Funny about Money

The only thing necessary for the triumph of evil is for good men to do nothing. ―Edmund Burke

One of Those High Blood-Pressure Days

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Hugely one of those days, for Godsake.

This morning I had what I expected to be my LAST regular appointment with CardioDoc. The blood pressure has been well in the normal zone most of the time, except for a few moments of rage or drunkenness, despite the fact that I’ve gained 12 pounds since going off the Great Diet Plan and I only get off my duff when forced to it. Overall average for December was 132/83, despite several spikes attributable to a) dental pain and b) episodic stress.

Like, for example, today’s episodic stress.

You know how much I love sharing the roads with my fellow homicidal drivers. This morning, as per usual, all my pet morons sensed that I was climbing into my car and so leapt into theirs and swarmed onto the roads.

Dear God, where do You find these people?????

Notable winners:

Runner-up: The guy who decided to dawdle down Indian School Road. Traffic is moving OK, but this one thinks 35 mph (5 mph under the limit) is too fast and he’d better hold up the parade. He’s in the center lane. We come to the signal at Central. The light turns green and he…sits there. That might seem reasonable because the four or five cars ahead of him are also very slow off the mark: we all just sit there. I notice the adjacent traffic lane is empty, so glide into that…and find space for three or four cars between him and the car ahead of him, who is not moving, either. He has stopped for the light at least three car-lengths behind the guy ahead of him.

Grand Prize: Now I’m headed south and need to turn left off Seventh Street. The light is green and the northbound lanes are clear except for ONE guy, who, instead of moving through, STOPS in the fast, left-most traffic lane. I’m in the southbound left-turn lane waiting for him to get the fuck out of the way so I can make my turn. He stands there, in the traffic lane, and starts FLASHING HIS LIGHTS AT ME.

I think…Whaaa? Am I in the wrong lane? Am I standing in the oncoming lane??? Noooo. Close inspection reveals that I am indeed in the left-turn lane and he is not: the northbound left-turn lane is vacant, and he is in the fast northbound traffic lane. Sitting there. Flashing his lights.

What the FUCK? Finally the idiot swerves left in front of me, across four southbound lanes. Apparently he decided belatedly that he needed to turn west there, after he’d missed his chance to go into the left-turn lane; so, of course, instead of proceeding north a block where he could have turned left into the neighborhood and made his way right back to where he was supposed to be going, he went wackshit.

Meanwhile, in the Where’s Yore Sign competition, I make a wrong turn. Actually I make two wrong turns: one is just a normal wrong turn that sends me in the wrong direction; the other is a stupid decision. Second “wrong turn” is an effort to turn left onto 7th Street off the side street where I now find myself….you’d think I’d know better by now, wouldn’t you? Eventually I had to make an Arizona Turn: this maneuver involves turning right, then left, then right again so as to turn left across or onto a major thoroughfare. Or even a minor thoroughfare.

These exercises slow me down considerably, but I reach CardioDoc’s office in plenty of time. I’m clenching my teeth by the time I pull into his office.

My blood pressure is always higher than usual in any doctor’s office, so much do I love dealing with those places. Truly, I do hate doctors’ offices and hospitals as much as I hate and fear anything. But we’ve found that if I’m allowed to sit quietly in his waiting room focusing on something that doesn’t annoy me and doesn’t scare me, by the time I get in to see him and his army of sidekicks, the numbers are in the normal range. So yes, I’ve brought my computer so as to have something to amuse myself.

But no. First thing they do is shove a two-page form in my face: fill this out AGAIN — same form I’ve filled out four or five times. Then they demand insurance cards: I say nothing has changed. They say insurance companies require that they scan the cards once a year. I say look, give me an e-mail address and I’ll scan them and send you a PDF. She says she can’t do that. I’m irked. Go off to find some place to sit down and jump through these aggravating hoops. Again.

Before I can even fill in half of page 1, they’re calling me back there!

They do an EKG, requiring me to pull off my shirt in front of a man (yes, and a woman) and expose my exquisite scars. Then his tech takes my blood pressure. She does it wrong, allowing my arm to fall down by my side. This will jack up the blood pressure reading, even if you have, as advised, sat quietly for half an hour without any distraction or annoyance. Which (this latter) was decidedly not the case. I say to her, why don’t doctor’s offices follow the instructions put out by the makers of these devices and by the Mayo Clinic?

Huh?

You know, you’re supposed to have the person’s arm at about the level of the heart.

Okay, let’s try again.

Now she holds my arm at shoulder-joint height! Shit…I give up.

The doc surfaces forthwith. Of course, the result of this test is sky-high, after a half-hour on the road and the bullshit in the clinic and now this ignoramus. I’ve enjoyed a good 40 minutes of aggravation and hassle and haven’t even had a chance to take a deep breath.

He now decides he should put me on blood pressure medication. This is something to which I highly object and that I suspect can be avoided. I point out that my regular BP is not that high. Well, says he, nevertheless, better a few side effects (like swollen ankles and vertigo…) than a stroke.

Welp, I do not think I am in immediate danger of a stroke, although it must be admitted that less risk would apply if I never had to drive another frikkin automobile as long as I live. Nor am I about to put myself on a possibly unneeded drug after the circus I’ve just been through.

On the way home, I decide I will pick up the medication at the Walgreen’s; then set it on the kitchen counter for a week. During that time I will a) get back to exercising every day (have let that lapse with a vengeance!); stay completely off the sauce; and start working on shedding the ten pounds that I could do without.

When I point out to him that I drink a fair amount, for a little old lady, he says you can drink two glasses a day without affecting your blood pressure.

Oh yeah? That’s news to me. Apparently to the American Heart Association, too, which says women should drink no more than one (very small!) glass of wine a day. SDXB’s docs told him to stop drinking altogether, and the Mayo seems to favor that strategy, too.

I figure a week of brisk daily exercise — of better quality than being dragged forward by Ruby and backward by Cassie around a mile-long trace through Richistan — will start to have an effect, if an effect is to be had. Plus if I quit drinking and lay off the pasta and the sweets, in a week I’ll drop a pound or two, no problem.

Let us, I think, make a baseline measure after a half-hour or forty-five minutes of quiet this afternoon, and then compare it with a new set of measures after a week of this mild proposed routine. If there’s no change, then I’ll start swallowing pills. But if it’s back down into the normal range, I’ll call the Mayo itself and arrange an appointment to discuss the issue.

Right. A half-hour or forty-five minutes of quiet: NOT so much.

Run by the Walgreen’s to pick up the pills. Line is out the door. I stand and stand and stand and stand watching nothing happen…and finally think, oh screw it! This can wait for a day or for the proposed week.

Get home: Decide to make my first dog-free speed-walk of the day right now, hoping to run off some of the frustration and residual jaw-clenching stress. Fly around the park — that’s a mile and a half. When I get back, the phone is jangling with a recorded message to come pick up the effin’ pills. But meanwhile a lot of other Hell has broken loose. Gerardo, who was supposed to come over tomorrow to do a messy and much-needed job in back, has left word on the machine saying he wants to come today and will  be here around 2 p.m.  It is now after 1:00.

I need to do a bunch of stuff out back before they can get to the jungle vines that need to be hacked back. Race out there to do that; find some tarps to help keep the worst of the mess down. Haul around and thrash around.

SDXB gets on the phone and announces he wants to come over not on Thursday but on Friday, a typical swivel-hipped move. What is it about men — TWO of them in one day! — that they think women have nothing to do but sit around waiting with bated breath for them to show up? Hassle with the junk in back, hassle with an Excel spreadsheet, hear Gerardo’s truck pull up in front.

By the time he and his guys leave, it’s after 3 p.m. and I’ve been charging around since 10:30 in the morning.

Needless to say, I have not spent five minutes seated in a straight chair with my feet flat on the floor, trying to relax. 😀

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8 Comments

  1. Grr. Don’t even get me started on the medical so-called profession. I’ve had good luck with specialists and ER docs–can’t fault my neurologist, MrH’s oncologist, or the docs who removed our son’s appendix. But general practitioners…shyeah. It’s as if they don’t feel right if they can’t *do something*–and the first something they want to do is prescribe some more drugs. Or some different drugs. Every time it seems we’ve found someone with some sense at the clinic we visit, they’re gone the next time we come in.

    And the blood pressure readings… I’m told one should sit quietly while having blood pressure taken. So why does every nurse/tech wrap the cuff around your arm, then immediately pepper you with questions? Or stick something in your ear? And do they ever use the large cuff on my or MrH’s large arms? They do not. On my more paranoid days, I’m convinced these are deliberate tactics used to let them prescribe more drugs and schedule more appointments. *sigh* I reckon I’m getting old.

    Sorry you’ve had such a run of crappy days. Here’s hoping there are less stressful days to come!

    • I really, strongly resist being stuck on pills for the rest of my life — which is a proposal I’ve run into time and time again since about the age of thirty. Doctors are SO strongly pressured by pharmaceutical company sales reps that they apparently truly believe pharmacy is the key to eternal life and glorious health.

      It may be…but I do so doubt it. I could count on the fingers of two hands the slew of drugs various doctors have suggested that I must swallow from now into eternity…and you know, today I’m 72 years old, still kicking very hard, and have (to my knowledge) no chronic diseases. Well…unless you believe an average blood pressure of 132/83 represents a chronic illness.

      This guy is not a GP; he’s probably one of the most prominent cardiologists in the city. And as a practical matter, most doctors’ office staff haven’t the FAINTEST idea how to do a proper blood pressure reading. This was pointed out to me by the first cardiodoc, whose grating personality sent me running: he said he always took his patients’ BP himself specifically because office staff do not know how to do so.

      And time and time again, they prove him right: they do exactly the things you describe: perch you on the side of a table with your feet dangling in the air, drop your arm in your lap or on a low chair arm, demand that you yak at them, jab something in your ear…on and on and on. They seem to have no clue.

      Which is weird, because it’s very, very easy to find the instructions on the Internet, provided by such worthy sources as the Mayo Clinic and the American Heart Association.

      Are they deliberate tactics to manipulate you onto prescription drugs? Sometimes one wonders. After talking with the young woman this afternoon, I would say not: I would say it is the manifestation of mind-bending stupidity.

      One’s confidence is not raised when one learns that the cause of the massive spread of opioid addiction in this country apparently was enhanced by pharmaceutical companies encouraging doctors to prescribe highly addictive drugs in gay abandon. As I mentioned earlier, during the Year of the Surgeries my doctors gave me THREE BOTTLES of Oxycodone, of which I used one (count it, 1) pill…and that, reluctantly.
      And that wasn’t because I thought it was addictive — indeed, I had not ever been told that it was. It was because I felt I didn’t need it.

      Well, here’s for a doctor-free, moron-free, stress-free 2018! 😀

      What would possess doctors — any doctor — to fall for this vast sales pitch? Unless…like their employees…possibly they’re not too bright?

    • And as long as we’re on the subject, take a look at this:
      https://www.minnpost.com/second-opinion/2014/09/overtreatment-mild-hypertension-causing-more-harm-good-say-experts

      and this

      https://www.medicinenet.com/script/main/art.asp?articlekey=179024

      and this skeptical report: https://www.healthnewsreview.org/2015/09/nih-sprint-study-sparks-questions-about-overtreatment-of-mild-hypertension/ [NO FREAKING DATA?]

      and this (!!!!!): https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/1484590?redirect=true

      And this little gem: http://www.nejm.org/doi/full/10.1056/NEJMoa1600175#t=article Summarized:I “The researchers in the study randomized 12,705 people with at least one cardiovascular risk factor (like high cholesterol) to get blood pressure medication or placebo. At the time of randomization, the average systolic blood pressure was 138. Some people’s pressures were higher and some were lower, or course. In fact, a third of the people had a beginning blood pressure less than 132.

      “So what did HOPE-3 find? The blood pressure medications worked. Study participants in the group that got blood pressure medicine had their systolic blood pressure lowered about 6 points more than those in the placebo group. However, after almost six years of follow-up, the investigators determined that lower blood pressure didn’t translate into lower risk. The risks of death from cardiovascular causes, heart attacks, strokes and other problems weren’t different between the groups.”

      Indeed, say the authors of this study, “our data are compatible with the hypothesis that treating persons without cardiovascular disease who have a systolic blood pressure above approximately 140 mm Hg appears to be beneficial, but treatment would not be of benefit and may be even harmful in persons with lower systolic blood-pressure levels.”

      Do I have a systolic blood pressure above 140? Sure, when I’m mad as a cat and forcing myself to go into a doctor’s office. You bet I do. But what is the real average systolic BP? In December 2017: 132. Between 5/26 and 6/27/2017, the average figures were 125.4/72.7 … and that average includes some spikes above 140.

      Heh heh heh… Frankly I don’t think there’s a problem here…except that doctors make me crazy. 😀

  2. Couple of things….First, Can self driving cars get here fast enough? Second, Why is it Docs are so eager to write script for drugs despite an “epidemic” being declared on drug abuse? Your experience at the Doc’s office is the very reason I hate going to the doctor. Good luck with the new exercise regiment and diet….Happy New Year.

    • Yes. The result being that we delay going to a doctor when we really do need to see one.

      Self-driving cars are going to solve a lot of problems. They may present their own problems — among which privacy issues will be way up there, and as a practical matter they won’t get from point A to point B as fast as our present cars do. But they will help to keep a lot of folks in our generation in our homes and out of institutions.

      It’s alarming to realize that doctors simply don’t have enough time in their days (or maybe enough strength left after a day filled with 15-minute appointments) to stay up-to-date with current research. The HOPE-3 study (the one showing that even tho’ BP meds dropped patients’ blood pressure, they actually made no difference in the number of strokes and heart attacks) was published in 2016. That is TWO YEARS AGO. But my guy apparently isn’t aware of it, or he’s ignoring it.

      As for their enthusiasm for drugs: their desire to heal people makes them willing tools of Big Pharma. Pharmaceutical companies send out an army of marketers to peddle their wares in person to doctors. At this time, there’s a Big Pharma sales rep out there for every 7.9 physicians. The pressure put on doctors by these outfits is significant:

      https://www.drugwatch.com/featured/big-pharma-marketing/
      https://en.wikipedia.org/wiki/Pharmaceutical_marketing

      Meanwhile, they also hustle consumers, especially aging baby boomers, liberally applying scare tactics: http://adage.com/article/cmo-strategy/big-pharma-marketers-terror-tactics/305784/ They launch advertising campaigns on TV to urge consumers to “ask your doctor about _______.” As part of this strategy, they infiltrate TV shows, like _General Hospital_, to raise awareness of diseases that you probably don’t have and nostrums you probably don’t need: https://www.vox.com/2017/5/18/15655520/pharma-marketing-disease-awareness-soap-operas-general-hospital

      It has become so ridiculous there’s actually a computer game skewering Big Pharma: Marketing & Malpractice… https://www.rockpapershotgun.com/2016/05/01/big-pharma-marketing-malpractice-expansion-released/

      • Yeah, big pharma scares me, no question. They’re everywhere, and they do way too much to influence patients’ (consumers’, really) expectations and recruit them into pushing their drugs.

        Many many years ago, I was researching some medical condition (I forget what) online and ran across a “screening test” on some pharma company’s page. There were ten questions, and you chose yes/no/maybe for each potential symptom. Just for shits and giggles, I ran through the test, ticking “no” for each question except the last, which I answered, “maybe”. Clicked for the results page and sure enough, “You should talk to your doctor about whether (our drug) is right for you.” Uh-huh. Needless to say, I did not.

  3. ha! Well, I’ll be the first to admit I’ve copped an attituted toward the medical field, and particularly big pharma, which isn’t entirely rational and may not be particularly fair. And I think patients bear some of the blame, too, because we expect doctors to solve our problems and that puts pressure on them to do something, anything.

    But I’ve come to believe a lot of us, patients and practitioners both, are asking the wrong question. It shouldn’t be, “will this make my life longer?” but “Will this make my life better?” and maybe even, “What will be the costs, physical, emotional and financial?”

    We’re all going to die someday, of something. I’m in no hurry to get to that day, but there are limits to what I’m willing to do to postpone it. If my brain tumor came back, for instance (unlikely, but not impossible) I’d be willing to try radiation and possibly drug therepy–but I don’t know if I’d undergo brain surgery again. And my decision would be different for 50-year-old me than for 20-year-old me, and different again for 70-year-old me.

    I recently read a fascinating book, _Being Mortal: Medicine and What Matters in the End,_ by Atul Gawande. It’s a compelling look at aging, death, and end-of-life care, and to my mind makes great points about quality of life rather than quantity of life. There’s also a documentary (_Facing Death_?) but I haven’t seen it. It really reinforced some of my own positions and made me more comfortable with decisions I might have to make down the road. Highly recommend it, if you get a chance to pick it up.

    • Yes. I think doctors in general are focused on saving lives, although that perspective also evolves with their experience and the things they see. Yet (again in general) I would speculate that younger doctors, like younger people in general, are more anxious to preserve life at all costs (well…”in general”) than are older ones who understand that nothing is going to make any of us immortal.

      There’s a point at which quality of life far outweighs length of life. IMHO.

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