u/Important_Method_665

Hello! I’m an experienced - advanced crocheter and I’m looking for suggestions for a small to medium decor item I can make for my friend as a housewarming gift. He’s moving in with his lovely girlfriend, and they are somewhat quirky. Here are some traits and preferences:
-they have 4 cats
-she’s into crystals, paranormal, plants
-he’s into TTRPG, boats (specifically whaleboats), creepy / horror stuff, art, movies, and hello kitty 😂 he also looks like a sea captain and wears kilts daily.

He’s got a dark sense of humor and is a bit silly at times, and is very loving and gentle.

I’m leaning towards a wall hanging, either from dowels or a round wooden ring. I’d prefer it to be a bit easier to make as he’s moving at the end of the month so I will need to get it done quickly. I am a fast crocheter, overall, though.

Any suggestions on where I could find something quirky? TIA!

In the past month, I have had a hell of a time. My PBM screwed my access to the manufacturer coupon for my meds, my deductible reset and I can’t afford them, and I started digging into my insurance and their nonsense and uncovered a whole bunch of unethical and likely illegal things. During this time, I didn’t know whether I would have my meds, and I was spending a lot of time on the phone fighting and a lot of time emailing and doing everything I could to be my own advocate in a broken healthcare system.

My best friend (who lives far away but we talk daily) is also going through some stuff. I did what I could to check in, tried to balance taking care of myself but also supporting her, etc. She sent me a message asking if we are okay, to which I immediately said yes, of course, I’m just really depleted with this insurance stuff and I’m fighting a stress flare and I am sorry if that means I’m less available right now but it’s not because of my feelings about our friendship, I just have to prioritize my own needs. She said she understood. She has a child with T1D and understands how chronic illness can be all consuming.

Then she messaged me a few days later and told me she needed a break from me because while she had previously told me that even though she’s having a hard time she can support me, she’s realized she can’t. Now, I wasn’t asking her for anything. She told me that she did want to hear about my insurance crap and she wanted to know what was going on with me, so I told her a bit, but I honestly kept a lot to myself because I know what’s going on with her and I have a lot of other support in my life. I didn’t want her to feel burdened.

About a week later after not talking at all, she informed me that she can’t be friends with me anymore. I know I’m leaving a lot of details out, but basically, she said she’s felt like she’s bending over backwards for attention from me and she needs to focus on herself and not seeking validation from me the way she has been (which I was unaware of).

In reflecting, I have realized that I was basically limitless and 100% available to her for nearly a decade, up until I got sick. Between us, she has had way more struggles in her life and has a much smaller support network due to both circumstance and her own choices and lack of effort towards increasing that circle. Since I got diagnosed, I have worked incredibly hard to be more vulnerable, more open, and more aware of my own limits. I have stopped saying yes to everything because I know if I say yes to something, I’m saying no to myself and my health (sometimes) and I cannot afford to do that. I have expanded my support circle because I can’t do this alone. And, I think in that personal shift and growth, she has felt as if I am pulling away from her or need her less, or I’m not as available for her because to be honest, I’m not. I can’t give what I used to because my body can’t handle it.

I think she was used to being the one who needed, and now it’s me, and I always thought that if that day came she would be able to balance it out and support me…. But it turns out she can’t.

RA affects more than health, it also exposes your limits as well as those around you. I’m really sad about this, and I wanted to share it because the grief from being diagnosed with an autoimmune condition can come from so many places and affect so many parts of life and if this resonates with you, please know I see you. It’s so lonely on this island sometimes.

Hello!
Looking for advice- I am well controlled on Actemra and MTX, but have been experiencing hip pain that’s clearly in the joint for the past couple of months. It feels like it’s increasingly worse, to the point it wakes me up at night. I mentioned it to my rheum, who recommended PT and ordered X-rays. The X-rays look normal, so I am not dealing with a loss of cartilage. I am not super interested in doing PT- I’m a very active person, exercise daily, have excellent core strength (I row whaleboats, paddle board, have two big dogs that I walk and play with and run with, etc) and honestly I don’t know how much value I see in it, which I did express to my doctor.

The pain is very targeted— if I poke in the crease where my leg meets my groin, behind the front of my pelvis, it’s in that spot exactly. I’ve been stretching, had massage and chiropractic, have tried aleve, and now I’m considering steroids possibly.

Have any of you had similar pain, and if so, what worked? Should I give PT a chance? I’m tired of waking up in so much pain.

Hello, I am looking for advice regarding a problem I have uncovered with my PBM.

My summary of benefits and coverage states $0 member responsibility after my deductible has been met for specialty injectable meds. However, when the pharmacy I get them filled through bills the PBM, they receive back that I have a member cost share of $120/125. I have a copay assistance program that is not part of my existing benefits (it’s a manufacturer benefit and not guaranteed) that then was covering that amount.

Well turns out now that copay program has flagged the PBM for not only me but all of the members on the plan for using copay maximizer practices, and that this violates the terms of service for the program. The PBM is telling me that because I can use the copay program (again not guaranteed and actually not available when I really need it now because of the flag) that I do have a $0 cost share, but they continuously process claims indicating I do.

Has anyone faced this? I have asked for so much documentation and have evidence of the claims
Being processed in this way that is contradictory to my actual SBC. No one will send me the full benefit details even though I keep asking for it.

Thanks in advance!

Looking for any advice about managing issues with insurance. I have a PBM that has misrepresented my cost share for my biologic and in doing so has jeopardized my ability to use the copay card program for my medication to help cover the cost of the deductible that has reset and applies to my meds. I am well versed in insurance overall but looking specifically for whether anyone here has been successful at holding a PBM accountable for providing benefits information that does not match their actual cost share and if so, what avenues did you take?

I’m planning to do the following:

1. File a formal complaint with the PBM and my healthcare insurance company
2. Contact my HR dept about the problem
3. File a complaint with the state insurance regulatory body
4. File a complaint federally with ERISA and possibly CMS
5. File complaints with the BBB and possibly the state AG?

Essentially they have been lying to me about my out of pocket cost for medication and now it’s jeopardized my ability to access a copay card because the copay card caught them doing it and exposed it. They have told me I have $0 copay 0% coinsurance after my deductible is met, but the way they make that happen is by forcing me into a copay card program that they have no ability to ensure will pay for my cost share, which lowers their costs but then takes advantage of the copay program. This violates the copay card terms of service, so now I’m always going to have a cap on my per fill support even if my deductible resets or I get a new insurance or whatever, I personally am flagged in their system for something my insurance did to me. And now my insurance is trying to make me change meds to a different one as a way to “remove administrative barriers” but the new med copay card has the same terms of service.

I know I need legal support and I will be getting it but I just hope someone here has any other advice or support to give as I embark on this battle. Thank you in advance.

Hey all,
I have woods on my property and ended up with some poison ivy. I know the rash well- I live in a rural area so it’s not new to me. Usually don’t react that much, I’ll get a few small bumps and that’s it.

HOWEVER I am now on Actemra and MTX and this time the rash is just not going away. I have some spots that are so bad I’m pretty sure they are actually infected. I am also EXHAUSTED like flare fatigue exhausted. Like I just wanna lay down. Like I cannot seem to keep my legs walking normally.

I am seeing my PCP tomorrow who will hopefully help me. Has anyone noticed something like this before? I know we have to be careful of infections but damn, this wasn’t an infection but now it probably is. Ugh.

I live in Massachusetts and have an abundance of beaches around me. I’m wondering if anyone has recommendations on beach specific foraging to do (looking for seaweed or other plants preferably) and if there are any good guides to check out? I love seaweed so I’m hoping to become more familiar with our local options and start branching out into that arena. Thanks!