The First Step

 A few days ago I took the first official step toward my own personal Ketamine journey with the full psychiatric and medical evaluation.  I logged on and did my check in paperwork, checked my camera and lighting on my video chat and then sat and waited. 

The last time I sat face-to-face with a psychiatrist it was many years ago when I was being filled full of pharmaceuticals.  I was unheard and unseen.  I was nothing more than money in his pocket.  I knew that then and I remember it vividly now.  Just thinking about it made tears well up in my eyes as I watched the flashing “waiting for doctor” message on the empty camera hole on my laptop screen. I could feel the anxiety welling up inside me.

I also feared what she would say.  Would my insurance be a problem? Would she be understanding or sympathetic to my journey?  Then at 10 on the dot the Doctor appeared on the screen.  Right away she was so kind and welcoming to me.  I felt like someone was really listening to me for the first time in years.  She listened to the whole story start to end and all the pitfalls in between.

My path to get here was not really a traditional path.  Most people try some meds and then pop into this treatment I suspect.  But with me I have almost 40 years of struggle to sort through.  I have more than earned this treatment.  But then she pointed out that possibly my insurance will not think so.  That being on over 20 meds was maybe not enough because it all occurred prior to 2010 when I finally gave up on pharmaceuticals and used exclusively Eastern Medicine to control my anxiety and depression.  But these last 7 years without that in my life and being unable to find anyone to fill the gap for me has left me rudderless in the storm upon me.  Ironically the meds I was prescribed in December were the only salvation to that timeline apparently.  It will now be in her hands to make a case for my treatment.  This is where I am glad I chose a clinic with good reviews and their own in-house doctors who have a vested interest in making this work. 

The other downfall I am facing is that the protocol for this treatment requires 2 days a week for 4 weeks and then 1 day a week for 4 weeks after.  With my work schedule being out of town for weeks at a time and only having my husband as my driver, which means his own commitment to this for me, the only time I could work out to do this was June.  It is not that I want to sit around being suicidal and anxiety ridden for 2 more months.  It is my only option.  But insurance will not accept that and feel that if it was that important and I was “that bad” then I would have this treatment immediately.  So if they seek approval now and I don’t start within 4 weeks they will revoke the approval. 

This is absolutely infuriating and disheartening.  How do people navigate this?  I have no one to drive me but my husband because the clinic is 45-60 min from my house and the same from all of my friends.  So for them to pick me up, drive there, then return me after sitting at the clinic for hours while I am treated is just way too much to ask of someone, even my closest friends.  It is not realistic for me to Uber nor would I being in a state of semi-consciousness.  That coupled with the fact that they are not open on weekends and my job is entirely out of town, makes this impossible.  I am lucky I could manage to juggle enough to do this in June and July.  So for the insurance to not make an exception for that or to assume I don’t need it if I don’t do it immediately is just unacceptable.

It is also unacceptable to not look at the totality of my treatment over almost 40 years and not just my “recent” history.  But here we are.  So not only do I have to worry I will be denied based on that lack of new data but that they will have to wait til less than a month before my treatment to even know if I can get it. So now I get to spend the next 2 months worrying that I will be denied coverage and that the fight to get that decision overturned will extend beyond the window I can make this rigorous protocol work while still paying my bills and managing my career which is already in the toilet.  It should not be this hard.

This country is a disgrace in its health care in general but mental health care is deplorable.  It is impossible to get the help that people need far too often.  And although we should be a leader in care we fall woefully behind other countries in both available care and options for care.  We are absolutely owned by the drug companies and insurance companies.  This blog was intended to be about the path to and through my ketamine treatment and now I have to fear I will hit a brick wall before even GETTING any treatment at all.