‘Non-pandemic healthcare’ – Mom’s update by doc, smart help for no insurance walk-in, CBD

In a time before COVID-19, a maskless Thanksgiving with family wasn’t a concern.

‘Non-pandemic healthcare’ puts COVID concerns “over there” for a little while, because while all metrics show we’re leaning into another wave, https://carolinapublicpress.org/29967/coronavirus-in-north-carolina-daily-status-updates/ life goes on. Beyond ‘low grade depression,’ ‘cabin fever,’ or ‘just sick of it,’ concerns for elderly others, taking care of one’s own meds, and how an uninsured person pays for what’s necessary still constitutes healthcare .

“I have to leave here with meds” was the point of a recent office visit, and the essential question was, beyond a $75 office visit, how necessary was anything else to get those blood pressure pills? Recalling a 2019 appointment, when ACA coverage had a $740 tag for bloodwork and whatever (I paid $20 for office visit), I appreciated a helpful worker taking care of my “no insurance but a long time client” situation when I showed up.

While getting my meds from my regular doctor as a walk-in was relatively easy, the customer service skills of Loretta, a listener and ‘pleaser’ type, is worth mentioning. It turned out I didn’t need a physical at all, just to be SEEN by a doctor, to allow a prescription to renew. It was a small revelation to learn I could’ve been seen in July, I’d assumed everything stopped with COVID-19.

I used to think I was doing great when talking with senior center personnel; its as much their training to listen completely to seniors, who often can’t get straight to the point. Still, yay! for smart helpers like Loretta to make situations like mine just a regular thing.

After 16 months without being physically seen, an online service ($19) I tried could only renew my previous prescription for thirty days – its usually 90 day supply plus refills. While I got decent telephone support (and some sympathy), and the online version had only been up four months, there was a frustrating number of screens to view without seeing a choice close to my blood pressure priority.

There were more expensive options, where video connection replaced lower cost version, but it was an ungood surprise at pickup to learn all the effort only gave me a month supply.

It turned out I didn’t need a physical, just to be SEEN by a doctor, for my prescription to renew.Two hours and one blood test (kidney function check vs. med) later, Loretta rang up a satisfied patient for $115.

(Still way) Healthier than most

This was the first time I’ve been beeped for temperature (97.2) during the pandemic, and I’ve been hunkered down for seven months. I’m 63, 193 lbs. (same weight forever), and until an August bicycle accident, was riding thirty miles a week.

My BP was 132/82 that day, higher than normal by 15 pts., and I blame the first front person, at a different, earlier clinic operation I tried before Loretta (Novant).

Person #1 was right in suggesting I could go elsewhere if the pricing ($99) answer she’d given for my visit – instead of Prescription Refill ($89) function from their web site – wasn’t satisfactory. If she’d done as good a job explaining the difference, I’d have gladly given her my card without griping about it while driving seven miles and getting Loretta.

ACA coverage – better than I knew

Because its a big deal in the news, and will shortly be a case in the Supreme Court, I’ve appreciated having ACA coverage since it became mandatory, especially it handling most of a $6,900 bicycle accident and a knee replacement that rejuvenated my lifestyle at sixty.

I never needed to compare how much a $250,000 a year dentist covering a couple kids paid, but I lost my coverage in January because – after hoping a particular deadline falling on Sunday would work out – being a day late meant I needed to pay $970 for the first month of coverage. As for many Americans, having a large unexpected bill was a real problem, and the economics of food and rent overruled insurance.

That old “When you’ve got your health…” bromide still works, and millions are ‘skating,’ trying to make it through these crazy and stressful times. Seeing the worst kind of communicable health hazard appear without any coverage is a yikes! experience.

The “better than I knew” aspect was getting a check ($13 and change) from Blue Cross/Blue Shield because ACA had only used 79.1% (instead of mandated 80%) of premiums in 2019, so they split the difference among the masses. That’s got to change your attitude about all government programs as screwed up.

I’ve been “hunkered down” for seven months now, and had two bicycle crashes, one with actual injuries. That I paid a mere $8 for an anti-bacterial that a PA indicated I should get to handle what was a bit of infection in leg, doesn’t encompass how ugly the possibilites could have gotten.

People hear bike accident, they ask if you were wearing a helmet.

Yes, always, same for mask wearing, except when I’m moving 15 mph.

Ask questions, get answers

Things are more than a little confusing and scary right now, but there SHOULDN’T be any confusion about wearing a mask as worthy of doing for the good of all, and taking care of regular, non-pandemic stuff counts just as much. For many, that includes a loved one who needs extra attention, and speaking with people – ie. Loretta and my Mom’s doctor – who have specific information about specific situations, is still the best way to learn things.

Medical and nursing personnel know what’s going on, but they won’t just start providing a lot of “then this and then that” if you don’t ask. The people caring for Mom know she’s a ‘fiesty sundowner,’ but there’s no reason to think an elderly parent knows how they’ve reacted to a change of any kind.

Elementally, this is what my sales and journalistic training makes me good at, becoming a subject matter expert (SME) to the extent I can ask, “What about A, B, or C situations?”

When two brothers and I had 15 minutes of discussion with the doctor regarding the course of my mother’s medications, the reason for reducing or adding particular ones, and his most recent – that morning – meeting with her, we all got the facts at same time. BIG chunk of good intell there, even if events since then haven’t been as positive.

According to her doctor, she was admitted with a bladder infection – UTIs happen more than it should, she just won’t drink enough fluids – and antibiotics in seniors often change personalities. Though she’d only changed meds four days to that point, “her lab work was good, and she’s still a little bossy, but not physical” was legitimate. They’re aware of not ‘bombing her out,’ and she’d probably need most of two weeks to adjust to what her body was getting.

trump says he was low-keying things (“its like flu”) to avoid panic about COVID. In real life, most of us want the straight up information.

There won’t be any visits where she is, although two of us can have an hour together at her senior community after she comes back. Only one vendor reported to have broken protection there, which I trust. I relayed things to brother #4 in upstate NY, and particularly at this point, knowing what you can’t see or affect is being handled the best way possible, makes a solid difference in stress levels for others.

A quickie story

Although it represents very different circumstances, before she moved to assisted living side three years ago, she was in the hospital with afibulation problems. Four oncology doctors (that’s cancer arena) told me that, after a “sugar scan” they’d waited three days to take hadn’t shown anything “we’d still like to get a snip from inside the lobe.” What seemed like an unnecessary step – with a rubber-hosed scope the size of my pinkie going down her throat – had me smiling though.

“Thanks for the explanation, I think I have enough information here to accurately pass it along to everyone else. I’m not sure I’d go for anything invasive like that, especially involving anesthesia, but Steve is the one you’re really going to have to convince.” (FYI – No.)

Legally and operationally, someone has the final say on higher order senior healthcare. Voting at times of high stress rarely satisfies everyone involved.

Social Distancing

Long, short, immediate COVID considerations (for me) start with keeping as close to home and always being masked for the last seven months (and yes, maskless clowns still tick me off), but I’ve decided to take care of what I can. They won’t go away after any election, but thus far, my steering clear of others has been successful.

We’ll see how that works out when I’m a poll worker for 15 hours next Tuesday.

Our church-related (St. Gabriel Men’s Club) community group had its first gathering since March in early October, a bring-your-own-chair with beers and brots, fire pit and comaraderie for a couple hours in the parking lot. We have a significant mix of much older fellows, so everyone wore masks.

We won’t have a Christmas tree sale (a 34 year tradition), the overnight Room in the Inn program (rated for 20 beds) for homeless is off, but we’ve still managed our furniture pickups for another ministry. It’s always done with masks on, and without doing the usual cooking and prep work once a month, paying for food at the Mens Shelter is the best we can do.

More immediate is my brother’s three days in South Carolina with his Mustang group this weekend – how many people can you trust when mothers send kids who have been exposed to school? I’ve been lax about wiping surfaces, but how many people might he be exposed to, was there a “less careful moment?”

With ZERO chance of attending a ‘super-spreader’ like trump’s Rose Garden events, and minimizing the moments here and there that become exposure, I’m doing the best I can.

The CDC changed ‘exposure’ from 15 minutes with same (tested or not) positive person to TOTAL 15 minutes in a day. That’s a legit piece of information, not to be discarded like trump’s continuing to hark back to “Dr. Fauci said no mask, now he says wear mask” like its sooo confusing. ‘Don’t’ was in March, not last week. As a current PSA points out, “This is a mask, not a political statement,” but we all wind up being at risk with non-maskers.

Being a good patient counts

Having $115 in checking account to pay for the office visit and a single blood test (checking for any kidney change) was a solid investment in my health. I didn’t have that available the week in August, when my bicycle tire torqued loose on a greenway ride, and as they say here in North Carolina, “I got tore up.”

A ‘skaters’ example of healthcare economics – A week after the accident, while doing a furniture pickup for that church group, a PA (physicians assistant) who pointed to a gouged-up leg and told me what I needed as an anti-bacterial to fight infection, THAT is a reason to use something. Within four applications, you could see results. Healthcare investment – $8, and thankfully, she was wrong about a possible torn ligament in my swollen ankle.

How often have YOU gotten by so easily with a total body smack health issue like this? https://cdtalententerprises.com/2020/08/18/bike-accident-low-grade-depression-match-us-mess/

Having worn a helmet since (luckily) just before the first time I truly needed it years ago, “An ounce of prevention is worth a pound of cure” is still a good way to look at things like COVID and masks.

That long-promised stimulus check is finally in the bank, and that’s an economic situation working out. I feel for the millions who don’t have even that much control over what’s coming next. I’ve worked from a depleted refrigerator and cupboards along the way, but I *could have* gone to get groceries; it hasn’t been a choice between the food and medicine, or rent. No insurance, I sure dodged a bullet on that score.

A primary personal healthcare habit

Two bike accidents since end of March lock down aside, I consider cycling a primary personal healthcare habit – it gets a major share of credit for my continuing good body maintenance. Regular shooting of baskets is a habit from way before any pandemic made solitary activities the rule, and after a week of lousy productivity, I recognized-rectified fact the CBD oil I neglected to order (300 mg) made a difference with ‘anxiety’ levels and focus.

‘A dark winter ahead’

Right now, the fact of 100,000-plus reported COVID infections daily should create some awareness among non-maskers that attitudes and actions need to be changed. The sheer math of projected 100,000 a day over 78 days from elections to when Biden (please God, give us a chance!) can put something in place instead of “herd immunity” nonsense, is going to be necessary for survival.

Healthwise, the entire Midwest – actually 41 states – are statistically on fire, and our healthcare front liners are already exhausted. Those aren’t resources we can replace like another box of wine in the fridge.

I have three brothers and a mother with underlying factors that make COVID exposure a real threat. Yesterday I brought flowers with a chocolate bar (cookies and cream) and a nice note to her senior community nurses. I don’t know if she still reads the paper regularly, but the note said she wasn’t going to get let loose for trick or treating, chew on this. Also, chocolate brings a similar reaction to being hugged, and this was best I could do because I couldn’t see her.

For any changes on COVID to begin will require many, many more people doing things they may not want to.

The only perfect healthcare solution available is petting the dogs or other pets. That’s always a freebie, an organic anti-stresser.

“In-place” Sunday on greenway, a moral lesson from bike accidents

20160528_192156
Sunday’s accident was a scraped knee, it could have been worse, like Memorial Day, 2016

Because the parks in Charlotte are blocked off to traffic, brother Steve came by Sunday with his carbon fibre bike, but he zoomed away as soon as we got to bottom of the ramp for the greenway behind the Hindu temple.

He’s considered essential with Wells Fargo, is looking for a workout when he gets the time, and using other brother Mike’s knobby tired, 21-gear mountain bike instead of my usual Miyata, I wasn’t worried about matching any training pace.

Sunday was an optimal day though, LOTS of people on the greenway, and whatever medical ungoodness is a fact of Life in America right now, being grateful for family and Carolina sunshine was working to lighten the load in a big way. Getting out again today, with mid-70s possible, has been part of a regular routine built around remote ‘gig’ work for most of two years.

I had an accident at the furthest point of my ride Sunday, right at Providence Road, and while I took some skin off a knee, kind of jammed two fingers, and heard my helmet scraping on the concrete, it could have been a lot worse, so lets talk health care.

2017 and ACA is the Standard

Cycling is more recreational training than a separate sport for me, I’m not even sure about the mileage of several urban routes I’ve used for years. I’ve had a couple glorious rolls in a peleton during three MS 150 Bike to the Beach fundraising rides with the Mojo Riders, and two-100 miles in a day (with a mountain in the middle) rides that required some extra training time to not get embarassed.

Since the earliest days, biking has been part of freedom, and it also gets most of the credit for keeping a solid fitness level (194) all those years of having a bum left knee. Biking meant I’d regained full range of motion after a late 2017 knee replacement, allowing me to walk versus have to skip across the street to avoid getting run over.

On Saturday of Memorial weekend, 2016, I was enjoying a ride like Sunday’s, when I became too enchanted looking at *something* and crashed into a curb, catapulting over the handlebars and face-planting on concrete. Everyone asks “Were you wearing a helmet?” but its not as helpful when your face is the contact point.

Four people stopped to ask if I was all right (I was bleeding, but not gushing), the EMTs arrived shortly thereafter, eventually there was an ambulance ride, and several nurses at Novant mentioned my good humor for a guy whose face was kind of messed up from sunglasses and concrete scrapes. (No, the nose was like that long ago)

The puncture wound – deep but not long – in bony (protective!) area over my right eye took six stitches, but the fact I was still using BOTH eyes to see was a great reason to be excited.

The two times I’ve really needed fixing up, the Affordable Care Act worked for me. On the top line, that bike accident was $6900 – I paid $325 for the $900 ambulance, and my $100 deductible. 

Knee replacement and rehabbing,   with a top line of $28,700 changed my physical trajectory for a small fraction of that from me, and no one will ever convince me “Obamacare” didn’t work exactly as I needed it to. A huge difference maker, you betcha .

There is zero respect for the social club member who pooh-poohed it every step of the way, but got HIS knee worked on with explanation that, “He shouldn’t be only person who didn’t take advantage of the (terrible, over-reaching, Democrats forced on us) program.”

CHOICES and Reality

What seemed like a legitimate analogy, even a moral, came with a two-beer examination of just how lucky someone can get while putting a bicycle into some rocks.

Maybe its germaine that having missed a deadline for submitting a simple tax form by one day several months ago, I’ve been “skating naked” insurance-wise. Not that the premiums were exorbidant for me as a 63-year old single, but just ONE MONTH I’d be required to pay almost $1,000 before ACA coverage kicked in was more than I could handle. Statistics indicate a lot of people are that close to similar lines.

So nobody else was going to pay for an emergency room visit when, in the moment I asked two ladies “How much further to the end of the greenway?” my foot slipped off the flat pedals of the clunky mountain bike, I lost my balance touching down, different brakes, boom! I’m down.

The two ladies come over to check on me, and I’m smiling from six feet away, feeling lucky there’s no real problem. The bike isn’t damaged, I tell them the same story about last accident, and away I go.

Community spread –  my biking example

When I needed first responders for that 2016 accident, the number of people involved:  4-6 drivers with passengers who stopped to help, with thanks again for the gent who delivered my pretzeled bike to the house. Plus two EMTs checking me out, two ambulance people, probably 4 nurses along the way, a doctor, and my sister in law who picked me up.

That’s 16 people, minimum.

It only took one instant, with the right answer directly in front of me, (“duh, the new section ends at Providence) and a flat pedal situation almost got me messed up. I don’t know how I’d handle a major economic hit for that.

Watching this situation about a renewed spike with COVID-19, protesting in-place regulations as tyrannical, and I think of elder care, where it truly only takes one careless moment for someone out and about at a protest among often unprotected others, to kiss their favorite aunt or grandmother, to touch a child, and THAT triggers “more.”

Freedom of speech, “except for yelling fire! in a crowded theater” was the theory I heard growing up. What’s righter about that gridlock stuff? 

20190727_192905
This scene at Whitewater Center isn’t the way of the world in April, 2020, but social distancing is going to be a byword for foreseeable future.

And for God’s sake, that old expression about “If you can’t be part of the solution, at least don’t contribute to the problem,” still works. Causing traffic jams that prevents those front line people from getting to where they’re needed, that is SUCH a negative.  That nurse blocking a pickup from jamming up a crosswalk, that’s an American I’ll shake hands with – well, at some point.

 Picture 
Glenn Shorkey – Creative eDitorial Talent Enterprises 
(704) 502-9947