Nanny State, Medical Division

Another bitch this old grouch has is the way our nanny state funnels business to medical practitioners. "Do you have a current prescription," is the lead up to, "We can't........ without a current prescription," usually with a barely disguised smirk.

I need to replace the lenses in my glasses. The frames are fine, but the lenses are scratched. My prescription hasn't changed in thirty years. For many years I used a wholesale lab, man and wife operation, that furnished glasses to the opticians. As long as my money was good, they didn't care. I don't know if they were libertarian minded, or just Jewish, it worked for me! They retired, and closed down their business. Drat!

I had a physical a year ago. The people were insistent I have a $2800 sleep study. "But your insurance will pay for most of it," is the first thing out of their mouths. Yeah, like that is "free" money. Copay and deductibles? Deer in the headlights look.

Diagnosed with obstructive sleep apnea in 1993, I've slept with a CPAP every since. If I want to upgrade my CPAP, or buy a new one, I hear the "prescription" song again. I've even heard it while trying to buy a new mask or supply tube.

So, the grey market. Hello Craigslist. 

Why, when we see medical people, are we suddenly subject to myriad rules and regulations? It has taken over a year for the Physicians Assistant I see to understand I will not do anything, or take anything, without a clear understanding of the reasons thereof.

But WSF, You don't understand. We.............. Your are right, I don't understand, don't care, and will not participate.

Just because I'm one tiny one out of a population of 310,000,000 or so doesnt't mean I can't be an Army of one. 

Remora Feeding Frenzy

Received by snail mail from the Social Security Administration, Form SSA-4926-SM (1-2012), detailing my 2012 “Benefit Amount”. Nice, off the top they deduct $1,198.80 for Medicare medical insurance. Not mentioned is few mainstream medical practices are accepting new patients.

I am extremely fortunate my city has a good public health clinic. Copay visit is $15. The care is adequate. Kind of like Sick Call in the Military.

(Thanks, Sisty, for your many years as a board member)

Now, if I don’t have supplemental insurance then I pay more. I don’t understand it all, and don’t want the brain damage of learning. My sister, who does understand, and the insurance broker in her building, hand me forms and tell me what to do. All I know is I have United Health Care, the outfit that gave their founder a $1.5 BILLION Golden Parachute, and is so close to AARP I think they are the same. While I despise both organizations, my broker tells me this is the cheapest way to go. Ah, money beats principal once again.

The tangible “benefit” is my generic blood pressure placebos are costing pocket change at Walgreen.

I do keep my VA status up to date. My children have been instructed, in the event of my becoming incapacitated, to drop me off at the VA Hospital entrance like an unwanted pet, and drive off.

Even the mainstream press report massive Medicare fraud. Didn’t the Lightbringer, he of the most transparent administration ever, promise to go after the fraud? Wasn’t that a centerpiece of paying for Obamacare? Perhaps when the political donor dollars were tabulated, money beats principal once again.

Seems the Remora have been feeding so long, and so lavishly, they are now part of the “entitled classes”.

I’m getting my “entitlement”. Never mind I’ve been paying into the program since 1958.

Sleep Apnea

A relative suggested I write about my experiences with obstructive sleep apnea. You can find more information at

http://www.webmd.com/sleep-disorders/sleep-apnea/sleep-apnea

I have always been a heavy snorer. This caused many personal problems with other people trying to sleep in my vicinity (camping trips, house guest, military barracks) and was a huge negative in my marriage.

My father died in his sleep at age 64. He was very fit. His Levi’s waistband was probably within one inch from his twenties. In later years, with better information, we now realize he showed all the signs of classic sleep apnea. He was a loud snorer. If you know someone who snores, who stops breathing for a minute or two, then snores again, they need to be checked. That minute or two is the only time they are completely asleep.

By 1995, my problem had grown so bad I fell asleep at red lights. I once fell asleep on a test drive; my customers woke me up. My general manager called me in. He pointed out we had HMO health coverage. He flat put it to me, get tested NOW or get fired.

Boring, but typical story, navigating Seattle Group Health’s rat maze, finally got me to the sleep order clinic. Much arguing led to me taking the equipment home, attaching the various leads, etc. and returning the equipment the next day (hint: Do shave the area the stickum adheres to).

Later the next day I start getting calls from the lab; they want to see me now. I’m busy and try to stall them. They finally call my boss. He explodes, tells me, “You damn mule, get your ass over there.”

At the lab, I meet the MD who is in charge. He starts off nice, showing me video screens with colored line and explains what they represent. He sees I’m not convinced so he smacked me with a 2x4 with the following.

“Mr. ______, I can tell you, with absolute certainty, that within six months you will have a major medical event. It may be today, next week, next month, but within six months it will happen. If you are lucky, it will kill you. Otherwise, you will be an invalid. You do have available to you, don’t you, constant nursing care for years to come? No, well you will require it.” Silence. (As a salesman I admired his closing skill) Finally, I said, “And my options would be?

Two days later I was using a CPAP. Other than one trip where I forgot it, one trip where I forgot the power cord, and a few nights when the power has been out, I’ve slept with a mask on my face and air blowing up my nose every since.

CPAPs and masks are a pain. You nose itches and sweats. Moving around the bed is restricted. You must make up your mind that you will use it, period, no excuses or rationalizations. CPAPs add new considerations for travel. Security check points, weight and space problems, and where is an outlet? I pack a 25’ drop cord to insure reaching an outlet. As an aside, I end up looking behind night stands and under beds for outlets. Rarely are those areas clean in the motels. Camping, or sleeping anywhere with out power, is a problem. Most CPAPs are set up to run on 12 volts. How far do you want to pack a battery? After one night, how do you recharge it?

For me, the biggest hassle has been dealing with the medical folks and, especially the medical appliances folks. Need a replacement anything? We want a prescription. Prescription? Need a new sleep study (at about $5,000 or so).

I love Craigslist, Google, and Ebay. All of my replacement CPAPs I’ve found on Craigslist. Those oh so secret adjustment manual the respiratory techs use are on Ebay. Now, I would happily pay the techs for their expertise if it didn’t come with the whole “need a prescription” deal. I can hear them saying now, “But we are required …………”. You are, I’m not. I’m a scofflaw.

The principal benefit to using the CPAP is, I’m still alive. Within the first six months, I lost over a 100 lbs. My blood pressure normalized (for me, 170/95 - bite me). My energy level zoomed. My sex drive became stronger; horny as a teenager (bit of a problem as I was divorced). According to those who had to deal with me, my personality went from “Impossible” to “Aggravating”.

I’ve never used things like humidifiers and supplemental oxygen. My nose won’t tolerate Nasal Pillows. I see ads for non CPAP solutions but have never perused them. What I have works for me.

Hope this can help anyone dealing with sleep problems, themselves or people in their lives. The machines have improved, and their size and weight are down. For some, surgery can help.

For those without health insurance, you may need to go the self help route. Google is your friend. Don’t fear it. My experience is the machines won’t produce enough pressure to harm your lungs. Crank it up till the mask starts fluttering then turn it down a notch or two.