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Health care

When Christian Science Starts to Look Good…

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crucifixCaduceus.svgMy great-grandmother Gree and her daughter Gertrude were both devout Christian Scientists. Each lived into her mid-90s without ever seeing a doctor. They never took any kind of medication, nor did they touch alcohol. Or tobacco. They would go to dentists, but whatever procedures took place were done without anaesthetics.

We, the enlightened generations, thought they were benighted. My mother thought they were stubbornly crazy. I saw them as products of the 19th century: they grew up during a time when going to a doctor was likely to do more harm than not. And even today, sometimes I reflect that about 90 percent of what ails you will either go away on its own or kill you, and no amount of doctoring is going to change that. It’s the 10 percent that keeps me visiting docs whenever some ailment comes calling.

So I’ve been taking omeprazole for the GERD forever and a day. Young Dr. Kildare, before he exited the nearby practice where I met him, had told me to take vast quantities of it for 8 weeks, and then if the symptoms abated, to titer off the stuff. He gave me a prescription for about a half-billion milligrams per horse pill.

Backstory: one thing you should know is that if a drug (OTC or prescription) has some rare, bizarre side effect that afflicts .001% of the population, I’m the .001%. It never fails.

That notwithstanding, the bellyache tried my patience and so I followed his instructions. Yea verily, it worked. So I was slowly easing the dosage down and looking forward to stopping it.

Now out of the blue I get this weird edema around the left eye. The eyelid itches, and I think it’s a mosquito bite. Or I do, until a day or so later I discover a big, ugly swelling in the old-lady bag under the eye. It looks like a blister, the kind of thing you get from hiking in new boots.

Naturally I discover this in the wee hours of the morning, which is when I normally wake up.

Naturally I have recourse to the Hypochondriac’s Treasure Chest that is the Internet. And what should I learn but that omeprazole can cause facial edema. If any such thing should arise, we’re told, you should “seek medical care immediately.”

Along about 7 a.m., I call over to my doctor’s office at the Mayo, where I hope to be referred by phone to the internist on call. The phone lady refuses to put me through and tells me to go to the ER.

As usual, the last thing I want to do is go to an ER. But I’m kinda worried that this could be the start of a more serious allergic reaction. So I drive over to the Urgent Care place just up the street.

Naturally, it’s closed.

So I drive up to the Mayo’s ER, where I kill most of the morning.

The doc who sees me is an old buzzard, well past retirement age. (I learned from my old doc, who retired from the Mayo, that the Mayo often hires its retirees on a p/t basis for the ER. Hm.) He orders a blood test and goes off. Eventually he comes back into the room, and he says it’s an infection. He says he could tell this from the blood test.

I think, without comment, “That’s a little odd.”

But he insists the redness (where I’ve been scratching at the itch) and the fact that it’s not bilateral means it’s an infection. I say, “But there’s no conjunctivitis, there’s no discharge, there’s no fever, there’s no sign that this is an eye infection.” He insists it’s an infection and puts me on Keflex.

Forthwith, this product causes my tongue and lips to turn bright red and swell up.

I call and get another Rx for a different antibiotic, one that the Treasure Chest says is likely to cause a roaring case of C. difficile. But I want to be rid of the blister on my face and I’m worried that it IS an eye infection, so I start taking this stuff.

The more I think about it, though, the more I think…hmmmmmm….

Time to see a doctor who has a preternatural gift for common sense. Young Dr. Kildare  is one of the two (count’em, 2) doctors I’ve met in 71 years on this earth who possess such a gift.

So I weaseled my way into YDK’s new office — fortunately, he doesn’t have many patients yet. I just got back from his precincts.

He took one long look at it and said, “That’s not an infection.”

I said, “What about the blood test?”

He said, “You can’t tell a person has an eye infection from a blood test! The most it can tell you is that maybe there’s an inflammation somewhere. Maybe not, too.

“THAT is not an eye infection. I can tell it’s not an eye infection because I’ve been to medical school.”

Hee HEEEE!

He thinks it’s an allergic reaction and recommends getting off the omeprazole (which I’d already done). His cure: Benadryl and ice packs. Come back in one week.

Can  you believe that? Raving incompetence at the Mayo Clinic. That is really unusual.

Jeez. Never a dull moment.

Images
Crucifix: CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=439493
Caduceus: By Rama and Eliot Lash – Drawing by Rama. Vectorized with Inkscape by Eliot Lash., Public Domain, https://commons.wikimedia.org/w/index.php?curid=662346

Slogging Along…

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Still buried in work! Was set to spend the day slogging through the rest of the Semiramis index (i hoped…) when the current Chinese Graduate Student send another iteration of her last chapter, slashed and burned by her dissertation director and reconstituted by her.

Rereading and updating edits on that consumed half the day.

So for the second day in a row (day before yesterday most of the hours were consumed by a client’s book formatting issues), I came back to the mind-numbing index job so tired I could hardly hold my head up. Keyboarded entries from a few marked-up pages (decided to dispense with the notecard technique, since this is already such a large and time-consuming job) and then crawled into bed around 10 p.m.

This morning I’m supposed to go out with a friend to breakfast/lunch (depending on when she gets away from her client). Then fly to south Phoenix to pick up page proofs of the client’s book and fly back up to Richistan to deliver them to the guy. Then fly home and get back to work on the index.

Really, I should farm this index out. But I need the money and don’t want to share just now.

Interesting news on the Hypochondria Front: since I have to submit to a major fishing expedition check-up in order to stay on the rolls at the Mayo, and since I’m supposed to revisit the cardiologist in another month, I decided to revisit the blood pressure issue. CardioDoc suggested keeping a running record of twice-daily readings for a period — when we were trying to shake off the hysteria engendered by the quack Young Dr. Kildare sent me to, he asked me to do that for six months, after which he declared me free of high blood pressure and probably free of any cardio-vascular problems.

Well, I hate taking my blood pressure — the act itself seems to drive up the numbers — so decided to limit that exercise to a week or ten days. But it seemed like it would be good to have a running record, because just walking into the Mayo (or any other medical facility or doctor’s office) pushes my blood pressure up. Way up. I’d like to have a little chart I can show this new doctor to fend off a new effort to put me on some not-so-benign med for the rest of my life.

Amazingly, despite the eight or ten pounds of overweight I’ve put on since the start of the bellyache problem and despite the endless, stress-inducing workload, the BP readings are well within the normal range: 116/72 this morning, after fiddling with the computer, feeding the dogs, and puttering around the house.

So that was a pleasant surprise.

Along those lines, I made another surprising discovery. In an idle moment while taking a break from the grind, I happened to google my father’s name. Discovered his brother is buried in Tarrant County, Texas, whence they came and where he returned after my aunt died. (He had moved to Sun City because my father retired there).

Turns out he remarried after moving back home in his old age. The new bride lived about ten years after they wed, and he outlived her another ten years. I had no idea!

My uncle lived to be eighty-nine. My father had told me he was 84 , and that his other brother had also died at 84. The only reason this uncle died was that he fell off a chair he’d climbed on to change a light bulb. He broke his hip and died of the ensuing shock.

If that hadn’t happened to him, he presumably would have lived into his 90s.

My father died at 84. The big difference between the two of them, besides the fact that my father worked on ships and my uncle had a quiet managerial job at a dairy, was that the uncle never smoked nor drank. My father smoked — and more to the point, lived with a woman who was smoking six packs a day at the end of her life — and he also had a drink or two almost every day.

At Find-a-Grave, I may have tracked down the third brother. If the record I found is his, then he lived to age 82. I believe he was a pretty tough character — a cowboy and eventually a ranch foreman. My father disliked him, and I knew almost nothing about him. The man I found in those records was married, briefly, to a woman who had a new last name by the time she died, and he is listed has having a son, born in the 1930s, who used his mother’s last name, acquired after his birth. So presumably they divorced early on, and it appears that this uncle never remarried.

At any rate, given that on my mother’s side, the women who evaded the family disease (cancer) lived into their mid-90s without ever seeing a doctor (they were Christian Scientists), it appears I have some pretty good genes in the offing. I may make into the 90s, too, barring a successful effort by one of my fellow homicidal drivers. 😀

Otherwise: all quiet on the Western front. It’s getting warm enough to swim, despite some unseasonably cool days. That would be nice, if I could find some time to do so.

Happy Easter! And may you, too, beat GERD

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Hallelujah, brothers and sisters! It’s a new day in America. And everywhere else. Happy Easter to one and all.

Feeling particularly bright this morning because for the first time since last June’s miserable surgery, I woke up without a bellyache and without a lump in the throat. And though the 3 a.m. alarm clock went off as usual, it was not to wake me up to enjoy another wee-hours bout of heartburn. 🙂

To what do I attribute this miraculous turn of events? To a little help from my friends…

Not those friends, but their prescription cousins.

I’ve been gulping horsepills of omeprazole in double the OTC dose. That seemed not to be working, but apparently because I was knocking off them too soon.

As you know, I have a moral objection to being put on prescription drugs for the rest of my life, which of course is what every doctor you run into has in mind. So as soon as the symptoms would fade, I would fade off the omeprazole.

The other day, Young Dr. Kildare explained why this doesn’t work: The symptoms of gastric reflux stem from something like a burn to your esophagus, resulting from acid bubbling up where it’s not supposed to be. If you burned your hand, you could apply a topical treatment and it would feel better, but it wouldn’t be healed. You’d have to wait until it actually was healed to stop using the painkiller and before you could bang around again. Ditto, your innards.

He said you need to take prescription-strength omeprazole (or something like it) for about three months, even after the discomfort abates, and then, once you think the damage is healed, taper off it by going to the OTC pills for a week or two.

The new quacklet at the Mayo (oh, these young things! How can you have acquired an MD, gone through an internship and a residency, and look like you’re 19 years old???) agreed, although her time frame was shorter: eight weeks.

YDK has GERD himself, and also he’s not a kid (even though he looks mighty young to the aged eye), so I figure he’s probably the one to listen to. He having been around the block a time or two…

So I’ve been swallowing omeprazole religiously for about a week or ten days.

Then I discovered Zantac, OTC. This stuff, which in the past has done nothing for me, seems to work to beat back an acute attack, but only when used in combination with omeprazole. It dawned on me that if it worked during the day, it probably would work at three in the morning. So I put a pill and a glass of water by the bed, and night before last when I woke up with the familiar tingling/burning sensation that results from rolling over on my right side in my sleep, dropped the Zantac.

Took about 20 minutes to work, but it did work. And the next morning I wasn’t very sick. Somewhat so, but not to the usual extent.

I haven’t had a cup of coffee, a cup of tea, a glass of wine, a bourbon and water, a salad, a still-crisp vegetable, or so much as a whiff of chili pepper in weeks. So I can assure you, depriving yourself of the things you love doesn’t help. Neither do the various folks and quack remedies. No, swallowing organic apple cider vinegar does not help. Neither does ginger. Neither do Gaviscon, Rolaids, Mylanta, or Maalox.

In the nondrug department, only one thing seems to calm the symptoms of GERD: vanilla ice cream.

Yes. I don’t even LIKE ice cream, but I’ve been living on it for weeks.

The other day I reflected on the reason for this, ad it occurred to me it’s probably because ice cream is essentially a liquid. Effectively I’ve put myself on a liquid diet.

So I decided to branch out to other fluids.

Those soups that come in boxes all taste terrible to me: they taste like their cardboard containers. However, they’re less oversalted than the Campbell’s varieties. And no, I do not feel like making soup just now. Ugh. So I bought some chicken broth, some lamb broth, some mushroom soup, and some pumpkin soup. They all taste the same: cardboard. But they don’t seem to cause direct pain. Probably today I should go over to Trader’s on the way home from the churchly frenzy and pick up some chicken that I can make into real soup. Chicken à blanc…hold the onions. {sigh} Onion: that’s another beloved food item I haven’t had in weeks.

I’m wondering if a puréed lentil or bean soup might work…again, I can’t imagine how these would taste without onion. But WTF? It’s probably better than living on ice cream.

Yesterday I baked an Idaho potato. Served it up with some yogurt, figuring that would add some protein. A whole potato was too much to eat, but it seems to have worked to fill the belly without causing undue discomfort. Dined on this around 2:30 in the afternoon and wasn’t hungry till I got back from last night’s Great Vigil frenzy, along about 9:30 at night.

And this morning, trying to imagine what is essentially liquid and also edible, I recalled that my mother used to eat apple sauce when she didn’t feel well. I personally am not crazy about the apple sauce that comes in jars. However…quite a few apples are laying around the kitchen, waiting to spoil because I can’t eat them. Why not bake an apple?

That worked pretty well. I’m now not hungry and not in pain. Interesting.

So what am I gonna do this evening, when I have to go out for an Easter feast with friends? I certainly can’t eat any feasty foods. It’s going to look mighty funny when I ask for a bowl of soup for dinner. No clue how to cope with that. Guess I’ll have to play it as it lays.

How to Bake an Apple

You need:

• 1 apple, variety seems inconsequential
• butter
• brown sugar, turbinado sugar, or whatever sugar you have in the house
• cinnamon, if you have some
• pecans or walnuts, if desired
• hot water

Preheat the oven to 375 degrees.

With a paring knife, cut off the stem and a cone of apple around the it. Loosen the apple flesh by carefully slicing around the outside of the core. Take the handle of a metal spoon and scoop out the core and seeds.

Fill the hole with butter. Push in some pecans or walnuts, if you like. Top with sugar. Sprinkle a little cinnamon over it, if you wish.

Place the apple in a shallow baking dish. Pour in a little hot water, about a half-inch up the side of the pan.

Bake for 30 minutes to an hour, depending on how soft you like your apple. If you like it a little firm, take it out of the oven after about a half-hour. If you want apple sauce, baking for an hour will do the trick.

Very tasty! A heckuva lot better than canned apple sauce!

Medicare: Watch Your Back

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Of interest: When you hit Medicare age, you will be shuttled into what looks like a single-payer system. But bear in mind: it’s NOT a single-payer system. It’s really a two- or three-payer system.

SDXB’s lifelong friend is dying of prostate cancer, a condition he’s been struggling with for several years. Recently he told SDXB that the costs he’s racked up will pauperize his widow. At one point, a hospital demanded they disgorge $9,000 up front, before he could be admitted for treatment.

That may be because he doesn’t have so-called “Medigap” insurance: a supplemental policy that picks up the costs Medicare won’t cover. Possibly, too, his prescription drugs have dropped him into the so-called “doughnut hole,” in which the victim of a serious illness has to cover Rx costs out of pocket after they hit $3,300 and until they reach an astronomically high ceiling.

Traditional Medicare, the safest option because it allows you to choose the doctors you will go to rather than limiting you to an HMO’s network, covers only 80% of most bills. A stay in a hospital can rack up tens or even hundreds of thousands of dollars in medical bills.

In the US, costs for treating major ailments vary by region. Rescuing you from a heart attack, for example, can cost as much as $92,000. Folks…20 percent of $92,000 is $18,400! Not many of us happen to have that laying around the house. And acute costs may be just the beginning. Treatment for most conditions of old age goes on and on and interminably on.

If you select traditional Medicare (Part A comes with the 65+ territory; the optional Part B covers doctor’s visits and outpatient experiences), you will also need to buy a couple of other policies if you want to be fully covered. These include a Medicare supplement policy (often called “Medigap”), which picks up the 20% that Medicare doesn’t cover, and a Part D policy to (partially) cover prescription drugs. These are supplied by private insurance companies, not by the government program called Medicare.

So now we have not one payer, not two payers, but three payers.

Yes. You can opt out of buying Part B, a Medigap policy, and/or Part D. But you do so at your extreme peril.

So, those who elect “traditional” Medicare so as to preserve their right to see a doctor of their own choice and who wish to be fully covered will end up with three-provider coverage: the U.S. government, a large corporation selling Medicare supplements, and another large corporation selling prescription drug coverage.

An alternative is to buy a Medicare Advantage plan, which is your basic HMO or PPO designed to collect your Medicare benefits in exchange for rationing your care. Medicare Advantage insurers usually sweeten the deal with dental and optometry benefits, which make those plans look more attractive to the unwary. Some, but not all, Advantage plans also include coverage for prescription drugs.

Does a Medicare Advantage plan keep costs down? Maybe; maybe not. Depends on the plan and the circumstances. In 2015, for example, almost half of these plans imposed limits on prescription drug coverage above $5,000.  For a victim of prostate cancer — just as an example — an androgen receptor inhibitor can cost $8,862.

AARP tells us that by law, “all [Medicare Advantage] plans…have annual limits on out-of-pocket costs.” What is this limit? Unclear. Says the redoubtable lobbying group and insurance provider for the aged:

Additional out-of-pocket expenses associated with Medicare Advantage plans depend on a variety of factors, including

• If the plan covers part of or all of your Part B monthly premium
• How much you pay for each service or health visit (copayment and/or coinsurance)
• Whether the plan has a yearly deductible that you must meet before it provides coverage
• What types of services you require and how often you require them
• Whether you join a plan with additional benefits such as vision, dental, or prescription drug coverage
• How much the plan’s maximum out-of-pocket limit is for medical services
• Whether you receive care from in-network health care providers

Some plans charge yearly deductibles. Some do not. Some plans charge copays for some benefits and services, and all Medicare Advantage plans are allowed to set their own coinsurance percentages and terms. In other words: good luck with that!

Only about 82 percent of Advantage plans cover Rx drugs. For some plans, your monthly premium may exceed the amount you’d pay for part D. Original Medicare has no out-of-pocket maximum. Unless you have Medigap coverage, you’ll keep paying for some part of as you use them. Medicare Advantage plans, by law, have an out-of-pocket maximum of no more than $6,700 per year. Once you hit that limit, the plan pays for all covered expenses.

And by the way, if you’re in a Medicare Advantage Plan that includes drug coverage, you must accept its terms for prescription drug coverage. Dare to join a Medicare prescription drug plan, and you’ll be expelled from your Medicare Advantage Plan and returned to traditional Medicare.

So how is SDXB’s buddy going broke despite a federal plan designed to protect the elderly from exactly that? Evidently he has traditional Medicare without a Medigap policy, or else he has a Medicare Advantage plan that doesn’t cover drugs and he failed to get a Medicare Part D (prescription drugs) plan.

The whole program is tricky, complicated, and loaded with land mines. You have to study it carefully and understand exactly what you’re doing — no small order! — to protect yourself from impoverishment should you face a medical problem that doesn’t carry you away quickly.

The Curative Power of Doctor’s Appointments…

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Have you ever noticed that a doctor can cure whatever ails you simply by making an appointment with you? Amazing, isn’t it?

My theory: I’ve become so scared of doctors that the very thought of having to see one — let alone having to talk with the critter — scares the peewodden (and the ailment) out of me.

Exactly one-half hour before I have to revisit the gastroenterologist, who was not happy to hear the vast quantities of omeprazole she has me swallowing have made no dent whatsoever in the GERD that arose after the last Adventure in Medical Science. I personally think I have esophageal cancer (of course…who wouldn’t?), but she seems not to be very ruffled by that possibility.

Whatever it is seems to have gotten significantly better since she had her underling call and demand that I come in to see her.

Magic!

Before I forget, in the half-hour before I have to fly out the door:

We’ve LAUNCHED the new “Family at the Holidays” series. It will run through the month of November, right up to that wonderful, scary, fun, hassle-filled annual rite, Thanksgiving Day!

This is the story of a large Latino family whose grown children are summoned (as usual) to the family homestead for a big Thanksgiving reunion. Some have to drive a long way. Others live close-by and so are called upon to show up with food in hand. All of the kids are interesting characters. All of the grand-kids are…well…kids and teenagers. You know what that means. First story is Ruby and Frank in the Bedroom.

Ruby & Frank LoRes

The author of this series has quite a nice sense of humor: low-key, mellow, and charming. It’s the kind of thing that leaves you chortling quietly as what she’s saying begins to dawn on you. I really love reading her stories. And yes, they are explicit, that being the nature of erotic romance. But funny.

Feeling reasonably pleased with the cover layout for this one. I think I’m getting better at cover-line design. If I get around to fiddling with it (probably won’t: too much to have to do), I might pull “in the bedroom” up tight against “Ruby and Frank” so that the descender on the “y” in Ruby appears to “hook” one of the letters in the second line.

But maybe not.

I thought making the font shadows pick up the shadowing in the quilt was freaking genius. 😀 Definitely, I missed my calling.

And one last thing: watch this space over the next couple of weeks. I’m going to run two give-aways: one for a fun little business book I picked up, a good and fast read with lots of practical advice; and one for a chance at an expensive gift, either for yourself or for a Christmas present.

Details to come!

Blog Blues, Doc Blues

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So far, I haven’t been able to move my little herd of blogs off my friend Jesse’s server over to WordPress.com or, as another friend suggested, to WestHost.

When I started FaM as a little hobby on the now defunct iLife, I was pretty techie for my times. But now I’ve fallen way behind the curve and worse, have exactly ZERO desire to learn still more piles and piles and piles of arcana, most of which will be out of date within a couple of years. I am just flat learning-curved out!

So, unless I can hire someone to help with this project or find a live person at WP.com (good luck with that!), I don’t know when or if Funny will find its new home. Or when or if Plain & Simple Press, Fire-rider, 30 Pounds in 4 months, or any of those will ever get transferred.

Meanwhile, I’m BUSY, dammit, and don’t have time to fiddle with that stuff. Have to break off what I’m doing here and run down to a grocery store to extract some money for Luz, who’s probably on her way over here as we scribble.

Then check in with the stoonts…OMG! Only ONE  MORE SET OF PAPERS and I’ll be free of teaching freshman comp for the REST OF MY LIFE!

I’m almost done with the second salacious book. Ooo la la! What a hoot! This stuff could get addictive — it’s pretty fun to write. Let’s hope it’s as much fun to read. 😉

And I still have to write the Boob Book proposal, notes for which have been sitting on the desk since before I went into the hospital.

And some laboratory sent a threatening letter saying I owe $952 for some test, the nature of which is not mentioned. They say “your insurer” rejected the claim. They don’t say what the test was for or why it was rejected.

In the same raft of mail, along comes a notice from Medicare informing me that they rejected whatever this was because it was for genetic testing for a DNA defect.

To my knowledge, I never had any such test. Had I been asked, I would have said “no.” If any such test was given, I never was told the results.

They want NINE HUNDRED AND FIFTY-TWO DOLLARS for this phantom test.

When you call the 800 number for the lab, you get a sales pitch. I’m sitting interminably on the yakkity hold button for the Mayo’s accounting department. I haven’t tried to contact Medicare  yet, because I know what a horror show that’s going to be and I at least need to know what on earth I’m talking about. If I can find out at all.

Medicare says the appeal was rejected because it was filed after the deadline.

So now I get to diddle away an hour or more screwing with this. I think I’ll cut it short by sending a letter to both of them — Medicare and this lab outfit — stating t hat I never had any such test, that I was never told of any need for an appeal or of the appeal itself, and that I believe the whole thing is fraudulent. That at least will delay my having to pay for it, for awhile.

God, God, GOD how I hate dealing with bureaucracies!!!!!!!!!