1. New glasses. The fancy new glasses I picked up two weeks ago suck. Well, they halfway suck anyway. The distance vision is crisp and clear, but the close in view might as well be trying to read a book or newspaper through a liberal coating of petroleum jelly. So far, I’ve been back to the doctor to confirm the prescription and back to the retailer to try having things adjusted. What’s “perfect vision” on their fancy machine just doesn’t seem to be translating into what ends up in the frames. Today, I had another check with a different doctor who feels confident he’s cracked the code to why they’re turning out wrong. Now it’s just a matter of waiting another 7-10 business days to see if the new and improved fix comes back right or if this devolves further into a farcical pain in the ass in the great tradition of 2023 being my year of all manner of medical fuckery.
2. EZ Pass. The one bill I review closely every month is the EZ Pass. It’s a rare month that goes by that I don’t find something wrong with it. This month’s problem was being charged for a Mercedes sedan going through the Ft. McHenry Tunnel with a tag similar to but clearly not the same as the one I have on the Tundra. It’s the kind of thing that’s easy enough to spot if you do any kind of quality control and look at the picture versus relying on whatever computer generated “decision” the vast EZ Pass data farm makes when determining what account to charge a photo toll against. But as usual, it’s the responsibility of the taxpayer to correct the issue rather than expecting the State of Maryland to get it right.
3. China. There are reports of a new illness circulating in China. Not that I want to be the harbinger of bad news, but the coverage I’ve seen so far feels awfully similar to what was getting published around late fall of 2019. It’s probably not the end of the world, but the thought of going through another pandemic when 30-40% of the country is absolutely committed to ignoring public health guidance out of spite just doesn’t feel like good times in the making. The Chinese government insists it’s just run of the mill cold weather illness cropping up… but while I wait and see, I’ll once again be stocking up on canned goods.
Tag Archives: healthcare
What Annoys Jeff this Week?
1. Meds. One of the fun parts of being on the new blood pressure meds is that it puts most common decongestants on the embargoed list. If there was ever a motivation to get my weight down and off the prescription medication, it’s 100% so I can take a goddamned Sudafed and a shot of NyQuil instead of just raw dogging cold and flu season with hot beverages and an occasional spoonful of honey.
2. Covid. There’s been a time or two I’ve felt worse, but my week with Covid is definitely ranked. From the raging sore throat, to rivers of sinus drainage, to sleep no longer being a thing I do in any appreciable block of time, it’s just unpleasant. Add in the 36 hour saga of trying to get some antiviral meds and this third week of October is going in the books as a shit week of what has already been a shit year.
3. Protestant guilt. I’ve hoarded sick leave since the day I started working for our wealthy uncle. Last time I looked I’m sure I had something like 1800 or more hours of it on the books. So far this week I’ve taken 23 hours from that total. So why the good old fashioned Protestant guilt? Despite having more than enough in the bank, I know that my being out this week means there’s mostly been one guy doing what three of us were doing a month ago. I hate knowing he’s getting dicked over because I finally walked into the viral buzz saw. Admittedly, even if I were there I wouldn’t be capable of doing more than warming a seat while trying not to hack up my left lung. I hate that when I get my feet back under me there’s going to be a hellacious backlog of whatever came pouring into my mailbox this week. I feel badly about all of it… but I’m keeping in mind that sick leave is one of the more valuable components of my total compensation package and I’d feel even worse for not using it.
Diagnostic tests, doctor shopping, and medical snobbery…
Since my original diagnosis of “probable SVT” way back in July took place under the umbrella of the ChristianaCare hospital system over in Delaware, my first appointment with cardiology was also made within their system. That was fine. Their main campus is reasonably well reviewed and I could get seen by a cardiology nurse practitioner in August, which I’ve found out through this process is a fast turnaround for a new cardiology patient who isn’t inactively laying in a hospital bed.
In the intervening days and weeks, though, I had a follow up with my primary care doctor, who operates as part of the Johns Hopkins system. He was less enthused about my decision to use Christiana for my cardiology needs – explaining that their cardiology department, while fine, is “not ranked” whereas Hopkins cardiology is currently ranked 13th in the nation with the hospital consistently ranking very near the top of any list of “America’s best hospitals” that’s ever put together.
Yes, my primary care doctor is a medical snob.
Despite his cajoling, I kept my original appointment, which led through a series of tests and reports that I was going to need anyway. I also reached out to Hopkins Cardiology to get myself on their waiting list for new patients and ended up with an appointment scheduled deep into October. It wasn’t ideal, but since I was going through all the preliminary tests and could then hand over a pretty good sized file, the timing wasn’t a major issue for me. I was able to take advantage of their wait list option to get my first appointment in the books last week – with a guy who has been practicing for 40+ years and has the look and feel of someone who has seen just about everything. In other words, he’s exactly the guy I want even if all we’re doing at the moment is preventative and exploratory.
With all other things being equal, if being able to access some of the best cardiologists in the country means driving 45 minutes west instead of 25 minutes east, ultimately it feels like not much of a decision at all.
It turns out, like my primary care doctor, I too am a medical snob.
So, I’m going all in. My optometrist recently retired. Instead of going over to the doctor that took over his practice, I’ll let Hopkins run the show for my eyes too. I’ve got my first appointment set up with the closest branch of the Wilmer Eye Institute later this year. That puts all but one doc under a single banner… and when the time comes sometime in 2024, I’ll bring that one into the fold too.
All of these new faces on my medical team are a little further away than I’d like, but I feel like what I’ll lose in adding a few minutes of extra travel time, will pay me back in the convenience of having them all working under the same organization. I was woefully unprepared for the level of coordination I’d need to do myself when my primary care doc and everyone else had electronic records systems that refused to communicate with each other.
I’m in no way fool enough to believe that being “nationally ranked” is any guarantee of better outcomes. For now, it appears that most of my problems are fairly benign, but should something become more involved or I develop a novel condition over time, I’m going to put my faith in the big name going forward. Hopefully they’re not just riding their 135-year-old reputation.
Some people would take this opportunity to rail against the American healthcare system. Undoubtedly, it has challenges – but I’ve been absolutely amazed by the level of services and the array of options that have been presented to me over the last three months. Don’t think for a moment I’ve failed to realize my great good fortune to have both the geographic proximity to one of America’s great medical centers and an insurance plan that makes walking through their doors possible. There hasn’t been a day go past recently when it hasn’t been at the forefront of my thoughts.
Security blanket…
For the last five weeks I’ve had an electronic security blanket. Far away, wherever Philips giant data center is located, computers monitored the output from their Mobile Cardiac Outpatient Telemetry (MCOT) devices, and their algorithm has been plugging along keeping a remote eye on my ticker.
The only feedback this little wonder device gave me was that occasionally one of the leads came unstuck and needed to be reaffixed. I’ve just been operating under the assumption that if there was something catastrophic happening, someone might have called or cut the testing short. I have no idea if that’s true or not, but in the absence of clear guidance, I’ve created my own.
I hate to admit it, but I felt just a little bit better with this little bit of plastic and silicon chips quietly doing its thing in the background.
The fact is, these last two months have been the only time in my adult life I’ve honestly been bothered by living alone. The only difference from June 28th to today is the fact that I now have evidence that something could go horribly wrong rather than simply knowing it as a purely intellectual exercise. That evidence is enough to leave me feeling decidedly uneasy now that my security blanket has gone away.
Taken as a whole, the last two and a half months have been disconcerting in a way I’d haven’t previously encountered. I don’t know that there’s anything to be done about it other than to accept that I’ll now have a new nagging thought in the back of my head for the foreseeable future. Moving someone in just to make sure I haven’t accidentally dropped dead as I go about my day-to-day activities, feels like it’s probably a wildly excessive overreaction… but don’t think the thought and a hundred other derivative ideas haven’t been banging around my head this weekend.
Anyway, I kind of miss my security blanket.
Slice and dice…
Over the last three months or so, I’ve been spending time with a local dermatologist. Fortunately, he’s not treating me for anything traumatic or catching, but we’re working through a pretty large number of skin tags that have annoyed me for years, but that I’ve never had the time, inclination, or, frankly, the ready cash to do much about. BlueCross is very clear that it’s the kind of thing they consider cosmetic, so anything done along these lines has to be fully out of pocket.
I would tell you that I’m not vain, but that’s obviously not entirely true. I have plenty of vanities, they’re just generally not the physical kind. Whatever else it may be, I’ve long considered my body just the meat suit responsible for hauling my brain around from Point A to Point B. As long as it’s managing to get that job done, it’s good enough. These little tags we’re working on now were starting to be an issue even in my general disinterest.
So, for the last three appointments, we’ve been trying to kill them with blistering cold. That has met with some limited success. Looking at the progress to date, the doc wasn’t happy – and in honesty nether was I. So, today was the last round of that approach. In three or four weeks, instead of the fancy cryo gun, we’ll be going with the more old-fashioned lidocaine and razor blade approach. As I understand it, where freezing is more akin to using a smart bomb, the razor is more like stepping up to wholesale carpet bombing.
Just now, well into this process, I’m willing increase the pain threshold in exchange for a shorter duration of effort. Sometime towards the end of June, I guess I’ll subject myself to a bit of slice and dice for purely cosmetic purposes. It turns out, my vanity isn’t as well controlled as I liked to imagine.
Pro-plague protestors…
This past Saturday afternoon employees of our regional medical center marched for their “right” to remain unvaccinated.
Their Facebook posts seemed to gin up all the usual things you’d expect. Arguments like “it’s not a vaccine,” or “the FDA hasn’t approved it,” or “I won’t be a lab rat,” or “government tracking,” or “my body, my choice,” or, more creatively, an oddly undefined “right to choose” abounded.
The thing here is, Christiana Hospital is a private entity. They have all the right in the world to establish their own conditions of employment. Employees, like the assembled jackasses who have decided the COVID-19 vaccination is a globalist plot to sap and impurify their precious bodily fluids, are free to either meet those conditions or go off to seek employment somewhere willing to tolerate their bat shit crazy ideas.
The only thing anyone is being forced to do here is make a decision – and then live with the consequences. As it turns out, people really hate it when they’re faced with consequences.
I’ve decided that I’m no longer going to call these people “anti-vaxers.” What they really are is pro-plague. In word and deed, they’re actively advocating medically irresponsible and dangerous theories. Frankly, the hospital system should be glad they’ve so helpfully self-identified. They’re exactly the kind of people that shouldn’t be involved in providing health services to the public.
If these pro-plague healthcare workers had the courage of their convictions, they would immediately resign in protest – refusing to participate in a system they believe is doing direct harm to patients or is otherwise engaged in unlawful practices. As it is, I can only assume what they really are is attention whores who want to stomp around shouting “look at me, look at me.”
Believe me, I’ve looked at you. I’ve taken your weight and measure and found you wanting in almost every possible way.
Getting cleaned…
Google reminded me this morning that I have a dental cleaning appointment in two weeks.
Through the sweep of the last four months living under plague conditions, I haven’t done anything that made me particularly nervous. Going for groceries didn’t bother me. Stopping off at Asian Garden for a carryout order of General Tso’s and some egg rolls didn’t feel particularly threatening. Even a quick pop into one of my favorite book shops, depopulated of customers, was fine.
The idea of sitting calmly, unmasked, while someone hovers inches from my face while prodding, poking, scraping, and kicking up the dreaded aerosolized droplets, and “defenseless” against whatever the patient before me kicked up, leaves me feeling deeply uncomfortable. Score one for my highly developed sense of self preservation, I guess.
I’m sure my dentist is following whatever protocols are required to make the experience reasonably safe… which does nothing to eliminate that nagging, and probably completely unreasonable thought that it feels like some kind of high-risk maneuver best avoided at the moment.
At the moment, I’m leaning soft no, but with two weeks to go you can count on me to spend an inordinate amount of time overthinking the situation and creating entire universes of arguments in favor and against. That gives me room to change my mind twenty or thirty times before it really matters.
What Annoys Jeff this Week?
1. Inefficiency. Look, I’m delighted that Big Pharma is reimbursing me 93% of my out of pocket costs for the meds that one of the smart docs from Hopkins tells me will contribute to being able to continue to living better through chemistry. I’d be even more appreciative if their reimbursement scheme allowed for ordering more than a 30-day supply of the stuff at a time. Everything else rolls in as a 3-month supply that’s simple enough to refill once a quarter except this one little pill. It feels like I’m online getting that one refilled or coordinating the refund about every seven days. If you’re going to spend the money either way you could save us both processing time and effort by doing it four times a year instead of 12.
2. Single points of failure. The world is full of people who want to gather all decision making and power unto themselves. I’ve never understood that particular logic for several reasons. First, the ones who seem to be drawn to absolute power are generally the last ones who should be engaged in decision making. Second, there’s nothing more ridiculous than a few dozen people standing around knowing what needs done but being paralyzed for lack of having someone explicitly telling them to do it.
3. Consistency in the space program. I really wish we lived in a country that had consistent and achievable, manned and unmanned space exploration goals. I want NASA to be above politics and be maybe the one instrument of government that is the best reflection of ourselves. I want to see big rockets with the stars and stripes plastered to the side hurtling American astronauts back to the moon and then getting their ass to Mars. To think that’s not the next logical step in exploration is nonsensical and flies in the face of humanity’s eternal struggle to expand into the unknown. Other people will tell you this should be way down on the list of priorities, but those people are wrong and should be quiet.
The nagging cough and steady drip…
I’ve definitely acquired some kind of crud. Since everyone at the office seems to be hacking or wheezing with something, that doesn’t come as much of a surprise. Our cube set up so closely approximates a late 19th century tenement that I’m surprised there aren’t reports of cholera outbreaks from the back of the room.
As sickness goes, the nagging cough and steady drip from my nose is far from the worst thing going around. It’s enough to be obnoxious – and enough to drive me deeper into the arms of Big Pharma to find some relief. The side effect of the OTC cocktail I whipped up, though, is the really delightful feeling of being just shy of stoned through a good portion of the day. I should probably apologize to anyone who got an email from me today. The spelling, punctuation, and even message itself is likely suspect.
I don’t really feel bad and I suppose that is the small mercy. I’m already burning enough sick leave this week on appointments that I’d really like to avoid wasting more of it on actually being sick.
Approach avoidance…
A few months back I’m pretty sure I cracked a tooth, or to be more specific I’m pretty sure I re-cracked a tooth that I had fixed about a decade ago. It only caused minimal and occasional discomfort and could be easily ignored. We seem, currently, to have slowly worked our way past discomfort and are edging into the legitimate pain category. I’m going to go ahead and blame the sudden appearance of cold weather since it appears to be introduction of cold air that’s set off the sensation of someone occasionally jamming a teeny tiny ice pick into my jaw.
This, of course, is where my problem starts. You see it’s not so much that I’m afraid of the dentist, per se. The one’s I’ve met seem like decent enough human beings and individually are not a fear-educing bunch. I am, however, entirely and completely in favor of avoiding pain for as long as possible. This, unfortunately, has now caused me a dilemma. At some point in the near future this untreated tooth is going to start being more than an occasional discomfort. That may be weeks or months from now. An appointment at my local dentist is a guarantee of pain and a sure and certain time. It’s one of the few occasions in life where I generally prefer the unknown future to the known.
Yes, I know this is a ridiculous approach towards dental health. Yes, I know I should have had it taken care of months ago. Yes, I know it’s utterly out of character for a guy who thrives on adding things to a list and getting them knocked off as quickly as possible. I’m unpredictable like that.
I also know that the last three times I’ve walked into a dentist’s office for anything more than a cleaning I’ve walked out chewing on a couple of thousand dollars worth of bills to pay. Pain in the mouth. Pain in the wallet. Completely ridiculous or not, there’s no doubt in my own head why my approach to “modern, painless” dentistry is so often avoidance.
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