Coffee heat rising

Just can’t believe it…

So up at the Mayo they told me it looks like I may have to have surgery for a torn rotator cuff, in the shoulder that got dislocated when I fell on Easter.

It takes six months to recover from this. At least. One site says it takes up to a year to recover. My arm will be in a sling for four to six weeks! Think of that. My life came to a screeching halt when I had to wear a sling for just a couple of weeks. According to the University of Washington’s Orthopedics and Sports Medicine site, you have to have convalescent help for three months after the surgery, and if you have no one to help you (that would be me!), you may have to go into a nursing home.

At the very least I’ll have to hire someone to come into my home to clean and help me fix meals, and I’ll also have to hire a pool guy. And what’s going to happen to my house and my little dog if I have to go into a convalescent home?

If I can stay at home at all, I’ll have to use my emergency fund to hire help. I do have nursing home insurance, but you have to meet several requirements for it to kick in, and I don’t think not being able to use one arm will fill the bill. A year’s worth of cheapskate living expenses won’t go far to keep me in a convalescent home.

Meanwhile, I’ll lose my teaching gigs. Adjuncts have no sick leave, and no slack is cut: you’re there or you’re not. If you’re not, you don’t get paid. I won’t be able to drive for quite some time after the surgery, and of course, I can’t teach an online course if I can’t type. Funny will go dark, so even the tiny pittance I’m making from Adsense will go away.

They’re going to do an MRI on Friday to see how much damage has been done. There’s only one tiny sliver of hope: the P.A. said sometimes ongoing pain is caused by tendonitis, and if that’s the case, a steroid shot may bring down the inflammation. And that possibility is not out of the questions: the symptoms do resemble impingement syndrome, which is apparently a combination of tendonitis and bursitis, also brought on by an injury. This can respond to nonsurgical treatments, and if you do need surgery, the recovery period is shorter and not so drastic.

On the other hand, the symptoms resemble those of a torn rotator cuff, too.

If the rotator cuff tear is small, he said, some people choose to just learn to live with the pain. In that case, it will never go away—the pain will be permanent. But at least I wouldn’t lose what little remains of my livelihood.

Very nice. But I can barely take care of my house and yard with the arm hurting the way it does. If I choose not to have the surgery—if the injury is minor enough that I can get away with that—I’ll have to sell this place and move someplace that doesn’t require so much work to maintain. And presumably over time I’ll lose more and more function. You can already see the difference between the two arms in the muscle size and tone. If this continues for years, eventually the left arm won’t be good for much.

My God. I can’t believe this!

Balancing the Budget on the Backs of the Vulnerable…Again!

What is it about Americans and American politicians that we think it’s OK to let the rich and the corporations get by with low or no taxes and then cover the deficit on the backs of the most vulnerable people in our society?

Our government, much reviled by the right for its new “progressive” leadership, is going to cut Medicare reimbursements to doctors by 21 percent!

Medicare reimbursements already don’t cover a doctor’s cost of doing business. Many doctors here won’t see patients who are on Medicare, and many more won’t take on new Medicare patients. The Mayo, where my doctor moved after “managed care” by HMOs first started making physicians’ lives miserable, will (for the time being) keep seeing you if were a regular patient before you were switched to Medicare, but it will not accept new Medicare recipients. One branch of the Mayo here in the Valley, a practice on the west side, fired all its Medicare patients and now sees no one who doesn’t have private insurance.

I expect that will be the way the main Mayo Clinic will go, too. Even though the present cut may (or may not) be temporary, the message is clear: expect a permanent version in the near future.

{sigh} The level of medical care here in Arizona leaves a lot to be desired. No doubt there are horror stories in every state in the union, but I’ll bet in many states not every single resident has a story to tell. In Arizona, unless you’re lucky enough and stubborn enough to stay away from doctors and hospitals, you’ve got a war story. The Mayo is one of only three hospitals (the last I looked) that has a top rating in national rankings of clinical care and safety.

So, when you find a decent doctor, you want to hang on to that doctor. The last thing you want is to be bounced from doctor to doctor, or to be forced to see someone whose competence you mistrust or who is too overworked to spend more than five minutes speaking with you.

It’s not “Cadillac care” to have a doctor whose skills are competent and who has fifteen or twenty minutes (or more, preferably) to listen to a patient and arrive at a thoughtful diagnosis.

This vicious slash in Medicare is going to put a lot of elderly people out on the street and yes, bouncing from doctor to doctor. If they can even find a doctor. It will push most of us into low-quality clinics or to hungry young practitioners without the experience and wisdom one needs to see in a doctor. I’m still fairly young—only just eligible for Medicare—and I’m too old to go through that. Imagine the suffering and just plain bad medical care this will inflict on people who are too frail to fight the system!

Inexcusable.

Sunscreens: Be scared, be very scared!

Sunbathers

If you haven’t seen Environmental Working Group’s 2010 sunscreen guide and Carrie Kirby’s excellent report on it in WiseBread, now is the time to start reading. Hang onto your hat (literally: you’ll be needing it!).

The long and the short of it is that most commonly used sunscreens are not as effective as claimed and contain ingredients that may do more harm than good. Vitamin A, currently popular in U.S. sunscreens, may actually accelerate growth of skin tumors. Oxybenzone, the most common ingredient in these cosmetics, is a hormone growth disruptor and should not be used on children.

Sunlight delivers two types of ultraviolet radiation: UVA, which penetrates deep into the skin, and UVB, which causes sunburn. Scientists believe that to avoid melanoma, an aggressive and deadly skin cancer, you need protection against both UVA and UVB. However, most sunscreens sold in this country provide little or no protection against UVA radiation.

Interestingly, researchers do not even agree on whether sunscreens prevent skin cancer at all. In fact, some speculate that use of sunscreens encourages people to stay out in the sun longer than they might otherwise do, and, since these products do not necessarily protect against the carcinogenic effects of ultraviolet radiation, they may actually increase the risk of skin cancer. To obtain any meaningful amount of protection from a sunscreen, you need to glop it on: a palmful at a time. And you have to reapply it frequently. Using high-SPF products does nothing to change these facts.

Seals of approval by the American Cancer Society, such as the one that appears on the tube of Neutrogena UltraSheer sitting next to my keyboard, get there because the manufacturer pays for the privilege of using it. Says the ACS: “…[W]e do not endorse a specific product and…a royalty fee has been paid for the use of our brand logo.” To get the Skin Cancer Foundation’s Seal of Recommendation, manufacturers pay $10,000 a year to belong to SCF’s Corporate Council.

Is there a solution to this conundrum?

Yup. You’ve got it hanging in your closet: clothes. Wear clothing and a hat when you go outdoors.

Indigenous peoples in hot, sunny parts of the world often wear traditional clothing that protects them from the sun. When I grew up in Saudi Arabia, the locals wore robes covering them from head to toe. We know, of course, of the notorious burqa intended to hide women from the public eye—because these were black, they must have been miserably hot, further discouraging women from appearing in public during the sunlight hours. The men wore white, sun-reflective robes that allowed air to circulate around the body, and a headdress that protected the back of the neck, much of the face, and any bald spots in the hair.

Meanwhile, we whiteys ran around half-naked in the 100-degree heat, all of us in pursuit of a “healthy tan.”

Loose cotton and linen clothing is readily available in this country, for men as well as for women. Get some, and get a few nice hats. Wear them when you go outdoors. And use the pool in the very early morning and at night, not in the midday sun.

This One Bears Watching!

Did you read the news that a breast cancer vaccine may be on the horizon? Wouldn’t that be something!

Well, we women have been guinea pigs before, so I guess we’ll have to watch this with care. But also with hope!

Next, a vaccine for atherosclerosis…

Glasses: You get what you pay for!

New-glasses

OMG!!! Just got back from picking up the $720 glasses of late, great fame. I can’t believe it… They don’t just work, they work with a flourish. I can see better through these than I’ve been able to see in years. In the car, I can see the road and all the signs around with crystal clarity, and see the dashboard perfectly. Hee! I haven’t been able to read the digital clock since I bought that vehicle…who knew it wasn’t Toyota’s fault?

On the way home I stopped by the Walgreen’s to pick up some dog-bandaging gear (more about which, soon), and mirabilis! I could actually read the fine print on the packaging!

It gets better. Back here at the Funny Farm, I experimented with the laptop computer, expecting exactly…not much. But lo! The little monitor is clear as a bell! The Mac defaults to show a fairly small image, so I’m often command-plussing to enlarge it. Noooo problem reading it. That’s not surprising, though, because it sits down fairly low when you’re loafing on the sofa while computing. Still…I couldn’t even begin to read the MacBook through the Costco progressives.

And I just discovered that I can even read the iMac’s monitor, if I jack up the desk chair as high as it’ll go. Since a little footrest resides under the desk, the fact that my feet barely reach the floor is moot. The footrest holds my feet & legs at a very comfortable angle.

You realize what this means?

Holy mackerel. It means GOODBYE TO THE VISION SYSTEM!!!!!

No more jerking around between three pairs of glasses. And maybe, just maybe, I’ll be able to use these glasses for choir. Just these glasses…no switching back and forth with ultra-strong readers. Would that or would that not be awesome?

There’s a lot of frosting on this cake: these glasses fit my face! The Costco pair looked like goggles. When I said I looked like Ma Makutsi from The No. 1 Ladies’ Detective Agency, I wasn’t kidding.

They’re so feather-light, it feels almost like there’s nothing hanging on my schnozz. It would be easy to fall asleep in these things, because you hardly even notice their presence.

And the marzipan roses on top of the cake? They actually look nice! In fact, they look amazing! The frame has this tiny, delicate temple piece of amethyst metal, and Tommy, the glasses dude par excellence, added a perfectly matching color around the lens edges. The effect is  too, too kewl!

New-lenses

Another Big Expense: Glasses

Well, after diddling away $700-plus on clothes a few weeks ago, I’ve done it again. This time, a like amount is going into the optometrist’s pocket. Over the weekend I ordered up two new pair of glasses. Actually, one new pair and a pair of lenses for an existing frame.

I’ve never been satisfied with the progressives and the up-close glasses Costco ground out for me last fall. They just don’t work for the tasks I do in my day-to-day life, which largely entail reading, an activity that apparently has fallen into such disuse that optometrists don’t understand that one or two of their customers still do it. And the truth is, I never intended to use those as my regular glasses, anyway—I bought them on the cheap to use as back-ups.

When we learned that the university would delay closing our office until December, I realized that the period between open enrollment and Canning Day would only be about three months. This made signing up for Avesis, the low-rent vision insurance program, highly cost-effective, since I would only have to make three payments to get the benefit of a year’s worth of coverage. It was only a few bucks a month. If I ran over to Costco, the only dispenser they covered that’s not excoriated in various online consumer reviews, I could try a new pair of progressives (which had never worked well for me in the past) and get a back-up pair for the up-close glasses at a deep discount. My plan was to continue using my old glasses, which at least more or less work, and stash these to use when the good glasses wore out or got lost.

Well, even though I can’t see to read more than a few words in them and they’re useless for computer work, I found myself using the progressives as distance lenses. They work OK to drive in, and I can read the list of ingredients on most (but not all) packaged foods in the grocery store. It’s easier to navigate Costco and Safeway with glasses that will allow me to see down the aisle, even if sometimes I have to take the glasses off to read what’s on a package.

However, they’re not very satisfactory. To read the music for choir, I had to take a pair of old, very strong prescription readers, clip a case to my music folder, and trade off the progressives for the readers whenever the print was smaller than about 12 points. Which is, we might add, most of the time. Some of the print on those scores is submicroscopic! This was a clumsy proposition from the outset. And though I could see the music with the readers on, I couldn’t see the choir director, who signals his desires not only with hand gestures but with various facial expressions. Through the readers, his face is a blur.

Add to that the fact that both the Avesis-underwritten pairs are plug-ugly. I’d selected the frames I thought were the least ugly at Costco, but their selection, despite being numerous, is actually pretty limited. These things are clunky and owl-like. They work at cross-purposes to my current scheme to start looking better.

Well, for quite some time I’ve known about this optician’s shop next to A.J.’s, my favorite overpriced gourmet grocery store. He has gorgeous frames, and he insists that he can do a better job than Costco ever dreamed. He claims he can make a pair of progressives that actually will allow me to read copy, and he does himself one better by proposing to make a pair of monovision intermediate glasses that will bring 8- to 10-point type into view and allow me to see the choir director well enough to follow what the man is trying to tell us.

So on Saturday, having bent the damn Silhouettes again sliding them in and out of the case I clipped to my choir folder (they warp at the drop of a hat), I dropped by his place to ask him to straighten them. This time I took my latest prescription, having already decided to replace the clunkers with a better-looking pair.

What I found there was a frame along the lines of the Silhouettes, but made of a stronger, bendier material. The temple pieces are attached to the lenses in a different way, so they’re less likely to snap off and less likely to crack the lenses. They’re almost invisible on your face, and they’re so lightweight it feels like you aren’t wearing glasses at all. And supposedly they don’t warp as easily as the Silhouettes; when they do, they’re allegedly easy enough to put back into shape that the consumer can do it herself.

So while the optician was measuring for this new device, he revealed the reason I can’t read through the Costco progressives without tilting my head back and peering down my nose. Though the prescription is right and the Costco optician’s measurements were correct, somewhere in the assembly-line manufacturing process they cut off the lower part of the close-up vision range. So in fact, there’s just not enough space on the lens to see a page of print. That’s why…not surprisingly…I can’t see a page of print. He said you should not have to tilt your head to see through the things—that you should be able to read by glancing down, not by doing contortions.

He suggested I take them back to Costco and ask them to redo them correctly. I pointed out that it’s been six months since I bought them, and he allowed as how after that long they probably wouldn’t do anything about it.

At any rate, he makes the lenses himself, at his shop, rather than shipping them to Indonesia or wherever these huge chains outsource to. This means the glasses will be ready the middle of next week instead of two or three weeks hence. And he does his own quality control.

So, we’ll see how this works. Of course, I don’t expect these new progressives to work for all the things I need to see. But I’ll be happy if they work a little better and don’t make me look like the owl-eyed Mma Makutsi in the Ladies No. 1 Detective Agency.

So…ahem! Where exactly is the money going to come from to cover seven hundred and some-odd dollars for a pair of freaking glasses? The frames alone were $390 (hey! I resisted buying the incredible $525 gilded pair with the ruby-colored Swarovski crystals), and then the progressive lenses were over $300, too.

Well, the truth is, even after paying for the clothing extravaganza, I still have enough in diddle-it-away savings to cover the cost. So when the bill comes I’ll probably just draw that down again. Even if there weren’t enough there to cover it, after having lived under budget for the entire spring semester, my $14,500 unemployment cushion has grown to something over $17,000. That overage was supposed to carry me through the summer, when, in the absence of teaching income, I’ll be living on nothing but Social Security, which covers only about half my base expenses. However, that extra $2,400 the college has decided to pay me for preparing the online course will moot the question of how I’m going to live through the summer. So, I figure there’s plenty to cover the glasses.

And in the justification department: one’s vision is not something to compromise on. Especially when dealing with it ties in so intimately with one’s vanity. La Maya once remarked, in justifying the wildly expensive pair of glasses she wears, that you have to wear the things on your face 16 or 18 hours a day. So if you have to have the things hanging on your nose all day long, you might as well break out of cheapskate mode and buy a decent pair.

Besides. Given the extravagant cost of Medicare B, Medicare D, and Medigap, this will easily push my 2010 medical costs high enough to make them deductible.