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Shortly after we returned from vacation (Apr 1) Richard picked up a 90-day prescription for his diabetes medicine, refilled his pillbox, and promptly misplaced the bottle in the post-vacation chaos. 10 days later when he tried to refill his pillbox he couldn't find the bottle. We've looked everywhere. This is the first time either of us has misplaced a bottle of maintenance meds and we don't know quite what to do. 

This is complicated by the fact that he was in the middle of getting his dosage increased, so he had two prescriptions on file from two different doctors but still doesn't have any pills on hand. He's talked to the pharmacy, which gave him a few extra pills while they "tried to contact the doctor" but it is not 100% clear which doctor. They claim "the doctor" is not replying despite repeated attempts.

Since it is now effectively impossible to talk to your doctor in person without a 2-3 month lead time, I've been sending MyChart messages. The nurses who respond to these messages seem confused by the complexity of the situation and are assuming that we weren't able to fill the 2nd prescription, which is not the problem. 

The problem is that he had the pills and LOST THEM. I'm not sure how that situation is supposed to be addressed. Do we really need another prescription? An early refill?  A refill that we pay for out of pocket (since I doubt insurance will pay for lost meds)? 

Has anybody here ever been in this situation? 
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 Richard and I are back from Oregon, basically feeling fine but still testing positive for COVID. It's been 8 days since Richard first tested positive (6 for me) and we only had noticeable symptoms for a couple of days. The test line no longer blasts forth within 15 seconds, but it does develop eventually. Probably aren't super-contagious at this point, but trying to be careful. So we're cancelling tonight's game party and skipping the Minnstf meeting tomorrow. 
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Our son Thorin appeared to have an unremarkable  cold when we left town on Tuesday, then called on Thursday (July 4) to let us know that he had tested positive. Richard had been coughing a lot - uh oh. Sure enough, his COVID test line lit up within SECONDS, even before the control line.   I made an unsuccessful attempt to contact his doctor back home to get Paxlovid prescribed, but Richard is actually doing fine without it. A little hoarse and sniffly and sleeping a lot, but hardly seems sick. My test was negative on the Fourth, but I wasn't feeling so well last night and plan to test again today. Probably puts the kibosh on today's tentative plans for OMSI (Science Museum). 

Other than that, and the heat wave, it's been a great trip so far. The kids loved the toys and "new" computer I brought them and we had a WONDERFUL day at the local amusement park on July 3. After sleeping most of the day, Richard felt well enough to set off some little fireworks for the kids on the 4th, which sent them into delirious excitement. We didn't have any big plans for the trip anyway.  *sigh*
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Last Sunday I attended the DFL District 62 Convention at Washburn High. It was the usual mixture of fascinating and intensely boring. The best part is probably meeting the candidates, or at least seeing them speak in person. And It's kind of interesting to see how government works from the ground up, even the boring parts. One thing about government at this level is that you have a lot of down time in which to get to know your neighbors (much of the time you are sitting in a tight group with the other delegates from your precinct, which in Minneapolis means that they are all people that live within about 6 blocks of you). TIP: try to change seats within the precinct seating every now and then so you don't have to make conversation with the same stranger for 6 hours.

At one point I took a break and went out in the hallway, met some enthusiastic young Samuels volunteers, and the next thing I knew I was creating a sub-caucus for them. (They couldn't do it because they were staff, not delegates). That turned out to be more fun than I expected. We merged with the other Samuels sub-caucus, sent out scouts to Uncommitted/Issues caucuses on the other side of the auditorium, and managed to grow our sub-caucus from 16 to 28. This gave us enough for TWO delegates! And then we had to figure out how to pick our delegates and alternates, which is not as intuitively obvious as you might think. Nobody in our group was very experienced at this, and a couple of the natural leaders that emerged had radically different ideas on how it should be done, but it was worked out peacefully in a surprisingly short time. Kind of like an escape room, with all the emergent group problem-solving. Really, there's nothing in caucus-based politics more fun than a walking sub-caucus. 
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On Monday I had a cardioversion procedure at Methodist Hospital to get me out of persistent AFIB (Atrial Fibrillation). It's the 3rd time in 3 years that I have had to do this, which I can live with. If it gets closer together I might consider drug therapy, but the last time I tried that the treatment was worse than the problem, so I'd rather not. Two days before the procedure I impulsively ordered a Kardia Personal EKG monitor so that I would be able to see if the cardioversion worked or not without having to wear a Zio monitor. I'm glad I got it, because (like last year) it took a few hours for my heart to settle down into a normal sinus rhythm. Once it finally managed that, it's been fine, and I feel considerably less anxious about it. 
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It is now a month since Richard's pneumonia and he's doing fine. The antibiotic they chose briskly dispensed with the unidentified pathogen, and the lingering cough has finally cleared up. Curiously, a nurse has called 4 or 5 times since he was discharged just to see how he's doing. It's nice to know that they care, but... why haven't they ever called about anything else? Nobody called me to see how my heart was doing after the cardioversions. I don't remember anybody calling him after his hip replacements, or even the heart bypass. How about you? Has any medical establishment ever called to see how you were doing after a medical procedure?  
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 Originally they expected to keep him for 3 nights, but he was doing so well that they discharged him today. He is still coughing but back to his usual self. He didn't find the hospital stay too onerous, and managed to watch SEVEN superhero movies on the TV. 
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He was out of bed eating lunch when I visited today, and looked great. Better color, better spirits. They expect to keep him 2 more nights to finish up the medication protocol (5 infusions/day of 2 different heavy duty antibiotics)

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I crawled home yesterday about noon and took a nap. When I called hospital they had him in a room, so I went out to visit. It's a beautiful private room with a  couch and lounge chair and a view of the nature paths behind the hospital, but he was too cranky to appreciate it. He's a lot sicker than I realized initially, but the nurse and respiratory therapist (both lovely) seemed pleased with his progress. His fever is now  gone completely (97.6) and he is concentrating on his number one job - coughing up the mucous clogging his lungs. 

He was a little happier once I helped him figure out the TV controller and locate a Marvel movie (which looked incredibly unappealing to me, but it was one he hadn't seen, so he was mildly excited about it). I also brought him a book and his reading glasses. The good news is that he is alert and coherent enough to read and watch movies (even dumb movies), which was not the case when I brought him in. 

It's now 11;30 on Monday, and I managed to get 10 hours of sleep and a shower. I had lost most of TWO night's sleep right in the middle of my own pretty bad cold, so I was hanging on by a fingernail there. I'm still coughing and honking, but I feel much better. Heading out to Methodist to see how he's doing. 

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Thorin and I took him in at 4-something am this morning and spent about 5 hours in the ER (Methodist Hospital).  He had a wracking cough, fever, low blood oxygen readings, physical unsteadiness, and confusion. The fever was never over 102 and the oximeter readings were inconsistent, but the last two symptoms were very disturbing. 

It's a good hospital. They were very thorough, testing him for UTI, COVID, RSV, flu, strep throat, and abdominal obstruction. Everything was negative except the obvious: pneumonia in one lung, lower lobe. More specifically: "Airway thickening with mucous plugging particularly in the lower lobes. Patchy peribronchial infiltrate in the right lower lobe. Mild bibasilar atelectasis"

They started treating him right away with fluid infusions (he was seriously dehydrated), Tylenol, and a couple of big doses of antibiotic. After a couple of hours of this he was much less feverish and more coherent. I hesitate to say "better" because once he was more aware of what was going on he became increasingly uncomfortable and unhappy, especially when he realized that he would have to stay overnight. Probably 2 or 3 days, in fact. When Thorin and I finally left a little before noon he was still in the ER exam room waiting for a room to open up. 

When I asked ER doctor how bad the pneumonia was, he cheerfully said, "At least it wasn't septic shock."  Indeed. Yes, Terry G was on my mind. 



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tldr; if you are on Medicare and have Health Partners insurance you might want to read this. 
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Richard and I have a Medicare Advantage program with HealthPartners, which we have been generally quite happy with. Sufficiently so that I have become quite lax at doing that thing where you review your health insurance plan every year, looking for gotchas and unfortunate changes. This year I was surprised to receive a couple of shiny white debit cards in the mail. They just say "Health Partners" in big letters, but on careful inspection I spied "Choice Card" in tiny white on white embossed lettering. This forced me to start trudging through the murky pathways of the HealthPartners website looking for the explanation. I took one wrong turn, leading me to a completely different Choice Card that seems to be some sort of FSA? Nope, it's not that. Finally found it. Here's the link, as a public service for other HP customers who are currently staring in confusion at their unexplained new cards.

Guess what! It's a new benefit! A rather obscure and limited benefit, but don't look a gift horse in the mouth. This card can be used to pay for certain "expenses not covered by Medicare" up to $475/year!  You can only use it for 4 things: chiropractic care, prescription eye ware, hearing aid products from one specific company, and home-delivered meals from one specific vendor (but only right after you get  home from rehab care). The "Mom's Meals" benefit is hilariously niche, but the prescription eye ware benefit can apparently be used at any optical service. Perfectly timed, since I really need new glasses. Wow!

While I was at it, I followed a helpfully placed link from the Choice page to something labeled "OTC benefit" and discovered another hidden program that gives you $50/quarter for drugstore stuff: vitamins, bandaids, pain relievers, sunscreen, bedpans, etc. This one did NOT come with a card; you have to order online from the limited list of products on their special portal. But hey, it's free stuff that anybody can use: $400/year for the two of us. Nothing to sneeze at. I struggled through their extremely broken registration process, managed to get our accounts established, and verified that there is indeed $50 credit in each account. I placed an experimental order for a knee brace and a couple of replacement cane tips for Richard. Curious to see how long it will take to get here.

I also discovered through closer scrutiny of my plan benefits that Medicare insurance covers prophylactic dental care even if you don't spring for the ridiculously expensive extra dental insurance. We've been going to the same dentist for the past 30 years or so, and I never updated our insurance info when we went on Medicare (because I did NOT buy the dental insurance, so I thought it wasn't covered). So we've been paying out of pocket for exams and cleaning for 8 years when we didn't have to. D'oh!  Note to self: give insurance info to the dentist at next appointment.  
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That's the handy-dandy home sample alternative to a colonoscopy. Good to know. 

Other than that, it hasn't been a great week. Dentistry, sewer line woes, and second-hand tragedy.  
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 I had a scary looking thing on my hand that was growing like wildfire and pretty much matched the description of squamous cell carcinoma. Six weeks ago it was just a flat brown spot pretty much like all the other age spots on my hands except larger than most (about 1 cm). Then sometime in mid-October a small scaly patch appeared, getting a little bigger each day.

By last week the scaly patch covered most of the brown spot, had thickened a lot and developed a depression in the middle. All of this is characteristic of squamous cell, including that dimple in the middle, so I decided I'd better get it looked at. Health Partners online scheduling is useless when you actually need care within the next 3 weeks and they don't answer the phone any more, but my clinic responds well to online messaging and I managed to get an appointment for the next day. Without any prompting from me, the doctor said it looked like squamous cell and did a biopsy. She also put an "urgent referral" in my chart which allowed me to get an appointment with a dermatologist for just 6 days later (even she was surprised that worked!). And she somehow prioritized the biopsy request so I would actually get a result before the dermatology appointment. I guess that worked too, because I got the results today.

I wasn't familiar with many of these words, but the word benign stood out.
 
Sections show a lichenoid tissue reaction.  The differential diagnosis includes a benign lichenoid keratosis as well as a lesion of lichen planus. There is no evidence of a melanocytic proliferation in the sections examined.
 
Of course I looked up the rest of it and learned that a lichenoid tissue reaction is an "auto-immune attack by T cells on the epidermis" that can manifest in all sorts of forms, very few of which look at all like the thing on my hand. It's most commonly caused by a reaction to various medications and vaccines, in which case it is referred to as Lichenoid Drug Eruptions (LDE). When the precipitating factor is a vaccination, it is sometimes called V-ILE (Vaccine-Induced Lichenoid Eruption). Memorable acronym. 

There has been no change in my medications for at least 18 months, but ... 
  • October 8 I had an RSV vaccination, which was (naturally) new to me
  • The keratosis on my hand appeared about a week later. 

Smoking gun? Maybe. I'll mention it to the dermatologist and see what she thinks. V-ILEs have been associated with a number of vaccines: influenza, hepatitis, shingles, COVID, and others. So far not the RSV shot, but it's brand new. And although this is apparently a well-documented vaccine side effect, it is described as "uncommon." 
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... inconveniently while visiting in Portland. It is very much like COVID except with less sore throat (and 2 negative COVID tests), Just sick enough to feel sorry for myself, but if the cough stays where it is in the upper respiratory it will end up in the rear view mirror as a mild one. But I am prone to bronchitis and post-viral asthma with fall colds, so not out of the woods yet. COVID isn't the only disease with post-viral sequelae. 

Should have known this would happen as soon as I posted about not having a cold for 3+ years. 
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Believe me, I'm not complaining. I'm normally a pretty healthy person, but typically I get 2 or 3 colds per year which are bad enough to make me miserable for a week. I'd be thrilled to never catch another. I just wonder why?

In November, 2019, I caught a mild cold in the airport on the way to Portland, just before COVID made its appearance on the world stage. I may have had another very brief cold in February 2020 on a subsequent Portland trip, but it only lasted 2 days so I wasn't sure. But I haven't  had a cold since, and that was 3-1/2 years ago.

The first year I figured it was because everybody was isolating and wearing masks. As I recall, influenza mostly disappeared for that year too. Okay, that makes sense. In 2021 came the vaccine, which was actually quite effective against infection with the earlier strains of COVID, so life became a little more normal. But I was still avoiding crowds and masking frequently so it didn't seem weird not to get sick. In 2022 things opened up a lot more, and I did finally get COVID in August. But still no colds. Now another year has gone by and I still haven't had a cold (or anything else, for that matter) despite the fact that I'm now socializing indoors and rarely masking.

Is it the COVID vaccine? Although I'm no longer observing the pandemic protocols, I have managed to get vaccinated every 6 months since April 2021. The same grandchildren that brought me COVID in 2022 have continued to expose me to their school-borne sniffles on a regular basis, but to no avail. Richard is similarly well-vaccinated, and I don't think he's had a cold either. Has anybody else noticed this? 

There hasn't been a lot of study on this, because colds just get no respect. But many colds are caused by coronaviruses, after all, so it wouldn't be totally surprising.  I did find one article that cites some evidence to that effect, but it's pretty preliminary. 

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I injured my foot on Wednesday at about 11 am. My Internet-fueled diagnosis was "Grade 1 Sprain." I applied the recommended (and obvious) treatment: ibuprofen, cold packs, elastic wrap, sit around with my foot elevated and whine. The Internet predicted that the swelling should go down in 48-72 hours, and it was starting to get minimally better by the 2nd day. Then on Saturday morning (exactly 72 hours) I suddenly realized that I could walk on my left foot!  Slowly and painfully, but at least I was no longer dragging the foot behind me on the ground. I was even able to get a shoe on! So clearly the swelling was WAY down, if not completely gone. Attended the Minnstf meeting on Saturday and nobody even noticed that I was limping a little. On Sunday I actually biked to the Farmers Market and back (a grand total of 2/3 mile, but less painful than walking, which is what I was trying to determine).

So it looks like it's  going to be fine. I'm not quite up to trying another trip around the lake, but maybe later this week. 
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 Two days ago I was boasting about how I had built up my biking stamina over the summer, and was looking forward to taking advantage of today's predicted beautiful weather to maybe do a longer bike ride. Then I tried to walk across my kitchen, somehow got my left foot wedged under a half-closed freezer door, twisted it hard as I fell, and sprained my foot. And just like that, I'm temporarily disabled for who knows how long. 

It appears to be a classic Grade I sprain: localized swelling, skin discoloration but not an actual purple bruise, tender to pressure but not intensely painful. Unfortunately it doesn't take much swelling in the mid-foot to make walking impossibly painful. My foot doesn't hurt at all unless I stand up, and then it hurts so much that I practically fall down. *sigh*  The Internet says that the swelling should abate in 2-3 days, but of course full healing will take at least a couple of weeks. No telling when I'll be able to bike again, which probably means that I'll be starting from scratch again building up stamina. I am disgruntled. 

I'm not even going to try to get a shoe on for another day, just sulk at home. But if I can walk a little better by tomorrow this might be a good time to focus on boring indoor activities like getting my drivers license renewed. 


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It's August 15, which (as I still have to remind myself every year) is the beginning of fall in Minnesota. And just like clockwork, here comes the ragweed pollen!

Just posted as a reminder to myself and a heads-up to others with hay fever.


Oookay

Aug. 12th, 2023 09:39 am
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Lake Harriet bandshell: you never know what you’ll find.

In this case, a giant pair of inflatable lungs and about 2 million people in red t-shirts running, sauntering or lounging around as a band delivers an impassioned performance of "Girls Just Wanna Have Fun."


In other news, I just biked around Lake Harriet for the SIXTH DAY IN A ROW (a 5-mile round trip from my house). While this may not sound like much, being able to do this repeatedly without a day or two of rest afterwards does represent an improved level of fitness for the summer. It probably means that I could bike 10-12 miles in a single day if I really wanted to (although then I really would have to rest up afterwards). 

ETA: Strictly speaking, although I did bike 5 miles each day it wasn't always around the lake.  Once was to the Wedge to buy lentils and crystallized ginger and once was to Uptown to get my ears pierced. But I have biked 30 miles in 6 days. 



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In this case, the ever-enthusiastic silver maple. Which doesn't seem to be bothering my nose this year, but Holy Cow are my eyes itching! Nose is actually much better than 2 weeks ago (juniper/poplar presumably).

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My nose has been running non-stop with explosive sneezing for the last few days, but I'm pretty sure that I don't have a cold because
  • I haven't had a sore throat, which is ALWAYS my first cold symptom
  • My eyes are a little itchy, which is one of my reactions to pollen
  • Nose is cleared up immediately (for 4 hours, anyway) by those little red decongestant pills
I should have started taking them sooner before my nose got sore and all the wastebaskets filled up with used Kleenex, but they raise the blood pressure and I'd rather not do that. I also should apply some allergy eye drops, but I'm too freaked out by the recent news reports of people losing their eyes to antibiotic-resistant infections from contaminated eye drops.

But I can't figure out what's going on. Usually Pollen.com starts sending me pollen notices in late March, but this year they insist that the local pollen count is Low. Is anybody else in Minnesota having hay fever type symptoms? 

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And it wasn't particularly easy. I waited until 3 months past my COVID infection and then discovered that there was a month's lead time on scheduling vaccines at Health Partners. Cub Pharmacy seemed to have loads of appointments, but the scheduling engine was completely broken (which I suppose is why all those appointment slots were open). I found out later that they did accept walk-ins, but you couldn't tell that from the website. 

The Walgreen's scheduling engine worked fine, but there were no appointments anywhere in less than a week and no convenient ones in less than 2 weeks. I went with convenience over urgency, and my appointment finally came up yesterday. Went relatively smoothly, except for having to fill in the check-in form again on paper because they couldn't retrieve it from the computer system. The shot itself is so tiny - I literally didn't even feel it. My arm is a little sore today, but no other side effects. I got my flu shot last week (walk-in at Cub) so I don't have the double sore arm problem. I'm glad I didn't get both shots at once, since last week's hi-dose flu shot gave me a sore arm for a week, much worse than usual. 

The guy who gave me my shot said that demand has been sky-rocketing in the past week or two as people look towards the holidays. There has been a lot of official hand-wringing over the low uptake of the new booster, but I can't help but think this is partly illusory. Perhaps the health care establishment hasn't noticed that they are providing 3 contradictory sets of advice on boosters (as well as giving the impression that boosters are trivially easy to schedule, which I did not find to be the case).
  1. Get your booster NOW NOW NOW! Do not delay! This is very important!
  2. Unless you've had COVID in the past 3 months (as maybe 20% of the population has) in which case you might as well hold off
  3. Or unless you have travel plans in the next few months, in which case you should wait
I'm probably not the only person trying to follow recommendations 2 and 3, while underestimating the scheduling issues.