Today I will be repeating the following:
- I am a bitch
- Bitches get stuff done
- I can handle this because I have resources, I can find help, and I am a bitch.
Today I will be repeating the following:
Over the weekend, we watched Arrival, an Oscar-nominated film. The movie was beautiful and made me think, but perhaps not in the way intended.
WARNING - SPOILERS
These aliens show up in 12 locations on earth. Ultimately we find out that they have arrived to teach us their language. As humans learn their articulation, our brains change so that we can appreciate time in a non-linear fashion, the way these heptapods do. Turns out, the aliens have arrived to give us their language because they will need humanity's help in 3000 years. We need to be prepared.
As the linguistics professor, Louise Banks, learns to speak with the aliens, she begins to experience things from her future life, including the birth and death of a child. Her relationship with the child's father deteriorates when she reveals that their daughter will die of cancer, and he leaves. Even knowing that all of this is ahead, she chooses to live this life.
Clearly non-linear time perception allows the heptapods to go to a timepoint and give us humans the tools to make us useful 3000 years from now. So nonlinear time perception allows at least some interference in outcomes, otherwise they wouldn't bother. Are there rules for such things? Or are all the outcomes written and it doesn't matter what we do?
So why doesn't Dr. Banks try to change some outcomes? Not the big stuff - having the child - but telling the father that his daughter will get cancer and die in a few years when she knows what that will trigger? Perhaps she could visit a time in the future when her daughter's disease could be cured? They make clear in the movie that at least a couple of people are running about through time, telling each other critical things.
Of course, I then had to ask myself if I would change my life, even the bad stuff. There are many things that I could have lived without, but what would I have done differently? I don't have to know, because, for me, time is strictly linear.
At the end of the movie, that's the biggest problem: it's very difficult to imagine time as anything but a linear construct of past - now - future. And that's OK, until the heptapods land for real.
Yesterday I received a medical bill for my husband, hardly an unusual occurrence given his brain tumor. Unlike the usual bills, this one included almost $4,000 in charges when his out-of-pocket expenses were satisfied last March.
Going through line-by-line, I discovered that no one filed claims for three procedures in November and December, including a surgical procedure that resulted in most of the amount due.
All of this should be covered.
I called the billing office, and they told me to tear up the bill and await a corrected one.
Yesterday was a stressful day anyway. We found out that the tumor was progressing again, and we are now waiting to hear what other trials my spouse can try.
Getting that bill was unnecessary stress. Part of me wanted to curl up and pretend it didn't exist. Part of me thought about just paying the damn thing so it went away. Luckily, the part that won said, "WTF? How can that be?" and went through the charges to find the problem.
Brain tumors suck.
I'm a woman "of a certain age" to put it delicately. I have birthed some babies, including my 9 1/2 lb son.
Even with lots of Kegel exercises, a full bladder and a sneeze can leave me with wet panties. And not in a good way.
Pantiliners for such events are fine, but not ideal. They get pretty pricey over time. When I saw an ad for Icon Pee-Proof Underwear, I decided to give them a go (pun not intended, but it works). The crotch of each pair has a special interior lining that can hold several teaspoons of urine without odor or leakage. They can be machine washed and dried without any problems.
After several wearings, I can report that these undies work as promised. I wear the bikini cut (see photo at right), and I tried one thong. They also come in a hip hugger and high-waist version. Colors are limited to black and beige in my size and styles, but what else do we really need? They do seem to stretch out a bit as washed, so you may need to go down a size.
This company also makes Thinx, the period-proof underwear. I don't need those (the certain age thing again), but I bet they work. The site is full of urine puns and "whizdom." And all their products help support the Fistula Foundation, providing surgical repair of obstetrical fistulas. A fistula is a connection between stuctures, in this case the things that empty out down there. Women in countries without modern obstetrical care often suffer genitourinary damage leading to urinary or fecal incontinence afterwards. Fistulas make my teensy bit of urinary leakage seem like such a first world problem...
I still have some other undies at this point, but they will be replaced by IconUndies as they age and go to panty-heaven. It's fun to be pad-free!
I know that the start of a new year is an artificial milestone for the convenience of we humans. Still, that fresh year brings out a desire for a new beginning, a new commitment to be our best.
A long time ago, in a galaxy far, far away, I went to the gym. To say I fell off the healthy living wagon in 2016 would be an understatement. That wagon left me sitting in the road, drinking wine and eating chocolate truffles. The weight on the scales did not suffer much, but my endurance and flexibility certainly nosedived off a cliff.
I am going to try and get back on track.
For January, my goal will be increased physical activity. I had been doing really well with 10,000 steps per day for a long time, but not so much recently. In December, with some attention and effort, I averaged 7,200 steps each day. My goal for January is to get that back up to 10k. Yesterday, I walked 11,081.
I will check in here periodically with my progress. I need someone to keep me accountable, and it will get me blogging again.
Oh, by the way - Happy New Year!
I get some test results. They are not yet optimal for whatever the patient has, so I want to make a medication change. We are using a well-established drug with minimal side effects. At the time it was first prescribed, we reviewed alternatives, and the family was in complete agreement with starting this treatment. The drug is also incredibly inexpensive, one of those most pharmacies will provide for $4 per month.
We call to increase the dose, and the family tells us they stopped the drug. Not because it caused side effects or other problems. They have decided to try some supplements for a more natural treatment.
We manage to renegotiate treatment with the original drug. We will now have to test again to assess its effects, at further cost. The insurance covers the cost of the drug, pretty much in full. The supplements the family substituted easily cost five times their out-of-pocket expense for the pharmaceutical agent. So they are more expensive as well as ineffective.
But somehow the family was willing to shoulder those expenses to be "natural," even though there is little "natural" about these supplements. These supplements "support" the systems involved in their child's health issues, so they were worth a try.
Isn't it time to get rid of this costly BS that the supplement industry is allowed to spew?
In 2009 I wrote the following for another blog, and I have reposted it several times as it remains relevant to this day. A kerfluffle erupted this week about the word bitch, thanks to the New York Times. There are those who clutch their pearls when this word is uttered, but many of us now consider it a badge of honor. I have obviously been on that bandwagon for some time.
Now for my bit of history:
Once upon a time, there was a woman who felt that her gender should not be an issue in her career. She wanted to be treated as an equal, she acted like she was equal, and the men called her a bitch.
1. a female dog.
2. a female of canines generally.
a. a malicious, unpleasant, selfish person, esp. a woman
b. a lewd woman.
a. a complaint.
b. anything difficult or unpleasant: The test was a bitch.
c. anything memorable, esp. something exceptionally good: That last big party he threw was a real bitchWhy does this 5 letter word have such power over women? We are raised to be “nice.” Malicious, unpleasant, and selfish are the opposite of this goal; however, this means that demanding equality may appear bitchy! At so many gatherings I have heard women ask how they can get their needs met without being called a bitch (generally these women spell the word rather than say it). The short answer? You cannot! Anytime you assert your needs and put yourself ahead of someone else, others may call you a “female dog.”When my daughter was starting middle school, I explained the world to her in my own warped way. I give my students the same advice. If you have a voice that gets heard in the world, someone will call you a bitch. If you perform acts of kindness and charity, someone will say that the bitch is showing off! If you show more spine than a jelly fish, someone eventually will brand you a bitch. Accept it. If someone calls you a bitch, you are probably doing something right.About a year later a classmate turned to her and called her a bitch. She thanked him for noticing, and then related how she had not reached her mother’s level of “bitchdom” yet. He said nothing more, and did not try to insult her the rest of the year. She came home from school empowered rather than insulted.Now, this advice does not mean you should be a bitch. Do not be mean or evil, and never treat those lower than you on the ladder of life with contempt. Always have a sounding board of friends who can help you determine the line between reasonable and bitchy. Sometimes you will cross the line, but, with their help, you will recognize this behavior and apologize for it. If you find yourself crossing the line too often, you may need to reexamine your attitudes and behavior. Do not be afraid to do this and make necessary adjustments. It is called “growth.”Someday I hope we get beyond the name-calling, but until then take pride in some bitchiness. It may just mean you are acting like a human being instead of an invertebrate. It may just mean you are living your life.Of course, I am not alone in claiming bitch as a term of honor. May I present Amy and Tina:
Are you a pediatric nephrologist? Or one in training?
We have a nice children's hospital with an amazing group of 3 current nephrologists. We have a transplant program and a hospital-based pediatric dialysis unit. We are working to officially post the job, but it's coming soon.
Contact me via email or social media - hell, you can even write via snail-mail if you want. If you see me at Kidney Week, give me a yell.
A four-person group makes for a livable call schedule. Besides, you get to work with me; what's not to love about that?
I feel your pain.
A lot of my patients have to deal with "mail order" pharmacies for chronic medications. Often insurers require that these "services" be used. They often present challenges for healthcare providers. Now I have a perspective from the other side of things.
My husband has been on chemotherapy since April. His regimen involves an oral drug that he takes at home, with few side effects. It is expensive, and our health insurance makes us use a specific national pharmacy. He is to get a round of treatment next week, so I called yesterday to ship the next refill. The pharmacy said they did not have the prescription. OK, I contacted the doctor's office, and they called it in (even though they had faxed back the refill 2 weeks ago - yes, medicine is keeping the fax machine alive).
This morning, I called to arrange the shipment. The prescription , given verbally, is still being "scanned in." They cannot verify the claim and arrange shipment until that happens.
Never mind that we only use this service because our insurer demands it. Never mind that we have filled this prescription monthly for 5 months. None of that is adequate to allow them to schedule the shipment. I have to call back in 2 hours. They cannot make a note to ship when approved. No, I have to call again during my clinic. I can't imagine dealing with this "service" without my medical background.
How this level of red tape saves anyone money is beyond my understanding.
A colleague helpfully pointed me to a website that could put me out of business. The headline promised to repair your kidneys naturally with one ingredient.
I had to know more! Here's the magical advice:
Repairing the kidneys after damage just may lie in a common household item, which you probably already have in your kitchen cabinet. Yes, we are talking about baking soda. In this articled we are going to show you how to cleanse and improve the function of your kidneys with just ½ tsp. of baking soda,every day.
The site goes on to try and explain the magic of sodium bicarbonate, implicating a variety of body systems.
So what's the tiny seed of truth? Acid may be bad for our kidneys.
Being alive generates acid. Metabolizing the food we eat produces acid. Our kidneys produce bicarbonate to neutralize this acid, as well as excreting it in the urine. There is some evidence that higher loads of acid may promote kidney problems, including chronic kidney disease and stones. Eating a lower acid load, by minimizing meat and maximizing fresh fruits and vegetables, may slow the progression of kidney problems.
So could ingesting baking soda help? Yes, but probably not at the level recommended.
1 teaspoon of baking soda can neutralize ~72 mEq of acid. Net acid production for children is 1-2 mEq/kg body weight/day. So a lean, 70 kg adult likely produces at least 70 mEq daily. This dose of baking soda would neutralize about half of that.
The real payoff here is the advice at the bottom of the article, recommending less meat and more fruits and vegetables. A healthy diet seems to be good for everything!
Besides, baking soda is pretty nasty.