I had a visit to ortho last weekend because my knees still hurt from the five point landing I had when I tripped back two months ago. They took x-rays to make sure that I hadn't chipped anything (I hadn't) and while looking at the pictures, the PA commented that they showed that I'd had Osgood-Schlatter disease.
Since no one has ever mentioned that to me, I asked what it was. Apparently if your bones don't grow in sync with the soft tissue, the pull on the bones causes some very minor remodelling which shows on the films even much later in life.
As soon as he started describing it, I said, yes, indeed, I had had something like that. Starting when I was about 11 or 12, I had awful knee pain, especially after activity. Not that I was very good at it anyway, but I'd had to give up ballet lessons, because after one one hour class I wouldn't be able to straighten my leg for about three weeks. I saw the ortho at St. Joe's (who also looked at the UofM football team's knees) and he poked and prodded, maybe there was an X-ray, and told us not to worry, it was just growing pains, and he described it exactly that way, as the bones growing first and the connective tissue having to catch up. From then on, I always knew when I was having a growth spurt, even in my 20s, and during my last 1/4 inch just before my 31st birthday.
My knees have enough problems now, thankfully that's no longer one I have to worry about.
Showing posts with label Medicine. Show all posts
Showing posts with label Medicine. Show all posts
Saturday, August 15, 2015
Sunday, July 07, 2013
Joys of Testing
I get to spend an exciting day tomorrow at the cardiologists' having a stress test and a nuclear stress test done. Hopefully we'll figure out why my chest keeps hurting, I'm short of breath, exhausted all the time, and retaining tons of water (worse than either of my pregnancies, though I retained so little it wouldn't be hard to retain more). At this point, I'd be happy for them to find something wrong, just so we know what's going on, and can maybe do something about it.
Friday, September 07, 2012
When you've lost the Daily Show.... where in I vent, and really wish I had a stiff drink.
Ø seems to have lost the Daily Show. I admit that while I don't go out of my way to watch it, I've usually enjoyed the bits I've seen, because even at it's most pro-Democrat, Stewart didn't seem to be mean the way folks like Bill Maher were. There have also been more than a few times when he seemed to be trying to poke fun at the administration, but something, whether his network, or his own personal biases, was holding him back. I also never got the feeling that he was hiding his personal feelings on the matter to try and come across as neutral.
But since the DNC convention started Stewart seems to be really going to town. I wonder if he and his writers are getting out all the pent up frustration of the last four years now that they're finally allowed to mock Ø, in spite of his "historicalness".
My parents still seem to be totally in the tank, Ø inherited a much worse mess than we expected, you can't trust anyone who fact checks the White House, even if it's part of the MSM, etc., etc., etc. I called them earlier about something and heard Daddy have hissy fits in the background over the employment figures. I may have misunderstood what my mother was saying, but it seemed that he was upset because the media wasn't buying the White House's rose picture of how getting people out of the job market so that the U-3 figure goes down is a good thing.
If, God willing, we get an R in the White House as well as an R congress, it will be interesting to see their cognitive dissonance, especially if the economy picks up faster than expected. Mother's take is that she almost hopes Romney wins so we can see how bad things really are, and that he can't fix it any faster than Ø has. Of course if R/R win in November, I expect the economy to start taking off immediately, the same way that it tanked as soon as Ø won in '08. Of course Bush was responsible for that tanking, because he was still president, and a Democratic Party controlled Congress, and the knowledge that a far left/marxist sympathizing (at best) President was going to take over in two months couldn't have had anything to do with it. Likewise if we see improvements after November but before swearing R/R in, it will all be due to Ø's fantastic policies, and we should have just given him that extra four years.
Sigh.
They will never admit that JFK was probably to the right of Romney; although they idolize JFK, they've been brainwashed to assume that the Dems have always been as they are now, and that that is always best for anyone who isn't a millionaire, and why would anyone who isn't a millionaire want to vote against their personal interests? These are the same people who when I pointed out where things were going with the passing of ObamaCare, told me that there was no way companies would stop providing employee health insurance because they want to keep good workers. (Of course they'll also agree that companies don't give a crap about their employees because they just want the profits.) I've shown them the articles where benefits companies tell how 50% or more of their clients are planning or at least considering dropping benefits and dumping their employees on the exchanges.
I wonder if they'll pay all my other bills when work drops coverage, and the government unilaterally changes their contract with my Navy retiree husband and starts making us pay for our Tricare, to the tune of what we'd have to pa on the exchange, which for us is 9.5% of our total income, which will be over $7000, up from my current $2K and his free. I don't know about anyone else but we don't have a spare $100 a week lying around and of course there will still be significant co-pays and stuff we need like new glasses for growing girls that isn't covered. As it is, if we don't get an extension on the Evil Bush Tax Cuts for the Rich Only (TM) and the SS deductions go back up that 2%, we'll be seeing at least $50 less a week after January, not to mention gas going up, oil going up, groceries going up, etc., etc., etc. And if, God forbid, all this were to come to pass, they would never believe that their vote choices might have had anything to do with it.
But since the DNC convention started Stewart seems to be really going to town. I wonder if he and his writers are getting out all the pent up frustration of the last four years now that they're finally allowed to mock Ø, in spite of his "historicalness".
My parents still seem to be totally in the tank, Ø inherited a much worse mess than we expected, you can't trust anyone who fact checks the White House, even if it's part of the MSM, etc., etc., etc. I called them earlier about something and heard Daddy have hissy fits in the background over the employment figures. I may have misunderstood what my mother was saying, but it seemed that he was upset because the media wasn't buying the White House's rose picture of how getting people out of the job market so that the U-3 figure goes down is a good thing.
If, God willing, we get an R in the White House as well as an R congress, it will be interesting to see their cognitive dissonance, especially if the economy picks up faster than expected. Mother's take is that she almost hopes Romney wins so we can see how bad things really are, and that he can't fix it any faster than Ø has. Of course if R/R win in November, I expect the economy to start taking off immediately, the same way that it tanked as soon as Ø won in '08. Of course Bush was responsible for that tanking, because he was still president, and a Democratic Party controlled Congress, and the knowledge that a far left/marxist sympathizing (at best) President was going to take over in two months couldn't have had anything to do with it. Likewise if we see improvements after November but before swearing R/R in, it will all be due to Ø's fantastic policies, and we should have just given him that extra four years.
Sigh.
They will never admit that JFK was probably to the right of Romney; although they idolize JFK, they've been brainwashed to assume that the Dems have always been as they are now, and that that is always best for anyone who isn't a millionaire, and why would anyone who isn't a millionaire want to vote against their personal interests? These are the same people who when I pointed out where things were going with the passing of ObamaCare, told me that there was no way companies would stop providing employee health insurance because they want to keep good workers. (Of course they'll also agree that companies don't give a crap about their employees because they just want the profits.) I've shown them the articles where benefits companies tell how 50% or more of their clients are planning or at least considering dropping benefits and dumping their employees on the exchanges.
I wonder if they'll pay all my other bills when work drops coverage, and the government unilaterally changes their contract with my Navy retiree husband and starts making us pay for our Tricare, to the tune of what we'd have to pa on the exchange, which for us is 9.5% of our total income, which will be over $7000, up from my current $2K and his free. I don't know about anyone else but we don't have a spare $100 a week lying around and of course there will still be significant co-pays and stuff we need like new glasses for growing girls that isn't covered. As it is, if we don't get an extension on the Evil Bush Tax Cuts for the Rich Only (TM) and the SS deductions go back up that 2%, we'll be seeing at least $50 less a week after January, not to mention gas going up, oil going up, groceries going up, etc., etc., etc. And if, God forbid, all this were to come to pass, they would never believe that their vote choices might have had anything to do with it.
Monday, July 27, 2009
Why I don't favor a rush to "fix" health care
I spent several years on Tricare (it's still my secondary), and rather longer before that in Ireland in their NHS system. Which is why I worked hard to get a good job so I would have something NOT run by a gov't. The Navy tried quite hard to kill my eldest child, and I still have occasional problems stemming from the post-appendectomy abscess in Galway ("Oh, but 10% to 20% of all appendectomies get post-op abscesses!")
At least HR 3200 is currently not quite as bad as HR 676 - Medicare for all! No co-pays, ever! No for-profits of any kind anywhere in the health care system (we'll buy them out forcibly)! The gov't will decide in advance how much they will allow a geographical region to spend on care for the year! (Ask the UK how that's doing - no money for cleaning and other basic supplies.) A rather Orwellian/Soviet-sounding "National Board of Universal Quality and Access"! What could go wrong?
Yes, the current system needs some fixing. But handing it over to gov't bean counters to decide whether the only treatment that will cure me is "cost-effective" or if I’m far enough up the queue is not something I ever want to deal with again.
One place to start reform is letting the uninsured pay the same as is accepted from insurance. I've been charged $70 for an inhaler when Tricare's computers were down and there was no proof that I was still insured. Two days later when they were back up, the pharmacy accepted a total of $40 between insurance and co-pay for the same med. But federal law requires that they charge the uninsured full freight, even though they must accept the lower amount from the feds. Why should a lack of insurance mean you have to pay 50-100% more for all your medical care? I'd like to see a provider being allowed to recieve the same amount for the same service, no matter who pays. The feds are responsible for that, so they could fix it pretty fast, if they were willing to. However, if they did, they'd have to up what they pay, since providers tend to lose money on the federal patients, and have to make it up on privately insured, and uninsured.
We could also buy basic private insurance for all the legally-here uninsured for far less over the next 10 years than the projected costs of HR 3200.
I just worry that if we get system which divorces end users even more from the costs, inspite of gov't rhetoric, the only way to contain costs will be rationing, and then we'll end up with folks dying of curable diseases, simply because it costs too much to do detection testing, such as pap smears on women under 25, because we know that they never get cervical cancer, or because at 80 how much use will you really get out of that pace-maker?
The problems with our current delivery of quality health care and - perhaps even more so - sick care are complex, and to ram through a fix on a rapid time frame, designed by who-knows-who, and voted on by legislators who don't even read, much less understand, what they vote on, just so we can say we "fixed health care!" will create even more problems.
Utah has what looks to be a distinct possibility in improving access to health care, MA's system is going (gone?) broke, Hawai'i tried something for kids which they had to stop within 7 months, because they didn't account for human nature and it cost way more than expected. Let's see how all these experiments work before we rush into fixing a damaged, but still functional-for-the-majority system.
At least HR 3200 is currently not quite as bad as HR 676 - Medicare for all! No co-pays, ever! No for-profits of any kind anywhere in the health care system (we'll buy them out forcibly)! The gov't will decide in advance how much they will allow a geographical region to spend on care for the year! (Ask the UK how that's doing - no money for cleaning and other basic supplies.) A rather Orwellian/Soviet-sounding "National Board of Universal Quality and Access"! What could go wrong?
Yes, the current system needs some fixing. But handing it over to gov't bean counters to decide whether the only treatment that will cure me is "cost-effective" or if I’m far enough up the queue is not something I ever want to deal with again.
One place to start reform is letting the uninsured pay the same as is accepted from insurance. I've been charged $70 for an inhaler when Tricare's computers were down and there was no proof that I was still insured. Two days later when they were back up, the pharmacy accepted a total of $40 between insurance and co-pay for the same med. But federal law requires that they charge the uninsured full freight, even though they must accept the lower amount from the feds. Why should a lack of insurance mean you have to pay 50-100% more for all your medical care? I'd like to see a provider being allowed to recieve the same amount for the same service, no matter who pays. The feds are responsible for that, so they could fix it pretty fast, if they were willing to. However, if they did, they'd have to up what they pay, since providers tend to lose money on the federal patients, and have to make it up on privately insured, and uninsured.
We could also buy basic private insurance for all the legally-here uninsured for far less over the next 10 years than the projected costs of HR 3200.
I just worry that if we get system which divorces end users even more from the costs, inspite of gov't rhetoric, the only way to contain costs will be rationing, and then we'll end up with folks dying of curable diseases, simply because it costs too much to do detection testing, such as pap smears on women under 25, because we know that they never get cervical cancer, or because at 80 how much use will you really get out of that pace-maker?
The problems with our current delivery of quality health care and - perhaps even more so - sick care are complex, and to ram through a fix on a rapid time frame, designed by who-knows-who, and voted on by legislators who don't even read, much less understand, what they vote on, just so we can say we "fixed health care!" will create even more problems.
Utah has what looks to be a distinct possibility in improving access to health care, MA's system is going (gone?) broke, Hawai'i tried something for kids which they had to stop within 7 months, because they didn't account for human nature and it cost way more than expected. Let's see how all these experiments work before we rush into fixing a damaged, but still functional-for-the-majority system.
Thursday, July 02, 2009
Response to a responses to post at Cranky Prof's place.
Here is the original post and comments.
Most hospitals and doctors in this country are more than happy to work with folks with no insurance. Especially the non-profit hospitals, such as the one I work at. We have foundations and other programs specifically to help people in your position. I know of no-one who has been denied lifesaving treatments solely because of lack of insurance or another way to pay. If you get your insurance through your employer, especially if it's a larger employer, the plan they offer HAS to take you, though some do deny payments on pre-existing conditions for up to 12 months. After that period, you ARE covered. And I know a lot of doctors who would rather do so-called charity work, than see medicaid or medicare patients, because at least with the charity case, their office doesn't have to spend hours trying to get the gov't to cough up the insurance payment, which is always less than the cost of the billing office's time, never mind the doctor's. And they legally DO have to bill the gov't, they can't just write it off.
I am a medical librarian, so I get to read a lot of the British medical literature - we subscribe to both Lancet and BMJ as well as some of the specialty journals. When patients have to wait over 6 months between cardiac imaging studies and the stenting those studies show is required, patients die. When studies show that of patients considered curable at the time they go on the list to recieve chemo or radiation treatment for cancer at least 10% have their disease advance to the uncurable stage before they can even begin treatment, it is obvious to most that that system is far more broken than the one in the US.
Remember, that if your insurance denies you, you have options which include legal, such as suing the bastards, changing your insurance, and if the bill is small enough, paying for it yourself. In a lot of nationalized systems, you aren't allowed to pay for procedures the gov't plan won't cover. For that matter, if the gov't plan won't cover it, the doctor probably can't even offer the procedure. If there is only one plan nationally, and it only covers certain drugs within a class, the other drugs cease to be available, as they are no longer financially viable for the manufacturer. I can't use albuterol sulfate for nebulizer treatments, since it makes me throw up for the first few doses, and then attacks my guts, which take years to recover (if ever). If the gov't plan becomes the only one, and they decide that they're only going to cover generic albuterol, and not Zopenex, I'm in deep s**t the next time I get bronchitis or pneumonia, because the xopenex will no longer be there at all, no matter how it's paid for.
I lived in Ireland for 8 years and because of my age I was on the national health system, and the waiting for anything other than my GP was months, and a lot of the stuff that had to be done at clinics was stuff my GPs here in the States have always been able to do in their offices. I've had to deal with only one drug in a given class being allowed, and that was one I had vile reactions to, so my options was to pay myself (very expensive) or do without. I was told I had a 6 to 12 month waits to have a "wart" removed at the clinic, when it wasn't even a wart, and if my GP hadn't been willing to inject a local and attack it with a scalpel, I'd have waited the 9 months or so for ineffective treatment, and then another God-knows-how-long for another appointment for them to try to figure out what it was (a dermatofibroma) and then who knows how much longer after that for an appointment to have it removed. In the US I made one appointment with a dermatologist, who looked at it (it had grown back due to not being completely excised in Ireland) and removed it that visit. And yes, my insurance covered it, but I bet it cost them a lot less than the three visits would have cost the Irish NHS.
Our system is hardly perfect, but instituting a gov't plan which due to it's subsidy by the gov't will put all the private insurers out of business it not the way to go. When patients are insulated from the actual costs of their treatments, a lot of unnecessary stuff is done (e.g. it is quite possible to diagnose appendicitis without a $2K CT scan, which also exposes the patient to LOTS of unnecessary radiation). And when there is only one plan and it's run by the gov't there will be no recourse when they tell you you're too old for a kidney transplant or a hip replacement, or not sick enough for the drugs which may not cure the problem but which will allow you to have a decent quality of life.
Most hospitals and doctors in this country are more than happy to work with folks with no insurance. Especially the non-profit hospitals, such as the one I work at. We have foundations and other programs specifically to help people in your position. I know of no-one who has been denied lifesaving treatments solely because of lack of insurance or another way to pay. If you get your insurance through your employer, especially if it's a larger employer, the plan they offer HAS to take you, though some do deny payments on pre-existing conditions for up to 12 months. After that period, you ARE covered. And I know a lot of doctors who would rather do so-called charity work, than see medicaid or medicare patients, because at least with the charity case, their office doesn't have to spend hours trying to get the gov't to cough up the insurance payment, which is always less than the cost of the billing office's time, never mind the doctor's. And they legally DO have to bill the gov't, they can't just write it off.
I am a medical librarian, so I get to read a lot of the British medical literature - we subscribe to both Lancet and BMJ as well as some of the specialty journals. When patients have to wait over 6 months between cardiac imaging studies and the stenting those studies show is required, patients die. When studies show that of patients considered curable at the time they go on the list to recieve chemo or radiation treatment for cancer at least 10% have their disease advance to the uncurable stage before they can even begin treatment, it is obvious to most that that system is far more broken than the one in the US.
Remember, that if your insurance denies you, you have options which include legal, such as suing the bastards, changing your insurance, and if the bill is small enough, paying for it yourself. In a lot of nationalized systems, you aren't allowed to pay for procedures the gov't plan won't cover. For that matter, if the gov't plan won't cover it, the doctor probably can't even offer the procedure. If there is only one plan nationally, and it only covers certain drugs within a class, the other drugs cease to be available, as they are no longer financially viable for the manufacturer. I can't use albuterol sulfate for nebulizer treatments, since it makes me throw up for the first few doses, and then attacks my guts, which take years to recover (if ever). If the gov't plan becomes the only one, and they decide that they're only going to cover generic albuterol, and not Zopenex, I'm in deep s**t the next time I get bronchitis or pneumonia, because the xopenex will no longer be there at all, no matter how it's paid for.
I lived in Ireland for 8 years and because of my age I was on the national health system, and the waiting for anything other than my GP was months, and a lot of the stuff that had to be done at clinics was stuff my GPs here in the States have always been able to do in their offices. I've had to deal with only one drug in a given class being allowed, and that was one I had vile reactions to, so my options was to pay myself (very expensive) or do without. I was told I had a 6 to 12 month waits to have a "wart" removed at the clinic, when it wasn't even a wart, and if my GP hadn't been willing to inject a local and attack it with a scalpel, I'd have waited the 9 months or so for ineffective treatment, and then another God-knows-how-long for another appointment for them to try to figure out what it was (a dermatofibroma) and then who knows how much longer after that for an appointment to have it removed. In the US I made one appointment with a dermatologist, who looked at it (it had grown back due to not being completely excised in Ireland) and removed it that visit. And yes, my insurance covered it, but I bet it cost them a lot less than the three visits would have cost the Irish NHS.
Our system is hardly perfect, but instituting a gov't plan which due to it's subsidy by the gov't will put all the private insurers out of business it not the way to go. When patients are insulated from the actual costs of their treatments, a lot of unnecessary stuff is done (e.g. it is quite possible to diagnose appendicitis without a $2K CT scan, which also exposes the patient to LOTS of unnecessary radiation). And when there is only one plan and it's run by the gov't there will be no recourse when they tell you you're too old for a kidney transplant or a hip replacement, or not sick enough for the drugs which may not cure the problem but which will allow you to have a decent quality of life.
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