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Count to Ten

People are losing their mother freakin’ minds. Our lifestyles, social practices, and in some cases, living arrangements are changing from day-to-day. The novelty of enduring temporary adjustments has worn off, and social distancing is forcing another new norm upon us. Health-minded, law-abiding citizens are trying to comply with each change, while resisters in places like Michigan are openly protesting. Nearly everybody’s patience is growing wafer-thin, and some people are spelling pandemic P-A-N-I-C.

I don’t go outside very often unless I need something from the store or am feeling claustrophobic and desperate for a change of scenery. This morning, I decided to go out and buy groceries, and I invited my daughter and grandson to join me in case I purchased more items than I could carry.

We were all wearing masks as was everyone who I saw in the store, and most shoppers were following the silly arrows on the floor, directing pedestrian traffic.

As we were preparing to leave, we apparently got too close for comfort (less than 6 feet) to a woman who was standing in front of the exit with her cart of groceries. She too was wearing a mask.

Perhaps she was waiting for a ride; I don’t know. What I do know is that if you don’t want people walking near you, then you need to stand someplace else instead of in front of the exit door. Anyway, as the three of us drew nearer to her, she got wide-eyed, grabbed her cart, and sprinted back into the store, all the while mumbling something mostly indecipherable about social distancing. I can smell attitude from a mile away, and she had a big-time bad attitude, which I chose to ignore.

As I said, people are losing their mother freakin’ minds. And to add to the madness – some grocery and convenience stores are now scheduling shopping days based on shoppers’ last names.

Stressed to the max is the phrase of the month. I won’t be surprised to see skirmishes start to break out in grocery stores and everywhere else over little indiscretions. I feel that if things don’t turn around soon, it will come to that. I say turn around instead of return to normal because I doubt if normality will ever return. Normal bought a one-way ticket to forever-gone. Having to adjust to new societal rules like social distancing is driving some previously mild-mannered citizens mad. What do you think?

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Not Embracing the Fear Factor

During times of despair, no matter how dire a situation looks, I choose to focus on the positive. I tell myself to travel in the light, not in the dark, to find humor in the most troubling situations even during a pandemic.

Darn the coronavirus. It’s no lie that it has changed life as we previously knew it and I am sick and tired of hearing about it. I may have to give up my claim to being a news and political junkie and leave the TV turned off for a while because there’s no escape. Breaking news reports about the pandemic has become more common than commercials about bladder leak and auto insurance. The mute button on my remote control is getting stuck from being depressed so often.

Aside from making people sick, this thing has everyone paranoid. Medical professionals are advising people to avoid physical contact and reiterating it so often that some people are acting like they are afraid to look at another person. Listen, people. Making eye contact with someone across the room will not infect you with coronavirus. Let me amend that statement by saying, not yet anyhow. Who knows? At any minute, a breaking news report could repudiate that claim. As of now, it is okay to look, just don’t touch.

Last week on the Today show, NBC medical correspondent, Dr. John Torres, said that we are safer if we maintain a distance of at least six feet away from people. Since then, I’ve heard numerous other medical professionals mimicking his statement.

Among other things associated with the current pandemic, I’m particularly angry over the no-touch factor. Touch is the first of the five senses, and it is a basic human need. Research suggests that touch is fundamental to social bonding and health. Studies have shown that human touch can improve the immune system, reduce the heart rate, and lower blood pressure. They also reveal that compassionate touching is a good thing. That is until recently. Coronavirus arrived on the scene like a spurned lover straight out of fatal attraction, and it is releasing fury and creating private hells for people worldwide.

I’m a toucher and a hugger. I don’t need a study to tell me that. It’s who I am. Now, I have to retrain myself not to reach out and touch people, and to avoid touching my own face. Believe me when I say that it is a struggle for me to resist the urge to high-five or shake hands with an acquaintance or embrace a friend.

We are temporarily (let’s hope that’s the case) living in an altered reality. It’s another so-called new norm among many new norms that have surfaced in recent decades. And it sucks.

Stores are bankrupt of essential cleaning and sanitizing supplies. Overburdened medical staff are setting up triage tents for testing. Businesses are temporarily shutting down. And some people are losing their minds.

This morning as I was out walking, I saw a couple approaching from about half-a-block away. The woman was wearing a hijab and an abaya. No problem. However, the person walking beside her (I couldn’t determine if it was a woman or man) was wearing a blanket over clothing. Yes, I kid you not. A full-length, gray, grabbed off of a bed-covering blanket. It was wrapped around his or her entire body probably secured with safety pins or some other device behind the head. The blanket extended from beneath the person’s eyes to below the knees of the trousers.

I struggled with the temptation to avoid pulling my camera out of my pocket to snap a photo of them before they got too close to me. But then I realized that I had reached my turn off point and veered in the direction of my home. As I said, some folks are losing their mind.

I am determined not to buy into the fear-factor, but I won’t take foolish chances either.

Moments ago, I was sitting at my computer typing this post, and enjoying the breeze coming through an opened window, when I heard a male voice outside sneezing several times, so loudly that I thought he would blow out his lungs. The sneezes were followed by a brief coughing spell. Just as I jumped up to run over and close the window, I noticed that I didn’t hear him hacking anymore. Perhaps he got into a car or went further down the street.

No sooner do I sit back down and begin keyboarding when I cough, twice. Dang it! For real? Where did that come from? I tell myself that it is merely a psychological response. I’m good. But then I hear a faint voice deep in my brain asking how long before symptoms appear after exposure, 7 to 14 days? Oh, hell no! Get out of my head. I’m not going there. I refuse to surrender to paranoia.

I just hope that before this mess is over, I don’t run out of hand soap, cans of disinfectant spray, Lysol wipes, bleach and hand sanitizer.  Oh, and that precious commodity for the porcelain throne – toilet paper.

 

 

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Remembering A Dog’s Life

Years ago, I worked with a wonderful man who had a basset hound named Cleo. Occasionally he would bring Cleo to the office. I liked that dog as much as her owner loved her. You know how you hear people say some things that stay with you forever? Whenever Cleo’s master was agitated with some of our business associates following a meeting or phone call, he would say to me privately, “That’s why I like animals better than I like humans.” At the time, I thought that was a rather odd statement, but over the years, I have come to fully understand why he felt that way, and I know other pet lovers who would agree with his statement.

Domesticated animals, particularly dogs, and cats are more compliant and much easier to deal with than people in general. The most agitation an animal will cause is when it chews up one of our favorite slippers or pillows, scratches the furniture, or has an occasional accident inside the home instead of doing its business outdoors. People, on the other hand, are not always acquiescent and tend to frequently get on our last nerve.

Animals, although territorial, tend not to be power-hungry, cantankerous, or disloyal. They give us unconditional love. In human relationships, this precious commodity is almost impossible to find. When our loyal, four-legged companion senses that we are in danger it comes to our rescue. If we are stressed-out, our pet is there snuggling beside us, wagging its tail or purring as if to say, “You’ve got a friend.”

Although I like both cats and dogs, I am partial to dogs, except for a few bad-rep breeds. Advocates of those breeds would have a hissy fit if I called them out, so I won’t, but many of you can imagine which dogs I am referencing. Face it; you rarely hear reports broadcast about a collie, poodle, or some other gentle breed mauling someone to death. (Note, I said rarely, not never.) If you don’t know which vicious breeds I am referring to, use your honest, unbiased imagination or ask Judge Judy. She will unhesitatingly tell you which breeds have the bad-repute.

When I was a youngster, our family had two dogs, during different periods in my life. Our first dog was a beautiful black lab named Tippy. I don’t recall where we got Tippy, but I remember that she was a lovely animal. Below is a photo of Tippy with my sister taken in December 1964.

After Tippy, came Muffy. I don’t have a photo of Muffy, so I’ll simply describe her as being a white mutt. She too was a sweet canine. If I remember correctly, my mom told me that a friend of my youngest brother gave that dog to him. That was around late 1967 or early ’68.

I have a memorable event relating to Muffy. She was still a puppy when I brought her outside one day. As I was sitting on the front porch of our family’s home deeply engrossed in a novel. I believe it was Valley of the Dolls. Muffy, off-leash wandered off of the porch, trotted to the end of the block and out into the street. You guessed it; a car hit her. Fortunately, it was a quiet street with very little traffic and not a busy avenue.

Some of the neighborhood kids came running to the house and told me that Muffy got hit by a car. Long story short, a handsome young man around my age had been driving the car that hit Muffy. He stopped, picked her up and was holding Muffy in his arms when I rushed to the scene. Muffy’s right paw was bleeding. He handed her to me and then drove us to a veterinarian clinic which was a few blocks away. Fortunately, Muffy had only a minor leg injury, but through that encounter, I met the greatest love of my life. And although we each eventually went on to live our separate lives, we remained the best of friends for over 30 years. I will always believe that it was divine intervention that led him to visit me one day in May 2001. For about an hour that day, we laughed and reminisced about old times. That was two days before he suddenly died. It is impossible for me to think about Muffy and not remember him, because memories of both are intertwined.

Even stranger is a dream I had recently. My former boyfriend was standing beside his car, which was parked in the middle of the street. The same street near my parent’s home, where he had run over Muffy years ago. In the dream, he is holding Muffy and smiling as I approach them. I return his smile. Muffy with her beautiful, big eyes, looks intently at me but seems quite contented to be in his arms. As I reach out to pet Muffy, they both vanish and I wake up.

I did some research about dreams about deceased dogs and came up with this. Dogs are usually a symbol of loyalty and friendship and often might represent good things in your life. I also discovered this — It could mean that you haven’t gotten over your dead dog and your subconscious mind is trying to communicate this to you. Very interesting, isn’t it? I’m going to leave that right there.

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Cracking the Nickname Code, It’s Ludicrous

What’s in a name? That which we call a rose by any other name would smell as sweet.” William Shakespeare (Romeo & Juliet)

Honey. Sugar Pie. Dork. Nicknames. That substitute moniker is sometimes assigned to people, places, or things instead of their given name. The habit of nicknaming people has been around for centuries, and those nicknames are popularly used. A nickname is acquired at any age, and often there is no code to crack. Some people get nicknames in childhood and retain them for life. Others eagerly shed them when they become adults.

My mother’s nickname for me was Lo. When I was in high school my best friend called me Retsie. Don’t ask, because I don’t know how my friend came up with that, but it was unique.

Do you have a nickname? What’s yours?

I’ve compiled a list of nicknames of some of my family members and friends. Some of them I easily recall. Others were reluctantly shared with me with the promise that I would not reveal their identity.  We have:  Andre, Bay-Bay, Big Bro, Boot, Bootsey, Buddy, Butch, Chico, Cookie, Crutches, Froggy, Jo-Jo, June Bug, Kip, Kippy, Little Bro, Min-gin, Moose, Nita, Peanut, Pickles, Po boy,  Pooche, Rai Rye, Sain, Skeet, Skip, Toot, and Whimpey. Initials as nicknames are also popular. AJ, CJ, DJ, JD, JJ, JR and RJ immediately come to mind. Raise your hand if you recognize your nickname. Don’t be shy; no one can see you through the screen.

Nicknames are so commonly used that sometimes a person’s given name is unknown. Even family members who have for a lifetime heard a relative called by a nickname might not know the person’s first name. For instance, when my son was born, I named him Kyle. I didn’t know until days later when my mother said to me, “You know that’s your cousin’s name.” “Which cousin?” I asked. “Your cousin, Kip’s name, is Kyle.” Who knew? I surely didn’t because throughout my life I had only know him as Kip.  One day, I was discussing my name blunder with Kip’s mother, my Aunt Ida. “I just liked the name,” I told her. “So do I,” she said before telling me that she was thrilled that I had chosen that name.

Nicknames are often given to denote familiarity, kindness, or to show affection. Take “Boo” for instance. It is usually a term of endearment that signifies love. It is also one of the most common nicknames bestowed on anyone from a loving companion, to a dear child, to a BFF (best friend forever).

Sometimes nicknames substitute for traditional titles. Like grandmother. I know people whose grandchildren call them, Nana, Ditt, Gram, Grammy, and G-Mom. I’ve always preferred the standard “grandma” but grew used to my grands when they were toddlers calling me GeGe (pronounce as if you were saying GoGo, only substitute the o with an e). Occasionally, one of them still refers to me as GeGe. And I love it!

Many people are stuck with nicknames given by family, friends, or frenemies. Some people are fond of their nicknames. Other’s detest them. One of my childhood playmates was nicknamed Weegee (pronounced like Ouija Board). Her family and all of the neighbors called her that. Although she answered to it, I always felt that she didn’t like the handle. I never did learn her real name.

Colors are popular nicknames. Most of us have known people whose nicknames are Black, Blue, Red, Rose, Pink, and Whitey.

Famous and infamous people have strange and sometimes embarrassing nicknames. Caryn Elaine Johnson has an interesting story about how she flatulently gained the nickname, Whoopi. The man we call Tiger Wood’s birth name is Eldrick Tont Woods. And who doesn’t refer to Jennifer Lynn Lopez as J.Lo? Many Baby Boomers remember comedians John Elroy Sanford as Redd Foxx, Loretta Mary Aiken was Moms Mabley, and Durham, North Carolina native Dewey Markham whose fans affectionately remember him as Pigmeat Markham. Perhaps most prominent among this group of well-known people was the man whose birth name was Malcolm Little. He had several nicknames over his lifetime:  Red, Detroit Redd, El-Shabazz, El-Hajj Malik , but he was widely known as Malcolm X.

Back in the day, Al Capone’s moniker was ‘Scarface.’ Mobster Benny Siegel was called ‘Bugsy.’

Even presidents are not spared nicknames. Some of his activities as a young man, a circuit lawyer, and eventually president of the U.S. earned Abraham Lincoln the nickname Honest Abe. Richard Nixon, infamous for Watergate, carried Tricky Dick to his grave. Beloved President Barack Obama was bestowed the name Barry O’Bomber by his high school basketball teammates. I am prudently self-censoring the nicknames for the current president.

By the way, Ludicrous is the nickname and stage name of the rapper/actor whose real name is Christopher Brian Bridges.

Whether you hold on to and cherish a nickname or shed it, remember William Claude Dukenfied aka W.C. Fields said, “It ain’t what they call you, it’s what you answer to.”

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Blame Your Doctor’s Time Crunch on Insurance Companies

Do you spend more of your doctor’s appointment time in the waiting room instead of the exam room? Blame the insurance companies and insurance reimbursement. Insurance reimbursement is the payment that your doctor, hospital, or other health service providers receive for providing you with a medical service. The insurers’ service comes with restrictions, and many tend to pay health service providers only enough for 15-minute appointments.

In addition to imposing time limits on patient visits, insurance providers are increasingly refusing to cover prescribed treatments for numerous patients, including those with chronic illnesses, even though many cannot afford the out-of-pocket costs. While astute patients know that their doctor is not solely to blame when necessary treatment is denied, less informed patients may be unaware that insurance companies are sometimes instrumental in limiting access to care. Both patients and their health care providers are at the mercy of the insurers.

A few years ago, I asked my Ophthalmologist for a prescription so that I could buy an additional pair of reading glasses. I had purchased a pair a few months earlier, but no longer had that prescription. She said that she couldn’t write it because my insurance would not approve another pair of glasses so soon after my previous purchase. I said that I – not the insurance company – would pay for the glasses myself, (just as I did with the original pair). She said that it didn’t matter; she still could not write another prescription so soon. What kind of jacked-up rule is that? I thought. It made no sense to me, but I didn’t press the matter. Insurance companies certainly have an arm lock on medical service professionals.

The days of private practices where doctors have the authority to make autonomous decisions for their patients without interference from insurers are becoming a thing of the past.

The shift from the time needed – for an exam and treatment – to 15-minute sessions occurred as a result of changes in how insurance companies and the government pay physicians for medical care.

In 1992, Medicare decided to adopt the RVU (relative value unit) formula as a standard way to calculate doctor’s fees. Then in 2010 came the Affordable Care Act.  In conjunction with other significant changes, increasingly, doctors were required to document their patients’ information on a computer causing them to spend more time with their laptops than with their patients. I witnessed the angst this causes first-hand while visiting my primary care physician shortly after her manila folder files became digital. Dr. Kaye (name changed to protect her privacy) has been my doctor for 35 years.

The first few times, when she used a computer to check data pertinent to my history or previous visits I could see that she was agitated. On one occasion, she called her assistant in to help her. On my follow-up visit, she struggled to do it alone.

“I have to get used to documenting information this way,” she said, almost apologetically while I sat patiently in the chair beside her desk.

“Don’t like computers?” I asked curiously.

“Never used one until recently,” she replied. “So many changes in recent years. Okay, I’ve got your chart now. Let’s go over this.”

The time-limit/payment procedure is unknown to numerous patients who often don’t understand why they feel like they are being rushed through appointments and exams, whether they visit their primary doctor, hospitals, or clinics. Physicians feel the time crunch too as they hurry through appointments to see more patients. Some perform additional tests and procedures to make up for flat or declining reimbursements. In addition to time restraints, other factors tied to regulations instituted a few years ago, takes a toll on the doctor/patient relationship, and is forcing many physicians to give up their solo practice and join group practices.

I’ve had personal experience with this also. Two doctors’ who I’ve been with for nearly half of my life have abandoned their private practices and joined a group facility. Two years ago, my eye doctor gave up her solo practice, and then last year my primary care physician, Dr. Kaye, did the same thing.

I’ve had the same primary care physician for 38 years. When I began visiting her she was the sole doctor in her privately owned practice. She rarely seemed hurried and took time to thoroughly answer any questions I might ask. Sometimes during my exam, we even chatted briefly about non-health related issues like how my then infant twin grandsons were doing – learning to crawl or being potty-trained – or how her daughter was progressing with her singing career.

Then, a few years ago, things changed. I noticed that although she willingly answered any questions, our unnecessary dialog had practically stopped. She was still the smiling, personable person that she has always been, but she often seemed to be rushing. It wasn’t long before her assistant, who takes blood and handles other incidentals, was notably absent, and we patients were sent elsewhere for lab work.

One day I mentioned that her waiting room was more crowded than it normally is and asked Dr. Kaye if she was seeing more patients than usual. Without going into lengthy details, she said that insurance company policies and restrictions were causing doctors’ to change some of their previous methods of operation.

According to studies, more doctors who, like Dr. Kaye, once had private practices, are joining group practice facilities where two or more physicians all provide medical care within the same facility. Doctors working in a group practice experience the advantage of shorter work hours, more flexibility in scheduling, and increased financial security. The larger number of physicians and increased patient base makes it easier for doctors to manage financial risks than private practices. Group facilities also usually have the resources to better manage the administrative tasks associated with running a practice. The disadvantage is that group practices tend to be more bureaucratic. Doctors have less independence, lack of the ability to develop close, personal relationships with their patients and staff, and often require a consensus on business decisions; while the private practitioner has autonomy and the advantage of more personal freedom to develop his or her practice as they would like.

According to the American College of Physicians, “Solo practices are often at substantial financial risk due to the costs of doing business (such as hiring staff and maintaining malpractice coverage)… [There is also] the small patient base, shifting patient allegiances because of insurance issues, and lost income caused by illness or vacation.”

Occasionally, when am in the waiting room, I get into a conversation with another patient who, like me, followed our doctors from private practice to a group facility or hospital. There seems to be a consensus that most “transplanted patients” are dissatisfied with the new arrangement. The wait time is often much longer than before, and the personal attention and the quality of care have changed.

Most frustrating are the times when I’ve called to make an appointment or ask my doctor a question, and the phone goes unanswered even though I make the call during the doctor’s regular business hours. The next worse thing to the unanswered phone is the voice mail that requires callers to navigate an agitating phone tree that asks that we press what seems like 101 buttons only to ultimately be told to (1) leave a message. (My experience has been that the call never gets returned and I wonder if anyone even bothers to check the messages) or (2) that the voice mailbox is full.

Studies show that the number of physicians who own private practices is dwindling, mainly due to transformational changes, and group facilities that are actively looking to purchase the remaining practices.

In a July 2015 report, Accenture predicted that a growing number of U.S. doctors would leave private practice for group or hospital employment by the end of 2016.

Family physician Dr. Linda Girgis explains it this way, “As self-employed doctors, we are not only responsible for all the patients in our practice, we are also responsible for the business. Tax laws and accounting principles are foreign languages to many doctors. And new regulations are aimed at decimating those remaining at the reins of their own medical practice.”

This fantastic video will reveal, in a nutshell, how some doctors feel about insurance restrictions and what they are doing about it.

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