Saturday, February 1, 2014


When I was going through my finances after my husband died, I was advised to apply for long-term care insurance.  An independent agent helped me submit my application, and after a few weeks, he called to say I had been denied for coverage.  I knew that my high blood pressure, although it is under control with medication, might be a factor against me, but the agent told me that it was actually an MRI from seven years ago that caused the denial, because it said that a finding "probably represents a [sic] old lacunar infarct."

I asked him what that meant, and he said they interpreted it as meaning I had probably had a small stroke and therefore wasn't a good candidate for long-term care insurance. 
He said, however, that he was willing to appeal my denial if I could get my doctor to indicate in writing that this was not the case.

I began with the GP who requested the MRI, but her office said I needed to call the neurologist to whom I had been referred.  When I called his office, I was told that I needed to call the radiologist's office.  When I called them, they offered to send me a copy of the MRI report, which I had not had, but said that was all they could do, and I should go back to the GP.  I called them back, and said I had remembered that they had had a second radiologist look at the report and conclude that it probably wasn't anything to worry about, but I didn't have that in writing.  However, I told them if this MRI was serious enough to have me refused for long-term care insurance, I needed to know if there is something else I should be doing to avoid any future difficulties, or whether in fact this was not actually a stroke. 

They made an appointment for me to see my doctor on Tuesday morning, and asked me to bring a copy of one of the MRI reports which I had, but they didn't.  I found this somewhat disturbing, and I was told that they were only required to keep records for seven years.  In addition, I discovered a small notice on the report copy that said "Prior images from 8/1/2003 are not available due to archiving error."   I had a vision of those images surfacing in some other person's file to disturb or console another patient. It also made me remember my oldest daughter calling up to her get her grades when she was at UCSD, and the recording said, "Physics, F." Since all her other grades were A or A+, she didn't immediately have a heart attack, but called the school to find out if a recording mistake had been made, which it had.  But I often think of the student who should have had an F, and when he or she called, discovered the A. It made me determined to ask for copies of any future reports!

In addition, I have what I think is a bad sinus infection, with laryngitis that has become severe enough that I have descended from being a soprano in our choir to being able to sing with the basses!  So, I hope I can not only get further information on the probable "lacunar infarct," but perhaps get some medication to relieve my much less serious condition.  When I did a little research on lacunar infarcts, I discovered that they are the subject of some controversy in the scientific literature, and I felt hopeful when I read that they can be "related to systemic hypertension, cause a variety of defined clinical syndromes, and imply a generally good prognosis."  

So I shall enjoy the Wexford Blue Iris and pink azaleas in a vase on my desk, and the view of pansies, snapdragons, and petunias in my garden, a sudsy fringe of clouds just above the pine trees and hills and clear blue sky above that.  As my dear husband used to say, after we moved here from New Jersey, "It's February 1!"

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