Cash: don’t carry; you need your phone

rejected

moneyMy oldest college friend complained on Facebook. “It is almost impossible to use cash in the airport. You’re SUPPOSED to use a QR code to download a Health/Travelers form because there’s No Paper, but you need to sign up for an ACCOUNT to do it!!”

Yes, that was worth at least two exclamation points!!

There are a number of places where cash is no longer king. Getting food on an Amtrak train, for instance. A lot of retailers at markets seem greenback-averse. My running joke at a store register is “Do you still take cash?” Apparently, you CAN accept cash and checks with the service Square. Are businesses required by law to accept cash? It depends on where they are

What countries are going cashless? China’s society is, its central bank is pushing backSweden and Zimbabwe, for two, are also getting resistance.

Also, increasingly, I NEED to have a cellphone. When I’m making a medical appointment, I get notices on my phone. When I get there, some places require that I check in via the device. And the photo of my vaccine card is stored therein.

Not covered

Speaking of medical things, I had gone to my doctor in September to get two shots during my annual physical. In October, I received a bill for $125 for services not covered. My physician’s office seemed to think it was because I had received both the flu shot AND the tetanus shot at the same time. But that wasn’t it.

Medicare had rejected the tetanus shot, the representative told me. Now, they would have covered it if I had been bitten by an animal or stepped on a rusty nail, or had another medical necessity. But since I was ONLY getting it because physicians believe I should get one once a decade, Medicare didn’t cover it. And since Medicare rejected it, my Medicare supplement carrier ALSO rejected it.

I’ll have to remember to step on a rusty nail in the fall of 2031.

Remembering three items; drawing a clock face

Next year, I’m told, the test at my doctor’s office will be tougher.

three thingsA couple weeks ago, I went for my annual physical at my primary physician’s new venue. The Physician’s Assistant, who was previously unknown to me, asked me to put the numbers on an analog clock face. Then I was to indicate ten minutes after eleven on said drawing. I succeeded!

We agreed that, a generation from now, this might not be a very useful exercise. Maybe sooner.

There were three words I was given to remember. Even that evening, retelling this to my wife, I couldn’t recall the first word. It may have started with S. It surely WASN’T Tequila because the second word was Sunrise.

The third word I feigned forgetting, lightly pounding the arm of the chair I was sitting in. Finally, I gave the correct answer: Chair.

I’m not sure how much this proves; I’m notoriously bad at remembering names. But good at numbers; I was asked to recall my weight, which I did. But that also had the visual cue.

Having to have this test administered really ticks off my primary care physician. It’s apparently a mandate of some sort for those who are eligible for Medicare; I do have Part A.

If the test HAD shown some developmental loss, it might well be at a point when it’s far too late to be of any use.

Of course, the “rule of three” is “a writing principle that suggests that things that come in threes are inherently funnier, more satisfying, or more effective than other numbers or things. The reader or audience of this form of text is also more likely to consume information.”

That’s SO true. When my wife asks me to remember three items to pick up at the store, I’m good. Add a fourth item, and out comes the pencil and paper. Some are even worse off: Fred Allen said: “I always have trouble remembering three things: faces, names, and – I can’t remember what the third thing is.”

Next year, I’m told, the test at my doctor’s office will be tougher. I’d start studying now but I don’t know what’s going to be on the quiz.

Family health report, July 2017: hammer toes

You start to feel better and you inevitably overdo.

The big story this summer is that the wife had surgery on the three middle toes on July 5. She had hammer toes. She didn’t have to do it now, but eventually, without being corrected, it might impact her mobility as she gets older.

The surgery was very successful. Her response, in terms of limited swelling, et al, was very good, her doctor told her at every followup visit.

One of the things we have both discovered, with my hernia surgery a couple years ago and her recent surgery, is that the cycle of pain is quite fascinating. Right after the surgery, when you get home, you feel really great. The anesthetic has not yet worn off.

Then the pain starts to creep in, and you better start taking that opiod right way, because if you decide to tough it out, it will take longer to get relief. But the prescription lasts only a couple days. It’s less than what you want, and you start taking the over-the-counter stuff, and for longer that you think, hopefully without ruining your liver.

You start to feel better and you inevitably overdo. The Wife is even worse in this regard than I. When she walked too much, and didn’t put her foot up, she is surprised how much it still hurts three or four weeks on.

Meanwhile, I chipped a tooth, for which I’m getting a filling on August 13. More significantly, both in terms of time, pain, and money, I’m getting a crown on September 13.

The Daughter noticed a mark in the whites of my right eye at the end of the month. It was a vertical red line that looks as though someone had drawn it with a Sharpie. The very next day, I went to my ophthalmologist, who said it was a broken blood vessel, and that it would resolve itself. It looked much worse than it felt.

I is for iatrogenic

Unlike an adverse event, an iatrogenic effect is not always harmful.

iatrogenicSomeone sent me this piece from an obituary: “…His demise was probably iatrogenic.” Iatrogenic was not a word I knew.

It means: “induced inadvertently by a physician or surgeon or by medical treatment or diagnostic procedures: an iatrogenic rash.”

The origin of the word comes from the Greek, iatros, meaning physician, plus the English suffix -genic. The word’s first known use was in 1924.

Some of the causes of iatrogenesis include side effects of a treatment and drug interactions, which may have been unanticipatable.

Also, “unlike an adverse event, an iatrogenic effect is not always harmful. For example, a scar created by surgery is said to be iatrogenic even though it does not represent improper care and may not be troublesome.”

Still, iatrogenic disease is the 3rd most fatal “disease” in the USA, with avoidable errors such as infection, and medication errors as leading causes of mortality.

Related: the dictum “first do no harm” doesn’t exactly come from the Hippocratic Oath, but it does come from the Hippocratic Corpus, at least in essence.
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Sam Simon has died at the age of 59; it was not iatrogenic. He was the co-creator of the hit animated show, The Simpsons. There’s a lovely article about him in Vanity Fair.

ABC Wednesday – Round 16

Colonoscopy preparation day!

If I’m a little slow visiting your websites, you will know why!

Preparing for my second colonoscopy

I’m having a colonoscopy tomorrow. Oh boy! The preparation starts today. Actually, it started a week ago, when I purchased the laxatives and the clear liquids to take today. Then a couple of days ago, start a low-fiber diet, avoiding nuts, seeds, popcorn, and corn. Yesterday, drink at least 8 glasses of water or other clear liquid while maintaining a low-fiber diet.

Today, low residue breakfast: eggs (not fried), bananas, apple sauce, juice without pulp. Clear liquids for the remainder of the day. At 3 pm, start the laxative/clear liquid regimen, finishing up tomorrow morning, which of course will keep me…busy. The actual procedure will be around 12:30 pm tomorrow, and my wife will bring me home.

So if I’m a little slow visiting your websites, you will know why!

Here’s what humor writer Dave Barry said about HIS colonoscopy back in 2008: “Which brings us to you, Mr. or Mrs. or Miss or Ms. Over-50-And-Hasn’t-Had-a-Colonoscopy. Here’s the deal: You either have colo-rectal cancer, or you don’t. If you do, a colonoscopy will enable doctors to find it and do something about it. And if you don’t have cancer, believe me, it’s very reassuring to know you don’t. There is no sane reason for you not to have it done.”

I did this before, a decade ago. It was no big whoop; I don’t believe that I watched the procedure on the monitor. My wife gets one every five years – her brother John died of colon cancer at the age of 42 in 2002 – and she likes to watch.
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Colonoscopies Explain Why U.S. Leads the World in Health Expenditures: “The high price paid for colonoscopies mostly results not from top-notch patient care…, but from business plans seeking to maximize revenue; haggling between hospitals and insurers that have no relation to the actual costs of performing the procedure; and lobbying, marketing and turf battles among specialists that increase patient fees.”

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