Medical Hell

So then I get the call for the follow-up with the ENT.

After I’m in the exam room he entered and, with little in the way of preamble, stated “You need to have sinus surgery”.

What.The.Fuck.?

“Oh yes, you have sinusitis, this will take care of it.  You should only have a 20% out of pocket,  the surgery is around $6000″.

“$1200?!  Does that include everything?” I asked “Anesthesia?  Room? Vestal virgins?”  “No,” he replied “those will be billed separately”

I then remembered something from my childhood, looked at him and said, “Hey, before we do anything else, how about taking a culture and see if the antibiotic you gave me is right for whatever’s in there?”. 

Back in the last century, before they prescribed anything they took a culture.  Before anyone cut on me in the 21st century I thought I deserved one.

You’d think I just pulled out my dick and said “Blow me”.

“Oh.  Uh.  Yes, I suppose we could do that”.  Imagine my left eyebrow arching up as I gave this guy my most withering look.

Ten minutes later the deed is done, my wallet again $40 lighter, and they said they’d call me with the results in a few days.

A week went by before I got the call about the results.

“Mr. Hill,” said the office medical minion “we will be calling in two Rx’s, you must take them exactly as ordered.  Your culture revealed you have an antibiotic resistant organism and…”.

Whaaaat?  Antibiotic resis… “I’m sorry,” I interjected “what do you mean “antibiotic resistant organism”?  Which one?”

What followed was a five minute game of verbal Chicken.  She tried stonewalling me, refused to give me a name for the bug; however I badgered her enough she finally said a single word:

“Staph”.

OMFG!  Antibiotic resistant staph?  In my HEAD?!?  I HAD FUCKING MRSA IN MY HEAD?!?!

I barely paid attention as she told me I’d be taking two antibiotics, one oral, one nasal, that the nasal had to be compounded, it wasn’t a “stock” item.  The oral was Clindamycin, the nasal Gentamicin.

I flew to the closest compounding pharmacy, shelled out a co-pay and $30+ for my two, new, wonder drugs, all the time wondering if, no, when, my nose would start rotting off.

The first three days passed uneventfully enough, though the taste of the Gentamicin spray was enough to gag a maggot.  On the morning of the fourth day I noticed something odd, my feet hurt.  So did my knees.  Later in the day my hands felt achy.  Weird.  Took some Advil®, muddled through the rest of the day and went to bed.

I woke up the next morning and HOLY SHIT, my legs and hands felt like someone’d partied with a ball-peen hammer on them.  I tried to get out of bed to hit the john and wound up taking geisha steps all the way there it hurt so much to walk.

This. just.was.not.right.

I hobbled my way to my computer and googled both drugs and soon was perusing terms like “Rare but serious side effects” and “Musculoskeletal: Polyarthritis”, “Arthralgia (Joint Pain)”, “Paraesthesia”, “Pain”, not to mention other really scary shit like “Ototoxicity”, “Renal Failure Acute (Kidney Failure)”, and “Pulmonary Oedema (Fluid In Lung)”.  Holy guacomole, this stuff could be killing me.  Phone.  PHONE!  WHERE’S MY FRIKKIN…?!?

It being the weekend I connected on the third ring to the doctor’s answering service, where a bored voice inquired “How can I help you?”.

“Make it so I don’t hurt would be a good start” I thought, but I bit my tongue, described my symptoms and asked they be passed on to the ENT.

Fifteen minutes hadn’t elapsed before my phone rang and a very stressed sounding voice told me to immediately discontinue using the antibiotics and if my symptoms didn’t abate to go to the emergency room.  Right.  No problem there.  Lemme go hook down another three Advil® and wait and see what happens.

/sigh x3  [I said it was a saga. I wasn't kidding.  Stay tuned.]

Medical Hell

When I said my sinuses blocked up I meant they became, for all intents and purposes, non-porous, impermeable, cement infused.

Literally overnight I became a mouth breather.  *At* night my snoring rattled walls, kept Paula awake, scared the cats and threatened my marriage.  She even video recorded it so I could share the delight.  747′s were quieter.

Back to the GP/PC.  This time to be referred to an Ear, Nose and Throat specialist (ENT).

I arrived, was ushered in, history taken, they then attempted to shoot shit up my nose that was supposed to lessen the irratation of the next shot of shit, which was supposed to open my sinuses.

It dribbled out my nostril and dripped from my upper lip.

Nonplussed, the tech waited a beat, then went for the gusto, shot the Roto-Rooter® decongestant up the pipe and told me to inhale.

I tried.  To no avail.  It dripped out.  She sprayed again.  It dripped out.  Again…

Finally, enough  got through to open an avenue for the ENT to safely shove the nasal scope up my schnoz for a look-see.

He then told me I’d need to start some new Rx’s and go for an MRI.  He scribbled out the scripts, said he’d see me again when the MRI results were back, handed me a folder to take to the office minion and reminded me my $40 co-pay would be due before leaving.  Right.

A word about those Rx’s.  One was a nasal spray that gave the sensation of Pop Rocks exploding intra-nasally, mutating to a cloying, sweet, post-nasal drip.  Don’t know what it was supposed to do, but I’ll never forget that sensation.

Now medicated for a few days I duly arrived,  by the scheduled time, at the Imaging Center for my MRI .

Funny thing about insured healthcare today, it’s the only service where you never know how much you’ll end up paying.  I’d been informed in advance I would need to pay $148.79 for the pleasure of climbing inside a clanging metal tube to have my head irradiated.   I was dubious about that.

Over the last few months,  I’d go a for test or appointment and within a week receive an “EOB” (Explanation of Benefits) from the insurance company would arrive that stated the service/test/procedure cost this, was adjusted to that, insurance paid this, disallowed that, and occasionally included an amount I “Might owe provider”.

Sometimes the EOB was followed by a bill from the lab or doctor, sometimes not, but since I’m seeing a radiologist this time after another month of co-pays and Rx’s, I’d like to minimize my chances of getting an after-the-fact surprise.  So, after checking in I requested the office manager call the insurance company and ask them point blank, on speaker phone, in front of everyone, what my out-of-pocket for that visit would be.

“$148.79″ said the insurance rep.  I asked for confirmation.  “That’s it,” she replied “total, complete, cross my heart and hope to die”.

Sounded good I thought, wrote the check and headed back to the Boom Tube.

Two weeks later the follow up bill from the Imaging Center hit my mailbox for $28 and change (a roughly 20% upcharge), so I called and asked to speak to the office manager.

She was utterly apologetic, but said it’s common practice for insurers to do this (i.e. lie through their teeth and let the provider take the heat).  She also said that they would need that 20% as soon as possible.

/sigh x2  [But wait, there's more]

Medical Hell

“So,” said Steven B. Sotman, MD, Infectious Disease Specialist, “as far as what I can do for you, we’re done”.

That sentence, spoken about six months ago, concluded my initial, year plus Journey Through Medical Hell.

But let’s back up, start at the beginning, and I’ll share with you why I’ve lost faith in Western medicine, several Doctors and maybe give you some insight into how broken “health care” in America is for an insured, late middle aged, gainfully employed, white male.

In September of 2010 I found my eyes were bothering me, more than usual (I’ve been plagued with dry, blood shot eyes for a few years now).  As time wore on they became by turns inflamed, puffy, swollen, weepy, painful and downright scary to look at.

The usual allergy pills and nostrums made no difference, so I scheduled a visit to the GP/PC who referred me to an ophthalmologist.

She is the daughter of someone I’d seen sporadically in the past, and I expected a quick resolution to the problem. Alas, that was so not going to be the case this time around.

Round One: Oral antibiotics, along with prescription eye drops (four different flavors; steroid, antibiotic, antihistamine, wetting agent) and the “Come back in two weeks” directive.

Round Two: My condition hadn’t really improved, so we switch drops and the directive this time is “Warm compresses on the eyes three to four times daily and come back and see me in a week”.

Round Three: She scratched her head, switched drops again, and I hear “Well, when you run out of those come back and see me”, which I translated as “Shit, I’ve thrown everything I know to at you, nothing’s stuck so far, I’m baffled, maybe you’ll just get disgusted and go away”.

Bear in mind, thanks to “cost cutting measures” introduced to our insurance plan, each of these visits nicked me for a $40 co-pay (this being a “specialist” visit) along with the prescription costs.

At this point the net result was I didn’t look *quite* as scary, it was only marginally painful on occasion, but I still looked like Steve Buscemi after a blunt fest bender.

I shared my misery with the leader of our usher team at church. She recommended me to her ophthalmologist who, she swore, literally saved her eyes ten years before.

Sounded like a hell of an endorsement to me.

So, back to the GP/PC for a referral, and on to the new doc.

He was old school, charming, cheap, (but in a good way, he likes to keep using his old equipment that works, rather than pay for shiny new toys and pass the cost of those on to his patients).  He examined me and I’m set up with more drops, more antibiotics, more “come back in two weeks”, and a $40 co-pay.

To make a long story short, after massive doses of Tetracycline, ocular steroids and what not, my eyes return to their previous state.

Woo-hoo!

I’ve also shelled out $200 in co-pays over four months, as well as the cost of the Rx’s, as well as having put massive amounts of foreign substances through my better-than-half-a-century-old frame.

So, even though he wanted to continue seeing me, I stopped after the fifth visit. It was getting hard to find enough change in the couch to have as gas money.

About a month goes by, and all is relatively well when, suddenly, my sinuses block up.

/sigh [The saga will continue soon]

•   A limit on the campaign season. Say… for no more than 9 months prior to the actual election. Clean up the airwaves and keep the vitriol to a minimum.
•   An aggregate time limit that any one individual can serve in all branches of government, maybe 15 years total. Feel free to mix and match. Spend four years as a Congress member, four years as a Senator and the remainder on the bench. Then you’re done. Period. No more life time politicians.
•   A “no compete” style clause, but in this case it would work like this: You may not enter any branch of government from a civilian position where your new position as “public servant” would allow you to benefit the business or industry you just left. Think Halliburton to Vice-President, in the case of Dick Cheney; or Geitner and Paulson, coming from the financial industry to run the Treasury. Automatic recusal would be de riguer, or you would be impeached, preferably tarred and feathered.
•   Conversely when you left office you would be automatically barred for a period of five years from interacting with any branch of government. Cut lobbying off at the knees and stop the revolving door in Washington.
•   An immediate end to the fiction of “corporate personhood”. It was nothing more than legal bullsh*t from the beginning, a way to open the floodgates to money that does nothing more than than warp public opinion. Because no one has more money than multinational corporations and big business, and who are *they* really serving?

If you agree with these sentiments, please pass them on.

After 14 years my job went away. I’m still employed by the same institution. Seems that out of an outfit with 5000 or so employees, I was the only one with my particular job title. Now, you might think that was kind of cool and unique, but in a place beholden to state funding and prone to budget cuts it can be more akin to feeling like a character from a Gary Larson cartoon.

Luckily for me some of the management felt I deserved “endangered species” style protection and moved ensure that. Abruptly.

Picture walking in on a Monday morning and your boss calling you up first thing to ask you to his office. Alarm bells anyone? Followed by a sudden internal review of work done, projects in progress, customer and coworker interactions, none of which reveals anything that should warrant this. Proceed to office. Enter. The boss turns and says “Sit down, we need to talk”. WTF?! This is never good way to have a meeting start. He continues, “The Dean has decided to…[end your job of 14+ years, take you out of this department and move you in under her office]*”

I digest this, then nod and say “OK, I have a few questions; but aside from that, when will this take effect?” Watching someone else’s jaw drop is always heart warming.

To make the rest of this story short, over the course of the next month and half I transitioned out of my old office, with it’s roaring floor fan, three servers and two workstations, into a new building, into a cube with two workstations and one server. The audio portion of my work life has imporved dramatically, at the expense of my privacy. What is it about cubes that make people feel it’s OK to try and sneak up on you?

The truly amazing part? While it’s a lateral (no increase in pay or change in title) I’ve had more fun on the job in the last five months than I’ve had in the last five years. I’m still pulling rabbits out of technical hats, I’m on a committee, etc., etc., etc., and the new boss gave me a Christmas present (in February) of… one pound of 100% Jamaican Blue Mountain coffee.

Oh yeah, I’m lovin’ it.

* The real lead in to this conversation was much longer, fraught with political correctness and some trepidation, as there was every expectation that I’d react negatively to the announcement. There was rumor of a pool on whether or not I’d quit or meltdown first. Everyone lost on that one. : )

With the drought that ensnared Texas for most of the summer, it became obvious that our favorite tree was  stressed, but we had every confidence that it would make it through the heat and continue to grace us with its presence for years to come.

Alas, that was not to be.  Despite $200+ water bills, scaling of diseased bark and our best wishes, about a month ago all but one of the major limbs leaves withered, dried and we knew our old friend was likely beyond saving.

Not that we didn’t hope.  But the arborists we consulted were certain we were simply the latest in a long list of drought casualties that were littered throughout the area.

So it was, with a heavy heart, and the help of my son and Mark Hagood (plantman extraordinaire), yesterday was spent … well, you can see for yourself below.

Hail and farewell old friend. You will be missed.

Last Man Standing?

In a stunning outbreak of common sense, an editorial in Student BMJ has experts warning that overuse of antibiotics in livestock poses definite risks to both humans and other animals.

For over 50 years farmers have been feeding antibiotics to their herds after scientists discovered the drugs improved the animals’ growth.  As time wore on however, it became apparent that the practice was giving rise to resistant strains of bacteria that could prove hazardous to the public.

In 1977 Congress proposed banning the practice, but the measure was shelved “pending additional study” (or more properly, after being lobbied out of existence).

In the interim we have seen the emergence of deadly strains of e coli, as well as “a global pandemic of methicillin-resistant Staphylococcus aureus (MRSA) infection [5–12]; the global spread of drug resistance among common respiratory pathogens, including Streptococcus pneumoniae [13–19] and Mycobacterium tuberculosis [20–29]; and epidemic increases in multidrug-resistant (and, increasingly, truly pan-resistant) gram-negative bacilli”¹ Additionally, “Three of four recently emerging infections in humans originate from animals: avian influenza H5N1, severe acute respiratory syndrome (SARS), and Salmonella.”

The Danish authors cited in the BMJ article, as reported in ScienceDaily, assert “that the routine use of antimicrobials can be reduced substantially, while maintaining profitable animal production, and call for their use to be monitored in all countries.”

Denmark, Norway and other European countries banned routine use of antibiotics in livestock, with no significant loss of production. In 2006 the EU mandated a similar ban for all it’s member countries.

Americans on the other hand have been left to the mercy of industry lobbyists and ineffective action from their elected officials.  As late as last year a “firestorm … erupted over a federal proposal recommending antibiotics only when animals are actually sick”².

In the face of such inaction, is it any surprise then that the only recourse seems to be in the courts?

Your Lightbulb & WiFi, What Could Go Wrong?

NXP, a publicly traded semi-conductor company, and Green Wave Reality, an energy management and automation company, have partnered and announced their intention that every light bulb should have an IPv6 internet address.

That’s right, your light bulb will be able to talk over your WiFi in the not too distant future, and the companies involved are ecstatically proclaiming “The possibilities are endless: You could monitor, manage and control every light bulb from any Internet-enabled device – turning lights on and off individually, dimming or creating scenes from your smartphone, tablet, PC or TV – to save energy as well as electricity costs.”

Green Reality has been instrumental in bringing Smart Meters (new, digital electric meters) to households nationwide, with less than universal appreciation.

While there may be legitimate consumer benefits, there are several issues to consider.  Such as, from the standpoint of network architecture, having a disposable endpoint as the agent leasing an IP address makes less sense than having the fixture that holds it leasing an address.  I want to light the room, and if the light’s burned out or not communicating that’s not gonna happen from my smartphone, pad or PDA.

Another is, what kind of traffic overhead will be produced by all of these internet connected light bulbs?  As Internet Service Providers (ISPs, like Charter, Comcast, Time-Warner) look to institute bandwidth caps on subscribers, how will these “intelligent light bulbs” figure into those equations?  If your light bulb breaks, will it eat your Netflix allowance for the month?

Finally, there are real privacy issues to consider here.  Smart meters are sensitive enough to know not only when appliances and such are used, but based on the amount of power drawn can tell what kind of appliance or device it is and they hang on the outside of the house (or maybe inside the garage).  What are the implications of have internet connected devices throughout every room of your house?  If one chip to allow communication can be put in, why not others?  There’s a war on, ya know?

I’m all for the “next big thing” and really cool gadgets, but this is one I’m going to watch closely.  Maybe you should too.

Press releases for Greenwave and NXP can be found below:
http://www.greenwavereality.com/greenwave-reality-announces-partnership-with-nxp-semiconductors/
http://www.nxp.com/news/content/file_1896.html

Car or Teachers? Which Is Worth More?

If you are a resident of Fort Worth, remember to vote on Saturday, May 14th.

I know it’s “only” the mayoral and city council elections, but these positions are often stepping stones to higher office, and not voting can allow people who make … questionable … decisions to ascend to positions where there are real consequences.

Take our State Legislature for example.

There’s an article over at Bloomberg online that mentions how “Texas, which may balance its budget by firing thousands of teachers, plans to commit $25 million in state funds to Formula One auto racing each year for a decade” in the capitol city of Austin.

That’s right, Texas, who ranks in the bottom ten of all states and US territories for spending on education, proficiency of its students, and graduation rates, is going to fire more teachers and give money to race cars.  Not only that, but taxpayers will be subsidizing a segment of the racing community that’s proven itself to be a total loser over the last three decades in Long Beach, California, as well as Las Vegas, Detroit, Dallas, Phoenix and, most recently, Indianapolis.

I can’t help but think that if we’d culled the candidate pool at the local level back in the 1970s and 80s, we might not be seeing travesties such as this play out in our fair state.

But then again, politicians do like a populace that doesn’t think too deeply.  They tend to stay in office longer.

Product vs. People?

A few years back the local warehouse store had a great price on a combination rainfall shower head / handle sprayer combination.  Lifetime warranty too.  So I bought it.

Fast forward to today and the spray handle has lost its rubber anti-scratch bumper, the head itself is loose, expanded from the seam, and leaking water.  OK.  Call the warehouse store.

“When  did you buy it?” asks the customer service person.
“I dunno, it’s been a while.” I reply
“Well, I have to know.  We might not be able to take care of this.”
“Oh?  It has a lifetime warranty.”
“Well, that’s the lifetime of the product, not your lifetime.” she replies

WTF? Are.you.serious?  Seems that the definition of “lifetime” keeps changing.

When I was growing up, a lifetime warranty was for as long as you owned the product, or shuffled from this mortal coil, whichever came first.

Then a few years ago I found out it was the lifetime of the company (so if the original manufacturer was “vertically integrated” all bets were off).

Now it’s the lifetime of the product?  Who defines that?  How does a consumer know?  More to the point, where on the packaging did it state that?

In my case, it’s five years. I’m just two months under the wire in this case, so I’ll get a replacement.  From now on, I’m going to ask what a warranty means, and get it in writing at the time.

Caveat emptor.