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?

 

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.

Ask the readers: How to get the word out about ACA enrollment?

The Trump administration is trying to kill the Affordable Care Act administratively since they’ve failed legislatively.

Open enrollment is open from Nov 1st to Dec 15th this year.  (In previous years, people had the chance to look over their plans during their winter holiday vacation.  This year that’s out.)

The website will be shut down every Sunday from Midnight until noon for “Maintenance” except for Dec 10th.  I assume that’s to keep people from getting help before or after church.

Advertising has been cut, money for people to help navigate the system has been cut.

Then there’s some bizarre stuff going on with the previously most popular “silver” plans– rates on these have skyrocketed because of government malfeasance, and it may actually cost the same (possibly less!) to get a “gold” plan than to get a silver plan.  (“Bronze” plans will cost about the same as before, but are generally high deductible.)

Forbes has an excellent article detailing these and other points as well as giving advice.  Huffington post also has a great article/video giving advice for navigating the system.

I’ve seen various twitter accounts reminding people to sign up for the Affordable Care Act.  But I wonder, what can we do to get to word out to people who don’t follow activists on Twitter?  I’ve posted a sign on my door at work and am considering mentioning it in class.  Most of my students (at least in the past when I’ve asked) are still on their parents’ plans.

Let’s brainstorm… any suggestions for how to get this information out?