SerenaOculis

so naturally, instead, i was put on a year+ waiting list to see the only dysautonomia specialist in the city who has a tilt table. this one doctor also doesnt charge $600 cash per appointment (i already saw the $600 guy, he doesn't have a tilt table, but he gave me prescriptions without any diagnosis which means my insurance has been rejecting the prescriptions randomly for years). i still have tachycardia. sometimes i faint when i stand up, or when ive already been standing up. i drop cups and pencils and priceless faberge eggs in humorous ways with cartoon sounds effects because my grip strength randomly gives out. this is a problem because my last remaining option for employment is being an "artist", a type of petit bourgeoisie that owns a printer he can make zines with to sell on Etsy, which requiires a lot of typing and holding pencils and folding etc. they give me a propranolol prescription which helps with the tachycardia but makes my low blood pressure worse and eventually makes half my hair fall out, which is a problem because my other employment option is being visible on cmaera in various ways and also i like having hair. so i quit the propranolol. the tachycardia gets worse. Trump makes it gradually harder and then impossible to order the grey market antioxidant-antiischemic that has been helping with moving blood to the parts of my body that need it (apparently all of them) but isnt available in the usa by prescription or at all, but also isnt illegal to import. this is relevant because the NFL has destroyed anti-ischemic/hypoxic drug research in the country for decades because if people find out taking a 300lbs linebacker directly to the face dozens of times a week is bad for your brain, democracy will collapse. so i was sent to a cardiologist. the cardiologist also doesnt have a tilt table. im still on the dysautonomia clinic waiting list.

POTS is the single most common symptom of long covid. approximately 30% of people who get covid will get long covid for some period of time, or forever. so just on raw math we can expect slightly <30% of the american civilian population to currently, or at some point, have POTS. i find this interesting from a public health quantics perspective.

anyway the cardiologist tests my heart with a stick-on monitor for two weeks and also gives me prescriptions for ivabradine and midodrine, which are rejected by insurance. in the office he does a quick 12-lead ECG and finds right atrial enlargement, a type of heart defect that is common in people with shitty collagen because, duh, your heart gets all stretched out from overuse and being made of wet tissue paper.

the cardiologist doesnt tell me about the atrial enlargement because i guess its around the holidays so you know, understandable. probably busy with his family. the heart defect is usually caused by lifestyle factors i dont have (alcohol, cholesterol, etc), so there's nothing i can do about it. i find out about this heart defect from reading my own test result documents after wondering "hm i havent heard back about my test results i wonder if they found anything". as i do this and find the technician's notes about my shitty heart i think about someone's grandma who doesnt know how to use MyChart not being able to download and read and interpret a PDF and never finding out about her heart defect and then having a heart attack, which i assume happens daily.

i message the cardiologist and say, hello, i see you found a heart defect! great shot kid, dont get cocky. anyway do you think you can try prescribing the ivabradine again with the new diagnoses included so maybe insurance wont reject it. the nurse writes back and says i mean i guess we can try. whats their fax number (this is because insurance doesnt reject a medication to the doctor, they reject it by 1. not filling at the pharmacy and 2. not telling you about it except via paper mail you may or may not receive within several weeks). so the doctor does not have the fax number of insurance. ok. i find the rejection letter by some miracle and send the nurse the fax numbers for both "Grievances" and "Appeals" (two separate departments apparently), but note to her that the medication was rejected weeks ago and they wont honor appeals that occur more than 10 (ten) days after the claim is rejected. i, the patient with no medical billing or medical diagnostic qualifications, advise ****her **** (the cardiac nurse who is handling billing, with a college degree presumably) to skip the appeals fax and just 1. put the diagnoses of "palpitations" and "right atrial enlargement" on my medical file because i assume no one has bothered yet (i didnt say this part) and 2. submit a NEW prescription with the new diagnostics attached. the diagnostics that say "patient has heart condition and need drug to not faw down pls :[".