My Appeal Letter To Anthem Blue Cross Blue Shield CT

This is posted at on Michael Moore's home page. This is also the second time I have commented on his page and I will continue to do so. My previous 360 post has my first entry. I recently watched his movie and I am one of those Americans that he is referring to. I do not have anything to lose if I should get a catastrophic illness, like the case for many Americans. I don't own a home or any other luxury. I just have to make sure that I can locate Dr. Kevorkian should I have to suffer. This country is pathetic enough as it is. People are convinced to focus on all the wars and it seems as though there is little attention on health care in this country. Is it because illness is about the other guy and illness doesn't apply directly to them YET? Unless you are lucky enough to die from a massive heart attack in your sleep, I can guarantee that every human on this planet, will all be faced with an illness at some point in their life. If not you, it will strike someone you love.
Most of the patients that come through the office where I work, are folks between the ages 50-65 or 65+. Almost every one of them tell me horror stories about their out of pocket expenses, such as prescriptions , heating fuel etc. Many ask me on a regular basis to provide them with documentation that proves what they have paid out of pocket for the year, , so they can get their rent reduced. One elderly lady asked me to try to get her seen by the doctor and out of there by noon, so she could go home and get her free lunch .That is offered to her where she lives...one of her benefits.
I am employed by a physician that was willing to pay for part of my health insurance, as a benefit to me, but I was denied. Connecticut has the right to deny anyone for health insurance for any reason. I can't get group where I work because he doesn't meet the minimum requirement of five eligible full time employees. He offered me a pay increase, which I might as well accept, but I know that I need to go ahead and find a job that will offer me the things I need for myself. This is difficult for me to do for several reasons. Most importantly, I do like the man I work for, I enjoy my co-workers and I have established rapport with the patients. In the long run, I am hurting myself for staying. My life as been put on hold as far as routine screening is concerned. I hope I don't live long enough to get cancer. My mother did but she got the right care and thus survived. My youngest son had stage III testicular cancer and survived but I had to fight Blue Cross of PA for over a month, while I had to watch my Sean burn with fever and night sweats and having the knowledge that he had cancer from his groin all the way up to his lungs.
So now I am fighting these people and I am not going to stop until I get someones attention. Insurance companies are here to make money and they are not the least bit concerned about anyone. I hope all of you are able to watch "SICKO"!
Megan
Megan Zopf Says: Your comment is awaiting moderation. December 1st, 2007 at 12:48 pm
Well everyone Anthem Blue Cross Blue Shield of CT hits again… Anthem Blue Cross and Blue Shield Attn: Connecticut Reconsiderations 602 S. Jefferson Street, VAG106-B700 Roanke, VA 24011
November 19, 2007
To Whom It May Concern:
This letter is in response to the denial letter you sent me dated November 5, 2007. I am demanding a copy of the reports that you received stating I have the following conditions: Alcohol abuse with use of alcohol within the past 5 years. I do not have a history of alcohol abuse and was never treated for such. I was, however. married to a severe alcoholic for 16 years. Is this what this was about? I got divorced in 2004 because of his alcohol abuse. My former husband is under the care of the VA hospital in MA. I may have mentioned to previous doctors that I was married to an alcoholic, but alcohol abuse was the furthest thing on my mind.
I was also shocked to see that you claim I have a history of Multiple Sclerosis. If that came from Dr. Shiling, I was never made aware of that diagnosis. He did a couple of MRI’s over a year ago to rule out AVM’s, which is a condition my father had. He noted brain lesions on the reports but told me he felt that that may have been the result of a old head injury. He never mentioned Multiple Sclerosis. I find this news alarming and I intend to pursue this. According to the following article I read, diagnosing MS is quite involved. Other than the Scans I had done, no other studies were ordered. Once again, I am asking you to show me the evidence you have gathered on me stating I have MS.
”The basic “rule” for diagnosing MS requires both of the following: · Objective evidence of at least two areas of myelin loss, or demyelinating lesions, “separated in time and space.” This means lesions have occurred in different places within the brain, spinal cord, or optic nerve-at different points in time. · All other diseases that can cause similar neurologic symptoms have been objectively ruled out. Until “1″ and “2″ have been satisfied, a physician will not be able to make a definite diagnosis of MS. Waiting in limbo is extremely trying. Receiving an incorrect diagnosis may be even worse. Depending on the clinical problems present when a person sees a physician, one or more of the tests described above might be done. Sometimes tests are done several times over a period of months to help gather needed information. A definite MS diagnosis satisfies the McDonald criteria, named for the distinguished neurologist W. Ian McDonald who sparked Society-supported efforts to make the diagnostic process for MS faster and more precise. The McDonald criteria were revised in 2005 to incorporate new data that should speed the diagnosis without compromising accuracy. ”
I was being treated for Lyme disease by a Naturalpathic Physician. Blood tests done in 2003 had some positive bands. I was treated by conventional methods but some lingering symptoms remained so therefore I took it upon myself to seek treatment holistically.
As far as the hyperadrenia is concerned, once again I took it upon myself to seek help through my Naturalpathic Physician. I have managed to keep myself healthy through means other than conventional means. In doing so, I have paid for these treatments out of pocket, except for lab studies or things that I was checked for routinely, which I believe is called “preventative medicine”.
To sum this up, the only reason why I applied for health insurance was because like every other American in this country, I wanted to have coverage in the event something catastrophic should happen, such as cancer or emergency surgery. Based on the evidence you claim to have on me, I don’t believe it’s ethical or legal for you to have a “decision resulting in a lifetime denial of health-underwritten coverage because of the condition indicated.” It also appears that someone has gone out of his or her way to falsify my medical history.
To conclude this letter, I also want to make you aware that being so I have served the medical community for the past 13 years, I have copies of all my medical records including the films that were done. I will give you time for you to send me copies of the reports that you claim you have so we can compare notes.
Sincerely,
Megan Zopf
November 20, 2007
I had the privilege of speaking to Dr. David Shiling today regarding your accusations about me having a history of MS the last five years. He read the last report to me and there was not one entry that said I had such a horrible disease. So per his request, I am sending him a copy of you allegations towards me. I will be going to Backus Hospital next to show them this letter as well.

Danika & Damien

These two children are my grandchildren from my oldest son Joey and wife Abbey. According to society and our culture, this should have never happened. After Joey finished high school he went to Cornerstone Baptist college in Michigan. While in school, he met Abbey and they were soon after married. They bought a home in Michigan, and are now raising their children. Joey has worked hard for all of this. He never had any help while in school. Often times, he had to go without books for his classes. He always worked while in school. He never had a license or owned a car. He relied on other forms of transportation to get him around, like buses, taxi's or friends.

I came across this post and after reading it, I thought of Joey and his path he chose to walk. I did ask him at one point why he was the way he was. The only answer I ever remember him saying was that he never wanted to end up like me. He must have observed how my life was and chose a different way to become who he is. The only goal I had in my life while I was raising my children, was for them to have a life that was different than mine. I didn't want them to suffer the consequences of lacking an education. Despite the fact that I was dirt poor while raising my children , I still managed to deeply fix into their minds, that they could go anywhere in their lives if they got immersed in reading. That included make believe vacations. After all, even when we do go on vacations, after all is said and done, all we have left are memories, journals and pictures. Going to the library was free, even if I had to push a stroller to get there.

I will never believe we are who we are because of our parents. They can help mold us in some ways, but the end result is because of our own choices. So I stuck it out and now I get to watch my childrens lives unfold.

Abbey sent me this picture today. It was sent at a good time. My life still feels like a ship that is sinking little by little, which is still the result of me staying in situations that are not the greatest. I still find myself giving to everyone else but myself. This is a gentle reminder for me to take back who I am and make my life matter. Something to think about!

Heredity plays a role in almost all human development, whether physical, mental, or emotional. We tend to look like our parents and are subject to the same sensitivities they have. We may even be predisposed to certain behaviors or preferences. As we grow older, we become increasingly aware of the traits that exist within us and the clear history of the traits of our mothers and fathers. Our response to this epiphany depends upon whether the inclinations, tendencies, and penchants we inherited from our forebears are acceptable in our eyes. We may honor some of these shared traits while rejecting others. However, there is no law of nature, no ethereal connection between parents and children, that states that the latter must follow in the footsteps of the former. We are each of us free to become whoever we wish to be. When we accept that our parents are human beings in possession of both human graces and human failings, we begin to regard them as distinct individuals. And by granting mothers and fathers personhood in our minds, we come to realize that we, too, are autonomous people and in no way destined to become our relations. While we may have involuntarily integrated some of our parents' mannerisms or habits into our own lives, conscious self-examination will provide us with a means to identify these and work past them if we so desire. We can then unreservedly honor and emulate those aspects of our mothers and fathers that we admire without becoming carbon copies of them. Though many of the tempers and temperaments that define you are inherited, you control how they manifest in your life. The patterns you have witnessed unfolding in the lives of your parents need not be a part of your unique destiny. You can learn from the decisions they made and choose not to indulge in the same vices. Their habits need not become yours. But even as you forge your own path, consider that your parents' influence will continue to shape your life-whether or not you follow in their footsteps. Throughout your entire existence, they have endeavored to provide you with the benefit of their experiences. How you make use of this profound gift is up to you.

Sitting With Feelings

It can take great courage to really sit with our feelings, allowing ourselves to surrender to their powerful energies. All too often we set our feelings aside, thinking we will deal with them later. If we don’t deal with them, we end up storing them in our minds and bodies and this is when anxiety and other health issues can arise. Denying what our bodies want to feel can lead to trouble now or down the line, which is why being in the thick of our feelings, no matter how scary it seems, is really the best thing we can do for ourselves. One of the reasons we tend to hide or push aside our feelings is that we live in a culture that has not traditionally supported emotional awareness. However, as the connection between mind and body--our emotions and our physical health-- becomes clearer, awareness of the importance of feeling our feelings has grown. There are many books, classes, workshops and retreats that can help us on our way to emotional intelligence. We can also trust in our own ability to process what comes up when it comes up. If sadness arises, we can notice its presence and welcome it, noting where in our bodies we feel it, and allowing ourselves to express it through tears or a quiet turning inward. When we simply allow ourselves to fully feel our feelings as they come, we tend to let them go easily. This is all we are required to do; our feelings simply want to be felt. We often complicate the situation by applying mental energy in the form of analysis, when all we really need is to allow, as the earth allows the rain to fall upon it. As the rain falls, the earth responds in a multitude of ways, sometimes emptying out to form a great canyon, sometimes soaking it up to nourish an infinitude of plants. In the same way, the deeper purpose of our feelings is to transform the terrain of our inner world, sometimes creating space for more feelings to flow, sometimes providing sustenance for growth. All we need to do is allow the process by relaxing, opening, and receiving the bounty of our emotions.

First Day Of Summer June 21, 2007

First Day Of Summer June 21, 2007

I took this from my porch right after a storm, It was the first day of summer. It was also the first time in months that I felt the urge to pull out my camera. I felt alive and motivated to do something I love to do. I am going to find a new job doing something I want to do, not what others want me to do. But first, I need to find a place I want to come home to after I am done working each day. It's time to move on!!!
The most destructive habit......................Worry The greatest Joy...............................Giving The greatest loss................Loss of self-respect The most satisfying work...............Helping others The ugliest personality trait.............Selfishness The most endangered species.........Dedicated leaders Our greatest natural resource....Our youth The greatest "shot in the arm"..........Encouragement The greatest problem to overcome.................Fear The most effective sleeping pill........Peace of mind The most crippling failure disease............Excuses The most powerful force in life..................Love The most dangerous pariah..................A gossiper The world's most incredible computer........The brain The worst thing to be without................... Hope The deadliest weapon.......................The tongue The two most power-filled words..............."I Can" The greatest asset..............................Faith The most worthless emotion..................Self-pity The most beautiful attire......................SMILE! The most prized possession................Integrity The most contagious spirit.................Enthusiasm
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The B…
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(((hug)))What a wonderful picture, it spoke to me.
Friday June 22, 2007 - 03:14pm (MDT) Remove Comment

Sexy …
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That's a beautiful picture. :)
Sunday June 24, 2007 - 07:51pm (PDT) Remove Comment

BabyD…
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It was a beautiful moment even if it was short lived.The tall building to the right is Mohegan Sun.I am sure you have all heard of it. It is the second largest casino in the world. I used to work there in VIP services/marketing. I didn't care for it so I moved on. Overall, I did learn some valuable lessons to take with me, like phone skills since I didn't really deal with the public face to face.And it was close to home so gas wasn't a real issue like it is now. I am happy that I got a chance to share this picture with all of you.
Monday June 25, 2007 - 08:12am (EDT) Remove Comment

Review, A Grief Observed by C.S. Lewis Entry for June 09, 2007

" A Grief Observed" is the intensely personal and touching account by C.S. Lewis of his experience after the death of his wife, Joy Davidman Gresham. The book opens at a point about one month from his wife's passing, and Lewis writes "like a man concussed." He would rather not believe in God at all, than believe him to be cruel. He asks if God is the vivisector, and we the rats in his laboratory. Yet he opens with a rail against Heaven, with all of those agonizing questions--if God is good, how can he allow this? Is God really good, or is he indifferent? Are we all just rats in the cosmic laboratory? In these moments Lewis experiences many self doubts as well, and the most profound question is whether he will remember his wife as she really was, or as his memory reconstructs her.
In the third chapter, Lewis has started to come around a bit, admits to "snarling" at God, much like a cat will hiss at its operator, whether it is a vet or a vivisectionist. In other words, the reactions of the creature have little to do with the nature of the creator/caretaker. Lewis also talks about those whom we call "good" but who also cause pain; surgeon, dentist, etc. Even with the pain of the surgery, would we have the surgeon stop in the middle, whether or not the operation is complete? No,,,,the more healing we need, the deeper the knife must cut. And if we abort the process in the middle, the true healing will never come at all. It's an interesting analogy, one that I am still reflecting upon, but I see his point.
Throughout the narrative, Lewis traces the spiral of his grieving: moments lived over again, many in darkness but some in light, recounted in a moving way. He also struggles with doubts about the condition of his faith. He asks if his was a house of cards, easily knocked down, and was he merely reconstructing it until the next trial should knock it down again? He also compares faith to a rope, which a man says is strong and reliable, but in which he cannot say he could put his trust until he is dangling from it over a cliff. He questions if this is the case with his own faith, and finds he cannot trust the rope.
Lewis discusses with great eloquence the subject of finding our loved ones again upon our own entry into Heaven. If to enter Heaven, we must love Him above all the others, and we can accomplish it, then when we arrive, how important will seeing them be to us? He makes the very strong point that God cannot be used as a road to our loved ones; "if you're approaching Him not as the goal but as the road, not as the end but as a means, you're not really approaching Him at all." He ends on a note of acceptance, if not understanding. Some questions simply cannot be answered. God does not refuse to answer, but waives the question, as if to say "Peace, child, you don't understand."
I don't know how well I've done summarizing; for four slim chapters this book is amazingly full. Many of his thoughts weave around themselves until they come to some conclusion or fruition. But it is a book that I highly recommend, to anyone who is grieving or to anyone who is a fan of C.S.Lewis. The afterward in my edition was readable and a wonderful insight into the character of C.S.Lewis, especially for someone who wasn't completely familiar with his background.

REASON FOR LIVING Sean's Wedding 05/06/07

Child of mine
Although you see the world Different that me Sometimes I can touch upon The wonders that you see All the new colours In pictures you’ve designed Oh yes sweet darling So glad you are a child of mine Child of mine, child of mine Oh yes sweet darling So glad you are a child of mine You don’t need direction You know which way to go And I don’t want to hold you back I just want to watch you grow You’re the one who taught me You don’t have to look behind Oh yes sweet darling So glad you are a child of mine Child of mine, child of mine Oh yes sweet darling So glad you are a child of mine Nobody’s gonna to kill your dreams Or tell you how to live your life There’ll always be people To make it hard for awhile But you’ll change their heads When they see you smile The times you were born in May not have been the best But you can live the times to come Better than the rest I know you will be honest If you can’t always be kind Oh yes sweet darling So glad you are a child of mine Child of mine, child of mine Oh yes sweet darling So glad you are a child of mine

The Meaning of a Caregiver Entry for July 21, 2007

The person that wrote this also has cancer, also my first husbands stepson. I have walked this road so many times and it never gets easier. This is a true story that most people will avoid reading, never mind playing the actual part. How many of you are willing to care for your loved ones to this degree? You can't punch out at the end of the day. You can't drink it away. You can't stop it. It becomes your reality. This is where you have a one to one with God. When I found out my son had cancer, I took a walk to the cemetary and I screamed at God saying "How dare you do this to me!"There is no pain greater than this.
The Meaning of a Caregiver What does being a caregiver mean? I think it has many meanings: a mother, a father, a lover, and a child- who cares for someone and oversees their well being. It can also mean a doctor, a nurse, a priest, or a nun. All have one thing in common: keeping the well being in mind for another person.
When it comes to cancer (or any other serious illness), care giving becomes something much more intense. I will relate my story as it pertains to my thoughts & deeds during the care giving period of my Mother’s terminal illness---colon cancer. This story will also be very subjective and so what I say here, may or may not apply to you or your loved one. It will also include the deeds of my brother and a few others. This may be painful for some to read, especially if you knew my Mother. It is not meant to cause pain, but I know it will for some, because it brings me pain not only to try to write about such things, but to just think about them, even though this all took place in the time frame of 1994-1996. The pain and despire is still agonizingly fresh.
My story begins in 1994. My mother had been feeling a bit tired and just plain “crappy”. After visiting many doctors, she was diagnosed with Gallbladder disease. She was put into the hospital and had her gallbladder removed. She was in the hospital for well over a week and contracted pneumonia while there. With her in Florida and myself in New Hampshire, I flew down to be by her side.
After bringing her home –I had to leave a few days later to return to work. A few months afterward, she was still having the same symptoms; it was then she was diagnosed with Crohns disease. She began treatment that didn’t bring the relief the doctors promised, unfortunately it was NOT Crohns disease.
On Thanksgiving Day 1994, she began to hemorrhage. Her wonderful and most kind hearted neighbors Ruby & Virgil Richardson (mother & son) helped her to the hospital. She underwent surgery and that is when it was discovered. She was diagnosed with colon cancer! My first thoughts was- How could this be?? Once again I flew down to be by her side.
Once again, she suffered tremendous pain & discomfort, but I was hopeful, as the doctor had taken me aside and said she has a 70% chance of survival. Months after I learned of his lies. But in any case, she decided to undergo the recommended chemotherapy.
I flew to her yet again in July of 1995, to take her on a vacation to Key West with her grandson Nate. It was an unsettling week as we were all on edge, for the day before she was told she was terminal. How do you vacation with such news???
Months went by as she tried all manners of crazy alternative therapies, but we all hope this was the magic she needed and we believed she would survive this, she was a strong woman. She was always strong—she could not do anything else but survive. How wrong we were.
In early 1996, we knew she was the end of her fight. My brother and I began to make plans to move her back to NH, till the end. She did not object---she was too weak and we were her family. She originally stayed at my home in Nashua and we hired a nurse part time to help, as we both still had to work. She was unhappy there, and I now know why, so we moved her to my brother’s house in Raymond. I felt such resentment towards the move—now I feel only shame.
When I visited her in Raymond, I knew she was happier. Now in March, both my brother and I stopped going to work—we needed to be there with her 24/7. She was weak; she could not care for herself in any way. Many times she cried and begged to die or for one of us to kill her. It brought the most horrific emotional pain to me, as neither my brother nor I could help her. She began to go delirious and did not know us or anyone around us.
We were so tired as we stayed in her room night and day, wiping her brow, cleaning her, giving meds (including suppositories). We had visitors, but alas, none that could provide us the help we search for, it seemed no one had the ability to take her pain away. We were barely coping, with the emotional pain growing as we watched our mother literally rot from the inside out. She would throw up black vomit with such force, she would cry & scream in pain. The vomit was actually decayed flesh. I would periodically push the morphine pump to try to alleviate the pain. By that time –the morphine had no effect on her. I tried to overdose her, so she would die peacefully—that was not to be. Two nights before she died, I argued with my brother that she could not and should not endure such pain any longer and that we must find a way.
I wanted to phone the famous euthanasia doctor, Dr Kevorkian—but he was in court on trial. I wanted to beg for him to come and help my mother, to bring peace. But as I said before- there was no help. My mother fell into a coma on April 24, and having been exhausted emotionally and physically, I drove home to Nashua, just to get away for a bit at 1am. It as the worst mistake I had made. On April 24 at 3am my brother phoned me and stated I needed to return ASAP—she was dying. I was furious with myself, as it was a 40 min drive.
I was even more furious because there was fog everywhere and I could not speed, I figured with my luck I would hit a deer and be delayed more! I cried and screamed all the way there. I swore like you have never known… on that evening I would have won the foul mouth contest for 100 years. I got there at about 4:15 am. The nurse told us she was losing her breathing and to get into her room right away. We did.
I held her hand and said “Jesus is here, he is taking you home. It’s ok to go now Mom.” She died 10 minutes later. After that, all I remember was my brother picking me up off the floor. I had collapsed in such pain & grief that I will never know it so deep again. I was a wailing fool like you see those women in 3rd world countries when their loved ones have passed. I shall never feel such pain again in my life.
My feeling is, I am glad we took care of her, as painful, grueling and ugly it was. How could we let her die in a sterile hospital room with strangers among her ??? We would do it again. It was the only gift we could give her, although it was not enough in my eyes.
My regrets are many: if you find yourself in this scenario, please keep in mind, the person who is terminal is the one who NEEDS the most, no matter how you feel, how tired you are, how horrible it is to see. IF you love them, you will do anything in your power to make them comfortable both physically and emotionally. I would say the emotional part is the most important. I feel as though I failed at that—and I will live to regret it forever. I did not give my Mom the time she wanted to just talk…and it will scar me for life.
You can hire people to help with the nursing end of things but you cannot replace the emotional & spiritual needs. It is the most important thing….make peace and give them the time and thoughtfulness they deserve. You will NEVER see them again, until you meet again in heaven.
I have left out much ----some is too painful to put on paper.
But, if you prepare to be caregiver, my advice to you:
· Spend time with the person—TALKING—laughing while you can
· Arrange for medical supplies such as hospital beds, oxygen tanks, and prescriptions well in advance
· Seek a nurse’s help as soon as you can –hospice organizations are use to this –they know what you need and WHEN you need it
· Prepare to take time off from work---indefinitely
· Prepare to see things no human should have to see and do your best to be strong
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Memor…
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I think of all the blogs I have read this one cut me like a knife. My mother (Catherine) the one in which I created a 360 for passed July of last year of Lung and Adrenial Cancer. I was her caregiver... along with one of my brothers. It was not a easy thing at all to do to see your own Mother go through so many different changes physically, emotionally and mentally. Unfortunately my mother ended up at the end going to the Cancer Center her last week or so of her life. It was way overwelming for me and my brother, both even together at once could not handle her in her condition. My Mother fought standing as long as she could, shopped as much as she was alive, lived still in her own home until that day. It was so much rewarding for me to be there for her in that time of her life knowing she gave birth to me ... I was able to learn all about Compassion in a way I never understood it before. Pain only lessons by time. Bless you
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BabyD…
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Job well done then. I have been there as well. When I was sixteen, my sister in law passed away from uterine cancer. I didn't understand then and I still don't now. It was a horrible experience. Then my son got cancer and survived and then my mother had it a little over a year ago. She is still with me. Working for primary care for almost eleven years, I witnessed this time after time as well. I think everone will experience this themselves and if not, they will be like us...I was hoping this blog would help pave the road for anyone out there that had to live this. Just to help them know that they are not alone. I wrote the blog on Dana Farber whem my mother was in Brigham being treated for her cancer. Pain does lesson with time.
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