Browsing Category Health

Take the Shot – or Not

This is a touchy subject, so Dear Journal, let’s keep this between you and me and my numerous blog readers.

I recently read an article written by Gene Weingarten, my favorite humor columnist at The Washington Post. He put a light spin on a serious subject, the COVID-19 inoculation process. As we know, health care workers, first responders, and people over 65 are among those who have first dibs on receiving the COVID vaccine. As a senior himself, he was indeed joking when he cited the priority arrangement as “some weird national system that seems to give preference to people who are already half dead.”

Before receiving his shot, Weingarten kidded about having “vaccine envy.” I do not. First of all, I hate getting shots. Just looking at a needle causes a full-blown anxiety attack. Secondly, I do not follow the crowd. If I do something, it’s because I want to do it, not because I feel persuaded by the CDC or universal acquiescence, or as some might call it, herd mentality. My rebuff was formed decades ago after reading Bad Blood by James H. Jones and studying other publications about the Tuskegee Study conducted between 1932 and 1972 by the U.S. Public Health Service and the CDC. I was young and naïve when I learned that our government would betray the public trust by sponsoring something so hideous. Though I’ve since learned of other shady events that are said to have been orchestrated by the government throughout my lifetime, I have never been able to erase the mistrust planted by the Study. It settled in my mind the way a leech burrows under the skin and it stays there.

Confession aside, clarification required. I am not saying that I will never take the shot. That’s something else I’ve learned during my journey to seniority. Never say never. But I will say that you won’t see me cutting the line or concocting methods to cheat to get ahead of other people who fall into the most vulnerable category. I’ll wait.

If – I said IF – I get the shot, I’d prefer the Johnson & Johnson single dose. However, it is my understanding that people being vaccinated don’t get a preference. You take what they give you.

I have read reports of people having severe allergic reactions to the vaccine and of at least four people who died shortly after taking the shot, including a woman in California and a Florida doctor. As expected, the public was told that there is no apparent link to the shot and those deaths. That may be true. Maybe it was just their time. We are all going to go, sooner or later, one way or another.

Of course, numerous people have been inoculated or will be, who will suffer no ill effects at all. God bless ’em!

I’m not kidding when I say — I don’t do shots. I haven’t had a flu shot since I was in grade school; haven’t had the flu either. (She said knocking on wood.) My doctor’s suggestion that I get the pneumonia, shingles, and any other vaccines recommended for older adults has also fallen on deaf ears. Don’t think that I don’t know that I am as susceptible as anyone else to falling victim to any of the illnesses mentioned above and some that aren’t. I also know that getting coronavirus could land me in the hospital or worse yet, in the Big Sleep. A heart attack, aneurysm, car accident, even a nasty fall could also be fatal.

Anyone who takes the COVID vaccine, I say more power to them. Far be it for me to try and dissuade people from doing their thing. As I said, I never say never. I may take it one day.

Sorry to continue on what some would deem a morbid subject, but there is only one certainty in life, and it is death. As Dr. Martin Luther King, Jr. said, “Longevity has its place.” Most people want to live as long as possible. Undoubtedly, some folks wish they could stay here indefinitely. The fact is, no matter how many precautions we take, whatever great physical shape we think we are in, or how many shots we take, it’s not our call. When the Almighty places a checkmark beside our name, calling foul or time out won’t mean a thing.

In the meantime, the best we can do is make the best of every moment we have. And if taking the shot gives reassurance, then, by all means, people take the shot.

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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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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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Things Nobody Told You About Food Delivery Services

I knew it! I would have sworn on a stack of courtroom Bibles that when people order food for delivery, the drivers sometimes tamper with the food. Even if they do nothing more than peek inside the container, that’s a no-no.

Some recent media outlets and a report broadcast this morning on HLN’s Weekend Express confirmed what I have long suspected and did not need a study by US Foods to reveal. That one in four food delivery drivers, 28 percent, admit to tasting or even taking a bite out of the food before delivering it to the unsuspecting purchaser.

Do you order from a food delivery app? I used a food delivery service only once. That was a couple of years ago. After the driver of UBER eats took an unusually long time to deliver my food, I contacted the eatery from which the food was purchased and learned that the driver had left there 30 minutes earlier. I knew this place well enough to know that it should have taken the driver no more than 15-20 minutes to drive to my home. Shortly after I hung up from talking with the counter clerk, the UBER eats driver called to say that he had gotten lost and would arrive shortly. Really? I thought. (Wide-eye roll.)

I was watching from my window and could see his car when it pulled into the lot. The driver didn’t see me when I first walked outside to retrieve my food. He was too busy talking and laughing with the female passenger seated beside him. Both of them were smoking cigarettes. As soon as he saw me approaching, he hurriedly climbed out of the car and greeted me as did the stench of cigarette smoke following him. He flashed a huge phony smile, opened the rear door, and took out my food that was browned-bagged and sitting on the back seat alongside two others. He handed it to me. Through tight-lips, I mumbled, “Thanks.” Then I tucked the tip folded in my hand, that he would have received, into the pocket of my jeans.

“Never again,” I promised myself as I walked back inside.

I immediately lifted the lid on the Styrofoam container and began inspecting my meal to try and determine if it had been tampered with; of course, I had no way of knowing for sure. What I noticed when lifting the container out of the bag is that the bag reeked of cigarette smoke.

That is the only time I have used a food delivery service. Since my one unpleasant experience with UBER eats, I don’t feel comfortable having ready-to-eat meals delivered. I admit that I periodically order Chinese food from a neighborhood carry out that I have frequented for years. My food is always delivered by one of the employees. Usually, it’s the same friendly older man who has been there for some time.

If you use food delivery apps and have never thought about it before, ask yourself, how would you know if your delivery driver snacked on a few fries or had a sip of your drink on the way to your home? Most likely, you wouldn’t.

NPR.org reports that “When asked if they minded if their driver snagged a few fries, the average customer response was an 8.4 out of 10; one represented ‘no big deal,’ and ten signified ‘absolutely unacceptable.’” As I see it, tasting aside, even opening the container is ABSOLUTELY UNACCEPTABLE!

As restaurant business owners are beginning to understand the problems involved with food delivery, the foodservice industry is working to address these concerns by developing tamper-evident packaging for to-go meals. Some businesses seal takeout containers with a peel-off sticker over the lid or an adhesive that will tear the bag holding the container when opened. Some containers have plastic seals that have to be broken to remove the food and cannot be replaced or resealed once that seal is broken. Tamper-evident does not necessarily mean tamper-proof, but I suppose anything is better than nothing.

In our busy world, everyone is looking for ways to save time and energy. Not having to come home after a busy workday and prepare dinner is certainly one way of doing that. Surely, anytime you don’t feel like cooking, a nice hot pizza delivered to your door is too tempting to refuse. Food delivery is convenient, and it is probably here to stay, but we all know human nature and the nature of some unscrupulous humans is fouler then rotting meat. People must understand the risks and realize that their food could be minus a few bites when it arrives. And if you are inclined to bless your meal, pray that the culprit had clean hands and no disease transmittable through saliva.

 

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You Can’t Handle the Tooth

I am not looking forward to tomorrow. Correction, at my age, I am always looking forward to tomorrow because every tomorrow that I wake up is another day that I am blessed to be above ground. What I am not looking forward to on the coming day is another trip to the dentist. The truth is, the cost of dental visits is getting to be the bane of my existence. In plain English, dental care is too darn expensive.

A year ago, after I recovered from having my last wisdom tooth pulled, I promised myself that there would no more dentist visits. I would dutifully continue to brush and floss the hell out of my mouth, but I’ve had it with going to the dentists. So, I said.

There is no question that dentists, endodontists, orthodontists, periodontists, and every other “ist” in the dental profession charge too much. No wonder there are so many gap tooth, snaggletooth, missing teeth, and no teeth people nearly everywhere you look. I’m not saying this to be shaming people who cannot afford regular dental care. I empathize with them. But for the grace of God, I could be in the same situation.

If you never go to a dental visit, don’t fool yourself into thinking that if nothing in your mouth hurts you are fine. Not necessarily. I know that from firsthand experience. I also know that dental care is ridiculously expensive. Over time, consistent and proper dental maintenance cost more than a full set of dentures. According to estimates provided by Healthcare Blue Book, medium pricing for a set of dentures start at around $1,300 and goes up from there.

My pending dental visit prompted me to do some research on how much I have laid out for dental care over the years. Although I have been going for regular visits to the same dentist since the mid-1980s, unfortunately, I did not have the foresight to save every receipt. It was only in early 2014 that I decided to create a “Dental Receipts” file and save everything related to dental care. A few days ago, I pulled out that folder from the small, two-draw file cabinet that contains records for all of my household expenses – insurance, receipts for furniture and appliance purchases; warranties, stuff like that.

Grabbing my calculator, I began totaling all of my dental receipts. In addition to the receipts in the folder, I found a half dozen or so others dating back as far as 2001, that I retrieved from an old purse, a dresser drawer, a too-small pair of jeans, and a few other places.

The majority of the receipts were for dental services from 2/19/2014 through 7/16/2019. They covered expenses for regular cleanings, x-rays, fillings, scaling, a couple of root canals, a crown, and a wisdom tooth extraction. The total for all of the dental expenses that I still have receipts for is (rounded off) $12,000.00. I began getting regular dental care with my current dentist around 1985, so, (although I don’t have receipts to verify it) I don’t think it would be a stretch to say that from the mid-8os to the present I’ve probably invested at least $20,000 in dental care. For those who don’t know it, cleaning alone will run you over a hundred dollars, full mouth x-rays (necessary to locate cavities and other defects), will cost you a couple of Benjamins.

As I said earlier, dental care is expensive, but it doesn’t require a dentist to convince wise people that nothing beats having your own teeth. You can have the prettiest set of dentures or implants that money can buy, still there “ain’t nothing like the real thing.” Cosmetic dentist, Dr. Thomas P. Connelly reminds people of that in his article, “Think Dentures Can Replace Your Teeth? Think Again.”  He also advises that “Many dentists have payment plans, they take credit cards, there is secondary insurance, etc. I’m not advocating getting into debt — I am advocating that there are few things as important as your natural teeth. They are worth the investment.”

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