HIPAA Issues


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About a month ago, I noticed that Mary had an soft enlarged area around the base of her throat.

“You ought to get that looked at,” I said. “That area around your neck doesn’t look right.”

So Mary made an appointment with our family physicians practice. She has a different doctor than Ralph and I, a soft spoken muslim woman. We like her for Mary because she is quiet and calm, and yet firm and confident. Mary made an appointment and because she hadn’t been seen for five years, she had to fill out new paperwork. Sometimes Mary wants to be independent, which is normal for anyone, even adults with high functioning autism. So she filled out her paperwork and did not give Ralph or I permission to talk about her health conditions.

A few days after Mary’s appointment, our doctor’s office called me at my work office asking to have Mary call them and talk to a nurse. They also called Ralph on his cellphone. They were very anxious to get ahold of Mary regarding her condition. But they refused to discuss her health condition with either Ralph or me because Mary had not signed a HIPAA form allowing them to talk about her health condition. Mary has a relatively new phone and did not realize that her voice mail was not set up.

We had to have Mary call the doctor’s office. However, this was frustrating for Mary because she works in a call center during the doctor’s office hours, and does not have enough time to wait on hold to talk to a nurse. Finally on the third day, she was able to get through to talk to the nurse.

She had to get an ultrasound of her thyroid nodule. After that the office made a referral to an endocrine specialist for a fine needle biopsy. Mary’s thyroid nodule is benign by the way.

This episode surprised us and demonstrated the importance of talking about medical issues and paperwork. We told Mary that we had filled out HIPAAs with permission for our children to know about our health conditions, and she ought to do the same with Ralph and I, especially since we need to rearrange our schedules to get her to her medical appointments. She agreed somewhat reluctantly, I think because this is an area for independence for her. Still, it is an important issue to discuss and not be surprised about.

When Ralph took her to the endocrine specialist, he made sure that she signed the HIPAA paperwork to allow her doctors to talk to us. The nurse from that office called me, again because Mary’s voice mail still did not work. They had had a cancellation just before the holiday weekend and they were anxious to fill the spot and also save Mary the anxiety of waiting over the weekend. I said to her that we needed to know some information because Mary had some physical limitations and we had to provide her transportation. She was much more helpful. And the doctor had Ralph come in to be with Mary during the procedure.

I know that some day Mary will have to make all of these arrangements alone, but for now it is simply easier for her to get help from us.


An Emptier Nest


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Two down, one to go.


About a week ago, I took Patty to University. Her brother Will went with us to help with the driving and help with the move. The trip down there was 434 miles (Google’s estimate). We had to stop every two hours so Patty could put her eye drops for her iritis in. We left at 7:30 and arrived at about 3:45 p.m.

I am so glad Will came with us. He kept Patty busy with conversation and did do some of the driving. He helped me carry things from my little red car up to Patty’s new apartment. “I’m amazed you go all of this stuff in your little car,” he said.  He went with us to Staples and bought her a printer and an office chair. Then he went to Wal-Mart and bought a T.V. for her. (His sister, Mary paid for part of the T.V.)

We left Patty to sleep in her new apartment, while we slept in an economy hotel. She said she slept surprisingly well, despite her new situation. We went to Aldi’s and Kroger and stocked her cupboards and refrigerator. We tried to do what we could to make her life comfortable and supplied so that she wouldn’t have to go to the store right away, since she has no car.


Will cooked spaghetti sauce and chili and packed it up in freezer containers so she would have something easy to warm up for meals. His dad did the same for him when he moved away three years ago.

When we left, we hugged long and hard. After we left she told us that she cried for two hours. She has to face everything in new surroundings, dealing with a fairly serious health issue, and missing her family. The second day, she told us she cried less. and she went to the ophthalmologist in her town, and found out that her iritis is gone. The doctor told her  She has to taper off the steroids; and is hoping that it won’t come back. She has been busier every day, met her advisers, and other graduate students in her department, along with the professor she is working for. Tomorrow she begins both her own classes and the class she will be T.A. -ing.

I drove all the way back; Will’s back was aching. Although he does drive his own car, he is an inexperienced driver, especially in the dark in the rain. We talked all the way back, even though he wanted to sleep. We had to pull over on the freeway in a large city because it was raining so hard. God kept us safe. We stopped at a hotel on the way home because I was too tired to drive anymore. But we got home. Will told me that helping his sister out was “worth it.” We talked about his beliefs, his home life, work life, struggles with making friends, and longing for a wife. In listening to him, I was overcome with joy at the man Will is becoming.

Our home is quieter, much quieter. Patty’s personality is big, effervescent, loud. (Our semi-feral cat, Wendy is officially afraid of her noise). Ralph misses her intensely. She took a year off between undergrad and graduate school. She has been home for him through his illness. It gave me some comfort to have her home. I went shopping for groceries Monday night. I had to stop myself from buying food that she likes. It was unsettling.

We are praying Patty will be successful, make friends in her new home, find fellowship in a church, grow spiritually and professionally.

Our nest is emptying out. Maybe Mary will move next summer. Then we will have to decide what to do with this four bedroom house. A transition for all of us. This is what we’ve been working for all this time. Thank you, Lord. It feels so odd, now that it is here.







Anxiety Overload


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With three weeks to go before leaving for University, Patty has developed inflammation in her eye (iritis). This is nothing to mess around with. Symptoms of Iritis include pain, sensitivity to light, blurred vision, etc. If left untreated, it can lead to vision loss and glaucoma.

She has been to an optometrist four times in a week. Her dad is helping her administer the eye drops (steroid and dilating). The pain is diminished and her iris is no longer sticking to the lens of her eye. But the inflammation is not improving as much as the doctor would like. If it is not improved enough by Tuesday, she’ll have to go to an ophthalmologist and get a shot in the eye.

Patty hates shots. Always has.

Now she can’t stop herself from thinking about it. I would have a hard time, too.

Before this, she was having some stress thinking and planning for her move to University. Would she be able to do her TA job? How would she do with her studies, and meeting her advising professor. How would she pay her rent before getting her first paycheck. Would everything fall into place? How would she feed herself, get herself where she needed to go? (Maybe some of these are my anxieties as well. Just maybe).

Now she fears this will keep her from going to University at all. Or at the least, it will make everything so much more difficult. She signed a lease in May. If she can’t go, she will be $10,000 in debt to the apartment complex. She would have to start paying her student loans from undergrad. She might not be able to fulfill her dream (PhD in history, teaching at University level). Maybe she has a genetic disorder. It turns out that Will has ankylosing spondylitis. Iritis is commonly the first symptom. He has had iritis four or five times since leaving college and was diagnosed through blood tests. Patty’s fear is reasonable. But she may have developed this due to other reasons…like stress.

This also put a complete stop to her driving lessons. We were hoping she would get her driver’s license before she left. Maybe this is a protection. The university is very compact for a place with 30,000 students.

Ralph and I have been trying to encourage her. We continue to prepare her for her time at University. I am buying towels, washcloths, and other odds and ends. Going through my spice cupboards to see what I have that I can share. Collecting items from my kitchen to give her, so we don’t have to spend money for them.

And we are praying that this will heal up before we leave for University. But if not, that she will be able to find effective treatment and be able to obtain it within her schedule. Patty has a full tuition scholarship and a stipend for a teaching assistantship. A lot is on the line for her.


My Place is Not in a Helicopter

Will turned in his two week notice today.

His current employer then counter offered  twice his salary.

He had already sent in his acceptance to the new company.

His dad thinks he should keep his word and go with the new company.

On the other hand…

This is the young man who moved to a town 70 miles away by faith, tremulously hoping that the job would work out. Three years later different companies are offering him huge raises. He has shown himself to be a creative programmer.

He wanted me to help him decide. I gave him some input… I always lean toward security. But I told him the decision was up to him. Whatever he decides is fine with me. I’ll pray for him either way.

This helicopter has landed.

Support needed, freely given.


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“Mom, I had an accident,” Will’s distress came loud and clear through my car speaker as I drove home from work Friday. “What happened? Are you hurt?”

“No. But my car is really damaged on both sides. And the couple who hit me, their old truck is old, but they can’t afford to replace their truck. I kept saying I was sorry.”

“It’s my fault, Mom. I forgot to look both ways and pulled out in front of them. I wish I had just gone home instead of going to the store to buy a new phone”

“Oh Will, at least you weren’t hurt. Was any one else hurt?”

“They were checking out the older lady. She might be hurt a little. … I have to hang up. The policeman is here.”

I could hear the policeman asking for Will’s proof of insurance and registration.

My phone rang a few minutes later.”

“Mom, I can’t find my registration. It’s not here, not here, not here, not here,” he said shuffling through papers in his glove compartment. “Oh no, oh no, oh no,” panic was rising.

“Will, other people have lost their registration. It’ll be alright.” I hoped. “Just tell the policeman you can’t find it, but you knew it was there the last time you looked.”

“Okay. I have to hang up. He’s back.”

The phone went dead. I had come in the house during the conversation, and I sat in my chair, praying. I prayed that Will would not have a meltdown. His autism might become especially troublesome at a time like this. I prayed that he wouldn’t be overcome by panic.

Ralph walked in the door a few minutes later with Mary. He had picked her up from work.

“Will had an accident.”

“Oh no. Is he all right?”

“Yes. But his car is very damaged. And he’s in distress.”

My phone rang again. “Mom, it was alright. The policeman was able to find my registration on his computer. Now I have to wait for the tow truck to come.”

“How are you going to get home.”

“They are going to give me a ride.”

“Who is going to give you a ride.”

“The tow truck driver or the policeman. I’ll call you when I get home.”

“When you get home, call your insurance company right away. They will tell you what to do next.”

Will called us after about an hour. He told us that the insurance company was setting up an adjuster to come out an look at the car. They gave him the choice of where to have it fixed with one of their contractors. And they were arranging for him to have a rental.

“Would you like us to come and visit you?”


“Do you want us to come tonight or tomorrow.”

“Tomorrow is okay. I don’t want you to come over tonight.”

“We will, if you need us to.”

“No, I’ll be okay tonight.”

“Have you eaten yet?”


“You need to eat something.”

“Okay, I will. ”

“See you tomorrow. I’ll bring some food to cook for you.”

The next day, Patty and I drove over to his house, took him shopping for food. We visited him. Let him talk it out. He didn’t eat the night before. I bought him lunch at McDonald’s, and he told me he hadn’t eaten much that morning either. He was too upset. But he felt much better after eating.

I made chicken and dumplings last night, and crockpot roast pork today.

“I’m so glad you came,” he said today. “But I still can’t stop thinking about about it. What if the company I am going to work for decides not to hire me? They are going to do a background check.”

“I don’t think they are going to use this not to hire you. Besides, it probably won’t appear on your record for a while.”

“Would you like your Dad to come over today? I’ll go home and send him back. He can help you get around and get everything arranged. He can drive you to work tomorrow so you don’t have to think about that.”

“Okay. I still wish I hadn’t decided to go to the store to buy that phone. If only I had gone straight home.”

“Will, it’s normal to feel that way. In a few weeks, you’ll feel better, but you’ll still think about it for a while. When I had my accident, I did the same thing. Running over it in my mind. But you have to stop yourself from thinking about it, distract yourself as much as you can.”

“I haven’t been feeling good. My throat has felt funny and I’ve had a headache this week.”

“That’s anxiety, Will. You’ve been dealing with these interviews this week, and made a big decision to leave your current job and go on to another job. That’s a big deal, even though it’s a good event”

Will had four interviews this week, received a job offer, and accepted it. A lot more money, and bonuses. In three years, Will has obtained a valuable skill set in WorkDay. He’s been contacted by numerous recruiters this year. He decided to send his resume directly to the companies the recruiters were trying to refer him to. He’s had interviews with three different companies this week. One of them hired him.

So on Monday, he is going to be messing with this car business, and giving his two week notice to his current employer. They called him into a meeting last week and told him they were trying to get him a raise and a remote position so he could work from home. They were too late.

“You’ll have to push on Will. It’s a risk, but they wouldn’t have hired you if they didn’t need your skills.”

“What if I can’t do it?”

“I’ll be praying for you, and so will your Dad.”

When I got home from Will’s I said to Ralph, “He’s looking pretty thin. I don’t think he’s been eating right. Patty said he’s been eating poptarts for breakfast.” Patty stayed with him for a week this summer. Cook for him when you get there.”

After Ralph arrived, Patty called to ask what I had done with the garbage bags. “Oh, I found them,” and she hung up. Ralph and Patty were cleaning his house.

Sometimes our kids need extra support.



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