Mets Day 219 - searching for solutions

Yesterday I sent the following email to Drs. Mark Schoenberg and Trinity Bivalacqua, the surgical urologists at Johns Hopkins who have been following my case:

I am still dealing with nighttime incontinence and the attending sleep deprivation.  Do you have any solutions?  Per Trinity’s instructions, I continued with CIC through October, ending on Nov. 5.  I have limited my fluid intake after 7 pm, and avoided irritants.  I typically will go to sleep at around 11:30 pm.  I find that I am incontinent regardless of whether I get up and void or not.  Once I start to leak, I find it very difficult to go back to sleep. 

Last week I met with a psychiatrist specializing in sleep disorders, and she found no psychological reasons for my sleep deprivation.  She prescribed Ambien CR 12.5 mg, which has helped me sleep through my leakage episodes, but I am still adjusting to it.  Plus, I still am not feeling well-rested.  I am trying to determine if this is just the way it’s going to be, or if there are other options.  Should I resume working with a physical therapist?  Would it make sense to schedule a consultation? 

With the coming week being Thanksgiving, I might not receive a response until after the holiday.  I really would like to see if there is some additional solution to stop my nighttime incontinence. 

I also exchanged emails with my oncologist, Dr. Aragon-Ching, who confirmed that it was ok for me to take a baby aspirin each day, since a few studies have suggested that is the single most effective way to inhibit microscopic metastatic cancer from forming solid tumors.  We had talked about taking baby aspirin prior to my surgery, then had decided to hold off while I was recovering and subject to further procedures.   

On the disability application front, yesterday I was advised that both insurance companies say that they have received no documentation from any doctors.  I submitted the forms six weeks ago.  I suspect that the insurance companies are not eager to part with their funds, and are slow-walking my applications.  It looks like I may need to personally gather the paperwork and send it in.  However, I'd expect that, after I do that, the insurance companies will tell me that they need to get the official file, and make me wait longer.  I had hoped to have a decision by the end of the year so I could have some clarity on my relationship with my firm, but that looks less likely now.  

I also met with my firm's benefits coordinator to explore options should I stop working full time.  She explained that, generally speaking, as long as a partner is working at least 50%, that partner can continue to pay for health insurance through the firm.  (As a partner, I receive no subsidy or discount for health insurance; I pay over $20,000 per year for my family's health insurance.)  If a partner was to work less than 50%, then the partner would not be eligible for ongoing health insurance.  I asked if the rules were any different for someone on disability, and she said there were limited exceptions, such as the one I have been using this year.  If I am no longer eligible for health insurance through the firm, I have the right to continue my coverage through COBRA, which lasts for 18 months.  The cost for COBRA is essentially identical to what I am now paying.  If I am disabled, my COBRA rights can be extended an additional 11 months, up to 29 months.  After that, my insurance options are either to go onto Medicaid, or join one of the new insurance pools being set up under Obamacare, or either Jennifer or I get a job that has insurance benefits.   

Jennifer quotes Sonny and says that everything will be all right in the end; if it's not all right then it's not yet the end.  Uh huh.