Monday, October 5, 2009

Genetic Screening for a History of Ashkenazi Jew.

This is going to be a rant...
After close to six weeks of trying to work through the various hoops set out by my HMO that sat between us and genetic screening for taysachs we finally got approval from the insurance company for the test.
To be completely fair, we allegedly could have done the test at any time, had we been willing to pay for it.  We were willing to pay for it, but it isn't cheap, so we decided to see if the insurance company would cover it first.  I'll spare the details of the request for authorization for insurance coverage rigmarole, I'm sure most of you have had to do something similar.
The fun really began when I got the authorization.  The genetic counselor left a message on our answering machine that the testing was authorized, and we got something in the mail as well.  Unfortunately, neither the message from the counselor nor the piece of paper actually said what to do to get the test now that it was authorized.
I called Kate's doctor's office last Thursday and told them that the test was authorized, now I just needed to know how to get the thing actually done.  The nurse that called me back just didn't want to do any work.  That's the only explanation for her response, which was to ask me when was Kate's next appointment (it happened to be the next day), and then tell me that she should bring the authorization form in with her and they'd tell her at the appointment. I asked her if she could just tell me over the phone but she said that she couldn't.
So, we brought the form with us.  Of course, nobody at the OB/GYN office knew off the top of their heads what needed to be done.  We ended up sitting in the waiting room for a half hour after the appointment while they figured it out.
An aside:  This is a blood test.  They have to stick a needle in my arm and pull blood out.  There's nothing particularly unique about that part of the process.  All I was trying to do was to get authorized to have a lab tech stick me.
Eventually a nurse told us that it was all taken care of, and all I needed to do was to go by the lab at my convenience.  Of course, the extra half hour spent working that out made it impossible for me to go that day (last Friday).  So I stopped by the lab today at lunch time, which was my convenience.
Of course, the desk clerk at the lab couldn't find any order in the system for me to have any genetic testing done.
He made some phone calls though, and eventually a nurse from the OB/GYN clinic came over to the lab (they're on the same floor) with some paper work for me that had to be filled out.  She sat next to me in the waiting room and filled out the form.  That produced this bit of dialogue (as Dave Barry often says, I'm not making this up):
Nurse (pointing to something on the form):  Do you have a history of this in your family?
Me  (not looking at the form):  No, but I'm eastern European Jewish on both sides of my family, so I'm in the risk group.
Nurse (still pointing at the form):  Then you do have a family history of this...
I actually look at the form, and she's pointing to the phrase "Ashkenazi Jew".  For those of you that don't know, Ashkenzi Jews are the ones who's ancestors are from Russia, as opposed to the ones who's ancestors are from Spain.
Me:  Yes, I do have a family history of Ashkenazi Jew.  I'm Ashkenazi Jewish on both sides of my family.  Nobody in my family actually has taysachs, though."
It occurred to me to explain how we'd been searching for a cure for Ashkenazi Jew for years, with no success, but by then she'd stopped listening.
She told me to give the tech the form that indicated my family history of Ashkenazi Jew, and that they'd know what to do.
A few minutes later the lab tech came and got me.
Of course, she didn't know what to do.
She had to ask someone else what to do while I waited some more.  Eventually she came back, strapped the rubber band around my arm and stuck me with the needle, taking two pretty ordinary looking tubes of blood.  Then she stuck a bandaid on it and sent me on my way.
I fully expect that in two weeks I'll get a bill for my blood test for hemophilia, and a letter telling me that I'm negative for sickle cell.

1 comment:

  1. There are many ways in which I could respond to this last entry, all of them grossly inappropriate, especially for one who is suffering from Scottish rather than from Ashkenazi Jew.

    Instead, I'll just say that I don't think even single payer health care would take care of certain personnel problems. Not that we can look forward to finding out soon or anything.

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