Looking Ahead

LOOKING AHEAD by Wally Dobelis Adventures in chasing after MRI and Medicare ; Bloomsday Once a Midtown Eastside Manhattanite reaches a certain age, bus trips north, along First and Third Avenue , the Bedpan Alley routes, become natural destinations, and such news as those of merger of the NYU Langone Medical Center with the Beth Israel /St. Luke’s/Roosevelt, aka Continuum Health Partners Inc. facilities cause concerns about coverages and prices. I have also transportation concerns – one cannot connect by M103 bus on 3rd Ave and a M59 crosstown bus to the 59th Street and York Ave East River MRI Center; there is no such crosstown bus, eastbound traffic is choked off at 2nd Ave, for the Ed Koch (formerly Queensboro) Bridge and construction traffic , and we are back to slogging eastward by foot. If you are less mobile, take the M15 northbound on 1st Avenue, and cut the walk to half a city block. I became involved through my quest for an MRI for a painful right shoulder. By sheer luck I had a good encounter on the M103 bus, with a retired MD, who has the same problem on his left, and who gave me a quick evaluation, guessing at a ripped rotator cuff, and advising me to avoid surgery, which takes a six month recovery, and is doubtful, and to swim and exercise, to use acupuncture for pain relief, and to take glucosamine, which produces results in three months. He also felt that the new MTA low level buses with no stepup were ok, that the high stepup taxi cabs should be outlawed and subways should have a lot more escalators, and we both agreed that walking NYC sidewalks idemands full attention, and never to put hands in our pockets while strolling. At 59th street, it took me about eight inquiries to find a local person to give me the walking directions – 59 th Street is tricky, the nortth sidewalk becomes the bridge , with a T.J.Maxx store and a Food Emporium built right under it. . The MRI Center is in an apartment building, with steps that my doctor friend would have hated. Magnetic Resonance Imaging first involves signing off that you do not have a pacemaker, defibrillator, brain or aneurysm metal clips, implanted coils, catheters, prostheses, joint replacements, limbs, magnetic dental implants , certain false eyelashes and similar metal gadgets in your innards and in blood. Reading this, one almost begins to see bionic people as a reality. Then, dressed in a hospital gown, one slips into a shallow tray, ear plugs in place, knees raised and head secured against injuries, and glides into the big white sound barrel for 25 minutes, in my case. The resonance test, involving banging the barrel, is initially mild, like a hast heartbeat, soon overlaid by high-speed electric drill noise, with further additions that feel like the Doppler effect of a train rushing towards you. After this first series , a more regular long hammering sequence begins, finally followed by a set that feels like getting a strong shower while lying in a tin washtub, with someone drumming against the tub’s sides. These sequences were repeated several times, each after my body had been moved an inch or two forward. This is the normal way an MRI recording proceeds. In my case, after two shifts of the body, the right shoulder started aching, to the point that I moaned and groaned and apparently interfered with the process. The technician rolled me out of the drum, to inquire, commiserated with me, but the process had to go on, no pain killers were available. Luckily, shifting the body this time produced relief, and we finished the MRI with technically acceptable results. I was ready to take the 2nd Ave M15 back home, with relative peace of mind, prepared to visit the shoulder specialist surgeon, in 20 days. In 20 days? Yes, our family doctor, aka Primary Care Physician, after viewing a current xray of the shoulder, had given me a prescription for that MRI and told me to see a shoulder specialist. He had two names to offer. In these days, with specialists opting out of Medicare patient treatment because of low pay scales, the PCP’s connections become important. The one MD of the two who accepts Medicare has a long waiting list, and I will probably have to pay a somewhat larger than the government rate, then wait for Medicaid payment, to me, and their referral of the balance of payment, the 20 percent deduction, to my secondary insurer. It is up to Medicare to forward the Explanation of Benefoits, aka EOB, to the private issuer of the Medicare Supplemental Insurance. Tricky world, but we hope for good doctoring results and easy paperwork. Meanwhile, do not forget that James Joyce in Ulysses described how Dubliners spent their time on June 16, 1904. Bloomsday enthusiasts will read the entire book out loud, in and appx. 29 hrs strretch. If so moved, you should be able to find a place to participate.