a surgon.

Will see.

I scheduled and appointment next week. The kind lady said the Nurse Practitioner is very popular, that people like her. She also knew my exising primary Dr.

To me it is so odd. Its like the medical facilities COMPETE with each other for busines to the detriment of quality patient centered care.

It felt like they worried more about getting all the businss and are not willing to play nicely (be available for referrals) with other doctors working outside of their practice.
Such bullshit caring about profit more than desire to provide lifesaving care to people.

So I did schedule the appointment.

This office used My Chart, a program and app which I signed up for and logged into, to see that they do have some of my historic medial records.

I read about the LEEP procedure.
AH this was what was done to me years ago. So back then , when there was some weird ness-

guess what, it was MOST LIKELY HPV! as I read about what I saw on the chart.

https://my.clevelandclinic.org/health/diseases/22042-squamous-intraepithelial-lesion-sil

I don't think I conciously ever really knew that,
I don't recall my then ob/gyn ever SAYING THAT. I mean he just took the darn thing out and did the biopsy and told me it was non cancerous and small and nothing to worry about and recommended to just have pap smears done regularly to keep and eye on my health. (or maybe I forgot that part. I mean I knew I had some abnormality and it did make me more vigiliant in telling all my kids to take care of THEIR health and get that vaccine!)

BUT--- I think I never really KNEW it was likely HPV.
Not that it is a big difference, really a very subtle one to realize HPV Could be a cause of those abnormal cells that grew into a thing removed
AND the realization that it is MOST LIKELY I had an HPV infection which caused the abnormal growth.

He acted like it was nothing to be concerned with but would keep monitoring just in case it came back at all.

" Multifocal high-grade SIL (CIN 3) present in numerous
endocervical glands."

"Cannot exclude squamous atypia at the cauterized ectocervical margins
of resection.
Case is peer reviewed."

SO... with that background. It is a bit more concerning that the excessive tissue could be HPV related and that is in fact the #1 cause of cervical cancer.

WHICH even though the ob/gyn I RECENTLY SAW acted nonchalant as she said
CALL this #to get in right away, tell them I am faxing over your records

well, perhaps

I should not have waited and should have had a bit more urgency. That "Oh likely nothing" to me now does not seem quite accurate.

Will see. Hope it is benign but I definately am feeling of late the weight gain in my middle and feel like a bit of extra holiday chocolate might not be the only reason.

So I am going to see the Nurse Practitioner next week and move forward trying yet again to get in with a surgon to take care of whatever this is and get the biopsy.

Think most likely however no worry of cancer ( but yes likely at some point had HVP virus exposure which cause extra cell growth) Fibroids DO cause weight gain and inches and fullness in belly. YUP That is what I feel. and yes exercise the best short term thing can do. Warm out so going for a run. https://www.lmgdoctors.com/medical-provider/foster-gavin-md-facog/

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