The Business of Medicine

How to begin. When I married at age 41, I just assumed that my wife would outlive me. That's just the way Nature intended it. Women usually live longer than men. My mother outlived my father and my wife's mother outlived her husband. I was a bit concerned that my wife's weight might lead to heart problems, but she had regular checkups and her heart is strong. The doctor's never seemed to be concerned with her weight.

About two and a half years ago, my wife, Alma, started experiencing severe back pain. She went to a chiropractor several times, but the pain just got worse. She finally went to see a doctor about it. X-rays and CT scans were done and it was discovered that she had a fractured vertebra which had compressed. A procedure called kyphoplasty was performed to lift the compressed bone and fill it with cement. This should have alleviated the pain, but she remained in agony. More tests revealed more fractured and compressed vertebrae and another kyphoplasty was done. And then, another. Finally, the doctors decided to do a battery of tests and they found that she was severely anemic; absolutely no iron in her blood. More tests were ordered, and even with pretty good medical insurance, the hospital and doctor bills began to mount.

Alma was finally diagnosed with multiple myeloma, a cancer of the blood. She had almost no bone marrow by the time the cancer was diagnosed. The orthopedic surgeon had to to into her hip bone to find enough marrow for a biopsy.

Only a few years ago, the prognosis for those with multiple myeloma was three to five years. There still is no cure, but real progress has been made in treatment for the disease. But treatment is very expensive and insurance doesn't cover nearly enough for those whose incomes are pretty meager to begin with. Alma was making pretty good money working for a software company in customer support. I had worked for the same company for four years, but got laid off when the company was sold and I was working part-time for a non-profit.

Suddenly, Alma couldn't work any more and the insurance for both of us was about to be canceled. The non-profit for which I work found a way to give me another part-time position which gave me full-time hours and benefits, including insurance. That insurance takes half my paycheck every two weeks to cover Alma. We got her covered without any lapse, so they couldn't deny her because of preexisting condition. However, when she began the procedure to get approval for her treatment, which included chemotherapy and transplants of her own stem cells, the insurer told her she had to wait one year. No exceptions, and too bad if you die while you're waiting. She finally found a sympathetic ear at the insurance company who helped her get an exception to the rule. Reminding her that there are HIPPA rules that might apply in this situation and a very strong and active insurance commission in this state may have expedited the matter.

Alma spent the whole summer of 2007 undergoing treatment at the Seattle Cancer Care Alliance. We took her there during the Memorial Day weekend and she didn't come home until after Labor Day. The cancer was put into remission, but it will come back. Her immune system is completely compromised and even catching a cold, which for most of us is an inconvenience for a few days, can make her ill for weeks. She's had pneumonia a couple of times. The worst thing was contracting shingles this past winter. She was in agonizing pain for months. The only drug that seemed to help was Lyrica, and the insurance company didn't want to pay for it. They finally relented after her pain specialist wrote them a letter explaining that Lyrica was the only medication that gave her relief and didn't make her even sicker.

I came home a couple of days ago to find that Alma had been crying all afternoon. The local hospital where she has been getting treatment had turned her account over to a collection agency. Now, she has been working with the hospital to make arrangements for getting the fees reduced and to make monthly payments. She thought it was all under control, but it seems the billing department at the hospital doesn't communicate very well within its own walls. To use an old cliché, the right hand doesn't always know what the left hand is doing. Of course the collection agency isn't being very helpful. After all, they get paid a percentage of everything they collect.

Alma will be getting another CT scan Monday morning. The doctors saw something in her chest x-rays after her last bout of pneumonia that made them want to check for lymphoma. It seems that pneumonia in multiple myeloma sufferers can lead to lymphoma.

Sometimes I wonder if we weren't all better off before all these diagnostic test were devised. We got sick and we either go better or we didn't. Something kills us all eventually. About three weeks ago, I was getting out of my car and found myself in a lot of pain. I could barely stand up and my lower back hurt like hell. I went to work the next morning, but by the afternoon, I knew I needed to see a doctor, so I went to an urgent care clinic I'd been to before. The clinic was recently purchased by one of the local hospitals (not the one my wife is in hock to). It used to be that you could get into and out of that clinic in a pretty reasonable time when it was privately owned. I spent nearly three hours in the waiting room and then another hour-and-a-half in a cold examining room waiting to see a doctor. When the doctor finally did come in, he asked me a few questions, poked and prodded a little and had a tech draw some blood and had me pee in a plastic cup. He then prescribed a muscle relaxant and pain killer and sent me on my merry way.

I suffered through the weekend with terrible back pain and decided to go back to the clinic instead of to work Monday morning. There was another long wait in the waiting room and examining room, even though I was the second patient through the door that morning (they don't take appointments now that the hospital has taken over). This time, I saw a registered nurse practitioner who spent a little more time with me and ordered x-rays and gave me a prescription for the anti-inflammatory drug naproxin (which the doctor should have done on my previous visit). He said he saw what might be kidney stones and suggested I schedule a CT scan and make an appointment with a urologist who zapped a large stone a little over three years ago.

I had the scan and a week later, I saw the urologist, who wondered exactly why the clinic had suggested I have a CT scan and see him. He said there was nothing there for him to treat. Well, I guess I could have told him what had just dawned on me. Medicine is big business nowadays. A CT scan, even that isn't necessary, makes money for the hospital. He made money by having me pee in another plastic cup , stick his gloved finger up my rectum and talk to me for about 10 minutes. Every time a doctor orders up another test for my wife, somebody makes money. We have gone through bankruptcy and incalculable stress over how to pay all the co-pays and deductibles and still keep a roof over our heads and food in the pantry. My wife now qualifies for Medicare because she's on disability, but we found out that, because of coverage “donuts” getting her prescriptions through Medicare will be prohibitively expensive. So, I continue giving up half my pay to keep her insured.

I know the conservative element out there hates to hear this, but we need affordable, comprehensive health care coverage in this country. Quite frankly, I don't think I can afford to outlive my wife. But I probably will and that's not the way Nature intended it to be.

Hard to Get Into the Christmas Spirit This Year

I haven’t written a blog entry in quite some time. Too damned tired and depressed I guess. My wife, Alma, went for her annual checkup at the Seattle Cancer Care Alliance the week before Thanksgiving. It seems like every time she goes over there, she comes back in worse shape than when she went. This time she was anemic – no iron whatsoever in her blood. When she got home, she spent most of one day at Kadlec Hospital in Richland getting a transfusion of whole blood. That seems to have done the trick, at least for now. She scheduled a colonoscopy and endoscopy to try and find out where her blood is going.

Alma got chest pains shortly after getting back from Seattle. Of course we were afraid it could be her heart or a clot on her lungs. It turned out to be pneumonia, so the doctors put her on antibiotics. That, of course, meant postponing the colonoscopy and endoscopy, so we still don’t know why she keeps getting anemic.

A few days ago, she started complaining about pain in her ear and neck. A rash developed, so one of her daughters got her in to see a doctor, who decided it was an allergic reaction to the antibiotic she was taking for the pneumonia. By Thursday morning, she was in terrible pain and couldn’t turn her head. The “rash” had turned to blisters. I decided to not go in to work because she obviously couldn’t be left alone. The other daughter, who was trained as a physicians assistant, came by, took a look at the blisters on her throat and scalp and promptly looked up “shingles” on the Internet and I called the nurse at her doctor’s office. The nurse took her own sweet time getting back to me, but we were able to make an appointment with the same doctor who had misdiagnosed her rash as an allergic reaction.

The doc took one look and apologized for his boo-boo and prescribed an anti-viral medication and told her to finish the antibiotics for the pneumonia. He also told her to up her pain medication for a few days until the shingles medication takes effect and the pain subsides.

Alma has an incurable form of cancer called multiple myeloma. It’s a cancer of the bone marrow. It has caused several of her vertebrae to fracture and compress. She has been in excruciating pain for about two and a half years. She’s been through chemotherapy and a stem cell transplant. And now, anemia, pneumonia and shingles. She’s got more guts than I’d have.

And a merry fucking Christmas to one and all, and to all a good night.

Another Tale of Woe

Ever wonder what you've done to piss God off so much? My wife was diagnosed with multiple myeloma over a year ago. She spent all last summer at the Seattle Cancer Care Alliance undergoing chemotherapy and a stem cell transplant. She's been sick from the chemo since she got home just after Labor Day. Finally this past week and a half she's started feeling better. She's started working on her EBay stuff again, taking herself to doctors' appointments and doing errands. She's even started being able to fix dinner and do a little light housework.

Today, she decided to drive to the post office to mail a package, but discovered that she had forgotten to bring her purse. She turned the car around and headed home to get it. The sun was in her eyes and she didn't see that a traffic light had turned red and that the van in front of her had stopped. Yup, she rear-ended the van. No doubt that it was her fault. So, the car had to be towed to a body shop and she got a ticket. Fortunately nobody was hurt -- and that's a miracle because the myeloma caused her bones to become very brittle and she had three back surgeries before the cancer diagnosis. We're counting our blessings about nobody being hurt.

My wife's cancer caused her to lose a very good job and we had to go through bankruptcy. Now the deductible will be at least $500 on her car and hard to say how much the citation will cost, plus our insurance will undoubtedly go up.

My job doesn't pay all that much and half my paycheck every month goes to pay for medical insurance for my wife. When does it end? I probably deserve all the bad fortune I get, but my wife has always been a good, God-fearing Christian. She doesn't deserve any of this.

OK, I got that off my chest.

Declaring My Candidacy

Okay, I’m ready to start my campaign for the vice presidency. I don’t want to be president, just the veep. I figure it would be a pretty good job, to be vice president of the United States. Pretty good pay and excellent health care benefits. You get your very own jet to fly around in. Chauffeured limo, secret service agents to keep people from kicking sand in my face, very little responsibility or real work to do and as I understand it, a hunting license to shoot people and claim it was a hunting “accident.” Yessireebob, I’m throwing my hat in the ring right now before anybody actually gets nominated to run for the presidency. I figure if I get enough of a head start on this and get a lot of support from you, I should be the logical choice of whomever gets nominated to run for president. It doesn’t really matter which party I’m the running mate on – they’re all a bunch of lying, conniving snakes in the grass anyway.

So, what platform am I running on you may ask. I plan to take the office back to its glory days and be the do nothing vice president! Nobody (especially the prez) wants his veep to do anything that might embarrass him/her, like make an intelligent decision. I should be very good at that, since I’ve made very few smart decisions in my whole life. I’ll even go so far as to promise not to try and spell “potato.” I’ll just spell it “spud.”

Now, I realize most folks with political aspirations begin their careers on a smaller scale, like running for congress. I don’t have time for that – I’m old. And besides, congresspersons have something called “constituents” that they have to pay lip service to every couple of years. I’d rather fly beneath the radar, as it were, and just be the seldom (or never) seen or heard from vice president.

So, you ask, what happens if the president croaks and you all of a sudden have to step into the job? Well, I certainly wouldn’t want that to happen, but I suppose I could muddle through somehow. We’ve had a number of presidents who’ve done just that, i.e. Millard Fillmore, Calvin Coolidge, “Ike”, Dubya, et al. I reckon I couldn’t do a much worse job as The Prez than Dubya.

So, when you go to your local party caucuses, please remember to vote for me, Xradioguyfrank for vice president of these here United States. Thank you.

First Day of a Brand New Year

First Day of a Brand New Year

I don’t know where 2007 went, but I can’t say I’m going to miss it. In 2007, my wife Alma was diagnosed with multiple myeloma. Because she could no longer work and she had run up a pile of credit card debt I didn’t know about, we had to declare bankruptcy.

Alma spent the whole summer in Seattle getting treatment for her cancer at the Seattle Cancer Care Alliance. That meant renting an apartment at the Pete Gross House, a facility built for just this purpose – housing cancer patients. I mostly stayed home here in the Tri-Cities and worked. Half of my paycheck each payday goes to pay for health insurance for Alma since she also lost her insurance benefits when she lost her job.

The treatment for Alma’s multiple myeloma consisted of several rounds of chemo therapy, a stem cell transplant and so damned many pills I don’t know how she keeps them all straight. The result? Her cancer is in remission, but she feels terrible from all the medications.

Nope, 2007 will not go down as my favorite year. At least I didn’t get a kidney stone. But I did have to have bilateral hernia surgery (that’s both sides and three hernias). Alma and I are both going into 2008 with colds. Having a cold is very serious for Alma because her immune system is still compromised.

The old saying goes something like, “Just when you thought things couldn’t get worse, they did.” I don’t pretend to know what 2008 will bring. Could it get any worse? Oh yeah! Could it get better? Sure – I’ve got both Alma and me entered in the Publisher’s Clearinghouse sweepstakes, so when we win that….

The year 2008 means it’s been 45 years since I graduated from high school and 40 years since I got drafted and decided to join the navy. It is just not possible that it has been that many years! I remember wishing the time would fly by when I was in the navy (especially in boot camp) so I could get “outta there,” but the days and weeks just seemed to drag on endlessly. Now even a mundane eight hour work day seems to only take about an hour. And, when I worked in radio, especially early in my career, a one-day weekend seemed adequate. Now it seems like I haven’t really had a weekend off at all, even after a three-day holiday weekend.

I’m hoping 2008 will be kinder to Alma and me, but I sure wouldn’t take odds on it. As the old expression goes, “Life’s a bitch, and then you die.”

Nice People in the Workplace

I’ve mentioned here in the past that I work with a bunch of pretty nice people. I’m just not used to that. In my previous life in the wonderful world of commercial radio, I kind of got used to my employers and many of my fellow employees being ego-driven, self-centered, everybody for himself jerks – including me.

I currently work for a non-profit company called Senior Life Resources Northwest (http://www.seniorliferesources.org). There are three agencies within the company including Meals on Wheels, Home Care Services and Senior Health Services. I applied for work there two years ago as an administrative assistant because, physically, I can no longer do many of the kinds of work I’ve done in the past. And I refuse to do outside, commission sales again.

I’ll digress for a moment. When you’re just shy of 60 years old and suddenly find yourself laid off from the best paying job you’ve ever had, you find that all the laws in this country against age and sex discrimination are nothing but a bunch of words on paper. You will be discriminated against, especially if you are white and male. Reverse sex discrimination was sometimes out-and-out blatant. The prospective employers knew there wasn’t a damn thing I could do about it.

So, I saw an ad for this job I was eminently qualified for with Senior Life Resources Northwest. I drove over to their office and spent about an hour filling out the employment application and releases for background checks. A week or so later, I was called in for an interview and I must say, I felt I did pretty well. God knows I’d had enough practice over the previous year! But I heard nothing back – the usual result. Finally, a couple of months later I guess, I got a letter from SLR thanking me for my interest, blah, blah, blah. Then the very next day, my wife called me and said that SLR had called my former employer, where she still worked, and was getting references. I said something like, “But I just got their rejection letter yesterday.”

But I got the job. Come to find out, I was not their first or even second choice. But the first and second choices, both young women, just hadn’t worked out. So, in desperation, the office manager said, “Let’s call the old guy.” And “the old guy” has been there for nearly two years now. They hadn’t wanted to hire a man because the women in the office were afraid I’d just join the “good ol’ boy” network. Well, hell -- there are only two other men in the office and they’re both in management. I told my new fellow employees to just threat me like “one of the girls.” They do, but to tell the truth, I think they’re more protective of me than they are of each other.

So, I took this week off to have some surgery done. I sent the office a funny email the day after the surgery letting them know everything went well. Thursday I got a call from one of the women in the office asking directions to my house because she and one of the other gals had something they wanted to bring me. They both showed up at my door after they got off work with a card and box of chocolate. No flowers because they knew my wife shouldn’t have flowers or plants in the house with her immune system being compromised from chemotherapy. I am still flabbergasted that these two people (who had not wanted to work with me two years ago) would go way out of their way to bring me a card and box of chocolate candy. My house is in the opposite direction from the office to their homes by a good many miles. To paraphrase Sally Field, “They like me! They really like me!” And I like them too.

Growing Old is Not for Sissies

My wife, Alma, finally got home from Seattle shortly after Labor Day after over three months of treatment for multiple myeloma at the Seattle Cancer Care Alliance. She is feeling a little better with each passing day but still tires very easily. I’m not going to dwell on her illness and recovery with this entry. I’ve pretty much covered all of that over the past year – from the uncertainty caused by not knowing what was causing her vertebrae to fracture and compress to the diagnosis of multiple myeloma, to the frustration with the insurance company and then the cancer treatment. She’ll be going back to Seattle for a few days in November for follow-up and maintenance.

So, Alma’s home, her progress is good and she has survived a form of cancer treatment that many others have not (we just learned this from another myeloma survivor recently). Life should be getting back to normal, right? My boss told me I have 40 hours of vacation time coming that I have to use before the end of the year. All right, vacation! I’ve been planning this for months now. I can virtually feel what I’m going to do on this vacation in my gut! I chose the week carefully because I work in a small office and I wanted to keep any disruption to a minimum. I got everybody’s blessing to take the week of October 22nd off. That done, I spent all one morning the previous week making my reservation.

Early on the morning of the 22nd, my wife and I headed out for a destination that is all too familiar to us both for the beginning of my “vacation.” We’re headed for the same day surgery unit of Kadlec Hospital in Richland, Washington. I have bilateral hernias that can no longer be ignored. I was referred to a surgeon by my doctor who smells of garlic, speaks with an accent I cannot quite identify and who has a name that is completely unpronounceable. The surgeon is a nice young man who cannot be more than 16 years old. He explains that he likes to do hernia repairs using laparoscopic surgery where he cuts three small holes in the abdomen and pulls the wayward intestine back where it’s supposed to be from above. That sounds fine to me because I had misgivings about having a teenager wielding a sharp knife so close to my, ahem, family pride. And since there are hernias on both sides, well, let’s just minimize the cutting “down there.”

Since I had pre-registered at the hospital the previous week, I checked in a little before 8:00. Was wheeled into surgery a little after 9:00 and was back home in my own recliner a little after noon.

Those of you who have read my posts about my kidney stone a couple of years ago may well wonder when I’m going to learn that medical procedures involving my plumbing are going to be very painful no matter what kind of fancy name they make up for it. I’m hoping that my next vacation is far, far away from any place that has “hospital” or “clinic” as part of its address. But at our age, maybe that’s just what we can come to expect from now on.