Another Day, Another $250 Hit… And more to come?

Once again…not a single month has gone by since the first of the year without at least one unplanned financial hit! And I expect there’ll be more, what with this annoying medical thing. Lots more, no doubt.

Young fellow from Swimming Pool Service and Repair came by. He took the filter apart and discovered that Leslie’s had only replaced half of the DE filter’s eight white filter pad thingies. Their guy charged me $250 to replace all of them. Hm. Looks like I should’ve fired that outfit long before their recent effort to corral me into buying an expensive new pump!

You could tell which ones were fairly new and which were the old ones — the old, tired ones are kinda yellowed with age, mighty sickly-looking, while the newer ones look noticeably whiter. One of the old ones had several holes in it, which explains why the pool has been kinda hazy-looking: DE has been seeping out into the water.

Ducky. That’s going to be another $250, payable tomorrow when he shows up with eight new pads.

He said he’s about to take over his dad’s swimming pool service company — at the age of 57, Dad is recovering from a recent stroke. The kid said he’d provide weekly service for $90 a month. Sooo…if I have to have surgery that puts me out of commission in the heaving-around department, there’s going to be Sickness Expense the First. If I can’t lift things and my arms are effed-over by having the lymph nodes ripped out of them, I won’t be able to keep that pool clean on my own. At least not for quite some time.

Tomorrow morning I’m going out to the Mayo to see my old, OLD doctor, who practices out there. This morning I drove a CD with St. Joseph’s radiology images and the radiologist’s report out there, because I realized I couldn’t be here to wait for the pool guy and out there delivering the data at the same time this afternoon. Fortunately, the dog got up up at 3:30 again, so it was easy to get dressed, fed, and out the door by 7 a.m. A huge wreck closed the north- and eastbound lanes of the two freeways I would ordinarily drive to make this ridiculous jaunt, so I had to take surface streets all the way to the far side of East Scottsdale. However, traffic was light despite the dire warnings on the radio.

While plodding across the city, I reflected that Dr. Daley and I have known each other for almost 45 years! Holy mackerel! Who would think it? At any rate, he’s one of the Mayo’s grand old men now, and so if anyone can help me navigate through the hideous shoals of the medical establishment, he’s the one. Before I got off the phone from his underling, I had an appointment with him this week, like right now! He wanted to get his hands on said images/report early so that he could have a Mayo radiologist look at them. So, with any luck he should be able either to reassure me or scare the bedoodles out of me.

I’m taking the HealthGrades and Medicare.gov data to present to him, because of course the first decision I’ll have to make, should these things prove to be malignant, is whether to proceed with St. Joe’s or to go to the Mayo for surgery. The Mayo has the best safety record for patients — St. Joe’s is surprisingly wanting in that department. And I do want to ask him about St. Joe’s 16.5% mammogram follow-up rate, 2.5% above the level Medicare classifies as “unacceptable” and a pretty sure sign that they’re doing unnecessary procedures.

God! I’ve become such a skeptic in my old age! Take things with a grain of salt? Hell, I take everything with a pound of salt, thank you very much. I just don’t believe anything or anybody anymore, whether it’s a pool guy or a high-powered M.D.

Here are the issues that set off my bullshit alarm with the present cancer scare:

• The radiology tech looked at the second mammogram images and said, of the alleged nodules, “Those aren’t cancer.” Admittedly she’s just a tech — i.e., likely a junior-college graduate — and she no doubt was shooting off her mouth when she shouldn’t have been. But there’s also a bachelor’s degree program for these technicians, and if she has a lot of experience, she may very well have a clue to what she’s looking at. Thirty or forty minutes later, I’m being told there’s a 50% chance the things are malignant. It plants a little doubt, albeit not much.

• By way of trying to persuade me that I need more probing and possibly surgery and radiation, the radiologist asked if I’d ever taken hormone replacement therapy. When I said I had not, she said that was a bad sign — not doing HRT is a risk factor for breast cancer. Well, that is not altogether true. The American Cancer Society reports that HRT using estrogen and progestin raises your breast cancer risk, whereas plain estrogen therapy has a nil risk or even a slight protective effect.

• Then there’s that 16.5% follow-up rate. It’s the highest of any of the area hospitals I looked at. Boswell, out in Sun City, has a 7.7% rate, below the state average of 8.9%. Good Sam’s is 13.7% and John C. Lincoln’s is 13.5%, dangerously close to that 14% figure Medicare considers “unacceptable.” IMHO, Medicare is a cash cow (heh…okay, pun intended). To the skeptic’s eye these diagnostic tools look a great deal like milking stools. We have a relatively simple procedure that Medicare covers; we have a public convinced it should be used routinely; and we have a dread disease that so terrifies women it can be used to herd them toward increasingly profitable extra procedures…from mammogram to new mammogram to sonogram to biopsy to…??? Hm.

That’s not to say I absolutely positively think it’s bullshit. Obviously, it’s best to assume the worst of any suspicious lesion, and then to be pleasantly surprised to find it’s harmless.

You know, that’s why it’s good to be a cynic: you’re always pleasantly surprised!

😆