Better Leg, No Thanks to Medicare Part D

There’s a woman on TV who reminds me of one of my sisters.  She has an attractive, open, mobile face with a wide smile and pretty lips.  She’s talking about saving our parents’ financial lives.  Oops, the resemblance ends.  The sister I’m comparing is not the financial analyst of the family.  Nevertheless, several of my sisters are deeply involved with preserving my parents’ way of life, keeping them in their home, and accommodating to their needs as soon-to-be ninety-year-olds.  What a milestone!  We are blessed, not just because it’s nicer to have your parents than to have the grief of their loss, but because we have such a comprehensive, intimate view of what aging can be. 
Because my father’s military career came with excellent health care, my parents never had the concerns that I saw in so many elderly folk that I treated in my healthcare days.  Dealing with people who had only urgent or emergency health care from adolescence to retirement was new to me when I first started training, but it was quickly evident that living without health insurance was common and deadly.  I became accustomed to seeing patients who had ignored medical problems for years, waiting for that moment when they were eligible for Medicare.  It wasn’t instantly deadly for most folks, but was manifest in the high disability rates from neglected or undiagnosed medical problems, the higher mortality for common medical problems in lower socioeconomic groups, and the lower quality of life in the elderly folk in lower socioeconomic groups.  Additionally, there was a racial divide, not a surprise now since a number of studies have documentedthat greater percentages of people of color (compared with white patients) are  offered the less effective course of treatment in common illnesses such as heart disease.  No coincidence that African-American women have worse mortality rates than white women in this country:  early diagnosis depends on education and screening, two things that are deficient in people with less access to health insurance. 
I heard a presidential candidate (not my favorite) mention that the United States of America has the best health care in the world, and I wondered what he was thinking.  Our infant mortality rates are higher (worse) than every European nation, Korea, Japan, New Zealand, Australia, Cuba and Canada.  Our average height in adulthood (excluding immigrants of origins with shorter stature) is ranked much lower than a century ago, compared with other western nations.  This is felt to reflect prenatal care and childhood nutrition. 
Why am I on this soapbox this morning?  I woke with a big improvement in my cellulitis.  Yesterday I was able to change from a cheap, less effective medication to a very expensive, newer medication which is clinically proved to be more effective in cellulitis.  My insurance is Medicare, coupled with a Medicare prescription supplement.  My supplement didn’t cover the newer medication, and the $118 had to come out of my pocket.  That is not very good coverage, and it’s all that most older folks have (minus the deep pocket to cover the difference).  If I had been forced to stay on the cheap medication and the cellulitis had progressed, forcing a $20,000 hospital stay for three days of IV antibiotics, Medicare would have picked that up. 
So…how smart are we, and how fiscally responsible, to choose elected officials who won’t insure all of the U.S. population?  Just sayin’…
Peace!

Today I am Rambling…Be Forewarned

Poopies!  I woke this morning with a leg that looked just like yesterday’s leg:  just a little bit back from the border, the red spot in my cellulitis hadn’t budged.  The tenderness was the same.  And there was ominous swelling around my knee.  My heart sunk.  It sunk deep into my abdominal cavity, while I thought about cellulitis spreading upward into my knee joint and causing a septic joint, which is much more serious than cellulitis.  The knee was tender when I prodded it.  Double poopies!!  Big hypochondria attack coming!  Sepsis, coma, death. 

I got up and hobbled to the potty and then back to the side of the bed, where I did a thorough knee exam.  The swelling was in the soft tissue above my knee, probably an aggravation of the falling injury, just from my walking in the house, doing chores yesterday.  There was no extra fluid in the joint, and the knee wasn’t warm.  Range of motion didn’t hurt.  There was no redness or tenderness or streaking between the cellulitis and the knee.  Okay, hypochondria attack subsiding.  I still needed to treat the cellulitis more effectively if I wanted to get off leg elevation by Christmas.  I called in a prescription for the next line up of antibiotics. 

Today it is cold and rainy, one of those days that would feel dreary even if I was more mobile.  I ignored the knee and drove the whole mile and a half to the pharmacy drive-through and got my medicine ($118 was my co-pay, I’m sure there’s a miracle cure coming!), then treated myself to an Arby’s deli sandwich.  Back at home I tried putting Reddi-Whip on my black coffee.  It was yummy but I was still bored.  I knitted while I distracted myself with a funny movie, Guru

I just wandered into my kitchen to see what to do about dinner.  Know anyone who gets excited to find dried beans in the pantry?  Here I am.  I was raised on beans by a mom who cooked them the Southern way, with lots of fat meat.  For the uninitiated, that means lots of pork, usually the fatter the better, cuts like streak o’ lean, fatback, hamhocks…Basically it was a pot of nutritious fiber served with a heart attack.  I disliked beans until I could cook them my way.  In my pantry I found pintos, navy beans, and garbanzos.  I chose pintos, loaded a pound into my crock-pot, picked out the few little clumps of dirt, and added water, a tablespoon of *Pasolivo’s tangerine oil, and the juice left in a can of **Big Franks.  I sliced a fresh onion into the pot…no fresh garlic-a travesty in my kitchen!  The crock-pot is on high and I’ll have tender beans this evening. 

The other day I promised to show the organic, undyed cotton baby sweater as it progresses.  organiccottondemosweater1.jpgYou can see that I started it at the bottom right corner.  This is the back of the sweater.  I’ve knitted about 2/3 of the back, enough to be up to the sleeves.  The sleeves are now on the needles at the top of the piece, added on in subsequent rows.  Basically, the pattern so far is this: 

I’m using  Pakucho, which was reviewed in Knitters Review(http://www.knittersreview.com/article_yarn.asp?article=/review/product/050609_a.asp), and I selected my needles to give a gauge of about 4.5 stitches per inch.

Cast on 50 stitches (need a multiple of 4, plus 2). 

Row 1:  (K2, P2) and repeat to end of row.

Row 2:  Knit the knit stitches and purl the purls stitches to the end of the row.  (That amounts to (P2, K2) and repeat to end of row.

Row 3:  (P2, K2) and repeat to end of row. 

Row 4:  Purl the purls and knit the knits to the end of the row, or (K2, P2) to end of row.

Repeat rows 1-4 until you have finished 39 rows.

Row 40:  (K2, P2) repeat to end of row, then cast on 20 stitches by using the wrap cast-on ( http://knitting.about.com/od/castingon/ss/wrap_cast_on.htm).  Turn to work row 41.

Row 41:  You now have 70 stitches, still a multiple of 4 + 2, so you can continue by staying in your same pattern (a repeat of row 1).  At the end of the row, use wrap cast-on to add 20 more stitches. 

Row 42:  You now have 90 stitches, still a multiple of 4 + 2, and you continue by staying in your pattern stitch (repeat row 2). 

This is a closeup of the stitching:organiccottondemosweater2.jpgThis is what I meant when I noted that the organic cotton needed some stitch-work.  This makes a beautiful pattern, really giving life to this basic, rustic yarn. 

I’m on row 55 right now, still working the stitch pattern.  Next I’ll figure out how I want to put in the neck opening, so bear with me if you are nipping at my heels.  I’ll get it out in a day or two.   

Oh yeah, my little references:

*Pasolivo is the fabulous brand of olive oil that I order from the Willow Creek Olive Ranch in Paso Robles, California.  It is a family business that makes award-winning olive oils, well worth the shipping cost.  A tasty oil can completely refresh a dish and make the simplest ingredients (like my beans) heavenly.  (www.pasolivo.com)

**Every vegetarian is familiar with a dozen different frankfurter substitutes.  My favorites come in a can, and at  more than 3 ounces apiece, they are appropriately named Big Franks.  They are a Worthington product. 

Alright, it’s really time to go.  What do you want?  I’ve taught you medicine, cooking and knitting today.  Gimme a break!

Peace, people.

Decisions, Decisions…

Hmmm.  My leg is not getting better.  I drew a line around the red area, and I look at it every morning, and the red still comes right up to the line.  Truthfully, it is inching over the line toward my ankle.  That isn’t good for cellulitis.  You want the redness to recede, and the tenderness to go away, and the swelling, firm feeling of that area to decrease-all are signs of improvement.  But it’s sort of an awkward time to make a decision.  This evening it will be 72 hours since my first pill.  I don’t want to jump the gun and say that medicine isn’t working without a reasonable trial, so I will wait until tomorrow morning, look at my leg and my ink line again, and decide.  It seems to be safe to do this since there’s no evidence that my ankle joint is involved (it has no pain or swelling), there’s no red streaking up my leg (indicating lymphatic involvement), and I don’t have a fever.  Yes, this is medical thinking, balancing this against that, lining up the evidence, being patient, considering what is significant and what is peripheral.

This leg is causing issues.  Issues-why do we use that word so much now?  I think we use it to keep from defining what is actually happening.  “I have issues with being here by myself” rather than admitting “I am lonely” or “I am afraid.”  Or “She has mental health issues” rather than “she is schizophrenic”.  It’s a vagueness, a euphemism, a covering-up of the real depth and seriousness of a problem.  Or maybe it’s a laziness, our desire to keep thinking at bay and not use the neurons to truly discern what the problem is. 

The issue with the leg is uncertainty.  I am scheduled to go to an easy, sitting down all day inside vendor situation with a friend next weekend.  The cellulitis must resolve for me to do that.  I have no way of predicting whether it will heal or not.  After so many years of similar spells of uncertainty, all caused by various complications of disease, it doesn’t bother me much to be in this position.  I’m poised to deal with going or staying.  But I hate how it affects my friends and family.  I frequently disappoint people who thought we had firm plans, and for some people it prevents them ever making a plan with me.  I have lost friendships with people who were a bit paranoid about this.  They felt that I was selecting them to cancel on, like my disease was adversely affecting some friends more than others.  (“You only get flares when you are planning an outing with me, never with Sally Sue…”)  One former friend ended a friendship emphatically telling me this, and when I next saw her, in the airport in another city, I had deteriorated to using a cane (temporarily) and was visibly ill and she pretended she didn’t see me.

That’s okay.  There are many reasons that relationships fall apart, and sometimes chronic illness in one of the friends or partners is the reason.  It changes the way we relate to one another, and the things that we can enjoy together, and we either change the relationship to fit that, or we part company.  I have some friends that I know I will never lose over a change of plans.  We have found a way to enjoy ourselves despite the uncertainties.  And we don’t seem to aggravate the situation by constantly dwelling on them.  We make plans that involve making a plan today, and enjoying it, or planning something that we can enjoy despite having a bad health day at the time. 

(Long swig of fizzy water.)

A bit of follow-up on my family relations angst:  My two out-of-town sisters endured a three-hour show obligation last night, then scurried over to see me.  I was delighted!  We had so much fun, visiting past 2 a.m., talking and having a midnight supper and laughing ourselves silly.  My sisters all have strong personalities, and they are interesting individuals to be around.  Lucy loves them all dearly. 

Congrats to my relative (you know who you are!) who is being haled as a tremendously talented performer!  This comes as no surprise to me. 

Peace.

The Create Channel

I am being a good girl, sitting on my bed knitting, keeping that leg with the cellulitis elevated.  Television was boring the poop out of me today and I dialed up to the mid100’s to look for a good movie, then higher when nothing was tempting.  At channel 203 I caught a title with the word “Knit” and I veered off to see what was there.  Holy moley, people, I have really been missing something!  (That’s assuming this channel wasn’t just launched today, January 19, 2008.)  PBS (Public Broadcasting System) has their own home/garden/crafting network, called Create.  I went to their website, http://www.createtv.com/, to see what shows they offered.  I scrolled through the entire list.  My impression was of many cooking shows, then a good representation of travel, home decorating, crafts and gardening.  The ones most interesting to me were Knit & Crochet Today, and Needle Arts Studio with Shay Pendray.  I had a chance to see a couple of episodes of both today and they were good teaching shows with excellent demonstrations.  I enjoyed the discussions and the projects were modern and relevant.  The host of Knit & Crochet Today is actress Cassie dePaiva of One Life to Live, a crocheter and chronic interrupter.  Her hosting style is a little distracting to me, but didn’t keep me from sticking with the show.  I understand that show also has interviews with needle artists from various fields done by Brett Bara (editor-in-chief of Crochet Today magazine).   Other crafts shows included one about glass making that I’d love to see, a couple of general diverse crafts shows, and several painting shows.
The DIY network just moved Knitty Gritty from 2 p.m. to 5:30 a.m. (at least on my cable schedule) and I hadn’t dared hope that there would be any other knitting show to enjoy.  I might get up a half-hour early some days to see Vickie Howell and her laid-back crew, because I love them lots!, but at least there’s a backup on Create.  This oughta hold me for a while.

Peace!

Family Invasion

I thought I’d better tell you the current family circumstances in case I suddenly disappear and am never heard from again.  Two of my sisters are coming to town.  In fact, one arrived last night, and the other will come in tomorrow.  There are six of us, collectively known as the ___ girls, half in town and half scattered about the U.S. of A.  Whenever there is a critical mass of ___ girls in one town, things happen.  With possibly one exception, we are not quiet.  Daddy has always said that the only problem with having six daughters is that they are very loud when they are together.  There are going to be many opinions expressed and explained and touted with certainty and devotion.  There will be competition.  Sisters will brag, some in that offhand, roundabout way that is intended to make you feel that no bragging is taking place, but that facts about genius and superhuman ability are just being recognized.  There may be crying and tissue throwing, and at some point, scripture will be quoted. 

My first reaction is to beat a hasty path out of town and hide out in a good hotel with an acceptable brand of coffee and 24-hour room service.  Unfortunately, keeping the right leg elevated is not consistent with driving.  I’m supposed to take my antibiotics and stay put.  I’ve toyed with the idea of being “too sick” to  answer the phone, but that would probably precipitate a visit to my door, and my car is clearly visible here.  Besides, I’m a sucker for any woman who stands on my front porch and pleads “Please let me in!  I have to pee!”  (Forget it, guys, you can pee anywhere.) 

There are things I would miss if I didn’t get together with the sisters.  The latest gossip, for one.  Some of the things we tell about our partners and our children and grandchildren are only told across a kitchen table, never in an email or on the phone.  I’d miss the jokes and insults, especially my opportunity to dish some out!  (“So you probably hadn’t had your medication when you got that orange streak put in your hair, hmmm?”)  I’d miss the babying.  I’m the next to the youngest and at least nine years younger than the next sister, and sometimes I like being treated “special”.  Hell, I am special!  And cute! 

Actually, I want to be with my sisters.  I read a book last year about a person who had the ability to become invisible, and as a child he always exercised this talent at family photo time.  I don’t want our children and grandchildren to look back and see me as the one who was missing from all the events, good or bad, the one who never contributed or argued or joked.  I would never want to be the invisible one in the family.  I want to wade into the muck and be elbow-to-elbow to the other ____ girls, holding my own in that enduring (if not endearing) family drama.  We have the advantage of having always been able to rally together and support one another, and get past any differences we may have.

Speaking of differences, although people think we look alike, we are really very different individuals.  We range from average height to super-short, looks- and fashion-conscious to oblivious to fashion, from graceful to awkward, from lilting sopranos to tone-deaf altos, and none of us chose the same career.  If I had to find the things in which we are similar, however, I would say that we all speak well, with good vocabularies and the ability to speak with confidence, and we all read a lot, two things that I think are related.  Both qualities were encouraged by my parents, as they thought it was important to be able to express oneself clearly and intelligently, without colloquialisms and grating accents.  They were both regular readers, and it was an activity that seemed natural in our home. 

Lord knows I have heard a million times that people with collagen vascular diseases should avoid stress.  My stress this time just happens to come from part of my support base, so I’m going to take a deep breath, carry some knitting with me at all times, and be with the sisters this weekend.  You will know if you see us-you can hear us coming. 

Peace!

Breaking News

Okay, I’ve been trying to give you an idea of what it’s like to live with this particular chronic illness.  Yesterday I mentioned sometimes loving the lupus for the gift of wonderful occurrences on a background of bad stuff.  Well, here’s the opposite.  This morning I awoke feeling pretty much okay.  My leg hurt a little, but hey, something’s always hurting, so I wasn’t concerned.  My stomach was upset before lunch time, so lunch was crackers and a hot ginger drink.  I had a nap.  Not so bad, hunh?  Well, I’ve awakened from my nap and my right leg (the one that I fell on, the one with the pretty bruises) has a warm, red, 4 x 8 inch area over the shin.  We call that cellulitis – a skin infection that must be treated with antibiotics and watched carefully to make sure it isn’t spreading.  I’ve talked to my doc, and I’ll go to my drugstore drive-through and pick up my antibiotics.  The care of a cellulitis involves keeping the area elevated and taking the antibiotics, with some acetaminophen or naproxen for pain and fever. Depending on how the leg goes, my plans for the next few days may be off.  It’s a good thing I can knit.  Days like today, radical knitting is my only recourse. Peace.