Archive for Ease and Disease

This I want

From Roger’s September Rambling #2:

From Donna: “Thinking of writing a bedtime book for grownups along the lines of Goodnight Moon. It will be titled Shutup Brain.”

Yes, yes, YES!

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Fark blurb of the week

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Life in Non-Drowsy Land

Saturday night, about five minutes before midnight, I extracted the little blue-green tablet from the card, and began my first test of Belsomra (suvorexant).

  • 12:00:  A book at bedtime.
  • 12:15:  A couple of yawns; I abandoned the book and turned off the light.
  • 1:45:  Still awake, and barely even drowsy.
  • 2:15:  Got up and cranked up the computer.
  • 4:00:  Went back to bed.
  • 4:45:  Last time I remember seeing the clock before sunrise.
  • 7:20:  Sunrise.
  • 7:25:  Discovered I’d pitched a pillow onto the floor.
  • 8:30:  Actually got around to retrieving the pillow.
  • 10:55:  Crawled out of bed.

Obviously I did get some small quantity of sleep, with various interruptions, out of this deal, but its onset was so long delayed from the time the pill was taken that I question whether it contributed anything.

Dosage: 10 mg. The prescribing information contains enough Scary Stuff to suggest that 10 would have been a heck of a lot safer than 20.

I will try again next weekend, perhaps on Friday night. I am not, however, particularly hopeful. The Holy Grail of sleep tabs — works in 15 minutes, disappears completely in six hours — has yet to be approached, let alone found. I will say this: it’s a wholly different dream function. Instead of the bad urban-fantasy stuff I find with Ambien, I got a bad memoir. Not really an improvement, but perhaps less frightening.

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All plop, no fizz

As usual this morning, I walked down the driveway toward the curb to fetch the newspaper. (I am one of those people who actually would prefer an afternoon paper, but the ten or twelve of us who still exist don’t count for much.) As usual, it was positioned on the section of concrete with the sharpest slant.

They say “Use your knees, not your back” to pick up stuff. If they had knees like mine, they never would have said such a thing. The Monday paper being generally smallish, I had a long way to go, and calculating the geometry of the matter, I spread my feet apart a few inches to buy some vertical. And then, having seized the paper, I unaccountably pitched forward, two, three steps, and wound up washing my face in the morning dew.

The fact that I was able to get up from this was heartening, or at least not leading to despondency. I dusted myself off and headed for the shop, figuring I can use the time at that traffic snarl around Penn Square to report that I wasn’t going to be in by 6:30.

No phone.

Evidently when I pulled myself off the ground, the little so-and-so stayed behind. I made a modestly mad dash in the opposite direction, retrieved the device, and started over. Okay, it was closer to 6:45. I can live with that. And they’re going to have to, you know?

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Not on your formulary

In fact, I don’t know how anybody affords this stuff at all:

A U.S. drug company is taking the Canadian government to court for its attempt to lower the price of what has been called the world’s most expensive drug.

Alexion Pharmaceuticals has filed a motion in Federal Court, arguing that Canada’s drug price watchdog has no authority to force the company to lower its price for Soliris.

The medication is approved to treat two rare blood diseases that affect about one in every one million people. A 12-month treatment costs about $700,000 in Canada, while in the U.S. it costs about $669,000.

Wikipedia contributes this little factoid:

Alexion tested the drug for rheumatoid arthritis, which afflicts 1 million Americans. The trials failed. But if it had worked for arthritis, Alexion would likely have had to charge a much a lower price for this use, as [it] would have to compete against drugs that cost a mere $20,000.

In other news, $20,000 a year is now considered “mere.”

I have been known to complain about a drug that costs me $75 a month. I don’t even want to imagine a drug that costs $75 an hour.

(Via Fark.)


Overnight insensation

The one characteristic that applies to all sleep medicines: if they work at all, eventually they stop working. Trying a new one, therefore, is fraught with peril:

It’d been a while since I’d tried anything new because, frankly, after a bunch of decades at this, you get USED to being exhausted and running on “dim” or, as I like to call it, “energy-saving mode.” True, I sometimes think, “I bet I would have cured cancer already, had I been able to get plenty of quality sleep every night, all during my life. And had I not gotten the D in chemistry and been at all interested in science.” My doctor has given me STERN warnings that I need to sleep because this will “kill” me. Ok doc then gimme some good drugs. Not drugs with butterflies. I need drugs with velociraptors.

Alas, butterflies are all you get:

The Lunesta … oh how I wish it had worked. It looked so promising. The marketing! See the pretty diaphanous butterfly? The website says it’s very “fast-acting” and warns that you shouldn’t even TAKE this pill unless you’re strapped into bed in your strait jacket and have hired a home nurse or Joe Don Baker to stand vigil. All this because you will be completely zonked out in a fucking minute, you skeptic you, and you will likely be trying to paint your home’s exterior overnight, ALONE, in your deeply restful dream state.

Pfft. No piñata confetti. Not so much as a plastic drink umbrella in the bedding this morning.

The doctor will be sending over a script for Belsomra (suvorexant), a totally new concept in sleeping pills, with a totally new level of TV-commercial creepiness:

If the little cloud creatures don’t scare you to death, the warnings will.

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Purell you say

Ramones Leave Home is one of those albums that got edited shortly after the original release, owing to serious pearl-clutching over track 5, “Carbona Not Glue,” the lyrics of which expressed a definite preference among major juvenile huffing substances. Certainly, though, none of these young punks would actually drink carbon tetrachloride.

But hand sanitizer? That’s different:

A new report is cautioning parents about the risks of seemingly harmless liquid hand sanitizer, after an increase in calls to poison control centers about children who’ve ingested enough of substance to make them dangerously drunk.

Since 2010, poison control center hotlines in the United States have seen almost a 400% increase in calls related to kids under 12 consuming hand sanitizer, CNN reports, citing new analysis by the Georgia Poison Center.

The high alcohol content in liquid hand sanitizer — ranging anywhere from 45% to 95% alcohol, compared to wine and beer at 12% and 5% alcohol — can easily cause alcohol poisoning with just two or three squirts, experts say. Children may become confused, vomit or experience drowsiness, and in extreme cases, a child might stop breathing.

Obviously the kids would be better off buying beer — even Oklahoma 3.2-percent quasi-near-beer. And it wasn’t that long ago I, a person of Obvious Age, got carded for purchasing a can of Krylon spray paint.

There needs to be a central database for all the stuff kids will attempt to ingest in a desperate attempt to get a buzz. I suggest they call it the Huffing (Some) Post.

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The impatient patient

The older you get, the slower you heal, and the more likely you are to respond this way:

The first 36 hours felt like Armageddon in my body, fever, chills, pain, nausea, weakness, the whole shebang. It would take me an hour to recover from the 10 minute drive to drop off the chicks at school. Takes longer in the afternoon because, apparently, sunshine and heat are not my friends.The bottle of antibiotics has two stickers on it: one tells me to drink lots of water, the other tells me to avoid prolonged exposure to direct sunlight. It would seem I’m now a fern.

All this started about two weeks ago.

(Via Bayou Renaissance Man.)


No sugar tonight

If this be blasphemy, I plan to make the most of it. Start here:

I’m also trying to clean up my diet. Oh, I eat pretty healthfully to begin with but I panic over these things and I actually wrote NO SUGAR! NO SUGAR AT ALL for the next week on the kitchen calendar. I worry, probably needlessly, about type II diabetes (and yes, I know: it’s how you eat all the time, not just in the week before bloodwork, but I want things to look their best). I think the tv ads I see for the million medications they have, some you have to inject, some with scary sounding side effects, that has the paranoid part of my brain convinced that probably everyone is actually diabetic and just doesn’t know it yet.

Fifty percent are there or close to it, say some of the alarmists.

But here’s the kicker: WHO issues a definition of Type 2 and it’s based entirely on readings. Oh, it says “with symptoms,” but everybody and his kid sister has symptoms of some sort. One arbitrary number applies to all seven billion humanoids, regardless of age, creed, color, national origin, metabolism, or astrological sign. This is convenient for those who compile statistics, and for nobody else.

It really does feel like everything is a moving target: you do, but you could do MORE. And it just wears me out. More exercise, more vegetables, less food that actually tastes pleasurable, less time spent just relaxing. (And I’ve seen several sites lately that remind us how awful sitting is for us, and we should, I guess, stand all the time, like horses or cattle…)

And I get that I’ll eventually not be able to outrun the Grim Reaper, it’s not that … it’s the whole fact that medicine in some sectors seems to be coming back to an idea not unlike the “you sinned, so you got sick” idea of the medieval era — “You sat too much on the job, now you have diabetes.” or “You relaxed when you could have exercised, now you have heart disease” and it feels to me like unless I keep pushing, pushing, more, more, more, eventually something terrible is going to happen and someone in the health-insurance office is gonna shrug and go, “You were insufficiently pure so you are on the hook for this financially, even if you can find a doctor willing to treat you.”

“Some sectors” eventually will be all sectors, because government.

I am resigned to not living forever. However, I reserve the right to sneer at the Reaper, that scythe-wielding son of a bitch, any time I please. And should some Deputy Associate Death Panel member object to this cavalier treatment of their true god — well, chuck you, Farley, this is why you get no respect from the population, while I’m having a bowl of ice cream in any flavor other than Pumpkin Spice.

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If this doesn’t make you smile, you have no face:

Directing a sci-fi blockbuster can be a rewarding experience for any movie maker. But when Guardians of the Galaxy director James Gunn found out that his character of few words — Groot — encouraged a child with a developmental coordination disorder to speak for the first time, he was astounded.

Josh Dunlap, a father to a child with dyspraxia, reached out to Gunn on Facebook to let him know how impactful Guardians of the Galaxy was on his son Sawyer… “When Guardians came out Sawyer could only say about three words and would communicate to his mother and I by other means,” Dunlap told Gunn on Facebook. “When he saw Groot, something clicked inside him and he connected with him on a level I haven’t seen.”

“He began to mimic him and he would use the word ‘Bah’ for a lot, but after he saw the film, he would change the tone in which he said it to convey a different meaning,” Dunlap added. “He would also start saying Groot for many things as well. Since that, he was finally able to go to a speech class and it has helped amazingly.”

I surmise that this probably wouldn’t have worked so well with Hodor.


The next-to-last nerve

The same Sudden Weakness that befell me Saturday afternoon at the supermarket hit me again at the office on Wednesday. It wasn’t quite so severe, but once again, it helped that I was near something to grab.

Normally I avoid seeking medical attention. I don’t think I’ll be able to this time. There’s no sensation that anything is ripped or torn: it’s just a pang, the muscles give way for a moment, and I do what I can to regain my composure.

The office, which does regular business with an occupational-health clinic, got me some chlorzoxazone, which relieves pain on a short-term basis. Clearly, though, there’s more here to deal with.

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Drop and give me $75

I was unloading groceries at the checkout stand this afternoon when something in my left thigh decided it wanted my attention and promptly knocked me to the ground, or at least several inches closer to it. If you’ve ever had anything that hurt like a son of a bitch, this is the son of a bitch it hurt like. For a moment I regretted not having bought a fresh bottle of Advil.

It can’t have been too severe: I was somehow able to walk, albeit haltingly, and I didn’t notice anything unusual-looking when I got home. Still, walking it off did not make it go away, and I may have to dip into my secret stash of Lortab if it doesn’t lighten up in the next couple of hours.

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Dear Addyi

If you were waiting on, for lack of a better term, “Viagra for women,” well, here it comes, kinda sorta:

Sprout Pharmaceuticals, Inc. (Sprout) announced today that the U.S. Food and Drug Administration (FDA) has granted approval of Addyi™ (flibanserin 100 mg) (pronounced “add-ee”), a once-daily, non-hormonal pill for the treatment of acquired, generalized hypoactive sexual desire disorder (HSDD) in premenopausal women. Addyi is the first and only FDA-approved treatment for this condition, the most common form of female sexual dysfunction, affecting up to 1 in 10 women in the United States.

It has been a remarkable journey to get to this breakthrough moment. Today we celebrate what this approval means for all women who have long awaited a medical treatment option for this life impacting condition,” said Cindy Whitehead, chief executive officer of Sprout. “We applaud the FDA for putting the patient voice at the center of the conversation and for focusing on scientific evidence.”

The pink pill — Sprout’s toll-free number is 844-PINK-PILL — doesn’t precisely match up to its blue cousin:

Addyi is indicated for the treatment of premenopausal women with acquired, generalized hypoactive sexual desire disorder (HSDD) as characterized by low sexual desire that causes marked distress or interpersonal difficulty and is NOT due to:
– A co-existing medical or psychiatric condition,
– Problems within the relationship, or
– The effects of a medication or other drug substance.

You definitely don’t want to use it while drinking. And where did they get that name?

Update, 20 August: Nancy Friedman reports: “The FDA official who announced the approval of the female-libido drug Addyi is named Woodcock.” But of course.


Forget about sleeping

Some nights I have to, and apparently by so doing I am setting myself up for something much, much worse:

[F]indings just published in the Journal of Neuroscience reveal that there’s an optimal sleeping position for brain health — and the good news is that this position is incredibly common.

According to the study, sleeping on your side, rather than your back or stomach is the most efficient way to help the brain discard toxic waste. The study examined rodents in three sleeping positions: lateral (side), prone (stomach) and supine (back). The researchers concluded that:

“The major finding of our study was that waste … removal was most efficient in the lateral position (compared with the prone position), which mimics the natural resting/sleeping position of rodents.”

Side-sleeping is thought to be the most common position, preferred by an estimated two out of three Americans.

And undiscarded toxic waste, particularly the protein fragments known as beta-amyloid, turns out to be implicated in Alzheimer’s disease, something I fear greatly. But there are going to be nights when every other fear in the catalog is going to be bidding for space in my brain, and behaving sensibly is completely out of the question.

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It’s the yeast they can do

People with pain, of which there are an abundance, swear by hydrocodone, an opioid obtained from poppies. Yes, those poppies. But what if you could make the stuff without having to go to the very same plants that support the heroin trade? It’s actually been done, on a small scale:

Over the past several months, scientists from around the world have published bits and pieces of a fascinating feat: In an effort to create pain medication components like hydrocodone — the main ingredient in the pain killer Vicodin — without the help of poppies, scientists have engineered simple baker’s yeast to synthesize these medicinal compounds from sugar. One by one, labs figured out how to get the yeast to turn A into B, and B into C, Y into Z, and so on and so forth.

Now, for the first time, researchers at Stanford University have done it from start to finish. In a paper published Thursday in Science, they report the successful synthesis of hydrocodone from sugar, thanks to genetically engineered yeast.

The abstract:

Opioids are the primary drugs used in Western medicine for pain management and palliative care. Farming of opium poppies remains the sole source of these essential medicines despite diverse market demands and uncertainty in crop yields due to weather, climate change, and pests. Here, we engineered yeast to produce the selected opioid compounds thebaine and hydrocodone starting from sugar. All work was conducted in a laboratory that is permitted and secured for work with controlled substances. We combined enzyme discovery, enzyme engineering, and pathway and strain optimization to realize full opiate biosynthesis in yeast. The resulting opioid biosynthesis strains required expression of 21 (thebaine) and 23 (hydrocodone) enzyme activities from plants, mammals, bacteria, and yeast itself. This is a proof-of-principle, and major hurdles remain before optimization and scale up could be achieved. Open discussions of options for governing this technology are also needed in order to responsibly realize alternative supplies for these medically relevant compounds.

I interpret that last sentence as “Those who wage the War On [Some] Drugs will have a coronary if this technology becomes widespread.” To them, Schedule II is the Voice of God.

Tangential: Apparently all five members of the research team — four are pictured at the WaPo link — are women.

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The glucose is clear

I’m not quite sure I understand this promotion:

Actually, that’s only half a gallon, but it still sounds a bit strange.

(Via Dawn Summers.)

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It costs how much?

What’s the single worst aspect of our current — and probably future — health-care system? If you ask me, it’s the fact that situations like this are possible:

[A] few months ago a doctor told me I should have a test, an angiogram, just to be safe. How much would it cost? The doctor had no idea. Nobody had any idea. If I wanted I could call up my insurance and be put on call waiting for half an hour to finally be told they had no idea. But, hey! Everybody wants to be safe, right?

Today I got the bill. Turns out it cost $7300. Who knew?

I’m not complaining that the test is too expensive. They had a big room with bright lights and computer monitors and machines going “ping!” Machines that go “ping!” cost money. I am complaining that I would have had to file a subpoena to get a ballpark figure for what it would cost. I was like, “Is it over $1000? Is it bigger than a breadbox?” Nobody knew.

How do they not know this stuff? Do they just make the numbers up afterwards?

Not enough people demand prices up front. Dr. Smith, who’s been there before, explains:

I’ve come to the conclusion that it’s the obligation of the seller to provide and display prices to the buyers. It’s not the obligation of the buyer to discover prices that are probably hidden. And in healthcare, most of the time they are. As a seller, if I say “here is what I am, here is what I do, and here is what I charge for it,” then the buyer can very deliberately determine whether that represents a value or not. They can comparison shop. And they can do it without revealing anything or providing any commitment whatsoever to me, the seller. This is present in every industry in the U.S. but it is largely absent in healthcare. Fortunately it is a growing phenomenon and more and more people are realizing that it is incumbent upon the seller to provide prices.

Worst-case scenario, which is actually the norm: prices are based on what the government will fork over.

[T]he government ultimately gets everything wrong. If they guess what my price should be, they’re either going to guess too low, which means I’m not going to provide the service, or they’re going to guess too high, which means resources are wasted.

Any attempt by anyone in a top-down central planning type of fashion to guess what the prices for services or products should be, is going to be wrong. Real prices emerge from competitive activity.

And avoiding competitive activity is at the very heart of American health care, a situation which the ACA does absolutely nothing to alleviate — but then, it was never intended to.

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March’s child is weak of heart

Or so this study would have you believe:

A new algorithm developed by scientists at Columbia University Medical Center (CUMC) supports previously reported associations between a person’s birth month and overall disease risk, including 16 new links that include nine types of heart disease. The study was published in the Journal of American Medical Informatics Association.

Prior studies have suggested a relationship between individual diseases (such as asthma and attention deficit hyperactivity disorder [ADHD]) and birth season, but this is the first large-scale study to compare rates of 1,688 diseases and the birth dates and medical histories of 1.7 million patients treated at New York-Presbyterian Hospital/CUMC from 1985–2013. More than 1,600 associations were eliminated and 39 previously reported links were confirmed, along with 16 new associations that included nine types of heart disease; risk of atrial fibrillation, congestive heart failure, and mitrial valve disorder was highest in those born in March. Previously, a study on Austrian and Danish patient records found that those born in months with higher heart disease rates (March through June) had earlier mortality rates.

You don’t think conception in the summertime (June through September) might have had something to do with it, do you?

Asthma risk was greatest among those born in July and October babies; this is consistent with an earlier Danish study in which the peak risk was in the months when Denmark’s sunlight levels are similar to New York’s in the July and October period (May and August). Data on ADHD matched those from a Swedish study suggesting that one in 675 ADHD diagnoses are for those born in November.

And if November children were more susceptible to ADHD, wouldn’t you expect at least one, or more, in twelve diagnoses? (Hey, look, a squirrel!)

Just the sheer number of potential ailments is enough to give Bill Quick reason to question the results:

The first red flag is the number of diseases used in the study — 1,688. I suspect that some correlations are inevitable with that large a number, whether there is any actual causal connection at all.

There’s always the astrological connection, and we all know how well that works.

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Ungentle benzo

Why all this screwing around with health-care coverage, or lack thereof, doesn’t really mean a damn thing in the long run:

A single dose of the anti-anxiety drug lorazepam — the generic version of Ativan — will run you about 14 cents at Safeway or Target.

At Good Samaritan Hospital in Los Angeles, the same pill goes for nearly $2,000.

At least that’s the impression Laurie Leigh came away with after being so overcome with grief when her 90-year-old father died at the hospital that she fainted at his bedside. She subsequently received a pill to soothe her nerves.

Leigh’s insurer, Blue Shield of California, covered about $200 of the bill, leaving her holding the bag for more than $1,700.

Of course, this doesn’t mean they charged her two grand for an Ativan; they also took her blood pressure and set her in a vacant bed in the ER for about an hour and a half. The tablet itself was a hair under $20. Still, you can buy thirty of them at Walmart for four bucks.

For the record, CFI Care — not its real initials — would have paid about $1360 had this happened to me, had I reached my annual deductible, which I think I’ve done twice in the last quarter-century.

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Bronco exhaust

Everybody’s seen the classic cuss jar. The Denver Broncos were alleged to have a fart jar:

Miller explained later:

Turns out Miller was pulling our finger chain, but I have to figure that this is probably more of an issue than anyone is letting on, inasmuch as if anyone smelt it, it may be safely assumed that someone dealt it.

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A white lab coat of enamel

The Z Man, for one, welcomes our new mechanized practitioners of medicine:

It seems to me that one place where the robot future should be a reality is in basic medical care. Instead of paying an arm and a leg for disinterested humans to act as a go between, let the patients talk to the robots direct. A mall kiosk could be used for blood pressure, urine and blood work. While you’re there you answer questions on a touchscreen. A week later the robot e-mails you the results and any recommendations.

Of course, the robot would also have access to your DNA. As we march into the humanless future, DNA will become the touchstone of medical science. Connecting the dots between genes and a wide range of diseases is a data problem, in most cases. Cheap collection devices in public places means masses of data to sort of collate.

Robot care would inevitably be cheaper and that means more people would get regular checkups by their local neighborhood robot doctor. If this sort of service were $50 a shot, most people would do it twice a year. Extend the services to things like flu shots, and nuisance things like colds and allergies and most of your basic care could be done on the cheap by the machines.

And if there’s one thing that’s not happening now, it’s basic care done on the cheap:

Of course, none of this is going to happen because the medical rackets are neatly aligned with the ruling liberal democrats. America does not have a government run system like Britain; it’s more of a partnership between the industry and the state. That way, we get the worst of both worlds. On the one hand there’s the avaricious private suppliers and on the other the mindless idiocy of government.

Yeah, but Big Business is generally happy to operate under Uncle’s thumb: they know that Uncle can sweep away competitors with a flick of his wrist — preferably his other wrist, but that’s the chance you have to take.

I’m fond of pointing out that we have all around us one of the greatest health care system on earth. American veterinarian medicine is better than what most humans enjoy on earth. It’s also cheap and plentiful. That’s because it is largely government free and parasitic lawyer free. Maybe when the robots take over, they can just kill all the lawyers and bureaucrats. Then maybe medicine will because a normal business again.

Dick the Butcher, your update is ready.

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Chronological Klonopin

You think maybe he’s been doubling up the doses?

Yahoo Answers screenshot: How early can i refill my clonazepam in west virginia?

I figure the guy’s having deep benzo reactions, inasmuch as (1) there seems to be a certain urgency to his query and (2) he posted it in the Cars & Transportation section.

For what it’s worth, my current pharmacy will not refill a Schedule IV drug on a 30-day prescription until day 25.

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This story is almost certainly not unique:

Recently, we were informed that our PPO no longer has a network in Indiana. They were one of the smaller companies in this state, and their analysts decided it wasn’t cost effective. As of the first of this year, they are still our health insurer — but we have been in some other network. And none of the online network-membership checking works for us.

Do I even have insurance in any meaningful way any more? I’m not sure.

It probably meets the letter of the law, which means — well, nothing, actually.

I think I might do better going to Vegas, finding a bookie, and making a series of bets against my health. — And paying for my own routine medical stuff.

The principle is the same in Vegas; only the regulations are different. (Sin City, unsurprisingly, has fewer.)

Prescriptions, at least in my case, seem pretty routine. CFI Care (not its real initials) has actually cut the copay on a bunch of garden-variety generics to $4, simply because Walmart and Target sell a lot of those tabs for four bucks. That said, a couple of my maintenance drugs are coming in at three bucks or less; it’s pointless to submit claims for them, which may be the whole idea.

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When airbags aren’t enough

If a long motor trip is on the agenda, I will try to drive as much of it as I possibly can before giving up the wheel: for somewhere around half a century I have been susceptible to untimely bouts of carsickness. (As though any bouts of carsickness are timely, doncha know.) It didn’t occur to me, though, that occupying the driver’s seat in one of those newfangled autonomous autos might be comparably pukulating:

The excitement over self-driving cars might be vomit-inducing. No, really. Researchers at University of Michigan’s Transportation Research Institute polled 3,200 people across the world and discovered that between 6 and 12 percent of adults will get motion sickness from riding in autonomous [vehicles].

A lot seems to depend on what those folks are doing when they’re not actually driving:

“Motion sickness is expected to be more of an issue in self-driving vehicles than in conventional vehicles,” [Dr Michael] Sivak said. “The reason is that the three main factors contributing to motion sickness — conflict between vestibular (balance) and visual inputs, inability to anticipate the direction of motion and lack of control over the direction of motion — are elevated in self-driving vehicles.

“However, the frequency and severity of motion sickness is influenced by the activity that one would be involved in instead of driving.”

The U-M report found that more than 60 percent of Americans would watch the road, talk on the phone or sleep while riding in a self-driving vehicle — activities that would not necessarily lead to motion sickness.

Unfortunately, I can barf in my sleep.


Quote of the week

Jack Baruth hits up the health-care exchange:

Strictly speaking, I should have signed up for my “Obamacare” when the last dregs of my “COBRA” ran out last year, but after seeing that the best “Bronze option” plan I could find charged ninety-seven dollars per week and didn’t kick in until I’d spent $6500, I decided to wait until I had a new day job.

My new day job was with the same contracting company for whom I’ve done half-a-dozen gigs since 2003. They explained to me that they no longer offered healthcare for full-time employees, but that I was welcome to use their ACA exchange. So now I’m paying five grand a year for coverage that doesn’t kick in until I spend $6500 a year. This is, apparently, Mr. Obama’s miracle. Once upon a time I paid $2000 a year for coverage that kicked in once I’d spent $250. The good news is that, uh, well — every poor person I know doesn’t pay enough taxes to see the ACA penalty, and even if they did it wouldn’t change their decisions regarding healthcare because poor people have low future time orientation. That’s why they are poor.

Unless, of course, they were driven to the poorhouse by medical expenses. Then again:

I have the same problem. The only reason that I am not desperately poor is because I know how to make money in a hurry. Someday I will be desperately poor. I have the mentality of a poor person. That’s why I didn’t sign up for ACA until last month, which meant that I wouldn’t receive any benefits until May, so my dental and healthcare expenses related to this Utah Ebola would be entirely paid by me. Well, they would have been anyway — but now they won’t even count towards my $6500 deductible. Sucks to be me.

Note: He was in Utah; he didn’t exactly contract Ebola.

CFI Care (not its real initials) offers no clue as to the level of metal for which 42nd and Treadmill is probably paying $6000 a year on my behalf, only a certification that the policy adheres to the new rules; but the numbers seem to fall between bronze and silver.

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Marginal improvements

Any human endeavor which requires spending money eventually reaches a point of diminishing returns, and health care is no different:

Health care reached the point of diminishing returns about fifty years ago. 100 years ago America spent 3% of GDP on health care and people lived to about 60. Today we spend about 15% on health care and people live to about 80. A good portion of that increase in life expectancy is due to better food and less violence. It is axiomatic that as things like health care improve, the cost of further improvement escalates. The marginal return on investment declines.

Getting people to about 100 would cost — what, 75% of GDP? Inevitably there will be some starry-eyed character who cries “But you can’t put a price on people’s lives!” Sure you can. In fact, it’s the only thing you can do, inasmuch as the money tree in the back yard is not producing.

I figure everything that threatens me on a regular basis — blood-sugar anomalies, hypertension, osteoarthritis, Al Gore — will be gone shortly after I am. However, I don’t even want to imagine the price tag for any one of those developments.

Then again, we do know how to do health care right. We just don’t:

America has the greatest health care system on earth. It is super cheap, with lots of options and a high degree of customer satisfaction. It is called veterinary medicine. American pets get better health care than 95% of the world population for pennies. The reason is there are few barriers to suppliers so there are many options along the price curve. There’s also incentives to innovate. My Vet has world class lab equipment because it helps attract business.

On the other hand, few pets live to 100 or 80 or even 60.

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The gentleman’s D

You’re probably sick of hearing about the bullet I didn’t actually dodge, but inasmuch as I got to see the actual numbers from my PSA test last month — 0.25 ng/mL, which is not too shabby — I’m sort of curious as to how come I did that well.

And then this turned up:

Taking vitamin D supplements could slow or even reverse the progression of less aggressive, or low-grade, prostate tumors without the need for surgery or radiation, scientists say.

How this was determined:

In a new randomized, controlled clinical trial, [the research] team assigned 37 men undergoing elective prostatectomies either to a group that received 4,000 U of vitamin D per day, or to a placebo group that didn’t receive vitamin D. The men’s prostate glands were removed and examined 60 days later.

Preliminary results from this study indicate that many of the men who received vitamin D showed improvements in their prostate tumors, whereas the tumors in the placebo group either stayed the same or got worse. Also, vitamin D caused dramatic changes in the expression levels of many cell lipids and proteins, particularly those involved in inflammation. “Cancer is associated with inflammation, especially in the prostate gland… Vitamin D is really fighting this inflammation within the gland.”

And as it happens, about four years ago I was somehow showing an unexpected deficiency in Vitamin D, and began taking 1,000 units a day, since increased to 2,000. Did this help? I don’t know for sure.

Then again, Bill Quick, a few years my senior, points out: “Luckily, I already take 10,000 units of D3 a day.” The Feds say 4,000 is as much as you should take, but they’ve had to back off so many claims recently that I find it hard to take them too seriously.

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T for tumor

Last month I had a smallish cancer scare, and by “smallish” I mean I did not immediately start pricing funeral arrangements. And that’s probably a good thing, since there seem to be people who have devoted their lives to calling things carcinogenic:

The New York Times published a story by Nick Bilton arguing that wearable tech like the Apple Watch could maybe, possibly, totally give you cancer as a result of the radiation these devices emanate. The piece was quickly met with a smart and thorough rebuttal by Russell Brandom in the Verge. Brandom highlights countless ways in which the Times columnist doesn’t reflect current cancer research, but perhaps the most glaring issue with Bilton’s piece is that one of his major sources is Dr. Joseph Mercola, who is widely considered to be a quack, and whose health “advice” has been the target of several warning letters from the U.S. Food and Drug Administration.

The good doctor has identified about two dozen Horrible Cancer Dangers over the years, including cell phones, tap water, and Pringles.

So maybe Joe Jackson was right after all:

My own suspicion, supported by no medical evidence whatsoever, is that cancer gets you only after everything else has tried and failed. Given my solid record (so far) against the Reaper, I figure he’s going to have to try the metastasis trick eventually.

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Getting through the morning after

I’ve never tried this, but Bill Quick swears by it:

A solid dollop of amphetamine will fix any hangover within 30 minutes. I have dozens, maybe hundreds, of personal experiments supporting this remedy. Worked every time. Worked for everybody I ever knew who tried it, too.

Most prescribing notes fail to define “dollop,” but I’m betting it’s more than one 20-mg tab of Adderall. Still, so-called “recreational” use of the drug calls for a hell of a lot more than 20 mg, so this would seem to fall purely into the therapeutic range. The drug warriors won’t like it, but then they don’t even like Sudafed.

And besides:

[I]f you’re slugging down half a quart of bourbon to produce that hangover, spare me the lecture about drug abuse, please.

Remember that just about anything can be abused in some fashion, from benzedrine in your Ovaltine to Krispy Kreme.

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Digital detox

“Perhaps they’re drugged,” I complained last fall:

The old online prescription refill at Target was clunky in the extreme, but it worked most of the time. And then they decided to outsource it … now it doesn’t work at all.

So I reverted to punching in the orders over the phone, which was tedious, but which worked.

Tuesday night I was clearing out the browser history when I saw the old, extremely long link to the old Target facility. On an impulse, I hit it.

And it brought up the old, familiar screen, just like before. I duly keyed in half a dozen, the max, and got all the proper responses.

I haven’t actually picked up the stuff yet — that comes later today, or maybe tomorrow — but if they’ve actually gone back to the previous system, that newfangled sumbitch they tried to foist off on us must have been even worse than I thought it was, and I thought it sucked pond water, and last year’s pond water at that.

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