Ask the grumpies: What are you doing for long term care/end of life planning?

First Generation American asks:

What are you doing for end of life care planning if anything? Have you calculated how much you need or considered LTC insurance?

… not that much.

We have done our wills.  We have life insurance until DC1 turns 25 (DC2 will be 20 and only have a little college left at that point), although even without it the kids would likely be ok at this point (we should probably change who DC2 lives with upon our deaths once my sister gets married, I dunno).  We’ve signed the medical things you can sign in a lawyer’s office (though I punted and put that decision on DH). I buy the optional disability insurance through work.  DH doesn’t have any so he hasn’t.

We have not calculated LTC insurance.  We have not started siphoning money to our kids in order to let Medicaid take care of us.

Grumpy Nation, have you taken steps for end of life care planning or end of life planning more generally?

 

Ask the readers: Headache remedies?

Heya Grumpy Nation!

I have been getting bad headaches.  I do not like them.

I’m currently keeping a headache journal for my GP doctor to look at the next time I go in, but I would also like to try to stop having headaches before then too.

Known headache triggers:  Flashing lights, pressure changes with the weather, yeast extract, dehydration, caffeine withdrawal.

I have been pretty good about avoiding flashing lights and yeast extract and I drink a lot of water and generally avoid caffeine.   My weather headaches have been getting more frequent and more protracted, sometimes lasting days if the weather doesn’t change.  I thought I would find a pattern with my cycle, but apparently not– there are weather patterns but not hormone ones.

One painkiller alone (advil/aspirin/tylenol) doesn’t seem to work– I need to double up sometimes with different painkillers and even then it’s not great.  Sinus medicines make me loopy so if I take them I still can’t work.  Dimetapp was working like magic for a little while, but I think I built up a tolerance.  Sometimes DayQuil is enough and sometimes it isn’t. NyQuil is pretty good but it also knocks me out so I only take it at night so I can sleep.

I *think* magnesium supplements might help.  Propel helps a little.  This one fruit drink that my grocery story has that has magnesium and potassium might help.  These supplements might blunt the pain, but it doesn’t go away completely.

Heat, particularly on my neck and sinuses works, but only so long as the heat is actually being applied.  Ditto massages.

I tried one of those nasal squirt things that’s kind of like a cheaper neti-pot, but it was really unpleasant and didn’t seem to do anything much on first application except make me salty from the saline solution.  Is it worth pursuing more?  (It took a little while to get used to a bidet for the toilet, but also a bidet for the posterior area was never as unpleasant as the nasal squirt thing.)

What do you do when you get a headache?  How do you avoid headaches?  How do you make headaches go away?

Attention Texans with kids under 12! Action today August 12th!

Sorry to interrupt the wonderful discussion we were having on books that appeal to kids, but this seems important.

I got an email from a reader who prefers to remain anonymous requesting that I post this so parents with kids under 12 can join a lawsuit against Governor Abbot.  (Sorry this is so late!)

https://cdn.fbsbx.com/v/t59.2708-21/234858038_204693384966169_3536159072851164687_n.docx/AFFIDAVIT-FORM.docx?_nc_cat=111&ccb=1-4&_nc_sid=0cab14&_nc_ohc=6ktRH-OFr3IAX-UpK_B&_nc_ht=cdn.fbsbx.com&oh=14612f240812985313c146b2a7c91b29&oe=6116766A&dl=1

YOU HAVE TO FILL The above affidavit out and have it notarized and scan to him by noon today.

Your local bank probably also has a notary public and may take less time than UPS.

===============================

Message – TO ALL PARENTS BUT PARTICULARLY PARENTS FROM ISDs THAT HAVE YET TO DEFY GA 38

NEEDED TODAY (AUG 12) BY NOON

Hey folks!  Late night plea for assistance.  The nonprofit I represent has filed suit against Governor Abbott in Travis County District Court seeking a statewide injunction of the Governor’s Executive Order GA 38.  But here’s the rub:  no one at the AG’s office is responding to our efforts to confer regarding a hearing date.  So . . . we are intending to file a request for a statewide temporary emergency restraining order by noon TODAY if we do not hear from the AG’s office.  How many parents would consider executing an affidavit in support of our TRO request?  One is attached.  Please limit to one page.  It is like 5 bucks at the UPS store to have it notarized.  Scan it to me at coordinator@thescca.org and save the original.  No children’s names, please.  Just parents and district, that is all I can hope to ask of you.  Your name will be part of a court proceeding that is public in nature.  But your address is not on the affidavit, ever.  Pray, meditate, breath, take an early morning walk.  Please let me know ASAP.  What I’ve said here is about all there is to say, but ‘friend’ me on FB (my page is public) and we can message about specific, unique questions.  greenbostwick.com

Visit us for updates on the case:

https://southerncenterforchildadvocacy.org/

 

Middle-aged health problems open thread!

About a month ago I promised an open thread for (non-life-threatening) health problems!  Here it is.  Middle-aged folk, gather round and complain and share and provide obnoxious unsolicited suggestions for others!  Tell us about how your friend of a friend had something similar and what they did!  (Note, you do not have to be middle-aged to participate.  This is just something some of us do instead of talking about the weather for small talk once we get to a certain age.)

Here’s mine:

My right FOOT.  OMG.  So, about 3 months ago, I started waking up around 5:38 every morning with the bottom of my right foot itching like crazy.  It wouldn’t stop until I walked around or just got up.  Scratching didn’t help much but squishing it around did.  I tried two different athletes foot cremes but neither did anything.  When I went in for my well-woman visit, my gyn suggested it was a nerve issue and to see a podiatrist, but I don’t want to go in again with the students in town and new covid strains spreading etc.  I thought maybe because I’m walking around barefoot so much on our hard floors since that’s the easiest form of exercise.  Then about a month ago, I decided to try walking with my slippers that have arch support and oh boy that was such a bad idea. It felt like plantar fasciitis again but owie.  Again, only my right foot.  But… the 5:38am itching stopped.  So, there’s something wrong with my right leg and foot.

I also had a lot of sitting problems– a blocked gland (hot baths worked) and hemorrhoids and … a pimple (!) on my gluteal area.  For those I bought a purple pillow.  Which kept slipping off the aeron chair until DH found his velcro strap stash and now I have it velcroed in.  It helps somewhat, but I should probably be using the standing desk except, my right foot, you know?

So… mostly the foot thing.  I hate it because it’s so hard to exercise when you’re afraid of hurting your foot!  I dream about swimming sometime but the pool isn’t even open even if I weren’t worried about the trump supporting covid deniers in the neighborhood.

Share your health problems!

Ask the grumpies: Advice about hearing aids

D asks:

Some of us older academics are having aging issues, loss of hearing being one of them. Hearing aids seem to be very expensive and way overpriced at the neighborhood audiology office. What is the experience of similar folks in buying hearing aids and getting support? For example, I’ve heard Costco sells good, inexpensive “non-rip off” hearing aids- but the sample size is 2-3. Also, any experiences with insurance coverage?

Disclaimer:  We are not medical professionals!  Get medical advice from real professionals and/or do your own research before making any important healthcare decisions.

My father has a hearing aid from Costco.  He put off getting one for decades because, as you say, the neighborhood audiology office is expensive, but finally decided Costco was a good enough deal.  He seems happy with it.  So, that’s another N=1.

My FIL has the overpriced audiology version and he seems happy with it.

Both of them complain that it’s hard to separate out voices in a crowded room, and both tend to turn theirs off at restaurants or other crowded locations (my FIL tends to use restaurant time as time to catch up on napping).  Technology may have improved since they got their aids though, I don’t know.

Consumer reports reviews hearing aids, so you might want to look into what they have to say (they do like Costco’s Kirkland brand).  This article talks a bit about the pros and cons of Costco hearing aids.

In terms of insurance coverage, that will vary across plans so it’s probably easiest to give your insurance carrier a call and ask if it isn’t clear in the plan info provided by your university (or by wherever you get your insurance).  Some states only require that insurance provide hearing aid coverage for children.  Others include adults.  Many states don’t require it at all.  You can get more information here.  Many insurance plans will cover the screening but not the aids themselves.  But again, it’s something that varies by plan.

Grumpy Nation:  Do you have any better information than we have?  Do you or a loved one have experiences with hearing aids that you could share?

Ask the grumpies: Vaccine delayers… do they deserve our contempt (spoiler: yes, but not as much as deniers)

Jenny F. Scientist asks:

How to be less contemptuous of, say, vaccine delayers, or do they deserve it.

What stupid looks like. https://t.co/ER5hj5nE7y

— John Scalzi (@scalzi) February 9, 2019

Vaccine delayers are an interesting group. They tend to argue that vaccines are given too early because doctors want to make sure kids get vaccines so they give them at the first chance or on rigid schedules that coincide with things like daycare or elementary school requirements.  The argument is that some vaccination is better than no vaccination, so doctors give them too early.  A conscientious parent who believes in vaccines and has the means to get them done will get them done but “optimally”.  Now… why is delaying optimal?  One (refuted) argument (made by a son of the original Dr. Sears who has since been censured –– the original Dr. Sears was very much in favor of the regular vaccination schedule) is that too many vaccines at once overtax a child’s system, which is silly because the vaccines don’t work that way and even if they did, kids are exposed to more taxing things just crawling around the house.  Similarly there’s an argument about metals, but most vaccines don’t have the metals/chemicals that parents are afraid of anymore, and the metals they do have are in low amounts (one study says babies get more aluminum from breastmilk than from a vaccine).  Then there’s the argument that babies do sometimes get reactions to vaccines, things like allergic reactions or swelling and redness around the injection site, and an older child might be better able to tolerate the side effects.  (Moms who subscribed to this philosophy just wanted to delay vaccines, not spread them out.)

Another argument is that some moms just want to feel special and working out a special snowflake schedule for their kid helps.  This argument is unlikely to make you feel less contemptuous.

A more likely argument is that a lot of white dude MD doctors are exploiting women’s fears for their children in order to sell them products.  There’s a lot of evidence for this latter argument.  When white dudes with medical degrees are pushing something and they’re put on talk shows, how is a parent without a science (or other advanced) degree supposed to know if she should listen to him or to her own pediatrician?  You know and I know how to read articles in PubMed and how to evaluate evidence and when correlation is not causation… but most people don’t.  I have graduate students I teach this stuff to.  Instead of feeling contemptuous of the vaccine delayer women, perhaps the contempt should be saved for the men who are exploiting them and their children to sell their stuff.

When I was on a mommy forum vaccine delayers tended to be less stupid (…and less narcissistic) than deniers– one was even a microbiology PhD student.  She would try to talk deniers into getting vaccines later.  I think it worked on some of the mommies, though I think she also convinced some mommies who would have gotten vaccines on schedule to delay, so I’m not sure that there was a net positive.

Usually delaying isn’t going to be a problem.  Except when it is.

What, of course, worked to get more moms on that forum to vaccinate on time was a measles outbreak nearby.  Terrifying!

In an ideal world, enough people would vaccinate their kids on schedule that people who didn’t get vaccinated would have herd immunity.  In an ideal world, many of these diseases would be completely eradicated.  But we don’t live in an ideal world, so delaying vaccines carries risks that it shouldn’t.  It’s still safest to vaccinate your kids on schedule unless there is evidence of a known allergy.

In which DH does not have rabies but we spend as if he does

Three weeks have passed and DH is still alive.  Hale and hearty even.  We are all grateful and relieved.

So….

Remember how DH helped break up a dog fight and had to get tetanus shots and I purposefully didn’t get the dog’s information because it was an intact pit bull and I didn’t want it to be put to death?  (Turns out that is not a thing in this state– they would have just quarantined it for 10 days.)

A month later, DH came back from a business trip feeling nauseated off and on, with a headache off and on, and chills off and on.  After reading on the internet about how the incubation period for rabies is 1-3 months but can last up to 6 years, and reading up on the symptoms of rabies, and how you die within 1-3 weeks once symptoms have started (so far only 10 people have survived after symptoms started, and 8 of them had been vaccinated prior to getting bitten), he also developed anxiety and insomnia.  Which are also symptoms of rabies.  On the fourth day he started getting muscle twitches.

Early on in this process, we’d looked for places to get first of four rabies shots.  Walgreens has rabies vaccine, but not the first shot which has human blood in it and isn’t very shelf-stable.  None of the urgent care places in town had it.  No doctor we were recommended carried it.  Everyone said it had to be gotten at the emergency room.  DH’s insurance said they do not cover the rabies shot under any circumstances.  So to the emergency room it is.  This will be a minimum cost of 10K, and I would not be surprised if it tops out at 13K including the cost of the first shot.

At the emergency room they told DH he didn’t need to get the other three shots at the emergency room and recommended a couple of urgent care places or the department of public health.  Neither of the urgent care places would give DH the second shot.  The department of public health said the emergency room was smoking crack and they never give out rabies shots.  They said their protocol was to get the first shot at the real emergency room and to get the remaining three doses at the emergency room place without actually going into the emergency room and seeing a doctor in order to save $.

So I told DH to call the emergency room to make sure that things could work that way.  He called, but did not ask about the not seeing a doctor or the money stuff.  He just basically confirmed that they had the second shot.  Then he went and saw a doctor and had more unnecessary tests done.  So… >$20K so far.

I was not annoyed about the first emergency room shot, as I figured that was an unavoidable (albeit expensive) way to decrease DH’s anxiety, but I’m not that happy about the second shot given that he didn’t actually ask about the protocol the department of public health suggested.  He did talk to the emergency room billing again after, but they basically said they couldn’t talk to him about the bill until after it had been refused by his health insurance.  So there’s some hope he might be able to negotiate it down.  But who knows.

When he got his second shot, he got all the info about the shot (and the third and fourth shots) and it turns out those are exactly the same ones they give out at Walgreens as pre-rabies vaccines, so he could have just gone to Walgreens for the second shot and been done after paying $350.  Which he did for the third and fourth (and final) shots.  So $700 paid on credit card.

I don’t know when we’re going to get our actual insurance bill for the emergency room visits.  If we do end up paying more than $20K, that puts a really big bite into my car fund in addition to cutting into the emergency fund.  Which I guess makes the choice of cars easier as the options become much more limited.

So, you ask, why didn’t you just get the information for the pet owner?  It takes at most 11 days for an unvaccinated dog to die of rabies.  If the dog is still alive, then DH didn’t get rabies.

Well, we didn’t have the contact info for either of the dogs.  We posted on nextdoor (the neighborhood social media site) and on day 3 an anonymous neighbor pointed us in the direction of the golden retriever owners.  They were very nice about everything and gave us the contact information that night for the pitbull owner, but warned us that they thought the pitbull owner’s house was for sale.  And indeed it was.  For sale and empty of furniture.  DH tracked down the facebook page of the dog owner’s son which was blank, and then to the son’s wife which had lots of oversharing posts.  The posts mentioned the grandparents moving to the closest city (~2 hours) and it sounded like they were taking a dog with them, though no guarantee it was the dog in question.  But also no mention of sad dog deaths in the previous month.  The son’s wife did not respond to a FB friends request or any of DH’s queries.

We also called the agency that handles dog licensing in our county, since your rabies vaccines have to be up to date to be licensed.  But of course the dog wasn’t licensed.  So that, too, was a dead end.

On the morning of DH’s second shot, DC2 woke us up to let us know zie had thrown up in the night, the first of several throwing of ups.  As I groggily listened to hir, I realized I too felt nausea.  The nausea came and went.  So did a headache.  And chills.  All three symptoms would come and go randomly, seemingly completely unrelated to each other.  The chills were particularly disturbing.  I can understand how DH thought something out of the ordinary was happening.  (Though it turns out this weird virus has just been going around– it doesn’t last as long for most people because most people sleep instead of googling things that cause anxiety.  DC2 was better in a day and I was completely better by day 3.)

And that is our expensive and exasperating story.  My colleagues think it’s hilarious, and indeed, it is hilarious given that DH is still alive and we’re not going to have to go into major debt, just buy a cheaper car or sell some stocks.  Most insurance companies don’t cover rabies vaccines for people because they’re expensive and usually they’re just being given as anti-anxiety shots.  (Obviously if you’re bitten by a wild animal, you should get them if they can’t autopsy the animal in question.  But for pet dogs who are behaving nicely towards humans, not as clear.)

Morals:  If you’re breaking up a dog fight, use water, or lift the back legs of each animal.  Do not mess with their mouths.  If you get bitten by a pet dog, get the name and contact info for the @#$23ing dog so you can see if it dies in 11 days or not.  If you do get the series of four shots post-bite, get the first one in an emergency room and the remaining 3 at Walgreens (using a different schedule than the one that Walgreens will want to use– talk to the emergency room doctor about the schedule for all four shots).

List of things I need to do to take care of myself

1.  Get a haircut.  It has been 2 years.  Update:  I tried to do a walk-in at the place next to DC2’s newish Saturday morning activity, but they were full-up.  When traveling dies down, if I haven’t gotten a haircut in a conference city, I will make an appointment for during DC2’s activity one of these weeks.
2.  Get an eye-exam and new glasses.  I think it has been over a decade and my driving glasses have scratches.  I am also intrigued by the idea of computer glasses.  Update:  got the eye exam while at a conference at the Lenscrafters in [conference city] (everything is aok, though I’ve gotten slightly nearsighted in addition to my astigmatism; doctor says I can still use my glasses for just driving).  Will pick the glasses up at another conference in the same place later this month.  (Oddly, I think I’ve gotten all my glasses since 200X from the lenscrafters in this mall, and a good number of my haircuts.  I have several conference buddies who refresh their wardrobes periodically from the Ann Taylor there, though I don’t because there’s never anything in my size on sale.  I get my shoes in a completely different conference city.)  I also used my prescription to order an extra pair from (not sponsored!) zennioptical, which is where my DH gets his actual glasses.  Update:  have both pairs of glasses, and both make my vision really crisp.  I definitely needed an updated prescription!
3.  Get a mammogram.  I filled out the online form for an appointment a couple weeks after my birthday but haven’t heard back.  I should call.  Update: scheduled for May 2nd.
4.  Get tested for diabetes/insulin resistance or just get a metformin prescription.  I have PCOS.  Over the holidays plus during job candidate season I overindulged and didn’t listen to my hunger and gained weight eating all sorts of refined carbs.  Since then I’ve gone back to my regular mostly diabetes-friendly diet, but my weight has stayed the same instead of dropping like it usually does when I listen to my hunger, my periods have stopped (this could be menopause in action) but I keep feeling like I’m about to have my period, I’m tired and fatigued a lot, I’ve been drinking water a lot more, and I’ve been getting headaches (but maybe my hair is just too long).  Also I occasionally wake up with tingly fingers or toes.  In response I am going completely no-refined-carb (goodbye wheat thins, the cookie in cracker form), but I really ought to also just see a doctor for testing or medication.  Update:  diet change seems to help a lot, and when I do accidentally eat something with lots of sugar I feel cruddy and brain-foggy within an hour or so.  Still no period.  My current plan is to go back to the rule from my late 20s when I was first diagnosed:  3 months no period => go see the doctor.  That puts me at the start of summer to make an appointment.  Update 2:  diet change helped with that too… so I think I’m going to need to decide if I want to continue with the diabetes diet vs. go on metformin.  It is just hard to be careful about added sugar and refined flours (and I *like* refined flours), but metformin is unpleasant and can also interfere with B12 absorption which is something I occasionally have a problem with.  So I dunno.  After doing some youtube watching, it sounds like if you’re good about your diet over a 3 week period, diabetes won’t show up in the initial blood screen because you’re not getting the bad symptoms that show up in the bloodwork.  The fasting icky drink the awful orange drink tests should still show up positive though.
5. Eat more vegetables.
6. Get my skin checked out.  The problem with this is that the dermatologist office in town has a reputation for removing all moles, not just the ones likely to be cancerous, and he has a “non-disparagement” clause thing you have to sign, so nobody is allowed to leave a negative review on Yelp.  So I would have to find a dermatologist elsewhere and get to them.
7. Get new brown dress shoes.  My current Pikolino’s half boots (3-4 years old) are getting worn down in the heel.

RBOC

• DC1’s algebra teacher quit to join administration a couple of weeks after the second semester started (after a week long absence).  I guess we’ll have to keep a closer eye on the rest of the semester since algebra is so fundamental and I’m pretty sure zie doesn’t now how to factor polynomials even if zie does know how to multiply them.
• Super bummed that Teen Vogue is no longer doing a print edition.  The last few issues were AMAZING, including one guest edited by HRC.  Irritatingly, they switched DC1’s subscription over to Allure magazine “the magazine for people who care about beauty” or something like that.  Full of “beauty tips.”  This month’s issue was on nudity and had a nearly naked airbrushed stereotypical model on the cover.  Completely not appropriate for an 11 year old or really anybody.  And very different from a magazine that features people like Malala Yousafzi on the cover.  I will be getting a check for $2 in the mail for my cancellation– Teen Vogue should have been charging more.  It’s a different market and was worth much more than the ridiculous $10 for 2 years or whatever it was I paid.
• Forgive me, for I have referred to a paper about fertility as “seminal” in published work.  Next up:  referring to a paper about religion as “canonical”.  And a paper about building cities as, “ground-breaking” (or should I save that one for agriculture?).
• it is weird to me that my kids have had macarons before having had macaroons.
• DC2 has moved onto chapter books at school.  Zie is in love with the Geronimo Stilton that DC1 read maybe once or twice.  They have such different taste in books.  Really the only commonality is that they both love Jim Benton, author of Franny K Stein and Dear Dumb Diary.  I so wish we had Scholastic so I could indulge in buying sets of series we don’t have (like Thea Stilton!)
• Preserved walnuts are really good.  If you ever get the opportunity to try/buy them, take it!
• My cholesterol is fine this year (whew!), so maybe all that additional lunchtime walking did some good!  Unfortunately, it doesn’t seem to have helped with my vitamin D levels (which may explain the fatigue I’ve been having), so my doctor wants me to go from 2000 iu to 5000 iu.  I’m going to compromise and do 4000 iu because that means I can have a 2000 iu when I brush my teeth and keep another bottle of 2000 iu in my office when I get my mid-day slump.
• It isn’t a bargain if you can’t afford it.
• We owed an additional $2846 in taxes this year, not counting the estimated taxes for this next year.  [Update:  We forgot a whole ton of donations– didn’t go through the school email folder or the check register, so it’s actually $100 less than that.  With the additional donations, we’re just a little over the standard deduction.  Also turns out there’s no point for us to declare a home office since we don’t get anywhere near the minimum for it to count for us– We make too much and our house is too big and too cheap.]
• DC2’s school was having a performance for parents/relatives and one of their dances had them shooting with finger guns.  This disturbed DC2 enormously given that they started practicing right after the FL school shooting.  Thankfully someone decided to change that number to something in less bad taste.

Little kitty was overgrooming because she had dual ear infections

The headline is basically the story.  Little kitty was basically giving herself a buzzcut through overgrooming.  She also kept avoiding us touching her ears.  We worried it was allergies (she’s already on prescription food for her ideopathic too-much-calcium) or anxiety (we already have one cat on Prozac).  But the vet cleaned out her ears and gave her ear goop to fight the infections.  Within two days her ears felt better and within a week it was noticeable that she was no longer over-grooming.  So, whew.

Have you had any experience with pet overgrooming or ear infections?