update

[Guest guest]

Woohoo Andy!!! I will be cheering for you from CA on Monday. I

am very proud of you for all your hard work leading up to this race.

I can't wait to hear your report afterward. Hope that ankle stays

healthy and strong throughout the race.

Jen B.

> I've trained and I am ready to run my marathon on Sept 6th.

[Guest guest]

That is so great for you to be able to do that! I can just picture

myself laughing my butt off if my husband got a card from nada she

wouldn't dare though after all these years. But I love your, I'm so

over you attitude it's really a lesson for all of us. Even though I

am n/c for 4 years now there are moments when I am a little mental

if nothing else and miss her a little but it passes like gas. Lol

Lizzy

>

> Hi everyone. I haven't posted lately b/c I have had virtually no

> contact with nada and don't care to...and really try not to think

too

> much about it either. Maybe once or twice a year from here on out

I

> can talk to her and so far its been a few months since last we

spoke.

> In certain ways I kind of feel like a nada w/how I've pretty much

> ignored her out of my life- not returning phone calls or

responding

> to emails or snailmails. But then again, I know it took a long

time

> for me to get to this point and it wasn't an easy decision- no

black

> and white bpd thinking that went into this decision. I'm very glad

to

> have distanced myself though as I've had some more difficulties-

> traumas in my life that are so much easier to deal with when not

> having to deal w/her version of reality and feeding the

drama/trauma.

> Crap happens in everyone's lives. Crap is basically all that seems

to

> happen in a bp's life. I'm over it.

>

> Dh cracks me up though. Nada sent him a card for Father's Day and

we

> have our mailbox kind of like apartments mailboxes- shared and

locked

> w/other neighbors on our block (which is good for ID theft

reasons,

> but a hassle when its raining or really cold outside). I'm sitting

in

> the passenger seat of our car fingering over the mail we got that

day

> and I said " Oh look. How sweet. My mother sent you a card for

> Father's Day. " He said, 'Oh really? Let me see.'- mind you this is

> while we are driving the short half a block back to our house

after

> we'd been out somewhere. I hand him the card and as we pull into

the

> garage, he hits the auto window rolldown and proceeds to perfectly

> shoot the card into the big green garbage can we've got right

inside

> the garage as you pull in. I just started dieing laughing. He

doesn't

> even bother opening it. Just threw it in the trash and same for

the b-

> day card he got in the mail this week from her. He's soooo over

her

> bs and quite frankly, so am I at this point in my life. I feel

more

> like an adult than I ever have and I know it has to do w/having

> better models of adulthood around me vs her insanity of childhood

> wrapped in adult clothing. Ugh. I still feel so sorry for her, but

> its like feeling sorry for a snake. She'll still bite and possible

> excrete venom if I dare pet.

>

> Anyway, hope everyone else is doing okay for a KO.

>

> Best wishes.

> Kerrie and crew

>

[Guest guest]

well I got a big surprise tis morning. The university of washington liver center

called to set up and apointment for harvies liver evaluation. This after that

as@@@ GI doctor said he would not even refer him to them becuase of his age ect.

When we first went to his GI clinic they said they wold start the referral that

was a little over a month ago . Then about 3 weeks ago that GI doctor told me he

wouldnt even refer him and told me to set up hospice. Now the problem is getting

himm to eat and get dome weight and health back. His apointment at the

university is in 2 weeks. The hospice nurse visited today and said he was to

frail for such a surgery. He is having trouble swallowing the hospice nurse said

that was becuase the doctor gave him to high a doage of methadone so I am

cutting back on that for sure and giving him acid reflux medicine they pescribed

earlier. Anybody have any suggestions on a wieght strength diet I can work on. I

thought about getting those weight lifter shakes and getting as many down him as

possible. I am giving him ensure now and anything he is able to swallow and get

down. So I feelgodmay be answering some prayers by letting him slip thru the

cracks and get the liver refferall now i pray he helps me get him healthier so

maybe god willing they will consider him for a transplant. Suggestions and

prayers are welcomed

[Guest guest]

Sounds like things are looking up Bobofoly. Be careful with some of

those muscle building supplements because they have too much protein

in them for a liver patient. I'd confirm it with the doctor first.

Hope it all goes well for you both!

Roni

> well I got a big surprise tis morning. The university of washington

> liver center called to set up and apointment for harvies liver

> evaluation. This after that as@@@ GI doctor said he would not even

> refer him to them becuase of his age ect. When we first went to his

> GI clinic they said they wold start the referral that was a little

> over a month ago . Then about 3 weeks ago that GI doctor told me he

> wouldnt even refer him and told me to set up hospice. Now the

> problem is getting himm to eat and get dome weight and health back.

> His apointment at the university is in 2 weeks. The hospice nurse

> visited today and said he was to frail for such a surgery. He is

> having trouble swallowing the hospice nurse said that was becuase

> the doctor gave him to high a doage of methadone so I am cutting

> back on that for sure and giving him acid reflux medicine they

> pescribed earlier. Anybody have any suggestions on a wieght strength

> diet I can work on. I thought about getting those weight lifter

> shakes and getting as many down him as possible. I am giving him

> ensure now and anything he is able to swallow and get down. So I

> feelgodmay be answering some prayers by letting him slip thru the

> cracks and get the liver refferall now i pray he helps me get him

> healthier so maybe god willing they will consider him for a

> transplant. Suggestions and prayers are welcomed

>

>

>

[Guest guest]

Congratulations to you and your hubby! I so admire anyone who can go thru

tx or even more so a transplant. I wish continued good health...Best

wishes~~~Debbie

>

> i miss you all...barbie that was something else what happened to your neighbor

WOW...how tramatic...you know they are not going to treat the virus unless the

numbers get high and or start to cirrhose the new liver. we are doing good they

said we can be at home for good the wed before Thanksgiving. he is walking good

and is getting his energy back appetite and humor. he is spoiled......i am

trying to get him to do alittle more for his self...he still doesnt sleep

well...we are so happy and i am greatfull that we all have traveled on this road

together. love sandra

>

>

>

>

>

[Guest guest]

how you doing?

________________________________

To: livercirrhosissupport

Sent: Tue, November 17, 2009 7:54:07 AM

Subject: Re: update

 

Congratulations to you and your hubby! I so admire anyone who can go thru

tx or even more so a transplant. I wish continued good health...Best

wishes~~~Debbie

>

> i miss you all...barbie that was something else what happened to your neighbor

WOW...how tramatic...you know they are not going to treat the virus unless the

numbers get high and or start to cirrhose the new liver. we are doing good they

said we can be at home for good the wed before Thanksgiving. he is walking good

and is getting his energy back appetite and humor. he is spoiled..... .i am

trying to get him to do alittle more for his self...he still doesnt sleep

well...we are so happy and i am greatfull that we all have traveled on this road

together. love sandra

>

>

>

>

>

[Guest guest]

hey chicka!!! i am so happy izz is doing so good,and you all we be home for

thanksgiving,how appropraite huh,THANKSGIVING!! a spoiled man, never heard of

one hahahahaha. they are funny createures aren't they lol. i pray the hep will

not get this new liver, how often will they do his labs?? love ya toots!!

>

> i miss you all...barbie that was something else what happened to your neighbor

WOW...how tramatic...you know they are not going to treat the virus unless the

numbers get high and or start to cirrhose the new liver. we are doing good they

said we can be at home for good the wed before Thanksgiving. he is walking good

and is getting his energy back appetite and humor. he is spoiled......i am

trying to get him to do alittle more for his self...he still doesnt sleep

well...we are so happy and i am greatfull that we all have traveled on this road

together. love sandra

>

>

>

>

>

[Guest guest]

this is such wonderful news! I am so thankful for you and Izzy and

your family! Thanksgiving will never be more precious for your family than

this year! Spoiled, huh?! Don't worry, you've got YEARS to unspoil him

now!!!!! You guys remain in my thoughts and prayers. Luv ya!

>

>

> i miss you all...barbie that was something else what happened to your

> neighbor WOW...how tramatic...you know they are not going to treat the virus

> unless the numbers get high and or start to cirrhose the new liver. we are

> doing good they said we can be at home for good the wed before Thanksgiving.

> he is walking good and is getting his energy back appetite and humor. he is

> spoiled......i am trying to get him to do alittle more for his self...he

> still doesnt sleep well...we are so happy and i am greatfull that we all

> have traveled on this road together. love sandra

>

>

>

[Guest guest]

I'm glad he is doing so well and you can be home for Thanksgiving! My ALT and

GGT jumped way up about 6 months (July 2008) after transplant, and stayed high

until I started the treatment for the Hep C in December, 2008. Around that same

time was when I started feeling more tired too. The best I felt was the first

six months after the transplant.

Penny

>

> i miss you all...barbie that was something else what happened to your neighbor

WOW...how tramatic...you know they are not going to treat the virus unless the

numbers get high and or start to cirrhose the new liver. we are doing good they

said we can be at home for good the wed before Thanksgiving. he is walking good

and is getting his energy back appetite and humor. he is spoiled......i am

trying to get him to do alittle more for his self...he still doesnt sleep

well...we are so happy and i am greatfull that we all have traveled on this road

together. love sandra

>

>

>

>

>

[Guest guest]

Sorry, Myria. The Sermo post was 59 pages long when I tried copying it, and

copyrighted, so I guess I had better not. I'm glad to hear you are making

progress. I'm sorry about your commute. I know you wanted to do the

work-from-home option but were blocked by your town. What a loss for

them.---Sharlene---

>

> Wonderful! Congratulations.

>

> I hate signing into things that I won't be using much.  Any chance of getting

a

> copy of what was in SERMO?

>

> Great update.

>

> I've been open 2 years, Completely solo solo except recently found a good

> billing volunteer for one day a week to get me out of my billing mess.  I'm

> getting the bills out but not so good at follow up and posting so she's doing

> that (Newbies don't make same mistake of not having a practice managment

> system.)  Made 61,000 last year but I have lower expenses as no rent.  Time

> crunch ALWAYS a factor since driving 45 mintues each way.  (Can't move

because

> young adult daughter who is  " differently abled "  needs city services to

continue

> her growth towards indepencdence.) I don't like billing but am proud of the

> learning I've done to be able to do it.  Love taking care of patients the

right

> way.  Hate insurance and if Medicare keeps mucking around may jump to cash

> only.  (REALLY hoping AMA pushes that new bill successfully so we can

contract

> for patients for different rates even if par.)  I do find rural practice

> emotionally draining at times i.e. never thought I would be taking care of

> batterers! I now have 3 on my case load and the wives too! Yikes. I find the

> technolology learning curve still steep at times as I strive to become more

and

> more efficient.

>

>

> I too would like to thank all the IMP mentors out there!  Without you I

would

> not have made it and continue to learn from you all daily.

>

>

> Myria 

>

>

>

>

> ________________________________

>

> To:

> Sent: Wed, July 7, 2010 11:04:19 PM

> Subject: For physicians (and those who love them!) in

> crisis...

>

>  

> Hi, all! and and anyone else who fits the above description, here

is

> a link to an excellent thread on Sermo regarding support for a struggling

> pediatrician. I think there are many thoughtful suggestions and good contacts

> listed, as well as a wonderful sense of support for those of us who have or

are

> currently experiencing these kind of problems. I frequently don't like the

posts

> on Sermo, but I think this one should be required reading for docs in

financial

> and emotional crisis.

>

>

https://app.sermo.com/posts/posts/54139?utm_source=et & utm_medium=email & utm_campa\

ign=pick_sp070610act

>

>

> If that doesn't work, sign in to www.sermo.com and look in the General

Interest

> posts for " Colleague at his end-S.O.S.!! "

>

> I would also like to thank you all for the wonderful education and support

that

> I have gotten from this IMP group. I hope you don't think I am boasting,

because

> I know that private practice is very precarious these days and any number of

> events could bring my business crashing down, but I would like to let folks

know

> that I seem to be succeeding and that I attribute it all to what I have

learned

> right here. Fortunately, I have been collecting articles about solo practice

> since even before Gordon published his first one, although that was the one

that

> introduced me to the " ultra-light " model. In 2007, I was introduced to this

> group and read every single post here, going back to the very beginning. This

> helped me do many things correctly from the start, and helped me avoid the

> serious financial errors that many people have made by following traditional

> advice before becoming part of this group. I have been open in rural, central

> NY, working full-time out of my own home, since October of 2008. I started

> solo/solo, but quickly realized that I needed help to make the full-time

> physician's income that I need to support my family. So, I have sucked my

> husband in and he now mans the phones and does the back-end billing (after I

> send out the initial bills). He is also my IT guy and " director of facilities "

> (buildings and grounds!). This is a PLLC and he is not an employee, so I don't

> have to worry about Worker's Comp, OSHA, etc. We accept Medicare and many

> commercial insurances that pay at least Medicare rates. (NO United Health

Care!)

> We cannot afford to accept Medicaid, and there are 2 hospital clinics nearby

> that get paid a lot more to do so, so I don't feel TOO guilty about that. We

> give a hefty discount to the uninsured for PIFATOS, which brings their charges

> down to about what Medicare pays. Sometimes folks in trouble can't keep

paying,

> so I may slip in a free follow-up visit here and there. Over our first 14

> months, we spent about $75,000 of our home equity for the practice startup and

> living expenses. The money was going out very fast at first, and my husband

and

> I were quite frightened. I learned first-hand what generalized anxiety

disorder

> feels like. For the past 6 months, however, we have paid all our business and

> personal expenses, estimated taxes, and our daughter's state college expenses

> from our business income, with $4,000 to spare! WHOO HOO! I have 430 patients,

> many of them very sick and complicated, and am more than busy enough seeing

7-8

> patients daily. I have been so bogged down in charting and administrative work

> recently that I haven't been able to enjoy any summer activities, so we are

> putting a temporary hold on new patients until September, and I will then

> probably limit them to 1-2 per week. I LOVE my beautiful home office and being

> my own boss and spending an hour (or more) with patients who really need it. I

> LOVE never running late or making patients wait unless they are foolish enough

> to come early. I even kind of like billing (such a challenge!) with EZ Claims.

I

> HATE charting, administrative work, and insurance companies. I still work WAY

> too many hours of overtime, but would rather do it at home than somewhere

else.

> I don't think I could do it completely alone or if I had young children at

home.

> Anyway, that's my update! Best wishes to all who are planning or starting, and

> my prayers are with those who are struggling against long odds. Who would have

> ever guessed that it would be so difficult making a living AND a sustainable

> life in medicine?---Sharlene---

>

[Guest guest]

Thanks Sharlene for checking.

The commute is long but the people lovely.

If Vera continues growing like she's been I hope to move in about 10 years. :)Never been happier professionally or personally.

To: Sent: Thu, July 8, 2010 8:57:09 PMSubject: Re: Update

Sorry, Myria. The Sermo post was 59 pages long when I tried copying it, and copyrighted, so I guess I had better not. I'm glad to hear you are making progress. I'm sorry about your commute. I know you wanted to do the work-from-home option but were blocked by your town. What a loss for them.---Sharlene--->> Wonderful! Congratulations. > > I hate signing into things that I won't be using much. Any chance of getting a > copy of what was in SERMO?> > Great update. > > I've been open 2 years, Completely solo solo except recently found a good > billing volunteer for one day a week to get me out of my billing mess. I'm > getting the bills

out but not so good at follow up and posting so she's doing > that (Newbies don't make same mistake of not having a practice managment > system.) Made 61,000 last year but I have lower expenses as no rent. Time > crunch ALWAYS a factor since driving 45 mintues each way. (Can't move because > young adult daughter who is "differently abled" needs city services to continue > her growth towards indepencdence.) I don't like billing but am proud of the > learning I've done to be able to do it. Love taking care of patients the right > way. Hate insurance and if Medicare keeps mucking around may jump to cash > only. (REALLY hoping AMA pushes that new bill successfully so we can contract > for patients for different rates even if par.) I do find rural practice > emotionally draining at times i.e. never thought I would

be taking care of > batterers! I now have 3 on my case load and the wives too! Yikes. I find the > technolology learning curve still steep at times as I strive to become more and > more efficient. > > > I too would like to thank all the IMP mentors out there! Without you I would > not have made it and continue to learn from you all daily. > > > Myria > > > > > ________________________________> > To: > Sent: Wed, July 7, 2010 11:04:19 PM> Subject: For physicians (and those who love them!) in > crisis...> >  > Hi, all! and

and anyone else who fits the above description, here is > a link to an excellent thread on Sermo regarding support for a struggling > pediatrician. I think there are many thoughtful suggestions and good contacts > listed, as well as a wonderful sense of support for those of us who have or are > currently experiencing these kind of problems. I frequently don't like the posts > on Sermo, but I think this one should be required reading for docs in financial > and emotional crisis.> > https://app.sermo.com/posts/posts/54139?utm_source=et & utm_medium=email & utm_campaign=pick_sp070610act> > > If that doesn't work, sign in to www.sermo.com and look in the General Interest

> posts for "Colleague at his end-S.O.S.!!"> > I would also like to thank you all for the wonderful education and support that > I have gotten from this IMP group. I hope you don't think I am boasting, because > I know that private practice is very precarious these days and any number of > events could bring my business crashing down, but I would like to let folks know > that I seem to be succeeding and that I attribute it all to what I have learned > right here. Fortunately, I have been collecting articles about solo practice > since even before Gordon published his first one, although that was the one that > introduced me to the "ultra-light" model. In 2007, I was introduced to this > group and read every single post here, going back to the very beginning. This > helped me do many things correctly from the start, and helped me avoid the > serious financial

errors that many people have made by following traditional > advice before becoming part of this group. I have been open in rural, central > NY, working full-time out of my own home, since October of 2008. I started > solo/solo, but quickly realized that I needed help to make the full-time > physician's income that I need to support my family. So, I have sucked my > husband in and he now mans the phones and does the back-end billing (after I > send out the initial bills). He is also my IT guy and "director of facilities" > (buildings and grounds!). This is a PLLC and he is not an employee, so I don't > have to worry about Worker's Comp, OSHA, etc. We accept Medicare and many > commercial insurances that pay at least Medicare rates. (NO United Health Care!) > We cannot afford to accept Medicaid, and there are 2 hospital clinics nearby > that get paid a lot more to do so, so I

don't feel TOO guilty about that. We > give a hefty discount to the uninsured for PIFATOS, which brings their charges > down to about what Medicare pays. Sometimes folks in trouble can't keep paying, > so I may slip in a free follow-up visit here and there. Over our first 14 > months, we spent about $75,000 of our home equity for the practice startup and > living expenses. The money was going out very fast at first, and my husband and > I were quite frightened. I learned first-hand what generalized anxiety disorder > feels like. For the past 6 months, however, we have paid all our business and > personal expenses, estimated taxes, and our daughter's state college expenses > from our business income, with $4,000 to spare! WHOO HOO! I have 430 patients, > many of them very sick and complicated, and am more than busy enough seeing 7-8 > patients daily. I have been so bogged down

in charting and administrative work > recently that I haven't been able to enjoy any summer activities, so we are > putting a temporary hold on new patients until September, and I will then > probably limit them to 1-2 per week. I LOVE my beautiful home office and being > my own boss and spending an hour (or more) with patients who really need it. I > LOVE never running late or making patients wait unless they are foolish enough > to come early. I even kind of like billing (such a challenge!) with EZ Claims. I > HATE charting, administrative work, and insurance companies. I still work WAY > too many hours of overtime, but would rather do it at home than somewhere else. > I don't think I could do it completely alone or if I had young children at home.> Anyway, that's my update! Best wishes to all who are planning or starting, and > my prayers are with those who are struggling

against long odds. Who would have > ever guessed that it would be so difficult making a living AND a sustainable > life in medicine?---Sharlene--->