Friday’s Wandering Health Thoughts

Went to see my PCP earlier this year. 68 yo, I was dealing with my prostate (on meds for it), edema, hypertension, and mild IBS. Those had been ongoing since I was 65 or so. IBS is gone now, hypertension is responding well to meds and diet. The prostate is the prostate, enlarged but benign.

The appointment was an annual. My PCP is monitoring these things. She ordered blood panels in conjunction with the visit. Give us something to talk about. Well, as a retired military over the age of 68, my healthcare coverage is all gov: Medicare A & B, which I pay for, and Tricare-for-Life. Medicare happily paid their part of the lab work.

Not TFL. They balked. Yes, denied it. Didn’t see the need for it.

Second time I’ve gone through this with TFL. Honestly, they’re as bad as United Healthcare. What’s their motto again? Oh yeah, “Delay, deny, depose.” Guess it’s really the motto for that entire industry. I don’t expect it to get any better under PINO Trump.

Friday Laments

More first world blues…I’m just cryin’ in my coffee.

  1. One problem with the local C-19 vaccination plan: teachers are a high priority. Great! Many agree with this. But, boo, the shots are being administered during school hours. It’s not a dash and do, either.
  2. Our biggest issue in Oregon is as it is elsewhere, just not enough C-19 vaccine to do the job. People are generally accepting and patient, because that’s how it goes for now.
  3. I went for years without a doctor. Then I had trouble in Peckerville and ended up with a urologist. The trials exposed my hypertension, so I ended up with a GP. Each prescribed medications for conditions – BHP and BP – that I’ll probably take for the rest of my life. Less than three years later, both of these medical professionals are gone. They’d moved into the area, it didn’t work out, and they moved away. I liked both and they did a good job, but I’ll need to find someone new when my prescriptions expire this year.
  4. The healthcare insurance front grows more expensive for me. As a veteran and military retiree after twenty years, I had good healthcare insurance via Tri-Care. There were no premiums. That went on for years. Now, starting this year, I must pay $25 per month premiums. Not bad. But, since I’m turning 65, I’m required to get Medicare Parts A and B in order to keep my Tri-Care. A is free; B is about $150 per month. Guess this is all due to that wonderful ‘support the troops’ rhetoric that I often hear. As it so often happened, big promises were made with great patriotic fanfare and furor. Then, when the bill came, everything changed.
  5. I’ve ordered meals online from restaurants three times in the last three months. Each was to give us breaks from what’s in our larder and breaks from cooking. It’s a treat. But each time, they’ve offered a coupon, and then, each time, there’s no place to enter the coupon code when the order is processed. Small matter, but irritating: like a lot of modern life, it seems like a false promise.
  6. What I’m watching: “Baptiste” on PBS via Prime — terrific series; “His Dark Materials” on HBOMax, very strong, good production values and acting, faithful to the trilogy; “Doom Patrol” on HBOMax but it’s falling in our appreciation as the characters become sillier and seem to take forever to come to grip with matters; “All Creatures Great and Small”, a remake of the first series of that name, based on the books, and it’s almost as entertaining and charming as the first go-around. We’re not watching “The Undoing” which just seemed too insipid in too many ways after three episodes; we prefer more dynamic and intelligent characters. Just recommended to us is Portait of A Lady on Fire and Mary Shelley, so they’ve been added to the list. Still working through the last of “Vera” and “The Wire” during late night down time.
  7. Hulu manages to continue to irk me. Their system often seems to think we’ve watched an episode that we haven’t and wants to jump us ahead. It’s happened enough times that I don’t just click and go, but make mental notes: what’s the season, episode number, and title that I’m watching now? What was the last one watched? What’s the summary? Did we see this? No. I saw others experienced this. The fix is the digital equivalent of a hard reboot or a hammer to an appliance: sign out and sign back in. That works most of the time, it’s claimed. Guess I’ll try it. Haven’t done so yet because logging in with a remote is a pain, you know? I’m such a whiner.
  8. Meanwhile, Prime Video, the service previously known as Amazon Prime Video, has the opposite issue, insisting that I haven’t watched an episode when I’ve already watched it.
  9. Got my coffee. Time once again to write like crazy. Meeting Text for the first time today. She’s the late Zipper’s daughter. Looking forward to what she has to say.

Who We Are

Yet another rant, a vent of frustration to try to reconcile an experience. One side of me — the spoiled, arrogant, take-everything-for-granted white male, first world side of me – continues responding to the coronavirus actions as though everything is alright with the world and is thus annoyed, I tell you, peeved, even, about things like one day delivery requiring six days. “What in the world is with that?” that side cries in anger and despair.

The other side of me replies, “Dude, you are a jackass.”

The event in focus is my pecker meds (Tamsulosin). I always get it locally, thirty day supply. But with shit going down, I thought it prudent to get a larger supply.

First, I tried ordering it ahead of time at my regular place, Ashland Drugs. Nope, it was too soon, the system said. By then, shutdowns were announced, so I shifted to Express Scripts.

Well, there were delays. My prescription was for thirty days and I was asking for a supply of ninety days. ES contacted my prescribing urologist for approval. He, they said, in updates on their website, didn’t respond. A day passed. Two. I shifted the order to one day shipping, because I could see that this was gonna take more time than planned. Then I called the urologist’s office and explained what was going on and what needed to be done.

That worked. Presto, order was being processed.

The next day, the order continued being processed.

Ship, damn it, ship, I urged.

Yes, it shipped, on 3/31. Hoorah! Here was the tracking number. They didn’t know when it would be delivered.

Have I mentioned that the requested one day shipping cost twice as much as the prescription?

For some reason, “The Wells Fargo Wagon” song from from The Music Man began providing me background music.

I faithfully tracked the shipment from Arizona to California, and then, by truck, from California up to Washington via DHL. The road from California to Washington is a little trail that we locals call I-5. It goes past my house by a few miles.

That irrational, crazy part of me screamed, “Why can’t they just pull over and toss it to me as they’re passing Ashland?” Yes, even the irrational part of me knows how dumb that suggestion is.

By April 2 I learned that my Tamsulosin would arrive on April 6. The plan was for DHL to truck it to Washington. DHL would hand it over to the USPS up there (I imagined a furtive, midnight exchange). Then the USPS would drive it down to Ashland (probably on I-5) and sneak it to a local carrier and deliver it to me.

Okay, a plan. I like having plans. Plans are good. Problem with this plan was that I’d run out of Tamsulosin on Friday, April 3. That was my last dose.

Well, damn. Not much could be done at that point. I’d tried, I consoled myself. Now my body would just need to endure without the med.

Meanwhile, the reasonable side of me said, “You prick.”

(It seems like an appropriate noun for the situation.)

“You should be thankful that there are people out there risking their health so that you can sit on your ass in the safety of your personal space. And be thankful that someone like Express Scripts exists and that you have a computer and Internet to place the order and follow the tracking information. Be thankful, you cretin, that the drugs are there, are so affordable, and that you have a urologist to help you. Stop looking at the dark side of this, you pessimistic, selfish, jerk, and think of the bigger picture and be fucking grateful.”

To which the other side of me said, “Wow. Mean.”

So, seriously, thanks to all the USPS, DHL, and Express Scripts drivers and people working and all they’re doing to help the rest of us survive. Let me not overlook all those healthcare professionals and government employees. We do appreciate it, even if some of us act like jerks.

Please forgive us for being who we are. We are trying to change. At least, one side of me is.

Foley Memories

I’ve had two Foley catheters installed in me in 2019. The Foley has a long tube that’s snaked up your urethra and into your bladder. A balloon filled with fluid in the bladder keeps it anchored in place. Meanwhile, the catheter extends from the tip of my penis to a clip on my leg that holds the catheter in place. Another tube is connected to the catheter’s exposed end. That tube is attached to a collection bag. The installed Foley let me pee, so the bag is emptied when it fills. In essence, I was just about always peeing when the Foley was in, which amused me. I liked to drink a beer and say, “Look, I’m multi-tasking. I’m drinking and peeing.” I thought it was hilarious. Nobody else did.

As background, I had the first Foley installed because I couldn’t pee. My prostrate gland had enlarged (BHP), blocking my urethra’s access to my bladder. That meant that I couldn’t urinate. The result was a medical emergency.

The second Foley was installed after a cystourethroscopy and direct vision internal uerthrotomy. Essentially, scar tissue from the first emergency was blocking about ninety percent of my urethra. While I was still peeing, because I’m now on Flomax (Tamsulosin), the cysturethroscopy was a proactive measure to prevent another medical emergency. It has a fifty/fifty chance of working. We’ll know more in a few months.

While I was conscious during the first time a Foley was installed, I was unconscious under deep conscious sedation for the second. That was mostly because the cystourethroscopy required them to delicately cut the scar tissue in my urethra until they reach healthy tissue. There would be pain.

The procedure went great. After fasting, reporting in, being prepped, and waiting, I was wheeled into the OR, given the anesthetic, and was gone. I woke up a second later, it seemed like, and it was all over, except the aftermath. That’s where the Foley came in.

Like the first time, I had two bag options for the Foley. One is a bag that attached to my leg. That let me walk around more freely. It’s not a big bag, and had to be emptied several times a day. It also couldn’t be worn at night. The leg bag had to be worn below the knee, which meant I had to loop the tube around the leg but leave it loose enough that it didn’t pop free of the catheter, and had enough give to move.

The larger bag, which hangs separate from my body, must be worn at night. It also must be dragged around. That makes it inconvenient. I kept it in a clean plastic garbage bag and hung it inside a small waste basket. No, we didn’t put any trash in with it. It was only used to hold my urine collection bag.

I did need to discourage the cats from investigating. They were always walking up to the waste basket and trying to look into the bag with a “What the hell is this?” attitude.

I appreciated the smaller bag and the flexibility it allowed, because it freed me up. I admit, though, walking around with felt like someone was using a saw on my pecker’s tip. Every once in a while, too, a little blood could be felt squirting out. I monitored the blood levels through the days, watching as it decreased. The first day’s blood, after the surgery, was about a quarter cup. Ruined my underwear, but I was wearing old underwear which really should’ve already been tossed. By the last day, it was very light spotting.

Opiates had been prescribed for me for pain management after the surgery, but I just shrugged the pain off. It was mostly mild discomfort, at first, like someone was trying to pull something up out of my pecker. Sometimes, there was also light stinging. Not of it was a bad as a bee sting for me, though.

I sometimes fantasized about having a longer tube attached to the big bag. Although the big bag meant that I was tethered in location, the leg bag wasn’t that comfortable. If I was wearing the big bag with a longer tube, say twenty feet, I could leave it hanging in the waste basket in a central location while I walked around. I also speculated about putting wheels on the waste basket or putting it on something wheeled, but it was only five days, and I’m lazy. Walking around with the big bag meant picking it up every time that I moved more than three feet. Oh, the inconvenience.

Each morning and night meant a routine of cleaning off blood, showering, and then switching bags before dressing for day, or getting into my sleep clothes. The first time that I had a Foley, I went into the hospital and a nurse deflated the ball and ripped it out. The second time, I did it myself, per their instructions. Just grab hold and yank, right?

But first ensure you deflate the ball holding it in place, right?

Right.

All went well, and I thank the doctors and nurses who took care of me. All were friendly and professional. Sometimes, the system works as designed. I’m one of the fortunate ones, because it did.

 

 

Profits and Losses

They count the money and measure the angles,

lamenting what must be done.

The cost is high, to keep people alive,

and keep profits a tidy sum.

“What can we do, it’s the America way,

“that made us what we are today.

“Blame the old and dying, the sick, injured and ill,

“for not making enough money

“to pay their bill.”

 

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