Medicare Gap Insulin and Surgery

$7,140 of $7,000 goal

Raised by 118 people in 50 months
Created May 13, 2015

4568603_1537320389167074_r.jpegUpdated January 12th:
I'm a disabled veteran, and my husband is a disabled diabetic on Medicare. 

We originally set up this fundraiser strictly for paying for insulin during the "Medicare gap" (when the co-pay for  his insulin goes up to over $500 dollars a month- closer to 600 really, not counting all his other medication.)
and then he needed surgery... and more surgery... and more surgery...
Here is where we are now:

First the Good News:
Wayne had his Bariatric Surgery in November (just before Thanksgiving) and has been recovering very well.  He is on minimal insulin, and his endocrinology team is quite happy.  he has lost almost 100 pounds from his highest weight, and his pain has decreased significantly.

His first cataract surgery went very well, and he is recovering very nicely from that(among other things marveling that so much of his color perception had been  off).

Now the Bad News: (although it could be much worse)
When Wayne had his Bariatric Surgery (which went very well) his doctor didn't like the look of his liver. he was sent to a liver specialist.  His fatty liver disease (which we had been told about) had led to "non-alcoholic Cirrhosis" aka scarring on his liver. He will need regular ultrasounds, and testing for liver failure for the rest of his life, EVEN after he loses the weight.
understandably we are stressed.

Because his liver is damaged, many of the medications he would normally be able to take are now not recomended.  this means the medications for his other  chronic illnesses are going to be more expensive. The  addition of bi yearly ultrasounds, exams, and etc all adds to the expenses (and of course our stress levels)

in addition:
The out of pocket costs of his cataract surgery were much higher than we anticipated.
and as a nuisance:
while his weight loss is a GOOD thing, he is having to buy new clothes. he is still in plus sizes, which means fewer options and more expense, but we are trying not to buy more than the bare minimum until his size stabilizes.

About me:
Although this is a fundraiser for HIS medical expenses, i am his primary caregiver and i had to cancel most of my sales and shows over this year to take care of him.  at the moment i am in line for a second mammogram (first one unclear) a colonoscopy, a comprehensive neurological exam (again), and I am appealing for a higher disability rating from the VA since they have not included my PTSd in my existing rating.
put bluntly i am drastically over extended and financial stress just adds to that.

I thank EVERYONE who shares this fundraiser, contributes, or offeres support in any way- you have no idea how much you have helped me to keep going.



PAST UPDATES:

November 28th update edited for brevity

Wayne is recovering well from Bariatric Surgery. 
Owing to my neglecting my business, only my Legging Army online shop is active right now.

www.leggingarmy.com/#KirstenH 

My etsy shop will be up after the next show i hope.

Thank you for sharing.

thank you for contributing.

and thank you for your prayers and support.

*

October Update edited for brevity:

Wayne's foot surgery went well, although he is not permitted to use the pool for several more weeks (bacteria risk)

His knee replacement... well as i expected the surgeon told him he CANNOT have knee replacement until he gets his BMI down to 40 or lower (about 100 pounds from now) since the artificial joint cannot handle his current weight.  we expect that to be next year, possibly June.

We are in the medicare gap, despite our best efforts (by  using donated and sample insulin) to stay out of it, and that means his insulin goes from a co pay of  about $300 a month, to a copay of about $1,000 a month.

yes its gone up since last year.

the Bariatric surgery will reduce his need for insulin, no matter what, but comes with its own expenses... and we do not YET know if he can get off insulin entirely. his doctors have warned us to expect a reduction, not  a complete elimination of insulin... but we can hope.

*

September update deleted for repeated information

  *

Previous update
4568603_1534549092523279_r.jpeg
THIS is why they tell diabetics to watch their feet.

(photo shows husband's foot, red with infection, in the local Emergency Room, and does NOT show the bottom of his foot because that was just icky)

we were lucky. we caught it early and he only lost a little skin and tissue.  They think the oral antibiotics are beating it back (although these are some SCARY oral antibiotics)

initial X rays showed it hadn't progressed into the bone, and we have follow up x rays next week to be sure.  His podiatrist  did icky nasty things to his foot and pronounced it to be  a good job of home care, and is monitoring it (and at this point the red has visibly receded.)

may i say for the record that i am SO entirely OVER having medical crises?

  *

The basic story:


I'm a disabled veteran, and my husband is a disabled diabetic on Medicare. 

We originally set up this fundraiser strictly for paying for insulin during the "Medicare gap" (when the co-pay for  his insulin goes up to over $500 dollars a month- closer to 600 really, not counting all his other medication.)

Wayne HAD emergency kidney stone surgery scheduled May 2nd   Once they had him in the OR the surgeon found some issues.  he had a stent put in, and was in a lot of pain as you might imagine.  (better than risking a puncture!)

Wayne had a second try at kidney stone surgery May 16th.  it was successful in that they removed a lot fo stones (three blocking his ureter) but he had to get a new stent, and is in a lot of post operative pain several days later.

 He was in  severe pain from May 16th through mid July- it only began to be controlled in July.   Three urologists, 30 days of levaquin,  and a Pelvic Floor Physical Therapist later, (bless the woman) we finally have things a BIT better..

Then he got a foot infection. and was on first clindamycin  and then keflex before we beat it down. Then he had a recurrance.

Foot surgery September 28

Bariatric Surgery  November 19th

Cataract surgery January 9th


obviously the bills are now skyrocketing... have already skyrocketed really.






Unfortunately i have had to cancel almost all of my  sales events (like Maryland Sheep and Wool as well as local fairs and etc) to take care of him, so i don't have much chance to bring in any income other than my disability.

Friends did chip in to pay for my getting a Daith piercing in an attempt to  reduce my migraines (it seems to be helping).  Hopefully that will make  getting everything done  a bit easier!
NOTE:  the daith piercing is still helping markedly! not a cure, but certainly a help!
ADDED NOTE: the keto diet is helping my migraines as well as losing weight.

                  -----------------------------------------
I know a lot of people are on shoestring budgets, and believe me we appreciate all the help.
I also remind everyone that SHARING a fundraiser really helps, even if you cannot donate.


Thank you all for your support and generosity.

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wayne's Bariatric Surgery was almost two months ago now (time flies) and his Cataract surgery was last week.

he is using much much less insulin now (hardly any) which is lucky because the out of pocket costs for his liver maintenance
(scarred liver from his fatty liver disease... he will be getting ultrasounds of his liver every 6 months for life)
and his cataract surgery (medical eye drops are $$$)

means that even without the insulin costs being so high things have been tight.

sadly we have had several stressful times as well, including my retired service dog, Bella, dying on Christmas day, and the anniversary of my father's death in January.

please keep us in your thoughts and prayers
+ Read More
I updated our main story, but in brief:
Wayne went through bariatric surgery very well (i envy him his excellent reaction to anesthesia). As noted we have one of the better bariatric teams at Einstein medical, and a very experienced doctor.

while they were doing the surgery they noted he had scarring on his liver from fatty liver disease, and took a biopsy. since the first line of treatment is to lose weight... well, we are doing that already.

Wayne just graduated to "smooth food" like yogurt without any berries or etc, and 2 protein shakes a day, plus clear liquids... It is hard for him- he got used to a lot of vegetables on his pre-op diet and now he cant really have any for several more weeks as his stomach heals.

I updated the main story with more details, but once again: THANK YOU to everyone for your support.
+ Read More
a quick update
Wayne injured his foot when he got up overnight, and after looking at it in the morning (yesterday morning now) i insisted we have it checked by the podiatrist.

basically he kicked something (no we dont know what) and injured one of the toes that had surgery. in addition to impact damage he had quite a bit of torn skin despite the sock.

after a great deal of running around to get to the podiatrist (and road closures due to construction) we got in, and got it cleaned and re bandaged... and some "just in case" antibiotics.

we cannot afford an infection again, especially since it would delay his bariatric surgery. Sadly this means the pool is once again off limits until he doesnt have torn skin.

as to the pre-op diet (5 protein shakes and a lot of non starchy vegetables to try to get the fat off his liver)
he's fairly miserable, of course. its 800 calories a day (more or less) and both low carb and ultra low fat, which means he cannot eat ANYTHING but that very restricted diet (nope, not even fish, fruit, or yogurt)

he is doing better now (and has been very good at keeping to his diet) but he loses all his energy by mid-afternoon.

he is down almost 30 pounds, so hopefully his liver will be a lean, sleek, easily moved aside liver for the surgery.

he slowly dropped his long term insulin (as discussed with his endocrinologist) and is not using much short acting insulin since he isnt eating much in the way of carbohydrates.
---
as i suspected *I* am down quite a bit of weight as well... and back to eating a lot of vegetables and etc as i prefer...
+ Read More
So it has begun... (ominous sound effects)
actually its not as bad as i was concerned it would be.

hubby started his pre-op diet (bariatric surgery has a 2 week pre-op diet to shrink the liver and make the surgery easier)
he is permitted about 800 calories a day, mostly protein shakes, and extremely low carb and low fat. (aka protein shakes and non starchy vegetables)

as i told my own doctors and therapists, i expect to lose about 15 pounds this month because hubby is the cook and his preferred foods are not normally great for either of our waistlines.

he had an epidural for his back (spinal stenosis) just as the diet started, so his blood sugar has been high considering what he hasn't been eating (steroids spike your blood sugar) but we are watching carefully.

Because of his very limited intake, the main danger is OVER shooting his insulin, and low blood sugar (hypoglycemia) which can quickly become life threatening.

however bbecause of the steroid shots he has to be careful of not going high enough to cause damage, even now.

diabetes is not the easiest thing to manage.

he will have his cataract surgery in January, if all goes well, and his knee surgery when he has lost enough weight.

meanwhile the VA has scheduled me for a week long seizure trial in Maryland, sometime in January...
...

thank you again to everyone for your support
+ Read More
Read a Previous Update
Amy
10 months ago

I had my first cataract surgery on July 25th. It was really no big deal. The other two are another story. Praying for both of you!

+ Read More
Amy Rosen
10 months ago

My dermatologist also told me a way to kill germs on the skin. Mix 3 parts water and 1 part white vinegar together. She told me to buy gauze and soak my skin for 5 minutes and then let air dry. Instead I chose to buy a spray bottle for $1.49 and put the splotion in it. I spray me leg, where I have an infection and let it dry three or four times in a row before bandaging. I'm not saying Wayne shouldn't take the Keflex, but maybe in addition?

+ Read More
Amy Rosen
11 months ago

Please make sure you give him probiotics or, if he can tolerate it, yogurt with probiotics. Anti-biopics kill off good gut flora.

+ Read More
Ellen Reddick
48 months ago

Check also with his doctors. I have had doctors thrilled to be able to provide me with sample vials because they didn't have any other patients on they type I am on and they didn't like having to throw them out. You never know. Also, if you have not already, contact the manufacturer - some may help defray the cost. And one more thing to check is if there is a substitute by a different manufacturer that is lower cost. I don't know about medicare specifically, but I know on many insurance plans - including the "obamacare" plans - there is a tiered system for prescription meds and on some plans one manufacturer is on a lower tier (is, less cost) than the other. I am Type 1, so insulin is life-and-death, no other treatment options, so I have learned a few of these tricks along the way. I asked my endocrinologist and she switched me from humalog to novolog, which cut my co pay by more than half without any adverse effect. may not work for you, but it's worth asking. please hang in there!

+ Read More
Dave Townsend
49 months ago

What are the names of the insulins he takes?

+ Read More

$7,140 of $7,000 goal

Raised by 118 people in 50 months
Created May 13, 2015
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6 months ago

I know it is not much, hope it helps

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6 months ago
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7 months ago
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8 months ago
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8 months ago
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8 months ago
$100
Anonymous
8 months ago
Amy
10 months ago

I had my first cataract surgery on July 25th. It was really no big deal. The other two are another story. Praying for both of you!

+ Read More
Amy Rosen
10 months ago

My dermatologist also told me a way to kill germs on the skin. Mix 3 parts water and 1 part white vinegar together. She told me to buy gauze and soak my skin for 5 minutes and then let air dry. Instead I chose to buy a spray bottle for $1.49 and put the splotion in it. I spray me leg, where I have an infection and let it dry three or four times in a row before bandaging. I'm not saying Wayne shouldn't take the Keflex, but maybe in addition?

+ Read More
Amy Rosen
11 months ago

Please make sure you give him probiotics or, if he can tolerate it, yogurt with probiotics. Anti-biopics kill off good gut flora.

+ Read More
Ellen Reddick
48 months ago

Check also with his doctors. I have had doctors thrilled to be able to provide me with sample vials because they didn't have any other patients on they type I am on and they didn't like having to throw them out. You never know. Also, if you have not already, contact the manufacturer - some may help defray the cost. And one more thing to check is if there is a substitute by a different manufacturer that is lower cost. I don't know about medicare specifically, but I know on many insurance plans - including the "obamacare" plans - there is a tiered system for prescription meds and on some plans one manufacturer is on a lower tier (is, less cost) than the other. I am Type 1, so insulin is life-and-death, no other treatment options, so I have learned a few of these tricks along the way. I asked my endocrinologist and she switched me from humalog to novolog, which cut my co pay by more than half without any adverse effect. may not work for you, but it's worth asking. please hang in there!

+ Read More
Dave Townsend
49 months ago

What are the names of the insulins he takes?

+ Read More
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