Category Archives: health

the promise of better health care

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A friend of mind sent me an email that he got from a doctor friend of his that had these things to say about Obama’s health care agenda:

Those who serve in medical careers are also planning early retirements rather than go through the possibilities of the “change”. One friend’s doctor told him that if/when this is in place, the medical building he works in will be empty… that they will just get out of the health care business. There is no such thing as a free lunch!

Most of you know by now that the Senate version (at least) of the “stimulus” bill includes provisions for extensive rationing of health care for senior citizens. The author of this part of the bill, former senator and tax evader, Tom Daschle was credited today by Bloomberg with the following statement.

Bloomberg: “Daschle says health-care reform “will not be pain free.” Seniors should be more accepting of the conditions that come with age instead of treating them.”

It seems to me that that the elements of the legislation cited by the Bloomberg piece are open to interpretations a lot different from the ones suggested.

It is understandable (but not forgivable) that too many of today’s doctors who who have become used to their high incomes as a result of their successes in the current health care industry object to Obama’s plans to reform that industry.

I found one really good website that clearly explains how Obama’s proposals can clean up the mess we’re in and set up a system that focuses on the needs of the consumer. That’s us, right? The consumers of health care.

These are snippets of what the health care page on the Deloitte site has to say:

In recent history, health care reform efforts have fallen short as a result of two forces: The economics of the status quo make change an uphill battle for reformers and end users – consumers – have not demanded major changes

The issue of health care reform is not about bad people; it is about a flawed system in which the results reflect perfectly the incentives upon which it is built. Health care reform is about systemic change. It is not about a single program that benefits one stakeholder at the expense of others. It cuts across every sector, every role and, indeed, every household

We believe that four interdependent areas of focus provide a solid foundation for systemic reform. The pyramid (See Figure 2: The Health Care Reform Pyramid) reflects the essential relationships among these areas. Taken together, over a 10 year period, the result is a $530 billion reduction in spending while improving quality.

Figure 2
Figure 2

I am lucky to have found an excellent doctor who is interested in addressing how all of my physical complaints combine to affect my health. The goal is to get an accurate assessment of my health problems, to prevent any of the situations from getting any worse, and to avoid surgery and hospital stays. Her care of me is covered under Medicare, as my care under other doctors has been. But she is more thorough and thoughtful. We need a lot more doctors like her, who already are operating in the new “change” mode. We don’t need doctors like the kind quoted above, who threaten to retire rather than adapt.

The Deloitte Center for Health Solutions, part of Deloitte LLP, delivers research on and develops solutions to some of our nation’s most pressing health care and public health related challenges. Learn more about the Center.

If you’re interested, the Center will hold a live webcast on May 27. You have to register, but registration is free.

Topic: More than $140 billion of the $787 billion American Recovery and Reinvestment Act was targeted to health care projects. And beyond the stimulus package, the White House Office of House Reform has been working on key legislative and regulatory changes destined to reshape the health industry landscape for years to come. We’ll discuss:

* The status of these investments and how monies have been deployed.
* What’s ahead in terms of health care reform?
* Key legislative and regulatory changes.
* Recent activities within key House and Senate Committees.

Deloitte also includes several centers that explore other crucial issues such as the environment and technology. Those of interested in corporate and government use of technology for information management might like to take a look at its Center for Network Innovation.

As for me, I just want to feel better, and I believe that Obama’s health care agenda will support my continuing to work at that.

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the journey of a thousand miles begins with a single “Ow!”

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bilateral facet hypertrophic degenerative change
bilateral paravertebral disc osteophyte complex
bilateral neural foraminal stenosis
marked central spinal stenosis
bilateral subarticular recess compromise
flattening of the interior thecal sac
multilevel disc bulging and spondylosis
multilevel facet arthrosis and disc herniations

That’s what my recent spinal MRI showed. It’s not going to kill me, but it sure gives me some pain and concern. Some of it’s simply a result of aging. But some might have been prevented.

So, how come all of my former doctors who saw X-rays of my spine only told me that I had bone spurs on my spinal discs and that was nothing to worry about. How come not one of them thought to send me for an MRI to get a better sense of what was going on.

Well, my new excellent doctor, who also sat down and went over all of the details with me, took that extra diagnostic step. The next step for me is to see an arthritis specialist. Then, probably some physical therapy. Ow!

As a friend of mine says the Jewish Buddha says:

Accept misfortune as a blessing.
Do not wish for perfect health, or a life without problems.
What would you talk about?

and

If there is no self, whose arthritis is this?

old remedies, old bones

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I’m back in the place I left. Blood sometimes takes away the choice.

Plans hardly ever go as planned around here. New roofs sag, ceilings get cracks, seeds planted and nurtured succumb to frost, walls never get painted.

My plan for this trip to visit my mother was to help a new live-in aide acclimate to my mother and to this forsaken place. But, after an on-site interview, the aide changed her plans and is not coming after all. I can’t say I blame her. It would take a kind of frontierswoman personality to take on the situation here.

So, I’m here, instead to nurse my mother through some kind of sore throat. Or cold. The doctor said it is not strep.

She can’t seem to swallow pills any more, so I’m giving her liquid Tylenol. There are two bottles here, one is labeled “sore throat relief” and the other is “rapid blast.” The ingredients of both are identical. I guess the marketing ploy works, because here I am with two separate bottles when one would do When she wakes up at night, I make her tea with lemon and honey..

I am making a big pot of chicken soup. A whole chicken. Five cloves of garlic. Lots of carrots and celery. A parsnip and a turnip and onions. I wanted to put fresh parsley in the for Vitamin C, but the grocery store was out of parsley. Something to do with Easter and eggs, I’m supposing. I will cook the soup for hours and, hopefully, she will drink the broth.

She hurts all over. Our bones are tired.

I miss my grandson, he of the wall of hats, one of which belonged to my dad and is over a half-century old. Here he is, wearing it, acting out scenes for Mr. Magorium’s Wonder Emporium

From my daughter’s post on Facebook: Mr. Magorium: “You don’t have to be happy that I am leaving. All I ask is that you turn the page, keep reading, and let the next story begin. And when someone asks, tell them my story, with all its wonder, and end it, simply, ‘he died’.”

Ditto.

in the middle of it all

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In the middle of it all, my GPS gets stolen out of my car last night, my doctor has no record of my appointment when I get there today, and a lens falls out of my glasses tonight.

In the middle of it all, I’m planning to drive 5 hours to go to my cousin’s daughter’s wedding this weekend.

In the middle of it all, my cheap new small cpu arrives and is working like a charm.

In the middle of it all, my doctor takes me anyway, and I find out that my spinal X-ray showed something I can’t pronounce but has something to do with bone growth connecting my vertebrae, limiting my range of motion. The next step is an MRI. My blood test shows that I have less than half of the minimum necessary amount of Vitamin D.

In the middle of it all, I fill five prescriptions.

In the middle of it all, my grandson reads me his printing practice sheets, gives me a memory test (which I fail), invites me to play with his miniature veterinary clinic pieces, and runs over to say goodnight (as he does every night).

In the middle of it all, I have no idea how my mother is.

In the middle of it all, I blog.

Life goes.

family values

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No, this is not some kind of rant about that political football.

This is about my family (of origin) and how we deal with each other, the value we place on each other and on ourselves.

As I was growing up, “love” was equated with money. My parents showed they loved us by buying us things. I never refused any of their “love.” It’s all I knew, and I grew to love “things.” Until I immersed by self in therapy — years after a lot of damage was done.

I have a sibling. We have become about as opposite as two offspring from the same parents could be. Maybe because he never dealt with those warped family values.

And now I find that I am going to have to battle him for control of my mother’s assets and for her guardianship. She (93 years old with dementia) is in his care, and he doesn’t know how to care. I can’t bring her to live with me here at my daughter’s, and after the last eight years taking care of her, I need to take care of my own health and well-being.

I have avoided visiting my mother and brother for almost a month because he treats me so awfully. And I can’t stand watching how he treats her. When I go there, I wash her up so that she doesn’t smell, I change her sheets, her clothes, wash her hair. I dance with her each night before she goes to sleep. I make sure she takes her meds and eats nourishing food. I am tired, but she is being treated abusively when I’m not there.

He can use her assets to bring in professional help to take care of her. He won’t.

I feel angry and stupid and tired. I wonder where that “Kali” part of me went. I need to find that part of me to help me win the battle ahead.

I am going to be 69 in a few days. I think I need some Geritol.

cross that doctor off the list!

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After I moved here a little over a month ago, I immediately began to find a new doctor and dentist. My new dentist, a woman, is young enough to be my daughter. But then, just about every professional I see these days is apt to be the ages of my offspring.

Two weeks ago, I went for my initial visit with (what I thought would be) my new doctor. I chose him because the website of the group practice indicated that he had a sub-specialty in geriatrics, and I figured if I started now, I wouldn’t have to find another doctor when my age REALLY caught up to me. While I had sent my old medical records on ahead, it was obvious that he never even looked at those or the questionnaire that I had filled out summarizing my medical history. Instead, he began asking me those same questions, scribbling my answers in the margins of the form on which I had already written the answers. He did ask a few more questions about my education level and what kind of job I had; I’m not sure why he had to know that.

We went through my medications, and I asked for new scripts for two that had run out. He said I could pick them up on my way out. Because I have been having sinus problems and also need to get my hearing checked (again; it’s getting worse), he said that he office would make an appointment for me with an ENT specialist.

Then he changed the subject to tell me about a book he had published and proceeded to read me the introduction. When I asked him if he ever loaned the book out because I would be interested in reading it, he set the book down, turned around, and mumbled something like “…well, I only have 60 copies left…” — which made me realize the book must have been self-published, and he was trying to sell me one.

He leaned back in his chair and asked me if there was anything else I needed to add. I said no. He left the room.

As I left and went to check out, I found that he left NO scripts for me; neither did he leave instructions to make an appointment for me with an ENT. They asked me to wait while they got the necessary information from him. Which I did. For a half hour. Then I left.

After three phone calls over the next few days, they finally called in my prescriptions. I just let the rest go.

Yesterday, I make an appointment at the Jewish Geriatric Services Family Medical Care located a mile from here. A woman doctor this time.

a good day for a poem

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It’s snowing outside, and I’m marooned here with my mother and brother for another day. Mom is sleeping, exhausted just by getting up to eat. My sciatica is acting up and I have a pimple blooming on my chin. (That’s such a perfect metaphor for who I am!)

Several weeks ago, I waded through my stacks of poems and picked out a bunch of short ones to blog once a week. Of course, they are waiting for me in my new home, but I won’t be back there until tomorrow.

But today seems like a good day for a poem, especially after reading my daughter’s poignant post of yesterday.

So, instead of one of my poems, here’s one of Jim Culleny‘s — because it seems like a good day for this particular poem.

DUST
by Jim Culleny

A restoration of faith
(if only for moment)
makes that moment great
and raises dust.

Dust? Don’t wait.

Dust drifts and settles but can be shaken off.
We do ourselves a justice when we shake our dust.
Once it’s shaken off, work we must
to raise more dust.

Change raises dust.

In our metier (before we return to it)
dust is a must.

Well, mom’s up. So much for engaging with the world of the internet.

power and priorities: what are Obama’s?

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(No, I’m still not officially back, but this was something about which I just had to post.)

Democrats are giddy at being back in power. But I will suggest that being in power is all about priorities. One should watch carefully to see what the priorities of the new administration are..

The above is from an piece in the Huffington Post by Ian Welsh, What Obama’s Nixing Family Planning Money Tells Us
And what it’s telling us is that Obama’s priority seems to be bipartisanship at any cost.
From PlanetWire.org:

Obama was reported to have asked Rep. Henry Waxman (D-CA), who chairs the House committee with jurisdiction over Medicaid, to drop a provision that would enable states to provide family planning to low-income families without having to seek permission from the federal government. Other outlets said he was “distancing himself” from the provision as “not part of” his $825 billion stimulus plan.

According to the news tonight, the plan just passed by the House is, indeed, lacking support for family planning. And the Republicans didn’t vote for it anyway.,
Providing these family services might not seem very important in light of the priority to restore some economic stability to our faltering capitalistic system. However, an increase in unplanned pregnancies in all of those individual “little pictures” would put a drain on the economy on its most fundamental level.
According to PlanetWire,

…the Guttmacher Institute, a nonprofit organization focused on sexual and reproductive health research and policy analysis, points out that Medicaid spending has long proven good for the economy. In its own study in 2007, the Congressional Budget Office found publicly funded family planning would save the federal government $200 million over five years by helping women avoid pregnancies that otherwise would lead to Medicaid-funded births.

Publicly funded clinics provided contraceptive services last year that helped women avoid 1.4 million unintended pregnancies that would have resulted in 640,000 unintended births and 600,000 abortions. Without these services, abortions would have risen by 49 percent, the Guttmacher Institute says in a statement.

Having worked for a Senate Majority Leader in New York State, I am well-aware of the horse trading that often goes on to get major legislation passed, and so I understand why Obama might have chosen to sacrifice a part of what he wants in order to get Republican approval — not just for this stimulus package, but for other legislation still to come.
Well, you made your choices and took your chances, Mr. President, and it didn’t work.
There’s still hope, though. The Senate can put the family services request back into the stimulus plan legislation and then send it back to the House, where the Democrats can just go ahead and pass it again in the form in which they should have passed it in the first place.
Or the family services request can be incorporated into the next stimulus package, which is sure to come soon — although some legislative bill writer will have to be pretty creative to figure out a way to include it in with shoring up the banking and housing industry.
Whatever the strategy, President Obama needs to put his power behind making the family services request as a priority.

deadly beauty

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The ice storm hit us Thursday night, knocking out electrical power for a while. I didn’t realize how bad the storm had been further north until I set out for Massachusetts this morning with the car radio reporting on the tens of thousands of New Yorkers still without power.
I drove across the swaths that the ice storms devastated, paralyzing the trees along the way with thick crystalline bonds. I wished that I hadn’t packed my camera (somewhere in the back of my car that was loaded to the roof with boxes and bags of my life’s accumulations, including my desktop, printer, and monitor and more cables than I could possibly have use for).
The landscapes I passed looked like stage sets for the Snow Queen or a scene from some alien planet. When I finally stopped at a rest stop, it was closed (no power). The other rest-stoppers were as unwilling as I to use the outdoor port-a-potties in the 15 degree weather. But many of them went back to their cars for their cameras to capture the bushes outside McDonald’s, their thickly iced branches arched over like so many alien tentacles. The sun was out and the ice looked lit from within. I had no idea under which layer my camera was buried, so I passed up the chance for some amazing photos.
The news on the radio reported that some people will be without power until Monday. Several towns had curfews to keep people from driving over icy roads at night
It’s a little chilly here at my daughter’s, even though the heat is on. We have to figure out how to get more heat into my part of the house. I love it cold when I’m sleeping, but at the moment, I’ve got cold feet blogging.
I am worried about my (92 year old) mom — not because of the cold (and my brother has a generator in case of power failure). I’m worried because the dementia is getting a lot worse, and she cries and wails almost all of the time. My brother doesn’t want to sedate her, which seems to be the only thing to do at this point, as far as I and the doctor are concerned. I can’t tell how much pain she’s in, but when she moans, “oh..oh…oh….oh..” and seems to be in great distress, I can’t help wanting to give her something more than Tylenol to relieve whatever it is, to ease her brain as well as her body.
But my brother won’t let me, believing that there is no drug that will make her feel better but not knock her out. There might well not be. But I’d rather knock her out, take the pain and anxiety and fear from her face, give her some peaceful sleep, a respite from the demons of decay.
I can’t stand to have to stand by and watch her suffer. And that’s one of the reasons that I’m here and not there.
Our doctor ordered a nurse to come in once a week and see how’s she’s doing. My brother is objecting, for reasons that are only relevant to him and his demons.
Well, it ain’t over til it’s over, and I might have to get her out of there. But if I do, I will have to put her in a nursing home, and I don’t think that she would survive very long there.
A former colleague — one known for his series of extra-marital affairs — once told me that he could live with guilt.
I don’t live with guilt that easily.