Thursday, January 4, 2018

Surviving the Diet of the 1970s

I thought orange juice and Tang, a sugary drink made from dusty yellow powder, were the same thing until I was in high school. Of course Tang was marketed as what the astronauts drank, so that made it ok.

A New York Strip, perfectly grilled, delicately sliced into a bite sized morsel with a sharp knife, a tiny drop of peppercorn sauce quivering on the surface as I lift it to my mouth with a fork, juicy flavor flowing around my tongue, making me reluctant to swallow as it melts away.

That was the 50 dollar steak I had the other night. It was fantastic.

I didn't have a good steak until well into my 20s. In my experience, steak was always fatty and required endless chewing before you could swallow it. I'd heard it could be grilled, but my mother always prepared it in a frying pan. I don't think we even had a grill in my childhood home.

My family was pretty well off. We had the biggest house on the street. We had 3 cars. We  took nice vacations with our motor home and spent culturally uplifting weekends in the city. We had a swimming pool in the back yard. My siblings and I expected to be sent to college. We didn't show off, but we were clearly not poor.

So it baffled us that Mom scrimped and saved pennies as if we were still in the Great Depression. We existed on the cheapest cuts of meat and the lowest quality store brand instant foods. The milk we drank as children was made from powder in a box. It was terrible. I hate drinking milk to this day, and will only put Vitamin D whole milk on my cereal. I thought orange juice and Tang, a sugary drink made from dusty yellow powder, were the same thing until I was in high school. Of course Tang was marketed as what the astronauts drank, so that made it ok.

I don't think it was just my mom. In the 1970s, between inflation and middle class mothers going to work outside the home, nutrition was a secondary consideration compared to saving money and saving time.

Vegetables? Always canned. I didn't set my eyes upon fresh asparagus until I was in college. Green beans were soft and squishy as were peas. Exotic vegetables were the mushy "Chinese" variety in the can of chow mien purchased from the ethnic shelf at the grocery store.  I'll never forget my first water chestnut.

Today's moms would shudder at the nutritional value of what we ate as children: sugar coated cereals (preferably generic), lifeless white iceberg lettuce dressed up with fake bacon bits and Nebraska's famous Dorothy Lynch salad dressing, as much Kool-Aid as we could drink (in place of expensive carbonated sodas), dry Hydrox cookies (cheaper than Oreos), and sandwiches made from big yellow blocks of Velveeta imitation cheese-like substance along with Miracle Whip spread (not mayonnaise) and the store's cheapest (whitest) bread.

For the record, there was no such thing as "gluten free." We'd never heard of a Vegan. Vegetarians were hippies that lived out in far away California.

It's not like we weren't cared for. Mom made sure we had 3 solid meals a day. We never missed a breakfast, lunch, or dinner. We'd even get a special treat every now and then. For example, we'd occasionally get a Tony's frozen pizza with bits of pepperoni or something that passed for sausage on top.

If Mom needed a break, Dad would pick up a bag of McDonalds hamburgers and fries. He never got cokes though - we saved money by washing those fries down with Kool-Aid or Tang.

I'm a little surprised that obesity rates are higher now. That probably has to do with the amount of moving around that kids did then compared to now. There were only 3 channels on the TV. We didn't have computers and iPhones so we had time to go outside and run off all that fat and sugar.

Thursday, December 7, 2017

Slogging Through the Trump Era

"The United Corporations of America exploit ignorant citizens, largely those who are economically disadvantaged because of those same pro-corporate policies, with propaganda that would shock even George Orwell."

Regular readers of Billsweek have commented that postings have been few and far between. I apologize for neglecting this space, allowing mindless drivel to wash up in its wake on Facebook and in other media.

I like to inject a little humor into these posts, or at least something to think about. But it's been hard to work up the gumption to do that. It's been a depressing year.

The beginning, and it's only the beginning, of the Trump era has left many of us worn out. There are so many things wrong with the country that it's hard to know what to focus on. Every day brings another low point - often lower than the one from the day before. It seems the Republican strategy is to bombard us with outrageousness to the extent that while we're still reeling from yesterday's disaster, they throw another one at us today. We are kept running from protest to protest so we'll be too busy to take in the bigger picture of what they are really doing, which is dismantling the institutions of our democracy that protect civil rights, provide a safety net for the poor, and care for the sick. All the while, they cede more and more power to big business, benefiting only the extremely wealthy and weakening the middle class.

The United Corporations of America exploit ignorant citizens, largely those who are economically disadvantaged because of those same pro-corporate policies, with propaganda (via Fox News and other right wing media) that would shock even George Orwell. The media that our president calls fake news is not the fake news that endangers us, but his favorite program, Fox and Friends, the epitome of fake news. It's enough to make your head spin.

I think what would shock Orwell the most is that the citizenry swallows their propaganda hook, line, and sinker not at the point of a gun, but willingly and freely, drunk on credit fueled consumerism and vapid social media and, yes, fake news.

It's depressing.

Personally, I've had a tough year medically as well, and if politics weren't enough, my energy has been drained by health insurance paperwork, navigating doctors' office bureaucracies, and visits to Rose Medical Center - not to mention the medical conditions themselves.

In short: a bout with pneumonia early in the year uncovered an arterial blockage which led to a stent in my right main artery and a permanent diagnosis of heart disease. Several weeks of cardio-therapy ended just in time for a skin cancer scare which resulted in 2 separate surgeries. The cancer was not the life-threatening terminal kind, but was uncomfortable and inconvenient all the same. These were in addition to my other, pre-existing chronic illnesses which only complicated things with potential drug interactions and a spiderweb of communications between doctors, if I could manage to get them to communicate. All of this was expensive too, and I have health insurance.

Luckily, I have a good job and money in the bank. I have a loving husband and a warm home. I get to travel and have experiences that many others can't. I have the opportunity to serve my community through my church and in other ways.

The challenge is to keep the depressing stuff in perspective and to use the good stuff to slog forward so the bad stuff doesn't stop me. Because if I stop, "they" win. And we can't have that.

Sunday, September 10, 2017

Defying the Insurance Company Actuarial Tables

This has not been my year, medically speaking.

Of course, it could have been worse. I'm not dead yet.

It started right at the beginning in January. As I wheezed my way onto the examination table, the doctor listened to my lungs, diagnosed pneumonia, and took an extra listen to my heart. Noticing some swelling around my ankles (edema) and a somewhat alarming high blood pressure, he asked if I would mind if he did an EKG as well. In my feverish stupor, I was barely aware of what he was doing, let alone in any position to argue or question.

After a typically long recovery from pneumonia, two visits to a cardiologist (and all of the delightful related experiences dealing with insurance companies, lengthy referral processes, and lackadaisical doctors' office staff who didn't give a shit about whether my life was in danger), I ended up in the Rose Medical Center Cardiology Unit where it was discovered that my major left artery was 80% blocked.

No wonder I was always winded after climbing the stairs to my office on the second floor. I just thought I was in terrible shape. I was, of course, but anyway ...

Major heart attack and possible sudden death averted, a stent was inserted and I was prescribed several weeks of cardiac rehabilitation which turned out to be three visits to the hospital per week where nurses hook you up to an EKG machine and take your blood pressure while you exercise. Some of the nurses have extra training in torture as they push you to exercise harder and harder while criticizing your diet and general lifestyle.

By the end of the summer, however, I was able to bound up the stairs to my office without running out of breath. Yay!

Thinking that everything was under control and that perhaps I would survive my 50s after all, I woke up one night to discover that a mole on my back had decided to erupt in a bloody mess. Naturally this happened on a Friday so I had all weekend to worry about it before my doctor's office opened Monday morning. But I was on that familiar exam table by Monday afternoon and the results of the biopsy came back on Thursday - so I only needed to push away "worst case scenario" trains of thought (chemo, end of life directives, death ...) for four days.

The results were not benign, but neither were they of the terminal variety. It was basal cell carcinoma, a slow growing skin cancer that is merely annoying, not fatal. It did, however, require minor outpatient surgery, which I had on Friday. There is now a big crater in my back which because I can't reach it, Clyde has to clean and bandage twice a day. This is the part of marriage that they don't show you in the bridal magazines.

So I'm back to assuming I'll make it through my 50s, though I keep imagining the insurance company's actuarial tables which must show my ever decreasing predicted life span.

I realize that 100 years ago, and in many other parts of the world today, I wouldn't have survived long enough to even have these problems. Many men got into their 50s, had heart attacks, and died. I sometimes try to remind myself that beyond a certain point, every day is gravy and that I should be thankful for it. I have things pretty good, after all: happily married, good home, comfortable life.

I keep remembering my dad who because of a heart condition, was given six months to live around the age of 70. He was 86 when he died. I take after him in a few other ways, so maybe I can look forward to a long life in spite of some health issues.

Wednesday, August 23, 2017

What made the solar eclipse a life changing experience?

It was said by some to be life changing.

"I'm not a religious person," more than one individual was heard to say about a past solar eclipse. "But my first was a spiritual experience. It changed my life."

I'd hate to take that away from someone.  It certainly is an unusual experience. But life changing? I guess I feel like if you understand it - that the moon comes between Earth and the sun, causing a shadow resulting in darkness over a narrow line across our planet's surface - why should it change your life?

We were a little disappointed in the eclipse this week. The hassle of the crowds and the traffic kept us a few miles out of the line of totality, so we ended up in a spot where there was two percent sunlight. So it wasn't completely dark where we were. We got to see the eclipse using our special glasses, which was great, and we observed a twilightish glow on the horizon, a noticeable change in temperature, and a resulting cool breeze, but we missed the total darkness and starlit sky that we'd anticipated. It was hardly life changing for us.

If you were lucky enough to experience the totality and it changed your life, well, good for you.

I did appreciate the eclipse experience. Even where we were, slightly out of the line of totality, people gathered by the shores of Lake Yellowstone with their lawn chairs and special eclipse glasses. Park rangers handed out educational materials and explained what was going on and what to expect (it turns out, they too were a little overly optimistic about seeing stars, planets, and constellations). Park visitors, along with most Americans, were united by the anticipation of such an unusual event. No one denied the science that predicted what was going to happen. Republicans and Democrats temporarily put aside their differences to marvel at what was going on in the sky. People flocked to social media to share one experience - not another crazy speech by the President, but a wonder of nature that we could all agree was kind of amazing (if not universally life changing).

The next day, things went back to normal. We left Yellowstone and got back into a place with a good Internet connection. We learned that the President gave probably the most unhinged speech yet. Life on Earth returned to normal.

But the eclipse was a nice break, wasn't it?

Saturday, May 6, 2017

Guess How Much My Recent Heart Procedure Cost

The whole procedure took less than an hour. It prevented what could have been a major heart attack.

I recently had a stent put in an artery near my heart. This stent opened up the artery which was clogged so that blood could once again freely flow through. I was in the hospital for one day, not overnight. A tube was inserted in my wrist, directed through arteries up to my heart where a camera took a look at what was going on and installed the stent.

I was in recovery for a few hours after that. I am in cardiac rehabilitation for three months.

There is no doubt that it was a remarkable procedure. You could even say that it was a miracle of modern medicine. You could argue that it prolonged my life for many years.

Here's a fact that you can't argue with: the cost of having this done was over $74,000.

Here are my thoughts after seeing that figure on my insurance claim:

  • I'm lucky I have health insurance through my employer.
  • I'm lucky I could swing the nearly $2,000 copayment.
  • If I didn't have insurance I would have been financially wiped out by this one, single medical event because in the United States, not everyone has the right to health care.
  • If I didn't have insurance, I probably would have opted not to have this procedure done. I would have taken my chances, risking a heart attack or a stroke later on.
  • If I didn't have insurance, I would have ended up in an emergency room with a heart attack or a stroke, leading to my own bankruptcy, and/or costing someone (either taxpayers through public subsidies or the hospital resulting in higher health costs for everyone who can pay) much more than if I had been able to receive the less expensive earlier treatment in the first place.
I still don't know what the cardiac rehabilitation is costing. But I think it's worth it because it will help prevent future cardiac events. Fortunately, I'm in a position where I can work my schedule around the three times a week appointments, and I'm fairly certain I'll be able to afford the co-payments. 

But I've said it before and I'll say it again: I don't know what poor people are supposed to do. Just get sick and die I guess.

Saturday, April 8, 2017

National Health Care Couldn't Be Worse Than This

When I call, I'm always put on hold. Then, I can't get an appointment for a month because the specialist is just too busy. Once I get into the doctor's office, I have to show the special card with my identifying number. People who don't have a card get turned away. I've seen it happen. When my name is finally called, I see a technician who takes my vitals and reviews my history, followed by a nurse who does a test, and a nurse practitioner who does a preliminary diagnosis. Finally, I am seen by a doctor who reviews everyone's notes and makes a final pronouncement before I'm hurried out the door.

Is this the nightmare of a government managed, single payer, national healthcare system?

Nope. This is my private, state-of-the-art, all-American, employer subsidized insurance paid, health care provider.

After the appointment, when the test results are in, I'm telephoned by an administrative assistant who reads the results to me but who isn't allowed to interpret them and is unable to answer my questions. It's a little more personal than the other doctor's office which refers me to the lab's website so I can read the results myself, regardless of whether I understand them.

The pharmacy does not have the specialty drug I've been prescribed. They can order it, this one is on the list of insurance approved medications, but I'll have to wait, and it will cost me the higher copay.

Endless paperwork. Limitations set by insurance companies. Overworked professionals.

As a regular consumer of medical services, I honestly don't believe that a government run health system could be any worse than the one I have to deal with. Is a faceless, soul-less, government-run bureaucracy that considers you a number and doesn't really care about you any worse than an insurance company that considers you a number and doesn't really care about you, and in addition, seeks to make a profit off of you?

I don't blame the individuals, usually, who provide the care. I blame the insurance companies who dictate the kind of care that can be provided.

I am luckier than many Americans. I at least have health insurance through my employer. I have some choice in who my doctors are. My prescriptions are covered (sure, I have copayments, but it's a tiny fraction of the actual costs). Most common tests and treatments are readily available to me should I need them.

Plus, I'm relatively healthy. I usually have the strength to assert myself through the maze of receptionists, insurance bureaucrats, answering services, and technicians to eventually get what I need.

I've asked before and I ask again: how do really sick people navigate the system? What do people do who are weak with cancer or AIDS? What if you can barely hold the phone, let alone speak up to someone who is giving you the runaround about a bill or information about your treatment?

I don't want to hear about how our health care system is better. It's not. It's at least as broken as your average government run system. It has to be. All things considered, I'd just as soon put my trust in a universal government run system, which would at least guarantee the same healthcare for everyone.

Thursday, March 23, 2017

If Eggs Are Delivered, Shouldn't it be an Easter Chicken?

There are things about Easter that I don't understand.

I get the religious part of it. For Christians, after 40 days of subdued contemplation (Lent) and a particularly mournful Holy Week, Easter is a colorful celebration of new life. In my church, the lights literally go on and the music suddenly turns from hushed understated vocals to joyful full throttled organ and bells. It makes sense this holiday occurs during spring, when grass turns from brown to green and flowers start to pop out of the ground.

But outside of church, when American culture tries to jump on the Easter bandwagon, I get a little confused.

Secular Christmas, I get. I understand traditions around the winter solstice. I know where Santa originated and how the ancient pagan and Roman celebrations echo through our late December celebrations.

But what does a bunny delivering eggs have to do with Easter? In point of fact, why would a bunny be bringing eggs anyway? If something is supposed to deliver eggs, wouldn't an Easter chicken make more sense?

I suppose someone thought that since Christmas had Santa, Easter had to have some magical character who mysteriously visits in the dark of night, leaving things for children. It's like the Easter bunny evolved to make Christmas's lame holiday cousin more fun.

Yes, I said it. Easter is lame compared to Christmas.

Sure, Easter is liturgically more important, and actually more central to the Christian faith. For most of Christian history, Christmas wasn't even celebrated, or if it was, it was a drunken festival for hoodlums and troublemakers.

But these days, Christmas is the big one. That's when we pull out the stops, decorate our houses, and travel across the country to be with our families.

We try to work up some enthusiasm for Easter, but conjuring a bunny and decorating eggs doesn't quite do it. Even those disgusting marshmallow peeps don't add much more than a stomachache to the party.

Most of us don't get extra time off work. We might make an effort to go to church. Some of us might have Sunday dinner with the extended family. There may be leftover ham and cheesy potatoes during the following week. But Easter ain't no Christmas.

Don't get me wrong. I like Easter. I like spring and watching children hunt for eggs. I like looking at the ladies' hats in church. I like eating ham and cheesy potatoes.

But I don't understand the bunny. If some people enjoy it, that's ok. Maybe someone can explain it to me.