Health care

La Maya joined L.A. Fitness the other day, determined to get some exercise and lose some weight. Moi, besides the fact that sitting in front of the computer is turning me into a bowl of Jell-O, I need to lose about 20 pounds.

So I went over to one of their gyms and talked to a cute young sales dude. They do have a lot of stuff to do, including most notably yoga classes and Zumba. There’s a pool where you can do water exercise, and more exercise machines than you can shake a stick at.

All that gear and all those trainers don’t come cheap. Sales Dude offered two plans: one is $250 at the outset plus $20 a month for as long as you live, and the other is $100 and $30 a month. You lock in the monthly price, so if you stay with the club for, say, 20 years, you’ll allegedly still be paying $20 or $30 a month. I’ll believe that when I see it, but it’s a nice thought. For your dollars, you can go in any time you please, no appointment; you can use any facility you like; you can go to yoga class every day of the week if you so choose, and on and on.

If you use it faithfully, it really is a good deal. Yoga classes alone are $15 or $20 apiece around here; one outfit offers an auto-pay program that apparently will allow you to go as many times a week as you please, for $108 a month. So over time $20 or $30 a month would be incredibly cheap.

However, it’s not the cheapest game in town. I do get a tuition waiver, and so I could take PE classes at the community colleges for free. Advantage of the membership club, of course, is that one can pick one’s own hours, whereas signing up for a PE course means you have to show up at their convenience.

Assuming you would pay about $20/session elsewhere to purchase any of these activities on your own from an independent studio, here’s how costs compare:

If you  use it faithfully: therein lies the rub.

First, we have my underlying laziness. Getting me off my duff is quite the little challenge. The current painful spate of plantar fascitis—I can barely  limp to the fridge—works to complement the bone-laziness.

Second, I just purely hate gyms. At my grade school, we started “supervised play” (i.e., we couldn’t play as we wanted to, which was freaking fun, but instead had to do what our rather doctrinaire teacher made us do, which was boring and frustrating) just about the time the little monsters started to pick on me. So not only did the fun come to an end, four years of nightmare misery started…and I tend to associate the two, however unfair that may be.

Grade school was such a terrible time for me that to this day I have to force myself to go into a grade school classroom. The characteristic odor of little kids’ bodies makes my skin crawl. Subsequent years led me to feel a lot the same about gyms.

P.E. classes started in junior high and ran daily through high school. Oh, God! How I hated P.E. What a pointless waste of time, what boredom, and what misery. I already walked about three miles each way, back and forth to school every day. I did not need to be forced to run around a playground by some flicking moron who religiously believed that rigorous exercise would cure menstrual cramps so severe they would make me throw up, made to stand around a basketball court with other girls who were no more interested in the game than I was, or ordered to jump off a diving board that terrified me.

None of these memories incline me to hurry over to the gym several times a week.

On the other hand, four yoga classes a month would more than justify the monthly cost (though not the initial fee, at least not unless one stuck with it for a couple of years). The belly dancing and the Zumba sound like fun, and the aerobic classes could be good.

On the third hand… All those things are available for free at the Big Gym Class on the Internet, YouTube. (LOL! Aren’t these girls the prettiest things in action?) There’s no reason you can’t Zumba to a video, in the privacy of your home and at no extra cost.

The question is whether I really would go to these things, regularly and often enough to make it worth the money. Starting Monday I have to show up on campus at 7:30 a.m. My plan is to throw my hiking boots in the car and stop at a trailhead to North Mountain on the way home. That would provide about an hour to 90 minutes of hiking twice a week, free of charge. If I could add to that three more trips to the mountain, it would cause me to lose weight.

Not enough, of course: the last time I hiked five days a week, I lost about ten pounds over three months. But I was a lot younger then, and nowhere near as overweight. But it would be good to be back in shape. Hiking above the rim is a cheap way to entertain oneself—Arizona is full of spectacular places to sightsee on foot, once you get away from the ugly cities, for no more than the cost of gas to get there.

All of which brings one back to the same question: realistically, am I going to get off my duff and go hiking every day?

Well. No. Probably not.

It could be that if I’m paying for this stuff, I’ll feel motivated to go do it.

However, the cost is a little high for me—it will stretch an already too-thin budget. And I’m not earning any money while I’m jiggling around a gym. It’s a rare day when I have any free time, even when I’m not teaching. Really, yesterday afternoon was the first time in as long as I can remember when I didn’t have much to do…tho’ in fact, I did—I was playing hookey when I should have been editing another chapter from the current client’s book.

But I really need to get some exercise, and really need to lose the overweight, which some people think causes or aggravates GERD and which surely can’t be helping the sore foot.

Seems like an awful lot of money to pay for something I could do for free, though.

{sigh} I don’t know. Can’t decide.

Image: Brittany Carlson (USAG Stuttgart), U.S. Army. Public Domain.

Today have to decide whether to cancel the stress test the Mayo has set up for me on Thursday, and by extension the endoscopy they want to subject me to next Wednesday. It’s a dollar decision as well as a matter of interminable distance (the Mayo Clinic is 20 miles from my house) and suspicion that I’m about to be overtested and that there are less invasive ways to diagnose the present complaint than by sticking a tube down my throat and cutting chunks out of my stomach.

I’ve made an appointment with a doc in nearby Sunnyslope, in a practice that’s part of John C. Lincoln Hospital. He will take Medicare assignment, which means just about anything he chooses to do to me will be almost free. The Mayo does not, and so I’ll be paying through the wazoo for the nasty test they want to subject me to as well as for the stress test, which they demand that I take first. So that’s issue #1.

Issue #2 is that I’m just getting over another bout of plantar fascitis, which hurts like hell. I’ve barely been able to limp around the house. This particular recurring annoyance is something that takes about 8 to 10 weeks to get over, and after two months of pain it’s finally beginning to fade. Another two weeks without excessive irritation, and it should be healed up. However, it still hurts to walk, and I can’t even imagine how I’m supposed to RUN on an inclined conveyer belt.

Assuming I can do it, a) the pain will shoot my blood pressure even higher than it already is and b) you can be sure trying to run uphill with a wrenched Achilles tendon and a screaming painful heel is going to set me back several weeks in the healing process. As soon as the weather cools enough, I want to start walking again, but with this kind of pain that’s out of the question. I really don’t want to aggravate it.

So my sense is that I should cancel these tests and, if they’re to be done, have them done at Lincoln where I won’t have to face yet another financial disaster. This summer has been hellish enough in the dollar department.

There’s about a 4% chance that what ails me is a gastric cancer. On the one hand, I suppose one would like to ascertain, one way or the other, whether that’s the issue. On the other, by the time a gastric cancer is symptomatic, it’s too late—if that’s what the problem is, I’ve got about 6 months of not very good life left, and one way or another, it doesn’t much matter what is done about it. So I suppose a delay of a few days, by way of preserving capital, won’t make much difference one way or the other.

The ER staff did an abdominal ultrasound and could not see any masses. Over at the clinic, the young Mayo doc says that gastric cancer spreads to the liver first, once it metastasizes, and they couldn’t see anything in the liver, the kidneys, or the gall bladder, all of which they were especially interested in. She takes that as a good sign. And I take it as another good sign that the pain is finally gone and I’m now only mildly bilious and even that, only occasionally—rather than sick as the proverbial dog.

A 4% chance that it’s cancer means there’s a 96% chance that it’s not. The two issues working against those odds are the plexiform neuroma, which ups your chances of cancer and which causes a type of gastro-intestinal cancer that’s virtually impossible to treat, and the fact that gastric cancers have a genetic component and my mother apparently died of one. Apparently. That’s one man’s opinion: my beloved, now semiretired old doctor’s speculation made long after she was reduced to an urnful of ashes. She never saw a decent doctor and so we don’t know what specific cancer she actually had. But…it’s there, as a possibility.

At any rate, I think if it were cancer it would not stop hurting, as it did abruptly yesterday morning. And if it were cancer, there would be signs of internal bleeding, which so far is not the case. Since this is the second episode I’ve had in the past year, by now surely it would have metastisized and would probably be shedding blood. So I think it’s safe enough to delay the torture until I can get to another doctor whose ministrations aren’t going to break me up in business.

It’s frustrating. I’m nervous about John C. Lincoln, whose quality is no better than any of the other ordinary hospitals in the city. The only one that consistently scores well in clinical excellence and patient safety is the Mayo; there’s one in Scottsdale that does pretty well most years. The rest…well, we saw what happened to SDXB’s mother, who was rescued from a post-operative heart attack only because a cleaning lady happened to wander into her hospital room to pick up the trash and noticed that she was in distress. And what happened to mine, for that matter: a nonstop horror show. That’s pretty typical.

So it may be better to shell out the extra dollars to stay in the Mayo’s system. But I am running out of money, and with all the expenses, planned and unplanned, that have happened over the summer, the savings I’ve used to live on since Layoff Day will be exhausted by November 1.

I mean, really: if I have the new guy order the tests at Lincoln and I just MUST continue to traipse out to the Mayo to see whatever resident they happen to assign to me on any given day, I can have the results sent over to the Mayo and not have to pay extra for the privilege. If I like the new guy, I’ll just continue with him, and he’s right around the corner.

The two senior guys at the Lincoln practice say they specialize in gerontology, which would be nice assuming they don’t patronize. Depends on their personalities and whether they have any common sense, I guess. One of them has been practicing for 30 years, so he should be getting long enough in the tooth to realize old people are not children and not idiots. Well…most doctors think patients are idiots, and half the time they’re right about that. But one doesn’t need the preconceptions about age layered on top of it. The two senior guys are both MDs, but at this time they’re not taking new patients.

The new kid, whom I’m seeing and who just joined the practice, is a DO, which may or may not be a bad thing. One DO I visited was heavy into woo-woo—tried to get me on homeopathic nostrums. But recently I saw a dermatologist with a DO who seemed to have a scientific cast of mind. At least, he didn’t suggest treating plexiform neurofibromas with herbs and roots. Or bottles of water containing .001 to the –100th percent of some supposedly active ingredient. At any rate, the young fellow has two senior docs who apparently have a lot of experience, and one would expect they probably consult with each other on occasion. So…there’s hope for an actual doctor-patient relationship here.

Interestingly, yesterday’s abrupt improvement seems to be holding. This morning: no pain, no discomfort, no burping, and no general annoyance. To the contrary, I actually feel very good just this minute. I suspect that would not be the case if the past two or three weeks’ manifestations were cancer. So, the alarm bell is turned off, for the nonce.

Welp, the hour grows late. I’d better go swimming if I’m ever gonna get in the water before the blasting sun rises over the yardarm.

What skill! Few people can will themselves another step closer to the grave. I’m so good at it, I amaze me.

Spent the better part of the day before yesterday laying around the Mayo’s ER. I’d been resisting seeing a doctor for quite some time, having convinced myself that the chest pains that recently have visited were heartburn. These have been coming on about 11:00 p.m. or midnight, when I usually go to bed. But Tuesday after I’d made myself a magnificent midday meal—grilled coho salmon; corn on the cob; salad of shredded broccoli, avocado, and tomato; wine in a bottomless glass; two dishes of staggeringly delicious ice cream—the stabbing pain under the sternum would not go away. And boy, did that hurt!

So, since the 911 people will not take one to the Mayo from this part of town but instead will insist on delivering one to St. Joseph’s, where a) I almost died a few years ago, of neglect and b) the Church’s idea of medical care for women does not accord with mine, it was into the car for a quick schlep to the ER of one of the few hospitals around here that consistently ranks high in clinical care and patient safety.

Seven hours later…

They decided I wasn’t having a heart attack, thank God. Other than slightly (and not surprisingly) elevated blood pressure, apparently I have no cardiac issues.

No. The doc thought it was GERDS that probably has developed into an ulcer. Once they’ve decided there’s no emergency, they let me cool my heels interminably. Fortunately I’d brought an ARC from Poisoned Pen Press to edit. Managed to finish the entire book before I got out of there, bearing a prescription for omeprazole—the very same overpackaged horsepills I was complaining about the other day—and another for something called sucralfate. Omeprazole is Prilosec. I say to the guy, “I’ve already got this stuff at home, and in fact I’ve been taking it for the past two days” (what part of my chart did you not read?). He says no, don’t take that; this prescription is stronger.

Wise by now to the fact that neither Medicare nor my Medigap policy will cover a penny of a prescription filled in the Mayo pharmacy, I schlep to the Walgreen’s on the way to my house. Thought it was a 24-hour pharmacy, but no. Get there 15 minutes before they close.

Also wise to the fact that Medigap carriers will try to avoid paying for any prescription drug, no matter what, I ask the pharmacist if the things can be had over the counter.

She says the sucralfate is prescription-only (mercifully, it only costs $11—the alleged insurance covered $8 of the retail price), but, she says, “I don’t understand why he wrote a scrip for this omeprazole. It’s identical to the over-the-counter version.”

I say, “He said it’s stronger.”

“No, it’s  not,” she says. “It’s exactly the same: 20 grams”

“Hmm. So if I get home and discover the omeprazole I’ve already got is 10 grams, it’s OK for me to take two of them?”

“Sure.”

I finally reach home a little after 9:00 p.m. M’hijito has come over after work and fed the dog, and while he was here he discovered that I’d left a pan of chicken in the propane grill, which I was cooking up for Cassie. It was cremated, of course, and the grill was still merrily trying to reduce it to ashes.

Hilariously, he decided the result, toast-brown chicken chitlin’s, was edible enough for a dog, and so he retrieved the pieces, piled them on a plate, and stashed them in the fridge. He doesn’t realize, of course, that this is not a dog but a goddess visiting earth in furry disguise: hence the sobriquet “The Queen of the Universe.”

To rescue the pan, he filled it with soapy water and left it on the stove.

Well, the stink defied belief: cremated chicken is not something you want to invite into the house. 😀

The pan was brim-full of grease & water, which I couldn’t pour down the sink. Nor did I think I could carry it out to the alley to dump it without splashing it all over myself, the floor, and the flagstone patio.

Fortunately, I’d recently put the last of a bottle of distilled steam-iron water on a plant that’s sensitive to Phoenix’s gawdawful tap water, so dragged the empty gallon bottle out. It held most of the soapy greasy water so I could carry that and the rest of what remained in the pan to the garbage. What a mess!

Also fortunately, because I’d left the grill on “low,” the chicken and grease did not ignite and burn down the house…

I totally forgot. Forgot until I reached Walgreen’s and saw the text message from M’hijito on the new phone, and had he not come over and rescued the stuff, I probably would have gone straight to bed the minute I walked in the house and not remembered until the next morning. Or until the house burned down around my ears.

Speaking of forgetting, I forgot this morning’s SBA meeting. Told the painters I’d be here. Although…they did say they’d show up around 6:30, which would have given me time to get out the door to make the shindig. This pair works on mañana time. It’s 7:08 now. So presumably I’m not going to make it to Scottsdale by 7:15. Or at all.

So, anyway, back to the issue at hand: what ails me.

Booze, primarily. I have got to stop drinking.

And fat. About 15 pounds of overweight.

And indolence. Especially in this heat, the only exercise I get is wrestling with the pool equipment and the vacuum cleaner.

I don’t think I drink excessively, but I do have wine, beer, or whiskey every day. That’s because I happen to like a drink with dinner. And because I hurt myself: gave myself a fine fit of tendonitis that stretches from the hip all the way down into the heel, and it does hurt. What with the lovely new allergies to aspirin, acetaminophen, and ibuprofen, I can’t take anything for it…except booze. A glass of wine or a shot of whiskey works every bit as well as an aspirin, and it sure as hell tastes better.

Lately I’ve taken to fixing my large meal in the middle of the day, around 2 or 3 p.m. That’s when I get hungry, and besides, it’s less hassle and I have more energy then than late at night for cleaning up the mess. So this means I have a glass of wine around mid-afternoon. And then, usually, another glass of wine, because of course one glass doesn’t last until the food is cleared off the plate. Sometimes I might even have another half-glass, just to come out even.

This is probably not good.

Now that I’m stuffed, I don’t get hungry again until 9 or 10 at night. At that point, I’m likely to have a snack. And what am I going to wash it down with?

Yup. Whiskey & water.

Often I can’t finish a whole glass of branch water, especially at night when I’m running out of steam. However, the fact remains that I’m drinking some of it.

So, I’m officially off the sauce. Damn it.

As for exercise: That one escapes me. I can get a little exercise in the pool, but it’s not really big enough for laps and besides, my brain goes absolutely numb swimming back and forth and forth and back and back and forth and…. Plus I can’t stay out in the sun any length of time, because of all the interesting skin lesions a person who has spent her entire life in the subtropics develops. It is just. too. freaking. HOT to walk or run. Even after dark. The other day it was still 100 degrees at 10 p.m.

I hate, loathe, and detest gyms and even if I didn’t, I can’t afford memberships.

When fall semester starts, I’ll have a 7:30 a.m. class that will let out about 8:45. My plan is to toss a pair of hiking boots in the car and drive straight to one of the trailheads in the North Mountain park. Plenty of hills to walk up and down there, which is about the best way to get exercised in these parts. And when the weather cools enough that Cassie’s feet won’t burn on the pavement, she and I will be able to get back to our customary 45-minute daily constitutional.

And the fat? One of the approaches to GERDS is to eat a lot less food. Eat less, but eat more often. That would help. And since wine and whiskey load a fair number of empty calories onto your eating habit, I expect knocking off the booze will make some difference.

I’m not going back on Atkins. It may or may not be good for your health, but for a person who lives for pasta it’s not very sustainable.

And speaking of eating, the boys are still not here. I guess it’s time to conjure them up by trying to sit down to breakfast.

😉