Panic Attack Thoughts

This is the writings of a random panic attack I had the other day. I don’t normally have these, because I’m aware of what I can do and when I should stop, but they do happen for me occasionally, especially if I’m trying to do too much and I’m starting to falter.


I woke up at 3:30 this morning to my husband’s kicking, and I couldn’t go back to sleep. I got out of bed this morning crying and feeling hopeless. I feel orange and kicky inside. I can’t think straight. I don’t know why I’m feeling this way. The pictures are memories of today and last night and move too fast for me to try and pinpoint what my body is trying to tell me.

I made it to work though. I fought with Josh, but I made it. I knew I was being difficult when I told him I didn’t know what was wrong or how he could help me, but that was the truth. I felt panic trying to answer. I know that means this is in my head.

I know I need to calm down. Logically, I can reason there is nothing different about today from any other day. Logically, there is no reason to feel this way. This keeps me from being this way to others. So far I’ve only been told I look sick. I feel like something is going to happen, but I don’t think that’s right and I don’t feel good.

I know my feelings aren’t right and that’s why I’m still at work, but I need something. I’m trying to figure out in my mind what it is, because I don’t think that leaving work is the answer. I can’t do that, I have so much to do. I’m harnessing my anxiety into working on my accounts, but I feel like this is life or death. Sometimes I can trick my mind into making this some sort of fun battle, but right now I feel like I’m in danger. I can’t do that fun thing because this feels super serious.

I feel a quiet calm when I write this out. This is confirmation to me that this is what I’m feeling. I’m familiar with the kickback of when it’s not and so far it’s absent.

Talking to myself helps. Talking out loud doesn’t. Talking out loud makes me feel like I’m crazy.

I reach a certain level of calm where my mind thinks it’s safe to express and I start to cry. I can’t get past that point, I keep having to bring myself back up to get it to stop, it’s easier to raise my anxiety into manually faking calm than it is to actually calm down and relax.

I can’t think completely straight. I keep looking at all the time I’m wasting. It makes me panic more. I should stop doing that. I feel hunger in my stomach and fluff in my head. I’ve been needing so much food lately and I gained like 10 pounds in a week and I don’t know what to do. I’m so stressed. Even when I’m doing the things I love it’s been feeling laborious. That’s a sign of depression, which I was diagnosed with a couple months ago, but my life is awesome and I don’t know why I’m depressed. Chemical imbalance.

I don’t want to have all of this shit wrong with me. Why can’t I be normal-

Old demons coming back to bite. I’m not normal. Just let that go. My mind is picking anything to get me to react. It feels like my mind is trying to get me to do something about how I feel.

I feel like crap. That’s probably why I fought with Josh this morning. Actually fighting feels like that might help, but who would fight with me? I’m a grown up now and that’s not acceptable unless you’re in martial arts and I don’t have the money for that.

Also that doesn’t make sense either because it would deplete my resources and could potentially make things worse. The less resources I have, the more emotional I feel, the less control I have.

Exasperation is starting to rear it’s head. That comes with not being able to psychologically control my neurological problem. I need to figure out what physical thing will help me before I lose my shit. I’m going to try and get something in my stomach. I said I was hungry earlier.

Okay I’m snacking on this thing called “That’s It” which is a fruit bar from the vending machine. I feel calmer, more in control. I can make it. I wonder where the calmness comes from, if it comes from my mind and feeling good about taking control, or if it comes from my body’s needs being met.

I have no idea what sparks these things on. Sometimes I’ll be playing my clarinet and I’ll remember things from the past that hurt me and I get all glazed over. My husband always asks me what’s wrong, but I never know how to answer. It’s always different memories from different times in my life, coming through so vividly that I momentarily can’t shift them aside. Times like that and times like now make me feel like my mind and body take turns attacking my well-being.

Just because I feel better and calmer though doesn’t mean my hopeless feeling has gone away. Everything seems to be looking positive for me, and for some reason I’m scared of it. It feels like I can’t do everything that life has in store for me. I don’t completely understand why, but I feel it and I hate it and I don’t know how to make it stop.

I have the desire to do something about it. I need to do something.

What does that mean though?

If I still need to do something, but I feel calm and in control, what should I do?

Wait, if anxiety makes me question, “what do I need?”, and all my needs are met, what’s the answer? A problem.

I felt the kick, right now I need to work, but I can’t focus on that and I have to pee again. I can’t think straight still even with food and water and I feel panic over everything. It’s not my meds, it’s me, so I don’t even have that.

Racing thoughts just make it worse. I need to calm down my mind with focus.

Harnessing anxiety feels like catching a pissed off horse. It’s frustrating for you and the horse because you both need something, you need the horse to calm down and the horse needs you to acknowledge it’s feelings. It seems like an easy puzzle piece solution of using your skills to calm the horse down, but it’s harder than that, because the horse doesn’t trust you and it’s instincts are telling it that you mean harm and can’t help.

My anxiety demands that I pay attention to it, demands my time, my resources. Maybe my depression comes from feeling out of control and not feeling productive. That makes sense. I feel bad about myself for not being able to keep up with everything I need to be keeping up with. That makes sense as to why I feel hopeless too.

I suppose I’ll take these feelings and try to do something with them. Writing calmed me down enough to move forward, but it’s not enough to make me feel better.

I have work to do, always something to do, so I’ll just deal with it for now, I guess.

Maybe I’ll get something done and get to feel accomplished.

AFTERNOON UPDATE: After eating, drinking caffeinated tea, vitamin B12, shutting down for a little while and re-evaluating my demeanor, I was able to completely calm down 🙂  I don’t normally experience that hopeless feeling with panic attacks, but I know that does happen sometimes with my disorders, and it does help me to know that there are things I can do to help myself <3


For more information about anxiety and depression, visit:

http://www.anxietycentre.com/anxiety-attack-symptoms.shtml

https://www.adaa.org/understanding-anxiety/panic-disorder-agoraphobia/symptoms

http://www.calmclinic.com/anxiety/attacks/symptoms-and-signs

autism weighted vests

Yeah I’ve Thought About It: Autism and Suicide

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A recent story stated that 66% of newly diagnosed adults with autism/Asperger’s contemplate suicide.

Let’s think about that for a moment.

In all of the concerns about the numbers, I found an article that has really good ideas about why we contemplate suicide, but the point of view of an NT (neurotypical – someone without autism) kind of makes me feel invalidated. A molehill is a mountain to an aspie? Come on. I’m not small enough think a molehill is a mountain; a mountain is a mountain, and just because you have tools to climb it and I don’t doesn’t mean that my tools are something to look down on, but I digress…

I was officially diagnosed at 25. I would be considered a newly diagnosed adult, but for me the thoughts come because I feel like a burden, and I’ve always felt that way. My first thought was when I was 13. Is it possible that it’s not just newly diagnosed adults? What about diagnosed teens? Children?

It’s easy to think, “I’m the problem.” I can think of so many people in my past who made me feel like I wasn’t worth their time. I can think of situations in the present that I’m not prepared for mentally, sometimes those make me think I want to take some kind of action like that. I understand this to be a chemical imbalance, but a lot of people don’t.

I’ve acted in ways during meltdowns that have made suicide seem like a viable option in my mind. I’ve had short thoughts, like “just drink the whole thing, do it, quick”, and long thoughts, “does life insurance pay out if it’s obvious you killed yourself?”.

I learned early though that suicide is never the answer. I saw the affects that taking your own life has on loved ones on TV, and I reasoned that if so many shows posed the experience as, “How could so-and-so be so selfish?” then that must be how suicide is viewed, as a selfish act. I decided to never to put my family through that. While I know now that suicidal ideation is a symptom of a larger problem, I’m glad I learned this lesson early.

Every single time the thought has crossed my mind, I’ve conquered it, to the point where it’s just a “helpful” reminder that I’m still alive and thriving in some ways. Particularly in the way of surviving myself. I refuse to allow myself to self-sabotage (basically, I just think about everything twice before I do it, then I think of the most probable outcome), and that has led me to be successful for someone of my disabilities. NTs think with their subconscious, which means their conscious minds don’t have focus to recognize input, such as eye contact, body language, facial movements, etc. Their conscious mind only has to process what’s being said, making their brains much faster at socializing than ours.

Our brains and subconscious work differently than theirs, and our thought process involves word processing in lieu of subtle cues. The conversational problems involved with this type of thinking can lead to semantical disagreements and misunderstandings. We desire connection, probably more so than the NT, and the anxiety of confusion often causes us to be misconstrued as maybe aggressive, annoying, or intentionally confusing. (*side note, sometimes we can be interpreted as funny) This can lead to an NT being afraid, angry, confused, or curious by an our behavior, or lack of reciprocation. Most times they’re trying to talk in the feelings language, and subtle cues quicken the pace of conversation. We tend to feel sensitive at these types of exchanges. In our minds, we’re thinking, “don’t you see how hard I’m trying?”  

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I’m not meant for this!

More than once this breakdown has led me to feel like I’m an idiot, and then pissed me off. I’m a fiery soul, but not all of us are. Some of us are gentler and more susceptible to the rants of someone who seems to know what’s happening. Alexithymia strikes again.

Because we’re trying to figure out if we’re being annoying, being understood, communicating effectively, etc., using our ears instead of our eyes, we often miss or confuse visual cues by the NT person, which leads to more misunderstandings. People fear what they don’t understand, and hate what they fear. It often leaves us wondering, “Do Neurotypicals Hate Us?”

They don’t hate us though. They just don’t understand us, because it’s difficult for us to explain our emotions. That gap needs to be bridged, we can’t be walking around thinking they hate us and they can’t be walking around not understanding. It’s just not an acceptable predicament.

As an autistic person, I searched and searched for something I could do to help bridge this gap. All I found was that I needed to accept myself and my spouse needed to understand my needs. Self-acceptance is a steady and unconditional love of self, and was something I haven’t always had. And yet, there is no other way to co-exist, and that’s very real.

Self-esteem is based off of what you think of yourself. If you derive your self worth by what others think of you, it will be forever dependent on your behavior. This means that when other people judge you negatively for having a meltdown, you will feel bad about yourself. You will feel terrible about yourself for something you can’t control. What sense does that make? By accepting yourself, you are letting go of the illusion that you can psychologically control a neurological problem.

It’s important for the welfare of the person with autism to have self-esteem. Self-esteem influences everything we do, including hurting and killing ourselves.

If you or someone you know if contemplating suicide, it’s important that you/they don’t go through it alone. Here is suicide hotline:

National Suicide Hotline: 1-800-273-8255 via Psych Central

autism weighted vests

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Autism and Alexithymia

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What is alexithymia?

Have you ever been at a loss for explaining yourself? Or you just can’t put your actual feelings into words? Like you know there something wrong, and sometimes you might even know what to do, but the actual words aren’t readily available to describe how you feel. This is called alexithymia. Alexithymia itself is not a condition, but a symptom. A symptom that can sometimes wreck havoc on the patient experiencing the loss of words. I myself suffer from this, though as I’ve aged my “feelings” are more recognizable to me. Here’s an excerpt from my journal from two days ago:

I don’t feel so well. I’ve had a rough few days. I’ve had a lot of feelings and I’ve been emotional, which adds to sensory problems I have. I react aggressively.

Ugh. I can’t think. I can’t think straight right now. I want to write something explanatory, something worth a write but right now I don’t have any words. I want to express myself, but… I can’t even bring myself to asking how. I think there are so many ways but I don’t know how I feel about any of them. Writing feels good, but all I’m doing is explaining what’s happening in my head right now and not explaining any of the anxiety-

Anxiety. But from what?

Maybe painting might help. I’m looking at the file room painting I started a few days ago. The file room is where I keep my memories. I have a series that I’m starting about places in my mind. I don’t think I want to paint right now though.

Maybe sing? No, this is enjoyable, right now we’re watching Deadpool and my husband is drawing Maggie.

It took me 200 words to figure out I had anxiety, and then I didn’t even know why. I was sitting on the couch with my husband watching a favorite movie of ours and I couldn’t figure out what my problem was. I didn’t want to take it out on my husband, so I attempted to find a way to channel my anxiety into something constructive, but that isn’t the point.

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What does alexithymia look like?

Alexithymia can present itself as physical pain/distress, such as high blood pressure, joint pain, and chest pain. Clinically, it is thought to influence behavior, treatment process and outcomes due to the lack of patient recognition of emotions. There is only one study that suggests that alexithymia can be reduced over time with group therapy, guidance on recognition and communication of feelings.

How to help

If someone you know is experiencing this, it’s important that they are met with compassion and assistance. Alexithymia can lead to identity crisis, as having feelings but being unable to express or explain them can often cause the person to remain silent, and their pain and anguish ignored. If they finally reach the point where they are acting out behaviorally, it’s important to get the help of a mental health professional who might be able to assist with why the your friend or family member is suddenly acting irrational.

Wrongplanet is a great resource for people with autism and their families to come together and talk about the positive aspects of autism, and get advice and resources for the negative side of autism. A little acceptance can go a long way.

What to do when you can’t express yourself verbally

If you think you might be experiencing this, there are a couple of online tests that you can take to help you. Separate yourself from any outside stressors (environmental, conversational, etc.) so you can think clearly. This is an important tool to figuring out your feelings. Participating in a favorite hobby or relaxation techniques have also been found to help. Once you start to realize patterns within yourself (“I get like this every time xyz happens”), then you’ll be more able to express yourself in moments where you feel “like this”, and when “xyz happens”, you’ll be more in line with yourself to better explain your end of the situation.

In my marriage, we have breaks in heated discussion. This is because the more emotional I am, the less sense I make when I speak. When I start to feel like nothing we’re saying is making sense to me, I tell my husband I need a break. It also helps to dull down lights, sounds, smells and to wear comfortable clothing. Sensory needs must always be considered. After I have calmed down, I can coherently discuss compromises and solutions to various issues.

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I have found that painting, writing, singing, and dancing help me to make me feel better, or at least help me find what I’m trying to say. However, if you’re experiencing alexithymia you may be in the “rumble stage” of a meltdown, and it’s important for you to make sure that you don’t get overwhelmed by trying to figure out what your emotions are. If someone you know or love is pushing you past your mental limits in an attempt to figure out why you’re having a problem, it’s because they don’t understand this symptom. Due to the complex solution of their problem is needing more words and your problem is too many words, it’s important for both parties to realize that respect for both needs has to be met delicately.

Alexithymia is a complicated, yet minimally studied symptom of ASD, schizophrenia, depression, ADHD, and other mental health disorders. It’s important for the mental welfare of the patient that their needs to be respected. Just because someone can’t put their feelings into words doesn’t mean their feelings don’t exist, and it’s better for all parties involved for either understanding or outside intervention.

Here are some free hotlines for counselling in a crisis, but please dial 911 for emergencies:

Autism Research Institute: 866-366-3361

American Autism Association: 877-654-GIVE

Autism Speaks Crisis Response Line*: 888-288-4762


*I know, but that doesn’t mean they don’t have good resources

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Autism and Meltdowns

I hate them. I hate them so much. They hurt so bad, and they come on so quickly and so strong. I get them from extreme sensory over-stimulation and hunger, social overload, and during my menses. Crying happens swiftly, and the lever for the emotional dam is flipped. When I try to speak in between sobs, I sound panicked, unintelligible. The pain sets in my mind and I start screaming and hitting. The cyclone winds arrive and I become out of control. Writing helps me figure out what I need from that specific moment. Hold me, love me, understand me. Get away, I’m sorry, I need time. What never changes is the need for you to understand I’m not trying to hurt you. Common themes in my written art.

Most of the time I can keep my meltdowns under control, and I can use box phrases to communicate to those around me. I can restrain myself and keep my anxiety monster asleep.

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When my monster awakens, the battle inside begins.

The electricity, the flame, the pain, the rage in my mind distracts me from being able to comprehend consequence. I feel like I’d do anything to get that pain to stop. Words start to mean very little. I can’t be threatened, I don’t understand what’s being said to me, I can’t focus long enough, and the rage becomes desperation to express just how much my head is on fire. I start clawing at my own face, grabbing and pulling my own hair, hitting myself. If I stop, I’ll start to scream and cry. I’m losing my grip.

Don’t come too close or grab me, I might hurt you on accident. I can’t control how hard I touch things, they explode in my grasp, and I feel like my life is in danger. I feel like something is attacking me from the inside out. I feel like if you touch me, I might mistake you for the attacker. I can and will hurt you. Please handle me with care.

I don’t want to hurt anyone. I want to have normal reactions and normal understanding. For so long I wanted to be a normal person. I had to learn how to accept my monster and my madness.

I feel like an animal when I meltdown this bad. If there are too many senses on, emotions running too high, negative environmental factors, I get like this. I feel unsafe and a danger to those around me. I start looking at something, anything, to make it stop. My mind starts working against me and thinking in extremes, turning me against myself, adding straws to my camel’s back. No one can say anything worse to me than what I’ve said to myself. I push those thoughts away, knowing that they aren’t real, and I have enough dominance to be able to differentiate what will hurt me and what will help me. Central Command functions like a dam, a filter, a barrier between me and the outside world. Central Command connects me to my body. In those moments, Central Command is functioning on a skeleton crew during a crisis.

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I’m still hitting things around me, pushing them and throwing them away so I can’t hurt myself or others with them. I have rage jolts and I have to hit, so throwing, loud noise, screaming… those things help me. To not do them is torture, if I don’t spread my fire out, I’ll burn myself within. In brief moments of constraint, I can make enough sense to say I’m having an issue, but the window is so small. To small to last. I can’t fight my monster at the same time I’m trying to figure out why this is happening, at the same time I’m trying to communicate, at the same time I’m trying to stay alive.

I’m exhausted when it’s over. I feel remorse, but I’m unable to find the words. I process emotions completely different from normal people, which means in an emotional conversation I lose track, I get confused, I get lost. Words mean nothing, I just feel, and respond with the loudest response I have in my arsenal: silence. Raw emotion has finished it’s tremendous thunderstorm, and I have settled into a cranny of devastation. Every time I’m surrounded by the chaos I’ve created, I regret the firestorm I’ve caused and wish I could’ve burned instead. I desperately desire to explain myself, but how? I was over the edge because my disconnected body and emotions were running for the cliff while my mind was away from the reins.

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I never know how to come back from these. I always feel shame after, when I’m holding the pieces of whatever I broke, or looking at the trash I’ve kicked everywhere. My worst enemy has always been myself. I’ve always been told I couldn’t act this way. I’ve always maintained I’m not acting.

Meltdowns feel nonsensical, and the emotional overflow needs to be met with compassion. When my emotions are out of control, I will say something. If I can’t handle a situation, I need to be respected. When I can’t explain myself, I need whoever is around me to know that I’m not being this way for no reason.

We need understanding and acceptance. People with autism are people too, with different perspectives and experiences. It’s a painful, uncomfortable, embarrassing experience.

What to do When Someone You Know is Having a Meltdown

The best thing you can do for someone with autism experiencing a meltdown is to remain calm and give them space.

Remember that they may or may not be able to talk to you, so be prepared not to receive a response if you ask them if they’re okay.

Reduce anything that might irritate the senses, turn down the lights and sound, help make the person feel physically comfortable.

For more resources about meltdowns in autistic people, please visit:

https://themighty.com/2015/04/what-an-autism-meltdown-feels-like/

https://www.verywell.com/what-is-an-autistic-meltdown-260154

http://www.autism.org.uk/about/behaviour/meltdowns.aspx


 

thoughts on autistic meltdowns

To read more about how I dealt with self acceptance, click here

4 Things I Did Yesterday Instead of Working on my Camping Blog Post

My husband and I went camping last weekend. I thought for sure I would have lots of great material to write with, but my emotional support dog past away the day before the trip, so I spent most of the trip in a daze.

I still promised at least one post on my camping experience, so I’ve been thinking about different post ideas.

Yesterday was a good day. I cleaned, moved things around, lounged, but I didn’t write the camping blog post I’ve been promising. I did come up with two ideas though. One is a post about how camping strengthens our relationship, and how my disability affects us since my husband is a Neurotypical. The second post is a fun list about boring camping activities and how to make them fun. I’m confident I can sell that post, so when that happens eventually I’ll link it to my contracted work page. As soon as I know if it won’t sell I’ll post it to the site 😊

Here’s a list of 4 things I did yesterday instead of working on those posts:

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Organized the Bedroom

We recently bought a punching bag stand, and I reorganized how it was standing in the room. I also piled things based on usage, what’s being given away and what were keeping. Everything we’re keeping I’ve been throwing in the closet, which I’d planned to organize that today. So far I’ve been writing instead.

We’re trying to downsize, we’re looking to buy a house soon and we don’t want to have extra clutter. And with all the moving and consolidating I did yesterday:

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I stood just like that, only Will Ferrell was my cat because my husband was at work

 

Watched Sherlock Season 4

Highly recommend. It was a good watch. Moffat has this very particular type of writing, and he needs to make Cumberbatch stop saying that “THIS (whatever it is) is the most DANGEROUS thing [they] have EVER done,” because it’s getting old. It’s true, but c’mon Moffat, you have the capacity to be more creative than that. The smack use is a little overkill again, but I get it, Sherlock has problems. It makes sense that they would reappear that way, because they do with people. Mycroft’s secrets were out of left field and oh, how the psychosis was brilliant. All of them. I love imperfect characters.

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Indeed.

 

Ate S’mores

I was doing the layout for the boring camping activities before realizing I was just listing things we did and eating s’mores was fun not boring, and it made me want some. I took a handful of marshmallows and put them on a paper plate, then I lit the pile on fire and ate the tops ones. There wasn’t much to this one, but getting the marshmallows together was a little bit sticky. Plus it turned out later I ate from the expired bag, but I feel fine so whatever.

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I did this scene with my cat too.

 

Organized the Bedroom Some More

Our apartment flooded last week, so we had clothes and junk everywhere. I moved all the clothes to one quarter of the room, regardless of what is was or why they were separated (only if it was dirty or going to be given away) and it helped me out as far as space, and with all the extra room to work with I could put more things in boxes and shift them around to the closet, which still remains a problem for Future Arianne.

 

As you can see it was a productive day despite my dilly-dallying. I have two posts in my contracted folder and I’m waiting for one more to go live so I can put the link in my contracted work page. I’m working on a Maggie painting that I think is going to come out good. It’s not going to be for sale, but I want to post it as an example of what I can do. I’m excited about having a little corner of the internet just for me.

Keep an eye out for a couple of new posts this week, and click here to read more about my problems with being distracted 🙂

 

UPDATE: Finished the painting 🙂

Maggie

Autism

How To Hire Someone With Autism

Aspie Spouses: How to Show the Neurotypical in Your Life You Love Them (by Using the Five Love Languages)

Autism and the Hispanic Community

Autism and The Importance of Social Skills

Panic Attack Thoughts

Yeah I’ve Thought About It: Autism and Suicide

Autism and Alexithymia

Thoughts on Autistic Meltdowns

An Autistic Reflection of Societal Views of Mental Health

An Autistic Reflection of Self Acceptance

When Sensory Overload Affects Focus

Autism Through My Eyes

My Emotional Support Dog Died

Insurance Companies and Out-of-Pocket Costs

How do insurance companies determine how much you owe?

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Let’s start off with a scenario: Your stomach hurts, so you decide to see your primary care physician. She takes notes and decides that a CT scan would be an excellent diagnostic test for you. Her office obtains the needed authorization and sends you to a radiology facility to have your test done.

At the billing counter, after your test, the radiology facility staff tells you you’re going to owe a $70.00 copay for the visit. They’re very friendly and confident, so you pay the copay, thinking that’s all you’ll have to owe because that’s how it works at the grocery store.

After two months of not hearing anything from the clinic about the procedure, you receive a bill in the mail from the radiology office for $400. What happened?

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Now let’s take that same scenario and look at the “back-end”:

Once your doctor decided you needed a CT scan, she lets her office staff know to fax orders to the radiology facility. The Verification team of the radiology facility calls your doctor’s office to determine who is going to obtain the authorization; your doctor’s office decided to get it for the radiology facility.

Before your appointment, the Verification team “verifies” your insurance. This means that the verification department finds out the following: A) if you have coverage, B) what your benefits are (and if there is an authorization needed for your test), and C) how much you MIGHT owe.

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What do you mean, what I might owe? Why wouldn’t they know??

Allow me to explain:

A) Coverage is determined based on either a phone call or an online verification tool provided by your insurance company. Neither way of verifying coverage is perfect. This could be due to job loss, spouse coverage, COBRA, coordination of benefits (multiple insurances), and the like.

B) Benefits are determined based on the most recent information available to the provider. Let’s say in this situation, you had a $500.00 deductible with your insurance plan. In the phone call to the insurance, the Verification team is told that for diagnostic scans, you only owe a $70.00 copay. What doesn’t always get translated are exceptions; in this case, the exception would be that diagnostic radiology scans are applied to your deductible. Information that the Verification team doesn’t know before the radiology facility rendering services to you.

C) The Verification team tells the “front-end” team (the sweet, confident people you actually meet and talk to) that you only are going to owe a $70.00 copay, not knowing that your insurance policy has that very minute exception. Not knowing that you’re going to get a nasty surprise in the mail.

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I wish it was only $1.

After you have your service done, all your information is sent to the Coding team. The Coding team reviews your medical records, questionnaires, medical history, and medical report. The “code” the service based on what you had done at the facility and your doctor’s reasons for having the test. They see that contrast was used, only the abdomen was ordered, and you have no medical history of abdominal pain. The”CPT” code (the procedure code) they chose would be for a CT abdomen, which is 71260. The “ICD-10” code (the diagnosis code) the Coding team chose (in this case) R10.0, acute abdominal pain.

These codes are entered on a particular form (a “claim form”) that is sent to the insurance for payment. The insurance reviews the final charges and compares them to your insurance benefits. Over two months, your “claim” is processed by the insurance. The insurance representative notices a clause in your policy that diagnostic radiology tests are applied to your deductible. They calculate how much you’re going to owe based on what is called the “allowable” amount.

The allowable amount is the contracted amount of money between the insurance companies and the provider that the insurance is willing to pay to the provider. The retail price of this CT scan (these change per provider) is $757.00, and the allowable for this service (in this case) is $470.00.

It’s determined that you have not met any of your deductibles, and the copay doesn’t apply due to the clause in your policy about diagnostic radiology procedures. Since the allowable amount for your service is $470.00, this will leave you with $30.00 left on your deductible with the insurance company. So if you had another diagnostic radiology test, you would only be responsible for $30.00, and the rest of the service would be covered by the insurance because you’ll have “met” most of your $500.00 deductible with this first CT scan.

The insurance company sends both you the patient and the provider a document called an Explanation of Benefits (EOB). This document tells both the patient and provider how much the provider charges for the service, how much the insurance allowed based on their copy of the “fee schedule” (list of all charges they pay for and how much), and how much total the patient will owe. This EOB says you owe $470.00. Because you paid the radiology facility $70.00 and not your insurance, your insurance won’t have a copy of how much you paid to the provider. It’s up to the provider to send you a bill reflecting the information shown on your EOB.

$470.00 minus $70.00 paid at the time of service equals a $400.00 bill.

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The healthcare process in America is atrocious. We all must try to do something. Tell your representative to support healthcare for all Americans, because you never know if you’re going to be the one to get sick and be stuck with a $400.00 bill you can’t afford because of your illness.

Get involved!

Click here to view the Patient Advocacy series!

My Emotional Support Dog Died

I’m not sure how I want to write about Maggie. I started off not being sure how to express myself. I knew I was sad, but the words were coming out right.

Maggie’s gone.

I wasn’t sure what I wanted to do. Maggie’s body couldn’t stay there in the entryway, we needed to do something, but doing something made it real. Doing something meant that soon I would never see her again. So maybe she was just paralyzed. Or sleeping very uncharacteristically. I shook her, but no response. “Maggie…” I called to her, looking for something, anything, to tell me she was alive.

Maggie’s gone.

That was the first thing I wrote. I tried to write about how great Maggie was, but that felt… real. I couldn’t think straight, I was just writing shit on the paper and hoping that I’d feel something. My mom was already on her way over, and there wasn’t anywhere else to put Maggie, so we called my mom and told her we found Maggie. She came over to make sure I was okay, and then she went home.

My husband and I took her to the house we’re buying, and we picked a spot that we’re going to call “Maggie’s Garden.” I had never dug a hole before, but my (very naïve) idea of digging was like Disney’s Holes, and the hole we had to dig was only half as deep as the one in the movie. Piece of cake, I’ll just sing the song and all the other digging songs I know, and we’ll get this done.

Maggie’s gone.

It hit me again while I was trying to dig. My husband was very expertly instructing me on the actual digging of the hole because it’s totally not like the movies, and it kind of sucks. But if I wasn’t digging my dog’s grave, I’m pretty sure I would’ve kicked that hole’s ass. When my father- and brother-in-law came, I asked them to help my husband finish digging. Maggie was still in the backseat, I’d been helping by holding the light and staying out of the way, and I was ready to be done. I knew I couldn’t deal with that situation right then and there, and I had no outlet. I felt trapped.

There was no Maggie to come home to.

I miss her. I miss my dog like crazy. I didn’t realize how much I depended on her for stuff.

That next day I called in. I didn’t want to get out of bed or do anything, and I was ready to cancel the camping trip. The only reason we still went was that I couldn’t stand being in the apartment, and I was prepared to run away from my problems. There was no reason to text or call anyone to watch Maggie. There wasn’t a Maggie for anyone to watch.

Maggie’s gone.

On the drive to the park, I kept having slight panics at everything and feeling nauseated and anxious and exhausted. I threw up halfway there, and my husband drove, and by the time that we saw the park sign, I was so happy I almost threw up again. I didn’t want to think about anything bad. This was a camping trip to get away, to talk, to work. Of course, talking meant that we would eventually have to talk about Maggie, and everything I was writing was either talking shit about personal space invader families on the river or theories on why she died. Everything I wrote felt like crap. I felt like crap. But I also felt free. Free from responsibility, free from social convention, free from judgment. I decided to bask in that because I could be sad about Maggie when the trip was over. There wouldn’t be a Maggie to come home to.

Maggie’s gone.

I drew a picture of my feelings during camping:

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Pictured: My Emotions and my feelings on processing Emotions

I cried unceremoniously at the end of the trip, after a fight, I started about something stupid. Josh seemed to know I was crying about Maggie. He held me, and I felt better, and then it was time to go. It felt weird not worrying about needing to pick up Maggie. She was eight years old, and there were times when she couldn’t live with me, but there was always some part of me that knew she was safe. It seemed that part was absent on the drive. When we came home, the cat started yell-meowing at me because he was hungry. We’d left out dry food, and most of it was gone, so I fed him a can. I sat down on the couch, and after some time, he came and lay down in Maggie’s bed.

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Pictured: Greta missing Maggie

I don’t know what to do with her bed or her stuff.

We had a bond. People do with their dogs. I named her after the planet Magrathea from Hitchhiker’s Guide to the Galaxy. Every time we watched the movie, she would turn her head when they called after the planet. She protected me, loved me, and her fierce loyalty was never lost on me. She stood by my side, and she always knew when I was in trouble or having a mental issue. She’d let me hug her if I needed to cry, she exercised with me, and we spoke our own language. I don’t even know how a dog would become like Maggie. And every time I think about that, I remember that there won’t ever be another Maggie.

Maggie’s gone.

Maggie