A Good Example of Why Medicaid/Medicare should not be handed over to an HMO

In December 2014, I was all excited about our fundraising success and Tax Credit for Promise In Brevard. I was planning to join the festivities over a the Orlando International Airport Hyatt Regency...where Promise In Brevard was to receive the Tax Credit. However, Betsy suggested, we join the celebration at the Promise Thrift Store in Melbourne, on December 13. Three days before we were ready to leave, my Roho cushion went flat--after ten years.
Prior to this point, my HMO, PUP was placed into liquidation. The replacement was WellCare. My doctor wrote a referral for a new Roho cushion. WellCare told me it would only take three days. After the third day, I called back, and they told me it would take three weeks for the paperwork to be processed. My doctor told me, another one of his patients was experiencing the same problem.

This is why you didn't see me or my dad in the Promise in Brevard "Happy" video, because it was too long of a trip without the Roho cushion, which protects me from getting pressure sores.
As one pressure sore began to errupt, my dad told me to call the agent who sold me the policy, tell him to tell WellCare, that he was buying it out-of-pocket. Dad even called WellCare, and told them how negligent they were, knowing how serious this was. They never had any intention of providing a Roho.

Well...this was only the beginning of the problem. On the evening of January 1, 2015, I developed a cough with a wheeze, and went to the Emergency Department at Florida Hospital--Apopka. I had an upper respritory infection. They kept me one week. They found some bacteria coming from the pressure sore, attaching to my Herrington rod in my back. The infection was spreading fast, and I was beginning to feel weak, so they started me on antibiotics.

Just before the end of [my first] week, my parents received a call, from Florida Hospital--Apopka, they told my dad, that they were discharging me on January 7 by the order of WellCare, who never consulted with my doctor as to my health status. My doctor agreed with me, that I wasn't ready to go home. When my dad took me home on the afternoon of January 7, I could barely get into (or out of) the car.
The next overnight [Jan. 8/9], I started getting shortness of breath. I called my doctor the next morning [Jan. 9] and told the receptionist, I couldn't come in for my follow-up, because I was too weak. The receptionist said, to call the ambulance and rush me back to the hospital. After I was admitted, and they ran tests, I was suspected of having MRSA. I can't begin to tell you what this did to me. I thought I was going to die. I was very weak. After almost three weeks in the hospital, they sent me to rehab.

I was in rehab for only three weeks (where even they suspected MRSA), when in the very early morning hours (between 1-5am) of Sunday, February 15, 2015, I broke out in a cold sweat and my blood pressure plummeted to 80/60, and my core body temperature was 96.7 *F. The threshold for hypothermia is 96.5 *F. This was the beginning of Sepsis (Septic Shock).
I had about 3-6 hours to live. Sepsis was the next step of this "Superbug" that almost took me out. With MRSA already in my bloodstream, this made Sepsis even more deadly. They rushed me to Health Central in Ocoee, FL., where for nine days, I received the most exceptional care--along with the care I received at the rehab center.
They ran every test they could, bones (a nuclear test), organs...etc., as Sepsis was spreading by the minute, and they had to find out where. I had a blood transfusion (mine) because Sepsis had invaded my entire bloodstream, plus they needed to isolate the culprit infection, and remove it. I almost lost my left kidney because it shrunk and wasn't functioning properly, but they were, thankfully, able to save it, and prevent the Sepsis from damaging my other organs.

Another one of my doctors, also informed me that I had C. Difficile (or C. Diff). A contageous intestinal infection. After nine days, on February 24, I went back to the rehab center, to recover and for more rehab to regain some of my strength. I was finally strong enough to be discharged from the rehab center on March 30, 2015, and I'm now home, getting Home Healthcare (for my wounds, and continuing rehab).

However, I feel I'll never be back to normal, like I used to be, as Sepsis leaves its calling card behind...possibly forever...but at the very least for another 9-15 months (12-18 month, total), I will not have the strength or endurance I once had. Plus there are cognitive and emotional issues as well. However, I am grateful that I have my life and limbs, as some people are quad amputees.

Had I had my Roho cushion when promised, I would've never gone through his hell.

Dad said to take my time with this site, and if I get too tired, we'll just close it down, as he has his hands filled with my mother, who has Parkinson's disease, and she too, went over to WellCare. All of her Parkinson's disease medications were paid for by her insrance, but WellCare just informed her that they're changing the rules, and will no longer pay for here Parkinson's disease medications.

WellCare, and Florida Governer, Rick Scott, have a very good relationship. This tells you...the rest of the story. The good news in all of this, we will not have WelllCare going into 2016.

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I am fundrasing for Promise in Brevard. Your donation will help in the construction of a place where adults with special needs, like myself, can live a life full of opportunities. A community where we can work, live, and thrive. For more informaiton and/or to donate, click on the link in the app above. You can also visit the official site of Promise In Brevard.

 

--Tom