Sunday, June 26, 2011

Progress, Dead Ends, and The Elephant In The Room

So, it's been over two months now since I got health insurance and started setting up appointments. Much has happened since then, and much not. Most has been written about, but one thing not. Yet.

The allergist diagnosed my dermatographism as a symptomatic expression of underlying allergy(-ies), tested, and found a bundle of things to avoid. Some of that is possible. Most, not so much. After some thought, I decided to go for the allergy shots, which actually start tomorrow morning, and go Monday and Thursday mornings for a while. Three shots per visit. Wheee.

They cause their own "little" side effect, and I'm not talking about the possibility of reaction to the shots, or even my decreasing availability for work causing lessening of income. After ordering having them made up, I was discussing with their office how much individual shots would cost if the ever-looming possibility of a government shut-down becomes fact on July 1st. My insurance is, after all, sponsored by the state. (An alternative scenario is I could get kicked off any insurance if the legislature budget goes through as written.) She thought about thirty bucks a piece, which is a strain but doable, especially if any shutdown is brief. Then she threw the zinger at me: it's formulating the shots themselves that costs thousands.

Thousands!?! Oooohhhh. Ummmm, maybe it's time to check how much of my $10,000/yr. insurance budget I have left. I figured this was one of the two things this year that I could take care of. There are already enough dead ends.

Getting the fibroid evaluated cost a visit to the OB-GYN, an ultrasound, having a radiologist read the scans, and an option for shrinkage treatment with surgery to follow in a few years when Medicare kicks in. The main problem with that treatment is that it is standard for it to require an overnight stay in the hospital, a very sensible precaution in case the wrong arteries got blocked somehow, but all by itself busting my budget. So, no go there. Keep carrying that football around, watching it grow. Meanwhile, a nice chunk out of that ten grand.

Getting the knees evaluated involved an orthopedic visit, X-rays, and a recommendation for surgery which also is a budget-blasting $60,000, give or take. So, live with them for another few years. Another, expected, dead end. Another chunk of the budget spent.

The last thing I'm dealing with, and have been since three days after my original physical when the labs came back, is diabetes. This at least is cheaper to treat. So far it's been two nursing visits, diabetes education on diet and a meter kit for stabbing my fingers three times daily and reading the blood sugar levels from a blood drop. The lancets and test strips need to be renewed by prescription, and there is an increased cost in food because the cheap carbs have to be avoided, but it has to be dealt with - forever! - and I'm doing it.

Actually, I'm doing a much better job of dealing with it on a dietary basis than I am in coming to terms with it. Mom always used to nag me that if I kept eating the sweets I love, I was going to get diabetes. Though my nurse tells me that's not strictly true, it still feels like a shaming punishment from Mom that I managed to cause myself. But I have developed a basic diet that works well, and occasionally try adding things into it that might or might not work, and getting the instant (2-hours) feedback that tells me when I've screwed up. For example, a 6" Subway is supposed to fit in, but the test strips tell me that they're pushing it. Don't do it often. Naan is out, since the allotted amount is way too little to consider anything but a hardship as a meal, and the pashwoori naan is too sweet to even consider trying, though I love the flavor. The beef-filled naan isn't worth eating. When I go for a burger or hot dogs, much of the bun is left out, which is OK unless I had in mind something that would hold a whole slew of condiments.

It's a lot of brown bagging, and my hours translate that into simple, easy, no-thought, no-cook, easy-measure foods. Cottage cheese is king. One carton covers two meals with fruits stirred in. Hence my recent expertise on what is good and what not. Cheerios are still OK, one of my favorite snack foods. Of course, that could and used to mean half a box if I was watching TV and not paying attention. Now it's a half-cup serving in a leftover container packed as mid-morning and mid-afternoon snack. Baby carrots are not supposed to count as a starchy veggie (who's kidding whom here?) but my test strips tell me that they seem to accentuate the carbs in anything else I eat. I do have to go shopping at least twice a week, since fruits spoil quickly, and there's only so much room in the 'fridge.

It's a good thing I don't drink my carbs. For years it's been diet sodas, diet lemonades and fruity teas, water, and coffee. Morning coffee turned over a year ago into morning mocha, but I found a cocoa brand months ago that offers a good sugarless variety, 1/2 carb unit the way I do it, and still makes good mocha. I found months ago that I need a little something to get my stomach to accept the plethora of pills I cram into it with my morning cuppa, and besides, this is my daily allotment of chocolate, a necessary ingredient in quality-of-life. Since I have my mocha first thing and delay breakfast till about 8:30, I can still get a full set of carbs in for breakfast. That's 30-45 grams. You try reading labels to see how it works!

I'm supposed to have a bedtime carb. Many days I'm just finishing supper in time to run a test strip before bed, and a late carb just wouldn't get tested. So I choose no snack, a slice of meat, or if it's early enough, maybe a slice of toast, possibly with margarine and garlic. Hold the garlic if it's raisin toast.

The reason for a bedtime carb is that the liver tends to decide by morning that there's not enough sugar in the bloodstream and releases some of its store, shooting blood sugar levels up. It doesn't seem to happen to me. So I don't take the bedtime carb as a religious mandate.

One side effect of the change in diet is its effect as a diet. I've been losing weight, slowly but surely. Steve noticed, as did Steph. Apparently mostly it's around my middle, something greatly to be desired, but not really noticeable until I stand up. However, the uniform man-shirt I wear for work now buttons at the bottom button, and those are designed to taper in where we girls taper out. Monday I go in for a weighing on the original scale from 2 1/2 months ago, and find out if all these different scales in all these different offices are uniformly set. I figure it counts more on the same scale. If all are equal, two weeks ago it was 14 lbs. down. Or 29 lbs. less than my overall max.

The good news here is that I can pretty much monitor the blood sugar and treat the allergies on an ongoing basis if the state shuts down or I've exceeded my insurance limit already. The surgeries I already figured out will need to be postponed, unless I happen to win the lottery.

Yeah, that'll happen. Of course, the lottery office also shuts down July 1st if the state does.

But the two most important things will get taken care of.

And Koda can come back and sleep in my room again, after a few months. That's not to be sneezed at. Hopefully.

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