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Health care

How Long to Wait before Calling the Doc?

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Not goin’ anywhere…

This damn cold/flu/black plague/lung cancer/DEATH OF ME has gone on and on and on. I knew it would go on and on and on. If you get over a respiratory infection in, say, 10 days, it will take me two to three weeks to get over the same bug. That’s because my delicate little system lacks some part of its immune apparatus (according to a past doc), and so I just don’t recover from things the way normal people do.

But apparently I’ve overestimated how long I’ve been enjoying the current gasper. I thought we were in the middle of Week 7, and that next Sunday (by which time the thing, clearly, will NOT be gone) would be the start of Week 8.

No. No, however. Looked at the calendar and discovered that the day on which I came down with this thing — when I thought it was an allergy and so thought it would be OK to go to a Phoenix Chorale concert — was not seven weeks ago but only five.

So we’re actually in Week 5, not Week 7.

This means there’s hope. Typically a severe cold or flu lasts about six weeks for me.

Every evening as I’m choking and gagging and gasping for breath, I think tomorrow I’ve GOTTA call the doctor! But come morning, I’ve slept more or less through the night and I feel like I’m gonna live, until along about 2 p.m. when suddenly such a wave of exhaustion rolls over me that I can do nothing other than crawl into the sack. Literally, I’m not good for anything after about 1 or 1:30 p.m.

Yet…I am so All Doctored Out!

Just the thought of talking to another doctor makes me cringe. I do not want to see a doctor, I do not want to be treated by a doctor (nine times out of ten with drugs that make me sicker than the disease!), I do not even want to think about a doctor.

Am I crazy? Am I the only middle-class American who lives in fear of the avatars of the medical establishment? Is it normal to resist going to a doctor after you’ve been sick for five weeks?

Well, six weeks having proven itself a charm, I figure I’ll wait till a week from Friday (i.e., a week from tomorrow). If this thing isn’t almost gone by then, I guess I’ll be forced to call Young Dr. Kildare. Probably the scenic YDK over the Mayo, because he has common sense, that rarist of all qualities in a doctor.

How long do you wait before you call a doctor?

Update: The Disease

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Not goin’ anywhere…

So this weekend I felt so terrible and was still barking so frantically that I’d about decided if this ailment isn’t improved by today – Monday – I’ll have to call Young Dr. Kildare.

Trouble with that scheme, of course, is that there’s little YDK can do other than make sympathetic noises. Though he’s a past master of that skill, one hesitates to drive halfway to Yuma for the privilege.

One of my friends reports, on Facebook, that she also is enjoying the same epizoötic. She describes essentially the same symptoms with essentially the same soul-crushing severity. She went to the doctor, who decided she had a sinus infection and gave her an antibiotic.

Well, in the first place I don’t believe mine is a sinus infection, since there’s been almost no nasal congestion and what there was is now gone. And in the second place, most antibiotics make me sicker than the bug did. And in the third place, you know and I know that a cold that mostly consists of a crazy-making cough is going to be diagnosed as viral bronchitis (medico-speak for “cold with a crazy-making cough”). Last time that happened, the quack prescribed prednisone. The prednisone caused the cold to go away in about the same period that any killer cold goes away…and it also kicked up the GERD.

It’s taken two years to get that flare-up to settle down. And y’know what? I don’t wanna do that again.

Given a choice between coughing all night or lying awake all night with a bellyache whose outcome is, doctors want me to believe, potentially stomach or esophageal cancer, I’ll take the cough.

But it is freaking exhausting. As a practical matter, I do not lie awake all night, because by 8:30 or so I’m so tired I can’t do anything but sleep. Saturday I joined my friends at KJG’s house, where we have an ongoing project to throw, fire, and glaze our very own little pots.

It was great fun! We hung out with KJG and her Fireman all day, during which the cough nagged and nagged and nagged. But other than the cough, I didn’t feel too bad…until about two in the afternoon, when suddenly such a wave of exhaustion came over me I couldn’t even think.

That obviated spending Saturday evening on the current Chinese academic paper, meaning I had to finish it yesterday, when I also didn’t feel at all like working…much less dealing with Word’s effing weirdness.

Felt a little better on arising this morning. Am still so tired that really, all I want to do is go back to bed…and it’s 9 in the morning.

But there’s just too much to have to do.

This, That, and the ‘Tother

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Cheers! Check out Kostas Chiotis’s latest round-up over at Finance Blog Zone. Kostas hit up every finance blogger in sight to contribute a blurb on how to manage debt. It’s old home day over there! (And new home day, too: a bunch of younger writers are in there with us old bats.) There’s Trent Hamm, by golly: the original inspiration for Funny about Money. Others of the old guard are there — Evan of My Journey to Millions wins my prize for “Man of Fewest Words”: on the subject of managing debt, says he, “Figure out why you have it.” 🙂 Many of the younger pups are represented, among them Ginger of Girls Just Wanna Have Funds and Shannyn Allan of Frugal Beautiful. Though Funny has drifted away from Personal Finance as a genre (once you feel you have enough money, the subject gets a lot less interesting), the niche is still alive and well.

{grump!} Just poured coffee on my keyboard. Looks like none of it got down inside there, though.

Driving to Tempe in a couple of hours to meet my bidness partner at our favorite lunch hangout. Amazingly, she did not get accepted to law school (those fools!), so I’ll be interested to hear what her next plan is. We also need to cook up a scheme for next year’s Society for Scholarly Publishing conference, whereinat she proposes that we do a panel presentation. She actually had that in mind this spring, but we missed last fall’s RFP deadline.

Which is good: it gives us several months to come up with a winning idea.

The half-dose of codeine worked…half-way. Still coughing, but not gasping for breath. Kinda doubt I can sing tonight, but at least I should be able to make it out to Tempe without expiring on the freeway.

While I’m running around, I should drop by a Sears. We’re told that Sears is on its last legs, and there’s a household doodad I need to get only at Sears. Dammit.

My fridge is a Kenmore. It’s run well for lo! these 13 years — twice as long as its engineered life expectancy, with no repairs at all. It dispenses filtered water, which is rather nice for one’s b&w’s… To do that, it uses an expensive screw-in filter cartridge. These things last a long time. In theory you probably should replace them every six months to a year, but in reality I think I’ve only used about four or five of them. They’re made by Kenmore. You can buy them on Amazon…at considerably higher cost than the already bracing amount you’ll pay at Sears.

So I think I’ll make a Sears run and buy two or three of the things. That refrigerator can’t last all that much longer. But I’d like not to have to replace if for a stupid reason like “they don’t make those filters anymore.”

Here’s a marvelous little gem in this morning’s news: The FDA announces that the very type of breast implants the boob surgeons tried their damnedest to talk me into cause cancer. Holy shit! Am I glad or am I glad that I put my foot down and refused to let them stick those things under my chest muscles!?!

You know, I rather like being flat as a nine-year-old. A pair of fake titties tattooed on there might be nice…but since nobody ever sees me except an occasional passing helicopter pilot (who deserves what he gets 😀 ), it’s surely not a matter of any urgency. Or of much interest. As it develops, almost all of my clothes look just fine on me. And for sure everything is about 110% more comfortable: no binding, no rubbing, no squeezing, no itching, no riding up, no sagging, no hurting. Just think of that: clothes that don’t make you miserable! And the joy of never having to shop for another bra ever again: priceless.

Somebody tried to shoot up the British Parliament, we’re told. How’s that gun control workin’ out for ya, folks? On the same subject, though, it doesn’t seem to be working out well here. In lovely Arizona if you’re a felon, even of the minor variety, you are prohibited evermore from owning a gun. That notwithstanding, a pair of nitwits — the as-yet unconvicted wife no doubt operating as a straw purchaser — enjoyed keeping a pistol around the house. The female nitwit tossed the pistol on the bed as she was fiddling around the house. Their two-year-old picked it up and shot their nine-year-old in the head. He died, after a pointless spell on life support.

You should have to pass an IQ test to be eligible to buy a gun.

The Economist is agonizing over Brexit and Scoxit — the Scots now proposing a second referendum to divorce Britain, so they don’t have to leave the EU. Of course, the journal being a very liberal, free-trade sort of publication strongly espouses staying and is editorially abhorred by the vote to exit and the ascendence of Theresa May. Yet they do (unlike American publications of record) publish reasoned arguments for the other side. A commenter in the March 18 letters, Robert Aitken of Oxford, asks a very interesting question: “if Britain had never joined the EU, would we now vote to do so?”

His answer to that fine rhetorical question is, in short, no: “Looking at the wasteful, sclerotic, and undemocratic grouping it has become, only a Euro-enthusiast of the deepest hue could think that we would.” The remainder of his letter explains his reasoning — it’s very much worth reading.

But in the “reading” department, Firefox is busy threatening to crash again, so it looks like it’s time to close this and close all the other tabs and shut the whole system down and go get ready to drive across the city.

And so, away…

So…How Would YOU Replace Obamacare?

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Since a certain element in the Body Politick is bound and determined to kill universal health care — at least in the form of the Affordable Care Act — it might behoove our leaders to think about what (if anything) they would put in its place. They evidently haven’t a clue hidden inside their bituminous hearts. So…let’s help them out.

If you asked me, here’s what I’d tell them.

• All vaccines will be free, including flu shots.

No one can force you to get yourself or your kids immunized (although schools would retain the right to bar enrollment for kids who haven’t had a basic round of shots). But if you have to be treated for an illness that could be prevented or ameliorated by vaccination, and you cannot prove you have a current vaccination for it, then you should have to pay for the treatment out of pocket. This includes trips to ERs.

• ER treatment that’s not a true emergency — like showing up to get free treatment for a strep throat or a cold or anything else that would have been covered if you had ponied up the cash for minimalist coverage: that will be something you have to pay for out of pocket.

• All preventive health care: free.

• All birth control: free.

• Coverage for an elective abortion:  you pay for it out of pocket. An abortion resulting from a medical emergency or severe pathology will be fully covered.

• Coverage for Rx drugs: chemotherapy, cardiac disease, kidney disease, multiple sclerosis, and diabetes drugs are included in the basic healthcare package. For most other prescription drugs, you can opt into a special plan, similar to Medicare Part D.

You can’t be blocked from opting in if you’re suddenly diagnosed with something that requires long-term use of drugs.

OTC drugs that have been Big-Brothered off the shelves, such as cough medicines that actually work, are to be returned to the market, so that you don’t have to go to a doctor to treat a bad cough from a cold.

• All other coverage would be handled much in the manner of Medicare, partially covered with flat fees, partially funded by taxes. Base hospital coverage would be free , but as with Medicare, more extensive Part B-type coverage would cost a couple hundred bucks a month: $134-$268, depending on your income. Expanded coverage would be available optionally through insurers or the government, but strictly regulated, exactly as Medigap plans are regulated now.

• Care for self-inflicted harm from drug use and alcohol abuse: you pay for it. This includes treatment for ODs and injuries incurred in accidents caused by your own drunk driving.

• Mental health care, even drying out from alcohol and dope (exclusive of physical disease or injury caused by abuse): covered.

• Coverage for the indigent, the unemployable disabled, and the homeless: through expanded Medicare.

How will this be underwritten? With a tax on everyone, including people who are not now working but getting income from dividends or welfare. And a no-exceptions, no-cap tax on the wealthy and the über-wealthy.

If businesses are to continue offering health insurance as a job perk, then the tax exclusion for the benefit can’t be eliminated. Otherwise, Americans will have to resign themselves to paying hundreds more in taxes, as the cost of employer-based plans will be taxable. On the other hand, it may be fairer for everyone, including employees of corporations that can afford to swing health plans, to pay their own share.

Insurance premiums, after all, ARE a kind of tax. They work the same way as a tax works: everyone pays in, for the common good. If everyone in the country is paying in, individual premiums will be lower. And if we’re not ALL paying for stupidity (drug use, alcohol use, refusal to vaccinate), then shared costs will be lower.

How would you advise our doughty leaders about replacing the Affordable Care Act?

Image: DepositPhotos, © sudok1

New Diet/Exercise Scheme…works fast!

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Down only two pounds and already starting to feel much better. Old CardioDoc — the one who may have been a perfectly fine MD but who had a little personality problem (just talking to him was likely to bring on apoplexy…) — suggested the palpitations did not indicate a cardiac problem but were anxiety attacks. He said that if one would bestir oneself to get rid of the excess fat and exercise vigorously every day, one could bring the palps under control.

He was right then, and he appears to still be right. Over the past week I’ve managed to get rid of two of the 11 pounds of overweight and have combined daily one- to two-mile walks with some vigorous yardwork. Luckily, the yard has really gone to pot over the past year or two, so there will be lots of hacking and heaving to do over the next couple of weeks.

A-n-n-n-d…whatever it is does indeed seem to be getting better. Haven’t had a palp in days, and the average BP over the past 10 days has been 124/69. Not all that bad for a 71-year-old woman who favors rib-eye steaks, strong coffee, and bourbon.

🙂 {sigh} 🙂

There’s nothing like a fine spread of good food to improve your disposition. My god have I been eating!!!

Try this rendition of grilled fish, per serving:

• slab of fish (salmon, mahi, cod, whatEVER)
• canned or boxed Italian-style chopped tomatoes (the Pomì brand is especially good)
• a finely chopped garlic clove, or chopped little green onion
• a few leaves of fresh basil, chopped, or some dried herbs of your preference
• olive oil
• small amount of crumbled feta cheese

Preheat the grill. If you’re using one of those perforated grill pans, put it in there to preheat, too.

Rub the outside of the fish with a little olive oil.

Into a small microwavable bowl, place enough of the tomatoes to cover your serving(s) of fish. Stir in the garlic, onion (whichever you’re using, or both) plus the herbs and feta. Warm this gently in the microwave — no need to overdo it.

Grill the fish until it’s done to your preference. While you’re at it, you can put some veggies on the grill, too: I happen to like asparagus. Summer squash grills quickly and nicely, too: either way, toss them in a little olive oil to which you’ve added lemon juice, lime juice, or balsamic vinegar, to taste.

Place the fish and veggies on your favorite dinner plate and top the fish with the tomato concoction.

This is amazingly good. Serve it up with a salad: a handful of lettuce with whatever salady oddments you happen to have in the fridge, topped with a drizzle of olive oil and a drizzle of vinegar or lemon juice.

So much better than working…

cookbook

Handy Online Medical Reference

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UPDATE!

Be sure to read MD’s comments (below) before using FactMed to assess the side effects of whatever med you’re curious about. Try to find the information published by your medication’s maker — if you have a generic Rx, you usually can find a source on the net that will tell you the brand name if you enter the generic name.

Every now and again, you need a source for side effects of medications that is NOT a woo-woo naturopathic site like LiveStrong or any of the myriad sites of the various quacks who try to convince you that their snake oil is better than researched, tested prescription drugs. WebMD always comes up relatively high in a list of search results, and sometimes the Mayo Clinic will have a page describing the uses and potential side effects of various nostrums. The Mayo is reliable enough as a reference, but WebMD has occasionally been questioned.

I recently came across a site called FactMed. It’s a searchable database based on “more than 18 million FDA adverse drug reports for 20,000 different pharmaceutical products.” If you explore around in there, you find a search engine that will let you enter a drug and a specific ailment that you suspect might be a side effect.

Results show the proportion of patients reporting side effects who reported THAT side effect. So, if 100 patients reported that they’d had some side effect of a given med and 5 of them said the med gave them a roaring headache, you would be able to see that 5% of people who had some effect had reported “roaring headache” as the problem. It also shows you the proportion of ALL medicated patients reporting that as a side effect, and it provides a graph showing the proportion of physicians who reported that they highly suspected the med was a cause, that they thought it was a “likely culprit,” or that they thought a connection was highly unlikely.

This is extravagantly useful information. Even though, yes, correlation is not causation, FactMed at least provides some quantitative data to help you assess whether some symptom might be attributed to a drug or combination of drugs you’re taking, and it gives you some credible ammunition when you need to discuss any such issue with your doctor.

The cardiologist and I have been trying to figure out what caused the episode of presyncope (near-fainting) that occurred while I was flying westward across a major surface artery at 50 mph a few weeks ago. Since it was accompanied by a spate of heart palpitations, we of course have suspected a cardiac issue. But so far he has been unable to find any indication of a heart problem. Even my blood pressure, a subject docs love to harp upon, is well into the normal range.

Consequently, he has lashed me up in a Holter monitor — a device that listens to your innards 24/7 — and asked me to wear it for a full freaking MONTH!

This is making me unhappy, partly because it’s very hard to find any clothing that you can wear around such a thing without looking like Frankenstein’s monster, but more to the point because the cables they tape to your chest irritate the perennially sensitive mastectomy scars. These cannot be avoided, because they stretch from armpit to armpit. The discomfort is annoying during the day and makes sleeping almost impossible.

So I intend to get out of it, but to do so wish to explain a) why I’m not doing this and b) why I think it’s reasonable to believe the pseudoephedrine (Sudafed) pill I dropped that morning on top of a full pot of strong black coffee brought all this on.

And lo! Here it is, right in the FactMed database:

This stuff doesn’t just cause presyncope: it actually causes people to lose consciousness:

Proportion of pseud. patients reporting loss of consciousness as side effect: 4.6% [Holy sh!t! That’s almost 5%!]
Proportion of all medicated patients reporting loss of consciousness as side effect: .32%
Number of patients reporting side effects from pseudoephedrine: 999

As for heart palpitations…interesting:

Proportion of pseud. patients reporting palpitations as side effect: 3.0%
Proportion of all medicated patients reporting palpitations as side effect: .33%

If a medication has a weird, rare side effect, I invariably experience it. For godsake, if 5% of patients experience syncope after taking this drug, I am extremely lucky I didn’t actually pass out at the wheel and cause a wreck.

Three percent for the palpitations makes it a bit of a longer shot…but again, given my sensitivities to all drugs, prescription or over-the-counter, it strikes me as not all that unlikely that whatever already causes the occasional spates of palpitation could be kicked up by a drug that wires me to the teeth under the best of circumstances and that may cause me to faint.

The sample of about a thousand people isn’t huge, but it’s respectable.

So here’s what, in the self-diagnosis department: I feel enough confidence that whatever brought this on was not a true cardiac issue that I’m going to throw over the electronic traces and return the Holter monitor. I don’t think it’s worth irritating the scars, which are already uncomfortable enough, thank you, by having tubes rubbing on them all day & all night for a full month and by applying allergy-inducing stickum to the skin near them.

It may annoy the doc, but at least I’ll have a little evidence, based FDA reports, to make my case.