Saturday, March 25, 2017

Math Impaired MD

Having spent some time working on a pre-med major, before quitting college entirely for the hard knocks school, I'm aware of how much math is involved. Try taking quantitative or qualitative analysis without it, or just plain old organic chemistry. So my primary care physician's math skills level totally puzzles me.

He seems to do just fine with plain old multiples of 30 when he's writing out - well, actually emailing, these days - prescriptions to my pharmacy. If it's one a day, he gets 30, or 90 for a three month bottle. If two daily, he's got 60 and 180 down pat. Anything else in the dosage regimen, and he's hopeless.

A couple years ago we were fiddling with fluctuating warfarin dosages, before my cardiologist took me off the stuff, until I show symptoms that will require my going back on it. The pill schedules might be one, one and a half, or two pills, depending on days of the week and my last test results. Because it was fluctuating, he was only going for 30 days at a time. But he couldn't figure out what, say, one and a half pills a daily would translate to over a month. Heaven help us all if a couple days a week were just a single pill!

Somehow we managed. My INR levels never stabilized, but never killed me either.

Now my thyroid levels have slowly been dropping, so he started me on medication for that. The single pill dose wasn't quite high enough, so he told me to take two pills on weekend days.  He didn't change the prescription. That, of course, meant I'd go through them too fast and the insurance wouldn't pay for over the prescribed amount. Given a choice between staying with one a day or increasing the dosage, I stuck with taking one a day rather than upping the dose some days and running out early. At least there'd be some going into the system.

Refill time came this week. I called his assistant, reminding her that he wanted me to take extra pills but they needed to be prescribed in higher numbers. Nobody called back, other than the pharmacy telling me my pills were ready.

On the way home, I looked at the number of pills prescribed for the next 90 days. One every day would be 90. Add the extra two each weekend, assuming 12 weekends in 3 months, should be another 24 pills, or a total of 114 pills. I don't even need a calculator for that; I can figure that in my head. So the bottle has ... 98!

And most folks think that Grannies like me don't take enough pills because they're trying to save money?

Wednesday, March 22, 2017

See Something, Say... What?

It was just the beginning of terrorism scares in this country. To whit, shortly after the bombing scare in Atlanta during their Olympics. Abandoned backpacks and such were just getting recognized as a potential point of danger.

I was walking past the front corner of the old location on Wabasha Avenue for the St. Paul Science Museum's main entrance. It moved shortly to a new, bigger location, as it had already spilled over into a second building. That corner held the iconic iguana statue made from welded railroad spikes. (For those not familiar with the museum, the statue was relocated with the museum and is back in pride of place in front of the main door again. Yes, kids still climb on it.)

Memory puts it in the afternoon on a weekday. I was alone, and the combination says that I was working, going from the car to make either a pick-up or a delivery, and back to the car. I know that I passed it twice. The first time by, I noticed a full-looking duffle bag sitting on the corner. Nothing else and nobody were nearby. It was still sitting abandoned the second time I passed.

I decided to turn my suspicions into what had been recently often touted as good-citizen behavior. I dug out my cell phone, finally having gotten one, and called the local police. They were located about two blocks away.

The woman who answered wasn't impressed. I repeated what I had seen and where twice. I guess I thought if she heard why it seemed suspicious twice, it would somehow register. Instead, she started grilling me. Who was I and how did I know it might be dangerous? And what did I want the cops to do about it?

Reminding her that after Atlanta, we were supposed to report suspicious things, that this was what we were told qualified as suspicious, that I had no direct knowledge of what was in the duffle and wasn't about to go try to find out whether it might actually be a bomb or just an abandoned duffle bag of stuff, and I didn't give a shit (uh, not exactly how I said it) what they did with the information, I'd done my duty, and hung up.

Needless to say, I wasn't impressed with her.  Considering the total lack of news coverage on it, I have to presume no bomb was inside. I also presume if the same call went the same way these days, somebody would lose her frickin job!

At least I hope so!

Friday, March 17, 2017

Cut Meal On Wheels? You Bastards!

So Himself's new budget intends to cut Meals on Wheels because it's a waste of money? That is one of the cruelest, most cynical ways of transferring funding from the poor to tax breaks for the multi-millionaires who least need them.

Let's take just one example. My parents grew up during the Great Depression. They knew how to stretch a nickel, not to mention a buck, how to save for their old age, all in hopes of remaining as independent as possible for as long as possible. Mom's worst nightmare was winding up in a nursing home, like both their mothers had.

Dinners out as I grew up were a rarity, with meals made almost entirely from scratch - so much that I learned to judge weights from the size of flour or sugar packages and bags of potatos - and the grocery shopping was for what was needed after meat from hunting, fish caught from the lake, and what grew in the garden were taken into account. Clothing was hand-me-downs, whether it fit well or not, and invariably years out of style. My embarrassment was less important than what might be put away in the bank.

I used to say of my mother that she never found a penny she couldn't pinch. It took me years to realize it was a compliment.

There came a time when old age caught up to them. Mom started having TIAs, and cooking became more difficult, perhaps even more dangerous. The list of menu items shrunk. While Daddy could putter around in the kitchen a tiny bit, he really depended on Mom for meals, even more so as his blindness increased and his physical mobility decreased.

The two of them decided to get Meals on Wheels the last couple years before Mom died from a massive stroke at age 90. Suddenly there were new kinds of food in the house, meals were well balanced, and somebody poked their head in for a "Howdy" and a wellness check as the food was delivered. If they were going to be late due to a Doctor's appointment or something, a cooler was left on the doorstep, two meals were inserted, and it was assumed they were OK, at least enough to leave the house. Thrifty as they were, each of them stretched that one meal to both lunch and supper, making the modest amount they paid for the service stretch even further.

Once Mom, died, Daddy was in even more need of the service, along with some daily home health care and cleaning. When the agency we used became less than ideal, we moved him into my home. Varied schedules by the family, daily visits from a great county nursing staff, and yes, Meals on Wheels, all kept him out of a nursing home for his remaining years.  (He lived to 97 1/2.)
 
They were trained to walk right in with his meal, as by then his various handicaps left him unable to answer the door in any kind of a timely fashion. When he fell in the bathroom one morning, it was their lunchtime visit that enabled him to be helped back into his chair, or he would have been trapped there hours longer. When his doctor finally gave him hospice status, he still got his Meals on Wheels until his last few days when he stopped eating at all. It meant he could still be at home among family when he died, and whoever stayed with him, especially those last few months, could concentrate on keeping him company and tending to his safety.

I firmly believed that not only did Meals on Wheels prolong both their lives by helping maintain a high nutritional standard of living for them, but they were the reason my parents didn't wind up in a nursing care facility, with mediocre to indifferent care, and spending years supported by Medicaid to be there. Due to them, my parents knew, every day of their lives, that they were loved, not abandoned.

That would be priceless.

Tuesday, March 14, 2017

Pesky Junk Mail

Assumptions seem to be made about me. Top four: I love to go out shopping, I'm deaf, I'm crooked, and I'm stupid. I draw these conclusions from the plethora of junk mail I'm flooded with. One tip to you guys: keep the paper recyclable, please. That's where it ends up.

Take the assumptions in order.

1: I haven't "loved" to go out shopping since even before my knees made it exquisitely painful. Had I ever been wealthy, I may have reconsidered that preference, but I simply don't see the point in much of what's pushed my way... not even now that I can walk through Wal Mart without breaking out into a sweat.

2: I'm a long ways from being deaf. Now my generation may have, in the main, spent as much money and time as they could blowing their ears out with rock and roll. I didn't even care for the Beatles. At twelve I discovered both Beethovan and Peter, Paul and Mary. No rock, no heavy metal, and still good ears, thank you very much.  Save a stamp.

3: While I do have one major credit card which maintains a higher balance than I'll admit to you, I resent all the offers to take advantage of a little piece of law that allows me to ditch all my financial obligations over $10 grand. I'm working it down, fellas, not working my way out of it. Even if I thought it were an honest way to erase debt, I appreciate my credit rating. I may need it again someday.

4: Speaking of, my credit rating must be fairly good, as I keep getting offers again to apply for new credit cards. Today's one opened, in huge letters, to the promise of cutting my interest rates in half. Obviously they have no idea what I'm paying now, since their offer is four times my current rate, not half! They must believe people in a retirement community address, maybe even particularly women "because we can't do math", are stupid enough to fail to read past the big promise to the actual details. Think again.

There's a new kind of junk mail that's just starting to come my way. I figure it'll rise towards the top of my list soon, at the rate it's coming in. I'm selling my Minnesota house on a contract for dead. Wouldn't I just love to have the money now so I can spend it all at once? Hey idiots: yes, you I'm talking to. First of all, I'm selling it to my son. It's an agreement we both can live with. No passing it on to a second party who'll pass in on to a third, etc., until somebody changes the terms, raises the interest rate, defaults him after one slow payment, or whatever. There are a couple sweetheart clauses in that contract that raised our attorney's eyebrows, and which I know nobody taking on the CD would honor. Plus, I like being the bank. It gives me a steady income over a number of years that keeps my standard of living livable, and will total out to more than that one cash payment.

So go suck an egg.

All of you.

Perhaps one that's been sitting in the manure pile for several months.

With a crack in its shell.

Monday, March 13, 2017

Orange Blissoms

Yeah, yeah, yeah, I know. The world spells it with an "o". I just think they got it wrong. It comes just at the perfect time, between furnace and AC when the windows are open nearly all day, and the perfume muscles its way into the whole house for a couple weeks. Chase out the cooking odors, the doggie smells, the stale (at best) laundry stink.

This is bliss!

Saturday, March 11, 2017

Allergies?

Sometimes I don't know whether to trust my doctors, particularly when I don't understand them.

I have a relatively recent history of allergies, considering my age. As a kid, it was just poison ivy. Who doesn't get that, living where it's ubiquitous and the family dog wanders at will through it and then comes looking for affection? At least, that's how I explain those cases I got long after I learned to identify and avoid the plant. My parents always thought I was just careless, of course.

Back in the mid 90s I developed an allergy after getting really involved, along with my youngest, in a tropical fish hobby. We had a fish room in the basement, joined a club, bred both fish and plants, won awards. Then one day, while working on my income taxes, apparently after feeding the fish and not washing my hands, I rubbed one of my eyes and got a strong irritation in it. One might even call it blistering. A few weeks later, I was repackaging some of the special foods we fed the fish to keep them in top breeding condition. I can't remember why it was being done in my mother's kitchen. I started coughing, figured it was because of the dust raised by the dried worms, and Mom decided to "help". She turned on the ceiling fan, thinking she was clearing the dust out of the room for me when all she did was raise more. I had to leave the room for over an hour.
 
A doctor identified my symptoms as asthma. It was time to see an allergist. The results were unexpected.

She was convinced I was allergic to our cats and dogs, maybe pollen. Those were the most common. She did the skin test where she injected 8 of the most common allergens and waited confidently for results to show up in a few minutes. Nothing showed.

I think she was annoyed.

We agreed to a patch test, where a big adhesive patch with dozens of embedded allergens was fastened to my back for 4 days. It got a little itchy, but I tolerated it. I can't describe the sound she made when she peeled the patch off, but it wasn't anything resembling happiness. The first thing we found out was that I was allergic to the medical adhesive holding the patch on. In other words, my back was one big nearly solid red mess. She had to dig out a plastic grid form, laying it over the red blotch, and study all the holes in the grid to try to figure out where the red wasn't.We found a second thing I am allergic to: nickel. Unusual, yeah, unless you happen to be half Scandinavian. For us, not so much.

In addition to ruining an enjoyable hobby, a little research revealed that those ultra-rich breeding-conditioning foods, mainly bloodworms, are harvested commercially from effluent. Think concentrated sewage. Think concentrated all-kinds-of-stuff, including nickel.  No more hobby, no more asthma. Ever. And no more jewelry with nickel, no replacement knees out of stainless steel. I got the special order kind.

A few years later the world got itchy. Skin irritation, pinching, rubbing, tight clothing including shoes without super thick socks, all turned into red, raised, itchy patches. One day I mowed the front yard and just from the vibration from holding the mower handles my hands swelled so much I couldn't use them until the next day, and even they were still tender. Another doctor visit, different allergist recommended this time after my regular doc diagnosed allergies. Of course, without insurance, I spent a few years just taking Claritin daily instead of seeing one. Lucky for me, after only 3 months of paying $81 per each 30 pills, it came off of patent, and generic versions were available OTC. While it was mildly amusing to say I was literally allergic to hard work, I preferred fighting the itchiness.

It took about another three years to get insurance again, and I took advantage of it by seeing that other allergist. He gave what I had a name: dermatographic uticaria. That's a big mouthful of jargon for my kind of hives. His office had me stop taking the antihistimines for several days before seeing him. I wondered if I'd be symptomatic enough by then that I could show him what was going on. I need'nt have worried. Just the blood pressure cuff raised a huge welt. Skin tests diagnosed dog, cat, pollen, dust mites, and black mold as other things to avoid. Their approach was two-fold: how to avoid everything (not gonna happen) and allergy shots. I could continue the generic Claritin, but another new drug was just out in generic OTC form and it was more specialized for the hives: Ceterizine, or Zyrtec. I switched. I even went with his recommended double dose. And the shots lasted until after the insurance ran out again. By then I was down to monthly shots, at my cost of $30 a visit. I could handle that. But those vials eventually ran out, and - sticker shock!! - my next refills would cost me $3 grand.

You know, if I had that, I could have afforded insurance.

So no more shots. Kept the dogs, still lived with one or more cats, pollens still wafted by, mold still sprouted here and there, and dust mites... well, I'm sure they're still nearly as abundant as ever, despite different protective bedding. The symptoms changed, however. No more hives. Some drippy nose, tickley throat kind of stuff took over the symptom menu.

The years rolled by. I qualified for Medicare, got supplemental insurance, took care of a bunch of other stuff. I finally decided last month it was time to check in with an allergist again, see what was what.

This time I was told to stop antihistamines for 10 days before my appointment. While dreading that, I decided to add an extra day to that, since I was still taking the double dose I'd been on for years. Not too much happened. A scratchy throat for a couple days, a bit of a cough, that was all.The second this allergist heard my initial diagnosis of dermatographic uticaria, she bluntly stated it meant I was allergic to everything. She used her fingernail to scratch across my back, set a timer, and had a staff member come back to check.

Nothing.

Hmmmm....

They marked about 40 dots on my back, injected allergens at each location, set another timer, came back, and....

Nothing.

This time she sent me out to a lab to donate 8 vials of blood for testing. Because one of my meds is a beta blocker, they couldn't give me the larger doses of the various histamines which are the next step in the testing. If I reacted by going into anaphalactic shock, even if they used an epi-pen, which they keep on hand, the beta blocker would slow down it's getting into the system in time to save my life.

OK, lab it is then. Full screening, everything they can test for. I mean the works!

I waited for the call back to see where my allergy levels were. It took over a week. I got a very puzzled doctor on the phone. It seems my blood was full of histamines, meaning I was allergic to something. Maybe a whole lot of somethings. But there was absolutely nothing I tested positive for. Nothing they could do for me.

Nada.

She sounded disappointed. Unsolved mystery? Or no patient to treat? Who knows?

I still get an occasional drippy nose, dry throat cough. About two days after the blood draw I started getting mild symptoms again. So I'm left to wonder: do I still have allergies? I mean, besides medical adhesive which I know I'm still allergic to.  Was the 11 days off my meds not enough to clear my system? At any rate, I'm still occasionally taking cetirizine, just limiting it to one a day.

And still wondering.

Friday, March 10, 2017

How Bad Does the Treason Have To Get?

Another day, another handful of evidence: our so-called President and the cronies he's surrounded himself with are in bed with our enemies (start with Russia), himself is a pathological liar, a tad on the stupid side - enough to think he's really smart! - and a complete narcissist. Congress is doing less than nothing because the Republicons (yes, pronounce it that way) are so greedy about getting their agenda rammed through that they'll put up with anything crazy to get their way. Now we find out Turkey's gotten their bribes into the mix as well, and on and on and on.

If this were a Democrat in office, by now s/he'd have been impeached, imprisoned, possibly even drawn and quartered before the Supreme Court could have had a chance to intervene citing cruel and  unusual punishment. But it's not. Nothing appears to be happening, on the legal side, and it doesn't seem to be in the offing. Yes, the wheels of justice grind slowly, but can that do any good, in time?

Steve and I have been discussing this. For the two of us, it's been a pretty good life, and we agree that if something as unnecessary as a global war, nuclear catastrophe, or whatever it'll be, happens, we've had our run. Steve says he expects that an EMP could happen any day. It could even be something worse - or quicker - than that, in which case we at least won't be around to watch the end of civilization as we know it. Or the consequences of global climate change.

Since the powerful are raking in the profits while they can, and somehow figure they and theirs will survive whatever catastrophe, we don't see much of anything changing. Not for the better, for sure.

We both imagine, should the very worst happen, that Himself and his closest cronies will be hunkered down in a bunker somewhere, imagining something wonderful to step out into after whatever-it-is is all over. Heck, Himself will probably still be sitting there, tweeting, he thinks, to the world. Somebody, after all, would probably rig up something to fake "likes" coming back to him, prolonging the illusion that there's something still out there to come out to!