Tag Archives: medicine

Old dogs…

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People will spend a lot of time telling you about the trials and tribulations of life with a new puppy. Poke around Google and the internet is littered with Twitter and Instagram accounts dedicated to the foibles of puppy ownership.

You’ve got to dig a little deeper to find the blogs and message boards that talk about what it’s like to live with an elderly or ailing dog. It’s not the wide-eyed adorableness and puppy breath side of having pets. It’s the astronomical vet bills, fists full of medications, and a body slowly wearing out even when the spirit is still more than willing.

Old pets are heartbreaking not just because we can sense that our time together is growing short, but also because their compressed life cycle points us inexorably towards our own fate at some point in the future. It’s one of the reasons I’m always a little bit perplexed by people who give up and give away their old pets. They have no sense of the broader context of life.

My dear sweet Maggie had a bad morning today. After years of perfect behavior, I knew she was embarrassed and upset. I could read it all over her face – and especially in her eyes. Climbing out of bed to scrub the bedroom carpet wasn’t exactly on my list of things to do today, but looking at those cloudy brown eyes I couldn’t even bring myself to scold her. Going on 11 years together she’s earned the benefit of a few hundred doubts.

Maybe this morning was a one off. Maybe it’s a warning sign of things to come. I’m trying not to let the first thoughts of my sleep addled brain read too much into it. I hope beyond measure this isn’t something that will become the new normal… but if it does, we’ll cope. Maggie is the grand dame of the family I got to pick for myself. She’s entitled to expect that level of effort in her golden years.

I wrote most of this before seeing the bloody urine this evening that set my alarm bells clanging – and before I took off to the local emergency vet to have my girl checked over. Maybe I’m paranoid or at least a bit too cautious. I’ve also seen how fast things can go bad and when warning signs start stacking up, it’s not the moment to prioritize time or money.

What Annoys Jeff this Week?

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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.

In recognition of Big Pharma…

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I’m not going to lie here, I was a bit skeptical when I was given a link that promised a “significant rebate” on one of the more expensive meds that are currently keeping me alive. Sure it was all nice and official and came to me by way of bitching at my doctor about the ridiculous cost of this new pill, but the claims of being rebated almost 95% of my out of pocket expenses seemed outlandish and unrealistic.

After getting my second check back from the nice folks at Merck, though, I had to admit to being pleasantly surprised. Sure, they make they process convoluted and require a fair deal of bureaucracy, but in the end what would otherwise be an obnoxious monthly expense ends up costing a total of $5.00 out of pocket. I’m just going to ignore for the time being the small fortune I’m sure to be costing Blue Cross for all this, of course. I just think of myself as an insurance industry loss leader. They an feel free to use me as an example of someone who’s wildly pleased with their products and services.

As much as I like to bitch and complain, I think it’s worth doling out credit where and when it’s due. From my perch, kudos to Big Pharma for the solid work at delivering new and effective medication and for having a means and method to help offset costs for he end user. Well done.

Pain management…

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I got a call today from a number I didn’t recognize. Usually I (not so) cheerfully ignore those, but since I was working from home today, I accepted the call… at which point I started down the rabbit hole.

Them: Hi, Mr. Tharp. I’m Casey from Whatever-the-Hell-Company. I’d like to talk to you today about your prescription pain management program?

Me: Uhhh. My what now?

Them: I’m Casey from Whatever-the-Hell-Company and I’d like to talk to you today about your prescription pain management program?

Me: Yeah, I don’t have one of those.

Them: Well, Mr. Tharp, I’d like to talk to you about…”

Me: *Ends call and wishes hanging up a cell phone felt any bit as good as slamming down the receiver of an old fashioned rotary telephone*

Now this was a live person who I’m assuming was working off a script based on my three days as an inbound tele-marketing center employee. Cold calls are fine and all and since she had a pleasant voice and didn’t immediately try to sell me on Amway I was trying to be cordial… but when I’ve told you for the second time that whatever information you have is incorrect, it’s best not to keep telling me that I do, in fact, have a prescription pain management program. Frankly I feel like that’s something I’d know about.

I’ll be reinstating my policy of letting all unknown numbers ring through to voicemail immediately. I should have known better.

What Annoys Jeff this Week?

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1. Fuzzy thinking. I whore my brain out an hour at a a time. Clear thinking and the ability to assimilate large amounts of information into a coherent structure are sort of the baseline level expectation. I think one of the biggest reasons I’ll never be a “drug person” is how much harder it is to take on and process information even when just under the influence of fairly innocuous over the counter medications. Being stoned is fun an all, but I’ll be happy to trade it away for not having to will every single synapse to fire individually in order to get through a complete thought.

2. Taking ten minutes to tell a two minute story. If you have something to say, or if you think you have something to say, go ahead and get to the damned point. It’s bad enough that you’re calling me on the telephone, but when you don’t keep it to an absolute minimum amount of time required I’ve already tuned you out around the two minute mark.

3. A Day Without Immigrants. I don’t know anyone who is downplaying the roll immigrants had and continue to have on this country. I don’t know anyone who is arguing in favor of slamming shut the doors to American citizenship forever. What I do know, though, is the Day Without Immigrants protest refuses to make a differentiation between legal immigration and those who have arrived and/or stay in this country illegally. You can flail your arms and shout until you’re purple in the face and you will simply never convince me that I have a moral responsibility to provide for the care and feeding of those here outside the law beyond what is necessary to adjudicate their case and return them forthwith to their country of origin (or next convenient parallel dimension). So you can close all the big city restaurants you want for as long as you want, but I’m going to continue to insist that 1) legal immigration is a net positive overall and 2) illegal immigration should be stopped.

What Annoys Jeff this Week?

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1. Ghosting. If you thought dating at 18 was an exercise in the absurd, you should really try dating at 38. I don’t do it often, which is a testament more to my incredible shrinking tolerance to people than it is the number of opportunities available. As obnoxious as I find most human interaction, I think the thing that bothers me most are the ones that just disappear. You plug along being your normal charming self, go on a few dates, and *poof* suddenly they disappear from social media and stop answering texts. It’s one of those times when having generally low expectations of people is such a valuable trait. If you had any kind of decent personality I’ll probably spend a day or two wondering if you ended up in a ditch somewhere, but after that I’ll file you under T-for-twatwaffle and move on with my day. In retrospect maybe I shouldn’t be annoyed and just appreciate that I’ve been saved from discovering that factoid six months down the line after I’ve invested more than a few hours and a couple of meals into figuring out if you are a total asshat.

2. EpiPen. I’m always a little perplexed when people seem to be surprised that it costs money to keep yourself alive if you’re not in perfect physical health. As I pointed out to a colleague, a hundred years ago, people who needed EpiPens or really any significant medical intervention to save them from the earth’s flora and fauna just kind of dropped dead. While I’m not endorsing that as the ideal solution for people with allergies, but when death is the consequence, spending a few hundred bucks to stay alive doesn’t feel like too stiff a price to pay. Somewhere along the lines in this country we’ve developed the idea that more and more “essentials” should just come at no cost to us. I have no idea where that kind of mindset comes from. There’s a cost for everything in life, the only real question is whether it comes out of our pocket in the retail line when we decide it’s a necessity or at the point of a gun when government decides the next installment of our tax bill is due. We can give the government enough power to feed us all, to house us all, to clothe us all, and to medicate us all… and on the day that happens we’ll all be well and truly slaves.

3. Accountability. I’m bombarded multiple times a year with reminders to fulfill approximately 178 yearly training requirements. Among them are such classics as ethics and cyber security. Let me not check those boxes on time and there’s hell to pay. Let me violate one of the rules, policies, or laws they cover and there’s a good chance I’ll end up seeing the inside of a courtroom if not the inside of a federal minimum security prison. I’m smart enough to know that the rules are always somewhat different for the rich and powerful, but that doesn’t mean I have to like it. It certainly doesn’t mean I have to give my vote to a candidate who doesn’t feel in any way constrained by the rules and requirements that have a tendency to make the job such a pain in the ass for the rest of us. Just once I’d love to see a little accountability and a story of a senior official caught in a web of misconduct that resulted in more than solemn-faced apology or blanket denial.

What Annoys Jeff this Week?

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1. Big Pharma Guy. Despite the public outcry it’s actually not the physical embodiment of Big Pharma that bothers me about someone who ramps up the price of their product from $13 to $750. The dude might be an MBA, but he clearly wasn’t paying attention in the “shaping public opinion” part of class. Sure, it was a douche move, but hey, I’m going to tell you to go out there and charge whatever the market will tolerate for your product. The fact that he’s been so quick to backpedal gives me a pretty strong indication that he didn’t think things through all the way to their logical conclusion. What annoys me more than anything though, is that I’ve never had the foresight to buy the patent on some widget I can make for less than a dollar and turn around and sell to a willing marketplace for thousands of percentage points in mark up.

2. Volkswagen. Someone established tough standards and then someone else found a way to lie in order to beat the standard. That’s how it works. That’s how it’s always worked. While I agree that Volkswagen did a very bad thing, I’m not sure why anyone is reacting with surprise. People, almost as if by nature, look for the loophole that lets them do whatever they wanted to do with the least amount of trouble. In this case, jiggering with the onboard computer was the path of least resistance. A test is only as good as the way it’s validated, or as a wise old Warrant Officer once told me, “You don’t do what the boss don’t check.” If you’re going to insist on having regulations, at least then insist that someone is responsible for making sure the testing mechanism works. I don’t blame Volkswagen for following their own self interest so much as I blame a system that was put in place that let them get away with it for the better part of a decade.

3. Delayed interest. When I’ve been working on something for months, there is no conceivable way I can bring you up to speed on the intricacies of each bit and piece of the puzzle 37 seconds before that particular thing is done. Thirty seven seconds may be an exaggeration, but only a minor one. At some point when I tell you something needs signed it’s going to have to be ok in believing that I know what I’m doing. At least we can put that dirty rumor that we’re trusted professionals to rest now.

A real pisser…

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Six or so years ago I found myself limping around the house, the office, the grocery store, basically everywhere. It wasn’t quite agony, but it wasn’t pleasant. A trip to my primary care doctor and a referral to a orthopedic specialist later, the diagnosis was plantar fasciitis. It’s a problem of the ligaments of the foot, which tends to cause intense pain after sleeping and long periods of sitting, both of which are activities I participate in on a daily basis. The basic fix was some over the counter anti-inflammatory, some icing, staying off the thing as much as possible, and a fancy set of orthotic inserts for my shoes. It’s all part of my look as the world’s youngest 70 year old man.

Mostly the inserts and an occasional handful of ibuprofen do the trick to stave off any further issues. About once a year though I unwittingly do something to aggravate the hell out of the little bundle of ligaments… at which point I’m right back to limping around from place to place and generally trying to keep off the damned thing as much as possible. It seems that this week is that magical time of year.

So if you see me gimping across the parking lot or I don’t stand up to greet you, a) I’m ok and b) don’t take it personally. I once heard it said that getting old ain’t for sissies. The older I get – and the more wear and tear I inflict on myself – the more I’ve come to appreciate that statement. For good or bad we’re all living in bodies that were designed by biology to last 35 or 40 years, seed the next generation, and then make way for them. We’ve pushed that frontier back through the audacity of our science… but the bits and pieces that wear out and break down along the way are a real pisser.

What Annoys Jeff this Week?

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1. Being a ping pong ball. After many years of attending far more meetings than I want to recall. fortunately in that time I’ve cultivated a lead ass and a steel bladder, making it possible for me to endure just about any time suck thrown at me. What I don’t think I’ll ever get use to is the sheer volume of the damned things they throw at you while expecting you to get actual work done in the few minutes between them. Two before lunch, two after, and one blown off because it was scheduled after close of business. Add to that the slides, pre-meeting questions, general coordination, post-meeting minutes and that leaves about 45 minutes of the day in which real work might actually happen, except of course 30 of those minutes belong to lunch and even that gets interrupted a couple of times. It looks like I’m going to need to find a hidey-hole if I want to carve out a minute or two to have an actual uninterrupted thought for the foreseeable future.

2. Focus. Somewhere during my recently concluded vacation, I apparently lost my ability to focus. I’m sure it’s not helped by the ping pong routine referenced above, but it was brewing long before that. I can’t seem to string more than three sentences together without my brain running off in some other direction. I’m sure it’s not the worst thing in the world, but it’s a damned annoyance when you get home, try to spend some time working your “second job” and can seem to squeeze a coherent thought out of the space between your ears.

3. My shoulder. I’ve been ignoring the nagging pain in my shoulder for a while now. For the last year or so it’s one of those things that comes and goes. Lately we seem to be in a mode of it coming more often than going. I’ll spare you the image of the face I make when I accidentally reach for something over my head. It’s probably one of those things that’s funny, just not to me. I’ve got a check up coming at the end of the month. Maybe I’ll remember to bring it up, if only because it might distract the German from yelling at me for packing on a few more pounds since he switched my meds and still loving red meat. Unfortunately, I suspect that kind of distraction would require some kind of major trauma in the head and chest region, but I’m willing to roll the dice on that.

What Annoys Jeff this Week?

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Well, it seems like the question really answers itself at this point, doesn’t it? But since I know nobody is going to let me get away with a simple “it’s self explanatory,” here we go…

1. The common cold. We have machines that can scan the human brain. We can replace human heart valves with pork parts. We can perform knee replacement surgery on dogs. But do you know what we can’t do? We can’t cure the common goddamned cold. Are you effing serious? Through the miracle of modern science, the best we can do is dope someone up on decongestants, antihistamines, and nasal sprays so that they’re too stoned to care how bad they feel. WTF, science? What have you been doing for the last 400 years? I think it’s amazing that you can cure a disease that one person in 100 million will actually contract, but it would be even better if you could track down a cure for the thing that 5 billion of us will catch once or twice a year.

2. Daytime TV. After two and a half days of not doing much of anything besides sitting in front of the television, I can say with some authority that TV pretty much sucks between the hours of 8AM and 8PM. I’m sure there are some people out there watching, but I can’t understand why they would think there wasn’t something better to do with their time… like sleeping, or possibly gouging out their eyes with sharp sticks. I’m thanking the old gods and the new that we live in an age of Hulu and Apple TV.

3. Being “medicated.” I despise the feeling of being medicated – that feeling you get when you’re taking lots of meds that make your head feel like it’s full of cotton and not necessarily attached to your body. Maybe I’m not describing it right, but regardless, I don’t like it. I’m not a billionaire, I’m not an athlete, and I have no practical skills like welding to fall back on. My brain is what I’ve got going for me and what keeps me from living in an overpass-adjacent cardboard box. When it’s not firing at full speed, well, I’m sure it’s bad… I just can’t quite articulate why at the moment. Stupid brain.