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Health care

The Sky Is Blue Again…

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…out of both eyes!

Yesterday it dawned (heh) on me that suddenly the sky no longer looked like a smoggy day when viewed from the right eye — the one with the weird flashes. In spite of being declared free of retinal detachment, ever since that episode it’s felt like someone smeared a microscopically thin film of Vaseline over the lens of that eye. And when I look into the sky, it’s blue out of the left eye but kind of brownish from the right.

The optician — glasses dude — speculated that in addition to whatever is wrong inside the eye, I may be developing a cataract, too. Nice.

But suddenly, yesterday morning the sky was BLUE blue through both eyes! If anything, it looked even brighter blue from the right than from the left.

Hallelujah.

Most of the annoying floaters had disappeared, too.

One of the websites I stumbled across while mining the Hypochondriac’s Treasure Chest for information on whatever ailed me said that sometimes the floaters reabsorb after one of these incidents, though it could take three or four months. But the vision was so badly hazed — to the extent that if this had happened in both eyes, there’d be no way I could drive at night — and it seemed so unchanging that I figured I was just going to lose that degree of vision permanently, and that eventually I would pretty much go blind in that eye.

So. It’s reassuring to have the sky come back.

Image: Mohammed Tawsif Salam. Creative Commons Attribution-Share Alike 3.0 Unported license.

NINE HUNDRED DOLLARS for a 20-minute visit????

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Bill came from the Mayo Clinic, whose ER I visited a few weekends ago at the urging of my doctor’s office. You may recall the flashing lights: possible detached retina, possible pending blindness. Off to the ER.

The Mayo has made itself into an avatar of efficiency. Literally — this is not an exaggeration — I got in there and out in 20 minutes. The doctor, who was not an eye specialist, spent a good 7 or 8 minutes with me. He turned off the lights in the room, shined a light into my eye and peered in there, said he couldn’t see any sign of bleeding and therefore believed I did not have a detached retina, and advised me to call a specialist the first thing Monday morning.

For this, the Mayo is billing Medicare, my Medigap insurer, and me over $900!

And they did almost nothing.

No joke. They checked me in, they sent this guy in, and they said good-bye.

Damn. If I could charge that much, I’d earn $2,700 an hour.

Obamacare Side Effect: Fewer Jobs? Or More Employers?

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Have you been following the Republican far right’s latest misrepresentation about the Affordable Care Act? Twisting a statement in an appendix to a Congressional Budget Office report on the ACA’s progress, the crazies claim the government admits that affordable health care will kill 2 million jobs.

HOLY mackerel! We’re all flying toward Hell on a skateboard!

What the budget office’s authors actually said is that once people no longer have to hold onto a full-time job, willy-nilly, in order to maintain health insurance, about two million American FTE jobs may be vacated by those who retire early or elect to quit working full-time so as to follow more worthwhile pursuits, such as rearing their children, spending their time in volunteer work, becoming self-employed, or simply living slightly less miserable lives.

That is different from the loss of two million jobs. It doesn’t represent the disappearance of jobs. It represents a reduction in the number of people forced to work at a certain type of employment.

As a practical matter, the CBO is probably right in saying that quite a few people will find better things to do with their time than trudging through the rat-race five or six days a week. I can’t even begin to count the number of people I’ve known, over a lifetime in said rat-race, who have said that the only reason they didn’t start their own businesses was that they had to have health insurance and they couldn’t afford it or wouldn’t qualify for it if they weren’t on an employer plan.

If these dreams now can be made to come to pass, will that actually cause the loss of umpty-umpteen gerjillion jobs?

Consider: Jane quits her job because she’s tired of working for the Man and she thinks she has a better idea. She starts a cleaning business. Within a year, she employs five cleaning staff and an admin to answer the phone. A year later, she’s regularly contracting with an exterminator and a painter, and she’s hired an accountant.

Her old job back at Avaricious Industries, Inc., may or may not be replaced with two part-time positions devoid of benefits. But in the process, she has created jobs for nine people, three of them self-employed in businesses that also create jobs for workers.

Okay: Annabelle, the lazy bum, just goes home and takes care of her kids, thereby creating…nothing? Nevvermind that one graduates from Johns Hopkins medical school and becomes a cancer researcher, another grows up to be a nuclear physicist, and the third goes to Africa to lead an NGO and, at the age of 63, wins a Nobel Peace Prize. As a woman and “just a housewife,” Anabelle’s obviously a drag on society.

So if for every two workers who quit a job, one of them founds an enterprise that ends up employing, on average, five other workers, it would seem that a “loss” of 2 million FTE employees should result in a net gain of five million new jobs.

New lies, anyone?

Why Is It So Much Cheaper to Be Skinny?

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Down to 128.8 this morning: hot dang. Exactly on target.

We’re now at the end of January. I hit the 130-pound diet goal on September 26. Since then it’s been too cold to swim and I’ve been too busy to walk every single day (though usually do get some sort of activity in most days). But I’ve managed to stay right around 130 pounds, give or take a pound or two.

I haven’t run a Quickbooks report to prove it, but it’s my belief that I’m spending a LOT less on groceries, despite the mountains of fresh veggies and fruits and the “less meat but BETTER meat” strategy. I’ve spent about $250 on groceries this month — a far cry from the typical $350 to $400 of a year ago.

Why? In theory, it should cost more to eat nothing but whole foods. Are we not told that poor folks consume all that junk food because it’s cheaper, on the surface, to buy processed junk and fast-food? Is it not true that corn is subsidized and healthier vegetables are not? Do we not believe that grass-fed beef, free-range chicken, wild-caught fish, and humanely raised pork are astronomically expensive?

The key, I think, is that when you’re not thinking ahead about what you’re going to eat, you’ll buy anything that comes to hand. Also, when you’re not thinking about cuisine, you tend to eat more at any given time.  When you have a diet strategy in mind, you’re a lot more careful about what you buy, and of course you eat less per sitting.

Now that I’m in the habit of eating smaller portions, the loot hauled in the door from a grocery trip lasts a lot longer. A single stir-fry, for example, provides two or three meals instead of one or two meals. Before, I would scarf the whole delicious thing down and so would have to cook, say, seven separate dinners for a week instead of five or six.

Also, with what we might call “mindful dining,” one is much less inclined to the impulse buy. Before, if I was hungry and in the vicinity of a better AJ’s or a Whole Foods, I would run in and grab a large box of sushi (maybe two!) and, naturally, a beer. Or more likely, a four-pack or six-pack of dark, foamy, delicious stout. And by golly, look at that: real Stilton! And what’s this “white” tea? And ohhhhhh I do love those spectacular barbecued baby back ribs. You can’t have those without a giant twiced-baked potato slathered in cheddar cheese…

“Ma’am? May I rent that llama over there to haul this stuff out to the car?”

And speaking of foamy-delicious beer, although I haven’t quit swilling a potable once a day, my choice of alcoholic beverage has changed enormously.

Quit drinking beer pretty much altogether, except as a special treat: too calorific.

Wine proved to be highly problematic: I dearly love wine and will drink it like soda pop. And it’s too damn easy to pour like soda pop. You finish a glass of wine halfway through your meal, so what do you do? Tip the bottle into the glass to add “just a little more” to come out even. And then just a little more. And then just a little… Uh huh. By the time you’ve finished your diet feast, you’ve consumed half a bottle of $10 red. This not only was too calorific, it was too much to drink and too expensive: at $8 to $12 a bottle plus exorbitant taxes, if you’re buying two bottles of wine a week you’re ponying up around $80 a month — and that doesn’t include the beer you’re buying to go with the sushi and the barbecued ribs!

So the wine imbibulation had to go.

Interestingly, certain breeds of hard liquor contain significantly fewer calories per dose than does a glass of wine. And because I’m not averse to watering my booze down, I can make a shot of whiskey or gin go a lot further than a beer or a glass of wine will go. A single bottle of very good bourbon from Costco will last well upwards of a month, at half the price of eight $10 bottles of middling wine.

Hard liquor has as its advantage that you have to get up and mix another drink if you want another. This activity — get ice, get the bottle out of the cupboard, retrieve the jigger from the dishwasher, get cold water from the fridge — is enough to remind you that it’s time to stop, whereas “just a few drops” more wine encourages you to keep pouring.

In the booze + food department, one thing that soon became apparent is that once you hit your target weight, you can keep it down more effectively by eating larger meals earlier in the day and smaller meals or even just healthy snacks at dinner time. I like a drink with dinner. So, I wait to have a large, glorious mid-day meal until I’ve finished whatever running around needs to be done and know I don’t have to drive any more that day. Because this is likely to be around 2:00 or 3:00 in the afternoon, it means I have to eat a good breakfast that will last until after the noon hour.

This eating pattern, by sheer coincidence, turns out to be an effective weight-loss and blood-glucose management strategy! That’s nice. It also means, though, that if I’ve had a bourbon and water or a gin rickey at 2:00 p.m., I am not going to go back out to the grocery store in the afternoon. By two or three, I’m done with running around spending money.

So, in a lot of subtle ways that have nothing to do with personal finance, the diet plan also works to promote frugality.

Image: Nejmlez. Creative Commons Attribution-Share Alike 3.0 Unported license.

Eyeglass Hit

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Lordie! So yesterday I dropped $830 on new visionwear. As a practical matter, I ended up with four new pairs of eyeglasses, so it’s not as drastic as it sounds. But still…like I had $830 just laying around the house?

Figure to make up for it by cutting $100 out of the monthly discretionary budget: for the next eight months, instead of having the usual $1100 to spend, the budget will have only $1000. That makes it seem like not such a big deal.

Except, of course, that most months I do spend all of $1100, and rather little of that is for indulgences. With every stitch in the house, including my underwear forgodsake, falling off my body, I do need to buy some clothing that fits.

But I think I can get away with it. There’s now plenty of stuff to wear while the weather’s relatively cool. And when I was wearing size 10 jeans, I discovered that I could convert the size 12 Costco specials into cut-offs and they fit just fine. So now that I’m down to size 8 in the Costco marvels, I should be able to turn the size 10 jeans into shorts for this summer. But that’s it: no new clothing  purchases between now and next October!

Managed to keep the average price down to under $200/pair (the progressives were significantly more than that!) by recycling old frames. The (very expensive) rimless frames I bought back when I had a job, will, I’m told, probably last a lifetime — all one has to do is reattach the temple and nose pieces to new lenses. Also, though, I had a couple of extravagantly old frames, from way, way way back in another lifetime. These were regular wire-rimmed frames, one from Costco and one from a private optometrist — the latter, a very nice pair. The lenses in the two antiques were even more out-dated than my regular glasses (…you realize…if I bought the fancy rimless frames when I was employed, then they are at least five years old —  but in fact they’re older than that).

Because I now can see neither in the distance nor in a close range (unless it’s held right up to my nose), and because of the amount of close work I do on computers, I need a whole goddamn vision system! And thanks to my stupidity in losing my very best pair of distance shades, I ended up having to replace a ton of hardware in the new prescriptions:

• 1 pair of progressives, for navigating grocery stores, classrooms, and other public places where I might need to see both in the distance and to read things
• 1 pair of clear distance lenses, for night driving
• 1 pair of extra-dark sunglass lenses, for day driving, neighborhood walks, and hikes
• 1 pair of computer-monitor-distance lenses, for working and for navigating the house and yard

In the depths of the Old Glasses Morgue, I found a pair of up-close glasses that still work nicely for reading hard copy — i.e., for  things that are closer than a computer monitor but not within six inches of my face.

All of which is to say that to get around in my world and see what on earth I’m doing, I need six pairs of glasses.

You doubt it?

• I can’t see to work on the computer in the progressives, because I can’t spend hour on hour on hour with my head tipped back, peering down my nose.

• Progressives don’t work for reading newspapers, either, because you can’t see even one full page, to say nothing of a double-truck spread. Often you can’t even read a small article without having to move your head and peer down your nose.

• I can’t drive in the progressives in the daytime, because they’re not sunglasses.

• I can’t drive in the progressives at night, because the distance portion is not strong enough, leaving me essentially night-blind.

• I can’t drive in the computer glasses, because they’re not strong enough to decipher road signs.

• The Arizona sun is so glaring, especially in the summer, that it actually hurts to drive or walk around in it without sunglasses — and, as a practical matter, that powerful sunlight and UV light indeed do damage your eyes over time. You’re crazy not to use a good pair of shades here.

That doesn’t count the nonprescription shades and the nonprescription readers for use with contact lenses. And right now I am wearing the contacts, because I can see a lot better through them.

Whatever was going on with the eyeball (and continues to go on, as of this morning) caused some kind of damage. Through just the right eye, things look kinda hazy, the effect one gets when peering down the street through thick smog. The sky’s a funny color through that eye, too — brown-smogged, one might say. Now, the air here in Phoenix is indeed very dirty during the winter, so there may objectively be some smoggification. But I think it’s mighty peculiar that the effect is visible only through one eye…

At any rate, until I get the Vision System updated, I’m falling back on the contacts, which are a hellacious nuisance…but not, possibly, any more of a nuisance than juggling six pairs of glasses, no one pair of which delivers decent vision.

ooohh well...

Another Bullet Dodged…Maybe?

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So, about a week ago I’m driving down Feeder Street a little after dark, and I see these weird flickering lights, sorta thumbnail-paring shaped, in the far right periphery of my right eye.

At first I think it’s headlights reflecting on some part of my glasses.

Wrong.

Then I think holy sh!t. Within a couple of minutes, though, the phenomenon dissipates. I’m wildly busy and don’t have any time to think about it and besides there’s not a thing I can do about it after doctor’s office hours anyway.

Next morning I’m heading out at the earliest crack of dawn for the weekly SBA meeting and the same damn thing happens. Only…uhm…there are no headlights at that moment.

When I get back from the morning’s junketing, I hit the Hypochondriac’s Treasure chest and and learn that flashing lights, especially when coupled with new eye floaters, are a sign of a retinal tear (serious) or retinal detachment (blindness!). Either occasions surgery, one more drastic than the other.

The weekend arrives and yea verily so does a new crop of floaters. And a headache.

Call Young Dr. Kildare’s office; get his partner, who’s on call. “Eek!” quoth she (not in so many words: think a doctorly “eek”), “you need to go to the emergency room.”

Ahhh shit. I hate the ER. But if this phenomenon weren’t alarming enough, a worried doctor saying “go to the emergency room!” will make it downright terrifying.

Amazingly, I get in and out of the Mayo’s ER in less than an hour. The doc on duty can’t see any obvious signs of a retinal tear or detachment; thinks it’s another optical migraine (ooooh no it’s not, I think, but refrain from saying so). He says I need to make an appointment with a specialist.

Monday the Mayo’s underlings are on the phone, trying to make an appointment with an ophthalmologist for me. Moi, not desiring to make yet another trip halfway to freaking Payson, I have already found a doc in town who will take Medicare assignment, very good. Make an appointment. Get in with him today.

He and his staff go to elaborate lengths to examine the suspect eye. After 90 minutes of eye dilating and examination, he delivers the good news: absolutely, positively, I do not have a torn or detaching retina. This interesting experience is yet another of the many entertaining events of advancing age.

He, who is even more advanced in age than I am, reports that he had the same darned thing happen to him a couple of years ago. And of course it happened on a weekend. He being the real deal — an actual living, breathing ophthalmologist — was petrified, understanding what this could mean. He betook himself to his office and was waiting with his eyes already dilated, early on Monday morning, for his partner to show up. The two docs came to the same conclusion in his case: old age creepin’ up, nothing much to worry about. Yet.

Then the bad news: he thinks I might have the start (maybe…maybe not) of macular degeneration. He recommends that I run out and start swallowing multivitamins and a special antioxidant snake oil concocted by Bausch & Lomb (which, we might add, paid to sponsor the study claiming this miracle supplement delays the advance of dry macular degeneration).

Delightful.

At least I’m not in any immediate danger of going blind, assuming I don’t accidentally stab myself in the eye with a fork while scarfing down a lamb chop. But…

Macular degeneration?

Not. Good.

I look up this study and find that the one published in 2010, the one sponsored by B&L, was a shade problematic and, even if you buy the results, proved rather little. A newer study, published in 2013, showed some benefit, maybe. However, the ingredients of the magical concoction of antioxidants pose some risks, not the least of them significantly enhanced chances of developing lung cancer if you have ever smoked (both my parents were very heavy smokers, and so I spent the first 16 years of my life inhaling the equivalent of several cigarettes a day in second-hand smoke). Neither study included people with “maybe” early symptoms: subjects were all people with intermediate to advanced age-related macular degeneration.

So. There we are: I’m not going blind, but maybe someday I will be going blind.

Here. Take these pills!