What would you have done? Walking through the library parking lot while returning to my car, I noticed four or five young children and a lady hovering over an elderly gentleman lying on the ground next to his car. It appeared as if they were trying to help him stand up but were having no luck. I quickly walked over and before anything else I talked to him. I asked him if he was okay- if anything hurt- while looking for signs of injury or discomfort. It appeared that he was more embarrassed than anything else. Continue reading “After The Fall”
By Larry Teren
If you mention peanuts to some people, they immediately think of the famous comic strip by Charles Schulz. Others break out in a sweat because they are allergic to the popular snack. For peanut allergy sufferers, it can be a deadly situation as the mere touching of peanut residue can cause them to swell up and choke to death. I know one teenager who carries around with him at all times a type of medical syringe pen that he or others can inject into him if he is having such a type of reaction. Continue reading “Peanuts and Allergies and Oh, For Thirty-two degree Weather!”
Everyone wants to be healthy and wealthy. If not wealthy, then have enough to at least stay even with the crowd. If not totally healthy, then at least enough to maintain a level of dignity and self-support as much as possible. Such are the dreams of those sleeping the night through in rehab facilities. “Hurry up and Wait” pretty much describes what goes on during physical rehabilitation as a result of injuries or surgery.
The rehab therapist sends an assistant to the patient’s room and rushes him or her via wheelchair to the exercise room despite whatever the beneficiary of the said workout is doing at that moment. Once there, the patient is told to wait while the therapist works with someone else.
The therapist finally focuses his or her attention to the said patient. He or she demonstrates for a moment or two what the patient is expected to do for the next few minutes but runs off to help someone else. After a wait of another few minutes, attention is again returned to quickly demonstrate another task to perform but off goes the therapist once more. Eventually the patient is wheeled out into the hall and told to wait until someone can wheel him or her back to his or her room.
Another type of ‘hurry up and wait’ is for the healing process itself. It can be a long duration depending on the injury to a broken bone and surgery to repair the damage. In Ma’s case, she fell and broke her left hip. That same night she had surgery and six weeks later, she sits in frustration at the rehabilitation facility. The other day she met with her surgeon who told her she was progressing fine but that six weeks was not enough time to heal back to her old self.
For one, older people have an issue with osteoporosis, which is a polite way of saying they suffer from soft bone tissue. Simply put, Ma’s bones break too easily and if she rushes the mending earlier than it should be, she runs the risk of re-breaking the left hip. Seven years prior, she fell and broke her right hip, had surgery and was back to her normal self- whatever that means- after two months. However, the break was not as thorough as this time and she was seven years younger and stronger.
The doctor also said magic words. “Look, Medicare gives you 100 days to get better on their checkbook. Take advantage of it as much as you need.” For her it means two weeks of putting at least 50% pressure down on her left foot whereas up until now it was four weeks of no pressure. She has used a walker during exercise time with the left heel down and her toes up. It is up to Ma to go about her business of proving that this next phase is a piece of cake.
After two weeks, it will be the sixty day mark from the time of the surgery. She will be able to try 100% weighted pressure on her left foot as well as walk stairs. The surgeon said that when she can put 100% pressure down, she can go home but that it would not be wise to do so if she cannot master going up and down stairs.
This obviously generates lots of frustration. She feels better than she did six weeks earlier and can do some things again but she wants total freedom. Who doesn’t? Healthy people take for granted that they can take care of themselves.
When I was sixteen and a half, I did a stupid thing- one of just many in my lifetime- and jumped over a fence that I knew had an eight foot drop to a cement floor. Naturally, I broke a metatarsal bone in my left foot which has never healed properly ’til this day. But, being 16, I was also young and strong enough to ignore the fact that I had done damage. Other than wearing a shoe with a wooden sole to act as a splint and cushion the pounding that walking did to the sensitive break, I went about my normal business. I even went to my high school graduation with that stupid wooden shoe. No cane, walker or crutches. I probably would do the same today. But if this were to happen twenty years from now, I suspect I would be grounded for several days as well as using a walker for a while.
That magic word- Medicare- helps soothe some of the pain for those in the same boat as Ma. American society decided that the age of 65 (or whatever it will be in the future) is the special passport to government financed medical care. The first twenty days after surgery, Medicare pays 100% for her recovery provided she is able to show an effort in cooperating with said recovery. After twenty days, Medicare pays 80% and the Medicare Part B co-insurer pays the other 20%. Ma has up to 100 days in a calendar year from the time of surgery to take advantage of all that Medicare will finance. If Ma stays in a rehab place for sixty days and then goes home, she can still return and use the other 40 days up to the anniversary of the surgery.
Once upon a time- sounds almost like a fairy tale, huh?- retired social security recipients were not asked to pay much at all for Medicare benefits. Now, each monthly payment they receive automatically withholds Medicare Insurance premiums. For some people this can be over $300 per month. That is a lot of money to take away from someone who is ending up with anywhere from $1400 to $2000 a month in social security money. And there are those like Ma who saw their social security money drop 40 percent when Dad passed away as well as lost Dad’s pension. The biggest slap in the face to senior citizens is that for the past couple of years there has been no increase in social security benefits due to the “Economy”. But there has been an increase in Medicare premiums withheld. Beneficiaries in 2010 are receiving less social security money in 2011 than in 2010. The situation does not look any better for 2012.
According to a recent study most children of elderly parents are clueless to what the various colored pills are that they see their parents take when they come over to visit. This is despite the fact that these same unobservant – myself included- scions intend to take responsibility for the care of their mother and/or father when the situation should arise.
Ma asks me to pick up her medicine from the pharmacy. I think she orders seven different items although all are not actual medicines. One or two items are testing devices. I’d be the first to admit I do not remember the names of all that she orders. I just give the person behind the counter her name and indicate the number of items I am supposed to pick up. I also give them a special credit card to pay for it. She asked the pharmacy to issue her a second card in my name so I would not have to always go to her to get her card first, pick up the medicine and return her card.
Even though I don’t know her medicine list it doesn’t mean that it is not recorded somewhere. And I can get access by requesting it. A couple of years ago after Dad passed away, Ma signed some legal papers that gives me authority to handle her legal and medical obligations for her in case she cannot do it herself. I’ve forwarded these documents to insurance companies and banks so that I can readily help her out without having to go through a song and dance to get the customer service person to cooperate.
Also, how about who your parent’s Medicare Part B Supplemental Insurance Carrier- do you know who it is and their policy number?
Both my sister and I have asked Ma to write down what she takes and make the list available to us. I suggest you do the same.
There has been a lot of talk lately about the concern of severely curtailing Medicare benefits. Some of us who are years away from the curse of old age do not appreciate the situation. Medicare takes care of the rehabbing that a senior citizen endures in an authorized facility as long as the patient shows signs of improving.
Knowing this Federal largesse, everyone who recovers from hip or shoulder or knee surgery and bone injuries in general tries to get placed in the best care facility possible.
Ma was no different. She knew about the excellent rehab center three blocks from my condo and we lobbied with the social worker at the hospital to get her placed there. Luckily, there were several bed openings and for at least one week she had the pleasure of having the room to herself.
Another quirk in the Medicare laws apparently is that if one has surgery on the injured bone, Medicare will pay for two therapy sessions a day. Without surgery, the patient receives only one session. When two sessions are involved, one session covers some occupational and not only physical therapy.
Once the patient’s doctor and therapist agree that the person has plateaued, Medicare cuts off funding. At the place that Ma is at, this means that the patient is either sent back to their own residence or to a long term care facility in which chances are they will never be able to leave. This is because there are a percentage of facilities that recognize it is in their own long-term interest to keep the patient, now called a resident, there as long as they can.
Of course, not many people are able to pay the six to seven thousand dollar a month cost to stay at a nursing home. If they do not have long-term care insurance, which most people do not have, then they may have to apply for Medicaid, in which the State agrees to finance their stay but requires the patient to pay down all their assets befre getting assistance. This will include, of course, the sale of the house. Exceptions are made if a spouse is still living in the house.
Continue reading “Rehabbing Medicare”
A little after 12 noon this past Thursday, while working with the chief financial officer and in-house computer network specialist at a client site, I got a phone call from my sister. She started off with, â€œI got bad news and worse news.â€
Earlier that morning I got into the car to drive out to a Western suburb of Chicago that was at least a twenty mile destination requiring two tollway fares. All the way there I fretted about temporarily running out of stories to add to this blog. To my dismay, that didn’t last long.
â€œI’m listening.â€ I said in a hushed tone. She said,â€œma fell down in the house and broke her hip. She is in the emergency room at St. Francis Hospital in Evanston.â€ That was the bad news. Now came the worse news. â€œMrs. So-and-So (my sister’s mother-in-law) had suffered a massive stroke resulting in heavy hemorrhaging and was at death’s door. She was lying in wait, so to say, in ICU, also at St. Francis Hospital.â€
My sister’s mother-in-law had come home from playing cards after 10pm Wednesday night. She lives in the condo down the block from mine, the one fancy enough to be able to afford a doorman. The uniformed fellow let her in and she proceeded in the hallway to the elevator but never made it to her apartment. She was found lying on the floor in an unconscious state.
On late Thursday afternoon I finished visiting with Ma on the fifth floor of the hospital listening to her mentally prepare to have surgery on the right hip where a surgeon would place a rod and bolts underneath the skin. This gave her a sort of symmetrical artificial reconstruction of her torso. Five years earlier, she broke both her left hip and shoulder.
Continue reading “Double Whammy”
By Larry Teren
I’m that “sucker born every minute”. You know- the one who looks for food products with the “fat free” label prominently displayed. I convince myself that by eating such-labeled foods, it won’t be long before I begin again to look like an Adonis.
Yet, it can be quite confusing trying to evaluate what is healthy to eat and what is not. There’s salt-free, sodium free, low sodium, low salt and unsalted. Huh? How about sugar free and low sugar? Or my favorite- caffeine-free and decaffeinated. I once did research on this last one. Apparently, decaffeinated means that the thing you are about to put into your mouth once had caffeine in it, but was heroically removed. Caffeine-free means that it never had it and never will (apologies to that soft drink). That’s why the label on pop bottles read ‘caffeine-free’. By nature, pop does not have caffeine, or if at all, just a mere trace. The pop bottlers add it in to give it a kick. Pop that is labeled caffeine-free means that on that production run, they did not add in your favorite addiction.
So, is caffeine a bad thing? Who knows? Some people need an artificial kick to get them going in the morning. I gave up coffee about thirty years ago… zzzzzzz.. Huh, what? Oh yeah, and I don’t have a problem with staying alert. My grandfather, well into his 80’s had a glass of shnapps to start the day off with luster. It was supposedly good for the heart, especially since he already had three heart attacks and wanted a cheaper alternative to a pacemaker.
Continue reading “Fat Free or Low Sodium”
Let’s Face it- we live in a world where thin rules. No one wants to look at a fat person on television or in a movie. You know, what they say- the camera adds fifteen to twenty pounds. Hogwash! Fat is fat.
I’m not fat (hey!) nor am I thin. I’m somewhere in between. I look at pictures taken of me years ago, and yeah- I look thinner back then. You can see it in the face. I used to exercise like crazy, playing baseball, basketball, volleyball, tennis and jogging. Slowly, over the years, each one of the above went by the wayside and my weight edged up.
I used to be able to power walk a couple miles or so at a time; now, I take it as it comes with my bad left foot- the one with the swollen ankle that is here to stay. It’s come down to sitting on a stationary bike and pedaling away like a maniac while watching a live sports presentation or a show that has potential to keep my interest for at least an hour.
But then one day I discovered that too much extended session pedaling was putting too much pressure on my stomach muscles causing me undue pain and I ended up spending a couple of thousand dollars getting MRI scanned at the hospital. Lesson learned- next time ease up on the pedaling and don’t complain about the pain.
My brother Gary, the baby among the siblings, is in his mid 40’s and still thin. He likes to jog for several miles as long as his energy permits. But even he is now at that point in life where he wonders if all the knocking himself out is worth it. A favorite expression of Gary is- “let’s get fat.” There will come a time for him as I say to other younger people as well- don’t wish it on yourself. You’ll get there.
The other day I bumped into a lady friend in her mid to late 60’s, someone who lives in the condo building down the block. She looks positively anorexic. She is not proud of it. She says that her frequent chemotherapy treatments has caused her to loss of appetite. Her equally thin and drawn husband suffers from diabetes and pines for eating sweets which he cannot.
Then there was the fellow who made a living selling illegal tax shelters and ended up spending some time in federal prison. He went in chubby, came out nice and svelte. Our paths crossed a couple of months after he was released and he still looked fantastic. I asked him why he didn’t go back to binge eating. He replied that he had been disciplined to eat only when hungry. So, I took up that mantra. It didn’t help as I found out that I was always hungry.
This obsession with weight brings about mind games. After each successful visit to the bathroom I try to convince myself that it is okay to once again eat like a pig. Or on a day that I decide to take a water pill and spend the next four hours being drained of excess liquid, I am confident that half a bottle of pop will do no harm.
The worst thing you want to say to a tailor when you buy a new suit is “let it out” but then you remember that you are doing this because when you bent down the other day while wearing your one good suit, the pants split in such a way that it was best to just turn it into expensive rags.
I can look down and tell you the color of my belt but that’s only because I memorized it before putting it on and besides- who is going to wear a brown belt with black pants? Yes, I remember when my waist was a 34 and considered anyone who was a 38 just plain fat. Now, I don’t trust anyone under 38.
Dad couldn’t walk and let alone stand the last few years of his life cooped up in a long term care facility but he sure could eat. That was his pleasure. He had no restrictions- he was not diabetic. Well, he did have one eating problem as time went on. He couldn’t eat anything hard- it had to be ground up or otherwise he would choke. He suffered from aspiration pneumonia. He didn’t lose weight. He looked the same as ever until the last few months when he got cancer of the bladder. That was not on his diet plan but then he wasn’t given a right to make a choice.
I’m in the middle of this quandary. Do I want to look corpulent, to be obese or a moving, breathing piece of blubber? Heck no! Can I get back to that size 34 waistline? Fat chance.
Why I Hate Hospitals
I have a modest proposal to reshape the health insurance system. It takes away some of the burden from the insurance companies and places it on the individual but also gives the policyholder a saving’s edge. It is based on the idea that the real culprit in all of this are hospitals.
First, here is the plan and then I’ll go into why I believe this is better than the current modus operandi:
|Category||Age Category||Insurance Premium||Deductible||How it works|
|Doctor Visits, Simple Tests, Emergency Room visits||35-44
(Self-insurance in a Health Savings Account
|zero||Individual uses up to the value of his or her premium for all outpatient visits by paying out of the HSA approved checking account. Once the HSA is exhausted, the Major Medical policy kicks in. The individual is then obligated to spend up to deductible until it is used up and then only pays 20% up to one million for the year.
If during the course of the year, the person does not use any or all of the HSA money, he or she may apply it to the next year, thereby saving them the need to again put aside extra money each year. They are rewarded for being fortunate enough to stay healthy.
Insurance companies lose out but also gain with not having to deal with the paperwork on the majority of medical visits.
|Major Medical- Surgery, Expensive Tests, Procedures||35-49
|2000.00 (paid to an Insurance Company)
|Individual is obligated to pay up to the major medical deductible and 20% afterward for all bills up to one million dollar cap for the year. At cap, insurance company pays 100%.|
Hospital organizations must also be required to drastically lower billing amounts. It is outrageous and way out of line. They do a lot of unneeded extra testing and then charge an outrageous amount for little time spent taking the tests.
Not too long ago my doctor insisted that I take a CAT scan. Correction- two cat scans, because the area of the body being scanned required two passes. I spent a total of twenty minutes going through the doughnut . The insurance company was billed over six thousand dollars for these twenty minutes of service.
The dye that they made me drink to prep for the test cost five hundred dollars! The insurance company thought that this was fair. Each scan was billed at $2800. The insurance company responded to the bill with, â€œnot so fast! We have a network (translated, a wink and a nod) agreement where you accept our negotiated rate. This brought the price down to $1400 each. Big deal! After using up my $1000 deductible for the year, I was still stuck with paying over one thousand four hundred dollars for an outpatient visit that took less than a half hour.
I called the hospital and asked to get the price reduced. They said that at best they could do was to lower it by ten percent or ask to fill out a financial aid form. I wasn’t about to be insulted by filling out such a form, so I took the discount but then asked for the right to pay it off in three installments. The customer service agent told me that she would not allow it- either pay the full amount in twelve monthly installments, or take the discount. I told her that the hospital already received a more than thousand dollar check from the insurance company on my behalf. It was not as if they were relying only on my payment to make a profit on the deal. I asked to speak to a supervisor. She transferred me into the voice mail for a higher echelon person. He returned my call on the next business day and was equally hesitant to offer compromise. He finally told me he was doing me a great personal favor to allow me to pay the bill off in three installments while also taking the ten percent discount.
There should be only one price for a procedure regardless if a person has insurance or not or whether they are in the insurance network. Period. And the price should be regulated by an impartial group that is not beholden to the hospitals.
I recognize that some of the dollar figures listed above may need to be adjusted for practicality. Paramount, though, is that we need to put intelligence and incentive back into health care decision-making for all parties involved- the patient, doctors, insurance companies and hospitals. Otherwise, we mind as well close down the hospitals and let the healthiest survive to the next generation. It will cut down on the price of gas as there will be less people who own cars.
Not too long ago I was eating a heavy supper at 5:00pm. Being a quick eater, I was sitting in the living room trying to stay awake while reading a book at 5:45pm. As usual, I started to doze off and could not fight it but kept to as much of a sitting position as possible on the sectional sofa. An hour later around 7:00pm I awoke feeling a heavy pain in my stomach and chest area. I attributed it to not allowing the food to digest properly.
I endured the pain laying in bed and reading, eventually falling asleep for the night. The next morning I felt much better. However, that evening the pain came back with a vengeance and lingered over the next couple of days. I informed my doctor who recommended that I come in for an examination. His probing hands confirmed that there must be something wrong but it was not what he initially thought as the pain was centered elsewhere. He therefore recommended a cat scan- two, in fact. I found out later that it was common to do the two as they are very much linked.
Continue reading “Warning: Hospital Bills Can Be Hazardous To Your Health”