Tag Archives: Test

The post in which I don’t bitch about health insurance…

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I know the hip thing to do is bitch about health insurance and the American medical system on social media. There seems to be an entire cottage industry dedicated to telling us how awful everything this. My experience over the last year has been the polar opposite of the narrative I’ve seen being pushed across the internet. 

About a month ago, I got a notice that BlueCross didn’t want to pay for my 30-day heart monitor. Frankly, with the $10,000 bill associated with it, I didn’t exactly want to pay it either. But, as it was “not medically necessary,” according to their note, they weren’t going to pay. That’s despite two cardiologists deciding that that level of monitoring was, in fact, medically necessary. 

After several long conversation with me – and presumably even longer discussions with people representing the hospital system and the test provider, it looks like BlueCross ended up paying out about $3,000 as the “insurance rate.” I just paid $36 as my portion, and everyone now appears to be satisfied that they’ve done their due diligence and has gotten a fair shake. 

I honestly was expecting more of a fist fight on that. Who really knows? It may yet come back to rear its ugly head, but for now I’m considering it a win.

Look, I’ve learned a lot about health insurance in the last year. It’s not an ideal system. It requires you to keep a very close eye on your treatment plan and everyone involved in it. Even more so, it means staying on top of your insurance provider, knowing their terms of service and the ins and outs of your policy, and questioning everything that doesn’t pass the common sense test. That’s just the baseline starting point to participate in the system. I don’t know that it would be any less complex under single payer. Under any universe of care, I expect that I would want to be very aware of what was happening and the services that were being provided on my behalf. 

What Annoys Jeff this Week?

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1. Heartburn. You know what you should definitely throw at a guy who’s trying very hard to get his cardiac health improved? A sudden onset burst of god awful heartburn, that’s what. Because there’s no chance at all that would trigger 17 bloody flavors of panic and hundreds if not thousands of dollars in fun new medical tests and their corresponding bills. This week proudly continues 2023’s ongoing effort to be marked out as the worst of my 45 years… so far.

2. Samples. Well, the do it yourself stool sample package they sent me home with in hopes of ruling out a stomach ulcer and more or less confirming acid reflux has definitely unlocked a new level of disgust. It also reminded me that modern medical science is apparently not nearly as far away from reading entrails, casting bones, and balancing the humors as they like to think they are.

3. Fall yard work. It’s not so much that it’s a lot to do as it is that fall yard work is just bloody continuous. In the summer, I cut the grass once a week and trim every second week unless it’s growing unusually fast. In the fall, however, the minute I’ve finished mulching up leaves and blowing what can’t be mulched, the yard is every bit as covered as it was before I started. Yes, I know this was a self inflicted wound when I decided to live in the woods, but still it’s just a little bit maddening.

Half a sick day…

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I took some sick leave this morning largely because I had a doctor’s appointment. In my head, though, that was just an invitation to “maximize” my use of sick time. As the only variety of leave that accumulates forever and can then be used to add time to your years of service at the end of your career, the stuff is precious. I try to dole it out as infrequently as possible. 

Since I was already going to be at the medical center, it only made sense to head across the street to get my blood drawn for a different appointment I have scheduled at the end of the month. And hey, since there’s a pharmacy at the opposite end of the shopping plaza, I might as well walk down there to see if they’ll dose me with a flu shot and the new and improved COVID booster. 

I had the very best of intentions here. I mean, from a time management perspective, knocking out all those things within 500 yards of each other makes eminent sense. What I failed to account for, however, was the net effect overall of two vaccinations, losing 7 or 8 vials of blood, having fasted for 16 hours, and there being absolutely no caffeine in my system. Let’s just say I spent a good part of the rest of the day feeling vaguely “muddled.”

After a couple of meals and a bottomless mug of tea, I’m feeling well enough for my troubles now. This evening, I’m mostly wondering if I’ll have the same reaction to Pfizer’s bivalent dose as I had to the two boosters from Moderna. If I do, sometime around 10 AM tomorrow morning my body will throw the switch from “feeling fine” to “feeling like hot microwaved trash” and that situation will persist for about 12 hours. 

That’s all a very wordy way of saying that I think I over scheduled the day today. Some things make perfect sense in terms of efficiency, but it pays to not forget checking in with other factors, too. It would have been nice to have that in mind this morning, but here we are.

What Annoys Jeff this Week?

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1. Coffee, black. I had blood work done this week and received instructions not to eat or drink anything prior to the appointment. Black coffee was excepted. I appreciate that I was allowed to get caffeinated and avoid the inevitable withdrawal headache, but honestly, even good black coffee is bad. I’m sorry, it just is. I mean I don’t want 10 times more cream in my go juice than coffee or anything, but I like it to come to a nice deep tan before pouring it down my gullet. I know there will be a chorus of “real coffee lovers drink it black,” well, you’re welcome to your bitter bean water, but I’m going to insist on something more civilized.

2. Hand wringing about corporate profits. “But companies are posting record profits,” they whine. Yes, they are…. and those companies are going to do things like invest in their infrastructure, identify growth opportunities, and return a big slice of that profit to their shareholders through increased value or directly by issuing dividends. If you follow the average news report you could be forgiven for thinking “shareholder” is just another word for the evil 1%. In reality, of course, shareholders reflect every single American who has a 401k, or an IRA, or a Health Savings Account, a 529 plan, or yes, even one of those old school union-backed pension plans. Big corporate profits are a good news story for the 55%+ of the population who have invested for their future. Sorry, but in a free market I’ll just never see businesses making a profit as anything but a good news story.

3. Anti-streaming. Look, if you’re going to have people schlep to the office and spend eight hours there doing work that they could be doing from the comfort and convenience of their own homes, the least you can do is unblock some music streaming options so we can make an honest effort at ignoring those inane conversations going on around us. Unless, of course, sitting around listening in on six conversations at once is the “organizational culture” it’s so important to preserve. I mean I know there are people who really dig being in the office, but I can’t for a moment imagine why. There’s not a single thing there that works better than its counterpart in my home office… myself included.

Another vetting…

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Yesterday Maggie and I swung by the vet so they could pull another urine sample. I’m expecting the culture to tell us one of two things: 1) Maggie’s UTI has cleared and the infection wasn’t what has been causing her wildly increased drinking and peeing or 2) Six weeks of progressively more aggressive antibiotics have failed to overcome the infection.

If it’s the former, the consulting internal medicine doc we saw last month has already proposed a preliminary course of action based on treatment to roll back a worsening of Cushing’s symptoms that isn’t indicated by the basic test of cortisol levels. I expect at least another trip to Malvern if that’s the result. If it’s the latter, well, we’ll have to see what’s left in the options box if this particular infection is truly uncontrollable with antibiotics.

I’m in the rather odd position of actively hoping that her Cushing’s has gotten worse. It’s at least the enemy I know – one that we’ve had good success wrestling into an uneasy truce if not submission over the last couple of years. It’s at least a fighting chance for some improvement. The same doesn’t seem to be true if we’re dealing with an unchecked infection.

There’s not much to do now until we see what we’re dealing with. It’s one of those rare times when I wish I was just a little more low strung and zen.

Sickly or otherwise…

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I dropped my dear, sweet, elderly chocolate lab off for her next round of tests this morning. A series of x-rays shows that the swelling in her front leg is almost certainly a very large and somewhat inexplicable hygroma – basically her leg holding a whole lot of fluid. It seems to be disappearing as quickly as it came on. It’s looking far better this morning than it did on Friday afternoon.

The other test for today, the ACHT stimulation test, should optimally confirm what we suspect – that her body has built up a tolerance to the current dosage of Vetoryl that’s been holding the symptoms of Cushing’s at bay for the last year or so. If that’s the case, we should be able to adjust the dosage upwards and buy her some more time. That’s what passes for a best-case result with her these days.

At almost 13, fighting this kind of rear-guard action is probably as much as we can hope for. How it ends, of course, is inevitable for all of us, but as long as she’s in control of her mental and physical capacities – and not in pain – I’ll clear the decks to give her the quality life that she’s earned from our long years together.

Maggie is the kind of happy go lucky dog that will follow anyone anywhere. Hand over her leash and off she’ll go. Normally she goes without so much as a second look. This morning, while the tech was leading her back the hall to her room for the morning, my girl gave me a look over her shoulder, making sure I was still there. My breath caught and in that brief moment, I had “all the feels” watching her disappear into the back room.

I haven’t always been that maudlin. I suspect the endless flow of years continues to give me an enhanced perspective on just how quickly things can change regardless of how much time, money, or expertise you pour out. 

We should have results from the stim test tomorrow. For now, sickly or otherwise, I’m just awfully happy to have her home.

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.

The paranoia of a idle mind…

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First the good news: The doc seems to think that with continued exercises and stretching, my shoulder should remain serviceable into the foreseeable future. Unless something changes, I’ve managed to escape the need for an MRI and potential surgery. It’s hard not to like that kind of report.

The next bit of his spiel was less ideal – apparently there were some “anomalous” results from my last round of blood work. The minute a sawbones breaks out the phrase “it’s probably nothing to be concerned about”, I start getting twitchy. Having blood drawn for a retest of the ol’ liver was not part of today’s original agenda… but given the last decade of being kept alive by chemistry, I don’t I shouldn’t be awfully surprised when it throws a few anomalies here and there.

While he was finalizing my chart for the day, the last thing he offered was to “throw in an HIV test” if I wanted one. Apparently that’s something they’re offering to everyone this month thanks to a new CDC recommendation. I’m assuming he didn’t offer based on my looking like an IV drug user or some kind of “deviated prevert.” Nonetheless, I figured while they have a needle stuck in my arm, why not offer up the second vial.

Up until now I’ve never so much as pondered the possibility of HIV. Let’s be honest here, I’m a middle age, overweight, wanna-be hermit who spends his free time reading, writing, and making sure the lawn is cut “just so.” I’m not sure how much sex the good doctor thinks I’m having, but apparently he thinks it’s a lot and that I’m probably doing it unprotected with complete strangers. I’m not sure if I should be proud or offended. At any rate, even though the results are a foregone conclusion, the damned test has been drifting around the back of my mind all day even though it would do as much good to sit here and worry about a satellite falling out of orbit and landing on me.

This is one of those times when living inside my head is an awfully troublesome place to be.

Can’t stay away…

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After what seems like an excessive amount of scanning, poking, prodding, and stressing, my faith in the marvel that is modern medical science, is somewhat less than complete. The good news is that there are no obvious signs of things that could cause me to suddenly drop dead. The bad news is that whatever it is that’s causing my head to occasionally explode remains as a diagnosis of “uhhh… we’re not really sure, but here’s some heavy duty pain meds to take in case it comes back.” Now I’m as big a believer in better living through chemistry as anyone around, I think It’d still rather know what it is than what it isn’t. Since that outcome is apparently a bridge too far, I’ll follow my other tried and true solution and try ignoring the problem until it goes away on its own.

… And now back to your regularly scheduled blogging hiatus.