Health and Wellness Chit-Chat: Your Primary Care Topic

[EtheltoTillie]

6 hours ago, shapeshifter said:

It looks like it's just this:

— which was not the case during the 40 years I lived in California and Illinois. 
So I guess it's either a newer thing or a NY State thing. 

If it helps me get a solution to my chronic pain, great.
But their receptionist is not a people person.

Now it makes sense. This seems to be a product of the new medicine era.  These gigantic medical groups are setting the rules for their practices overall. Armada Health indeed. Doctors no longer work in smaller practices and no longer have ownership. My husband and his friends who are all of close to retirement age say they wouldn’t want to become doctors now. 

[shapeshifter]

3 hours ago, EtheltoTillie said:

Now it makes sense. This seems to be a product of the new medicine era.  These gigantic medical groups are setting the rules for their practices overall. Armada Health indeed. Doctors no longer work in smaller practices and no longer have ownership. My husband and his friends who are all of close to retirement age say they wouldn’t want to become doctors now. 

Having wasted a lot of time, effort, money, and sanity running from doctor to doctor who were all happy to schedule a new patient vi$it (albeit not for 4 months), only to tell me there is nothing they can do, or try physical therapy again, or it's just that I'm getting old (I was once even told this when I was 25), I appreciate this change in general requiring an evaluation first by your PCP before seeing a specialist. 
I also appreciate doctors now being required to ask a patient to answer the same question 3 times about their medical history to avoid errors. 

What's missing is training the doctors and nurses how to request these things without using a tone of annoyance or a tone that comes from a place of blaming patients for their having to implement these new procedures. 
Simply acknowledging that this is something new would go a long way.

But the worst instance of the application of the new ask-3-times procedure was when a doctor asked a question about if I've had X, and then when I said "no," replying 3 times "so you've had X" and then noting it in my chart.😵‍💫

[Yeah No]

5 hours ago, EtheltoTillie said:

Now it makes sense. This seems to be a product of the new medicine era.  These gigantic medical groups are setting the rules for their practices overall. Armada Health indeed. Doctors no longer work in smaller practices and no longer have ownership. My husband and his friends who are all of close to retirement age say they wouldn’t want to become doctors now. 

This is precisely the reason a few of my long time, beloved doctors retired early.  They were forced to join those large medical groups and were disgusted with them.  Then when the pandemic hit they felt an extra nudge to call it quits.

Around here one medical group is getting so big that they are spreading out throughout more of the state and taking over many empty storefronts and buildings in retail shopping plazas on main roads.  In some cases they've even strong-armed the remaining businesses out to take over their properties.  A couple of local restaurants were forced out and still haven't found a new location to reopen.  And we don't need more good restaurants going out of business around here. 

1 hour ago, shapeshifter said:

Having wasted a lot of time, effort, money, and sanity running from doctor to doctor who were all happy to schedule a new patient vi$it (albeit not for 4 months), only to tell me there is nothing they can do, or try physical therapy again, or it's just that I'm getting old (I was once even told this when I was 25), I appreciate this change in general requiring an evaluation first by your PCP before seeing a specialist. 

I hear you, this does not sound unfamiliar as I've had similar experiences in recent years.  I feel like I'm getting the royal runaround anymore and never getting anywhere with a lot of things.  And it doesn't help that in my case the drugs they push at me usually cause me bad side effects.  After hearing that they pretty much write me off and act like there's nothing else they can do.

[GHScorpiosRule]

This was me a few minutes ago when I received the update that my 90-Day supply of Mounjaro had shipped.

It's coming from New Joirsey, and should arrive by Friday; could be tomorrow, but if it's Friday, I won't mind because the FedEx guy is my favorite-with his Oirish Brogue. He's been "my guy" for the past six years. We talk about India and Ireland all the time.

[StatisticalOutlier]

12 hours ago, EtheltoTillie said:

Now it makes sense. This seems to be a product of the new medicine era.  These gigantic medical groups are setting the rules for their practices overall. Armada Health indeed.

Armada Health is not a medical practice or a medical group.  It's not any sort of healthcare provider, and has nothing to do with any healthcare providers.  It's definitely not setting the rules for any medical practices.

It's a service you can pay for to give you a list of specialists.  They will consider your diagnosis, your insurance, and your location, and use "big data and expert clinical insight" to come up with a list of providers that "match" your needs.  They're differentiating themselves from "a random online search or the word of mouth of friends" (their words).  That's all.

And note that THEY are the ones who require you to see a primary care physician (PCP) before they'll recommend a specialist--it's not the specialist, and it's not your insurance company.  It's this middleman imposing this additional burden but using some crafty wording to not make it obvious:

Quote

Seeing a primary care physician first gives us a “working diagnosis” to ensure that we are recommending the proper specialist. Your primary care doctor can take care of any testing or imaging that may be required for an accurate diagnosis.

All perhaps true, but it's not clear that THEY are the ones making you see a PCP first, and not the specialist.  THEY are the ones who want a "working diagnosis," not any specialist they include in the list. 

And you know that they know that people will see that part about a PCP taking care of the testing and imaging and assume it's at the specialist's behest; it's not.  And note they don't call it a referral, while the question that's being answered in the FAQ does IS about referrals.

They go on to say:

Quote

Many specialists require that you first see a primary care doctor before scheduling an appointment with them.

Sez who?  The don't say where they got this information.  What does "many" mean?

They're also munging the "see a PCP first" and the referral process--they are not the same thing--and I don't think that's an accident.  It certainly caused confusion here.

Quote

QualityCare Connect gives [participants] much more than the names of physicians. We add value, a personal touch, by ensuring the optimal patient-physician match leveraging evidence-based data science and the expertise of our experienced healthcare team and world-renowned Clinical Advisory Board.

https://armadahealth.com/expert-human-intelligence/

They don't mention they impose an additional hoop to jump through that is completely unrelated to the specialists they include in their lists.  But people won't realize that unless they parse all of the mumbo jumbo.

Anyway, Shapeshifter, what this company does has nothing to do with what you're experiencing.  From what I can tell, specialists choosing to require referrals on their own, even if insurance companies don't require them, is not a prevalent practice.  You hear a LOT about doctors not taking new Medicare patients, and I would think that people with traditional Medicare or under-65 PPO insurance plans that don't require referrals to specialists would be bitching loud and clear about how specialists are refusing to see them unless they have to have a referral even though their insurance company (and traditional Medicare) doesn't require it. 

And you certainly hear a lot about hospital chains that are dropping Medicare Advantage plans from their networks.  But nothing, really, about specialists on their own refusing to see people without a referral.

Which does bring up the question of what Medicare Advantage plan you have.  Is it a PPO or an HMO plan?  If it's an HMO plan, then insurance IS the issue because they DO require a referral from a PCP to see a specialist.  Advantage PPO plans do not, although the specialist has to be in the plan's network (some Advantage PPO plans allow you to see providers outside the network, but you have to pay more to do it).

Or maybe you just happened to run across a specialist who, just because he wants to, requires people to have a referral to see him, even if the patient's insurance doesn't require it.  If he's super busy, it might be a way to keep down the numbers of people who show up but didn't really need to see a specialist.  But I'm just spitballing because I honestly haven't heard about this being a thing.

[StatisticalOutlier]

9 hours ago, shapeshifter said:

I appreciate this change in general requiring an evaluation first by your PCP before seeing a specialist. 

This is the hallmark of managed care--your PCP coordinates your care, and handles everything he can, and sends you to somebody else if more expertise is necessary.

I've always thought it's a sound concept, having an individual doctor coordinating care.  I like the idea of someone keeping an eye on me.  And there have been plenty of cases where someone is prescribed some medications by one doctor and some by another doctor, and there's nobody overseeing the combination, to the patient's detriment.  I have one friend in particular whose elderly mother was on all sorts of drugs prescribed by various doctors, and wasn't doing well.  They finally wiped the slate clean and started over, and her mother thrived.

However, the HMO model becomes less attractive when profit is inserted into the process.  Every referral or test or service costs an HMO money, and the more costs the HMO incurs, the lower its profits.  So there's a financial incentive for the HMO to limit the amount of care it provides to its members.  That's bad enough, but on a more granular level, the HMO's doctors can be financially incentivized to refer more frugally or use fewer services.  That directly affects the care that patients receive.

Not that the alternative, fee-for-service, is much better, since it financially incentivizes providers to provide more services that produce more revenue to them.  And ordering more tests could be a CYA measure by doctor.  Plus undergoing more tests often makes patients happier, especially if it's insurance, not them, that are paying for it.  The problem is that the increased revenue to the providers is paid for by members' insurance premiums, or traditional Medicare (this doesn't apply to Medicare Advantage plans), which makes premiums rise (whether under-65 health insurance or a supplement to traditional Medicare) and costs to Medicare rise.

All the alternatives available to Americans have their advantages and disadvantages.  The best we can do is pick one that aligns with how we want our healthcare handled--if we can afford the alternative we want.  For example, there are people who would prefer not to deal with the restrictions of an HMO, but plans with more choice are generally more expensive.

The key, of course, is knowing exactly what it is you're choosing, which is where a lot of people fall short.  Unfortunately, that's not surprising given the clusterfuck that is the U.S. healthcare (and health insurance) industry.

15 hours ago, Yeah No said:

I admit I pursued it for a while but then got tired of being told the same thing by every doctor (a total of 3 so far) so I've kind of shelved it for now.   

I don't remember if you posted an update before.  What did all three doctors tell you about treatment for your fibroid?  For that matter, what were you asking? 

[GHScorpiosRule]

Mounjaro supply just delivered!

[shapeshifter]

On 4/3/2024 at 6:53 PM, StatisticalOutlier said:

doctors can be financially incentivized to refer more frugally or use fewer services.  That directly affects the care that patients receive.

On 4/3/2024 at 6:53 PM, StatisticalOutlier said:

undergoing more tests often makes patients happier, especially if it's insurance, not them, that are paying for it.  The problem is that the increased revenue to the providers is paid for by members' insurance premiums

Thanks for your analyses, @StatisticalOutlier.

Up until I moved from the Chicago suburbs to the relatively rural Rochester NY in 2021

• which was coincidentally (and confusingly) close to when I changed from employer insurance to Medicare Advantage
• and around the time of the pandemic, which has brought a lot of changes in health care

if I would go to a doctor for pain, an x-ray would be ordered, and then an MRI. 
Now they do not want to do an MRI unless I would be seriously willing to consider surgery — for a diagnosis we do not have without an MRI.
Like the other changes I mentioned above, this makes some sense, but it also seems a bit wrong.  

And since my out-of-pocket impact for an MRI seems greater to me, I tend to not go for it. That is, when I had employer's insurance, my maximum annual out-of-pocket was around $2,000 per year, which I always incurred by July, which meant the MRIs were nearly free to me.
Now my out-of-pocket maximum is around $7,000 per year, which I will not meet unless I am dreadfully ill, plus I'm retired, so $300 for an MRI copay gives me pause
— especially when the doctor says it's only recommended if I want to have surgery.
Having had surgery, my inner-thought reaction is always: Who the hell "wants" to have surgery???
🤷🏻‍♀️🙃

I guess we just really need Star Trek tricorders to replace clunky MRI machines.

 

Edited April 5 by shapeshifter

[annzeepark914]

We have Medicare Advantage through United Health.  I see only one practice that's out of their network but we're not charged more. I think the only folks who have stress-free health insurance may be in parts of Europe. 

[Yeah No]

On 4/3/2024 at 6:53 PM, StatisticalOutlier said:

I don't remember if you posted an update before.  What did all three doctors tell you about treatment for your fibroid?  For that matter, what were you asking? 

I wanted to know if I could do the embolization and if they thought removing the fibroids would help my leg swelling.  But none of them would recommend anything but hysterectomy and didn't want to pursue the leg swelling angle at all.  I forget if I posted on this.  Probably in passing but I forget when or where now.

[StatisticalOutlier]

9 hours ago, Yeah No said:

I wanted to know if I could do the embolization and if they thought removing the fibroids would help my leg swelling.  But none of them would recommend anything but hysterectomy and didn't want to pursue the leg swelling angle at all. 

I can see that establishing a causal connection between the fibroid and your leg swelling would be a stretch, although I'm no doctor.  And if that's the only reason to remove the fibroid, then there's probably no reason to do it.

But if you do want it treated regardless of the lack of leg-swelling correlation, and you want a non-hysterectomy alternative, you should consult with an interventional radiologist--the specialty that performs the embolization (UFE).  As I said elsewhere, there's apparently still a turf war between gynecologists (who don't do UFE) and interventional radiologists (who do). 

The war isn't as bad as it was 20 years ago, when it was almost impossible to get any gynecologist to even talk about UFE, never mind suggest it, never mind recommend it.  In the intervening years some people have said their gynecologist was the one who brought it up.  Hurrah!!

But not all do, so to get the full picture, I'd always advise to talk to an interventional radiologist who does UFE.

(Off topic:  For some reason, I can never remember what year I had mine.  However, I have a method-- I know it was Halloween, and when they were talking about the pain meds I'd be getting, as I was lying there on the table, someone said "fentanyl" and I exclaimed, "The stuff they used in the theater attack in Russia???"  A few days before my UFE, Chechens had taken over a theater in Moscow during a play, and held everybody hostage.  The Russians pumped fentanyl into the theater to subdue the hostage takers, and it killed them and a bunch of the hostages, too.  But my guys assured me it was safe.)

 

[Bastet]

6 hours ago, StatisticalOutlier said:

(Off topic:  For some reason, I can never remember what year I had mine.  However, I have a method-- I know it was Halloween, and when they were talking about the pain meds I'd be getting, as I was lying there on the table, someone said "fentanyl" and I exclaimed, "The stuff they used in the theater attack in Russia???"  A few days before my UFE, Chechens had taken over a theater in Moscow during a play, and held everybody hostage.  The Russians pumped fentanyl into the theater to subdue the hostage takers, and it killed them and a bunch of the hostages, too.  But my guys assured me it was safe.)

This amused me enough to get me curious, and can thus report your procedure happened in 2002.  (And, apparently, Russian officials would not disclose the chemical agent used in the "sleeping gas", so doctors were delayed in effectively treating survivors.  But fentanyl was obviously an early guess if you'd already heard it; at some point [I'm unclear from my cursory search], Russia acknowledged the gas contained fentanyl-related compounds, and in 2012, a group of British scientists analyzed clothing from two survivors and urine from a third, determining the key agent was carfentanil [source: History.com article].)

Edited April 6 by Bastet

[StatisticalOutlier]

1 hour ago, Bastet said:

But fentanyl was obviously an early guess if you'd already heard it

Yes.  Within a matter of days I heard about fentanyl for the first time (being used as an agent of war, no less), and found out, while lying on the gurney for a procedure gynecologists were telling me could or even would ruin my life, that I would be getting fentanyl myself.  Fun times.

[Yeah No]

10 hours ago, StatisticalOutlier said:

I can see that establishing a causal connection between the fibroid and your leg swelling would be a stretch, although I'm no doctor.  And if that's the only reason to remove the fibroid, then there's probably no reason to do it.

But if you do want it treated regardless of the lack of leg-swelling correlation, and you want a non-hysterectomy alternative, you should consult with an interventional radiologist--the specialty that performs the embolization (UFE).  As I said elsewhere, there's apparently still a turf war between gynecologists (who don't do UFE) and interventional radiologists (who do). 

The war isn't as bad as it was 20 years ago, when it was almost impossible to get any gynecologist to even talk about UFE, never mind suggest it, never mind recommend it.  In the intervening years some people have said their gynecologist was the one who brought it up.  Hurrah!!

But not all do, so to get the full picture, I'd always advise to talk to an interventional radiologist who does UFE.

There is one other issue I have that might be caused by the fibroids and that's a urinary urgency issue.  I take "Azo" for that.  It's mostly pumpkin seed extract but somehow it helps a lot, even better than something a urologist prescribed that gave me weird side effects.  Even with help it gets worse in the cold weather anyway.  But again, no one can really confirm my theory.  I actually found a practice out of my local hospital that does UFE - I think you might have posted a link to it months ago and they look promising but I shelved that idea.  I admit I am not sure I want to go ahead with a procedure on the basis of theories that no doctor will get behind.

Also, my stomach is damned annoying for all sorts of reasons.  I'm short so it is even more annoying because of that.  And it's a nightmare with certain clothes too.

[StatisticalOutlier]

2 hours ago, Yeah No said:

There is one other issue I have that might be caused by the fibroids and that's a urinary urgency issue. 

Depending on where the fibroid is, it could definitely be the cause of urinary urgency.  It definitely was for me.  I could go all day without peeing, and then got the fibroids and couldn't even make it through The Last Waltz without going to the bathroom.  Leaving during a movie is strictly verboten for me; fortunately, as soon as Joni Mitchell came on the screen I knew I could run out without missing anything good.

[Yeah No]

3 hours ago, StatisticalOutlier said:

Depending on where the fibroid is, it could definitely be the cause of urinary urgency.  It definitely was for me.  I could go all day without peeing, and then got the fibroids and couldn't even make it through The Last Waltz without going to the bathroom.  Leaving during a movie is strictly verboten for me; fortunately, as soon as Joni Mitchell came on the screen I knew I could run out without missing anything good.

I never saw The Last Waltz.  Is it just that you don't care for Joni Mitchell or was it that you already knew the music and wouldn't miss anything to do with the plot?  I was always a big Joni fan back in the day.  

Fortunately I never feel the need to leave a movie in the middle of one, although it does happen at home now and then.  Some of it is normal in my opinion, though, like right after I've had a big glass of iced tea and haven't gone for hours.  Interestingly when I'm sitting or laying down the urgency isn't so much.  It's when I'm standing up that's it's more of an issue.

[shapeshifter]

On 4/6/2024 at 1:37 AM, Yeah No said:

I wanted to know if I could do the embolization and if they thought removing the fibroids would help my leg swelling.  But none of them would recommend anything but hysterectomy and didn't want to pursue the leg swelling angle at all. 

On 4/6/2024 at 11:38 AM, StatisticalOutlier said:

I can see that establishing a causal connection between the fibroid and your leg swelling would be a stretch, although I'm no doctor.  And if that's the only reason to remove the fibroid, then there's probably no reason to do it.

But if you do want it treated regardless of the lack of leg-swelling correlation, and you want a non-hysterectomy alternative, you should consult with an interventional radiologist--the specialty that performs the embolization (UFE).  As I said elsewhere, there's apparently still a turf war between gynecologists (who don't do UFE) and interventional radiologists (who do). 

My niece had uterine embolization about 10 years ago in Canada due to heavy menstrual bleeding that caused anemia (it runs in the family).
My mom would have much preferred this to a hysterectomy at 42 had it been an option in the 1970s. 

Anyway, @Yeah No, I don't recall if you already mentioned this or not:
Has your fibroid been checked recently for increase in size?
And have you had it biopsied or asked about having it biopsied recently? 

 

Edited April 7 by shapeshifter

[Yeah No]

10 hours ago, shapeshifter said:

My niece had uterine embolization about 10 years ago in Canada due to heavy menstrual bleeding that caused anemia (it runs in the family).
My mom would have much preferred this to a hysterectomy at 42 had it been an option in the 1970s. 

Anyway, @Yeah No, I don't recall if you already mentioned this or not:
Has your fibroid been checked recently for increase in size?
And have you had it biopsied or asked about having it biopsied recently? 

When I had a case of vertigo just about a year ago I had a CAT scan done of my body and the largest fibroid is 11 cm across.  There are two others that are very small.  I don't know if it grew because the last time anyone looked at it was over 10 years ago and that doctor retired last year and the office does not still have the sonogram results.  So I don't know if it's grown since then.  I was told they usually grow until menopause and then often shrink but I don't think this one has shrunk.  No doctor has ever recommended a biopsy and I've seen 3 in the past year about this so I hope one or all of them would have if there were any reason to do so.

[StatisticalOutlier]

On 4/7/2024 at 9:07 PM, Yeah No said:

No doctor has ever recommended a biopsy and I've seen 3 in the past year about this so I hope one or all of them would have if there were any reason to do so.

I've never heard of having biopsies done on fibroids.

[PRgal]

Had a follow-up mammo today because they thought they saw something on one of my breasts post-MRI.  The mammo was immediately followed with a breast u/s.  Thank goodness things were normal (so I'm proceeding with my usual mammograms later this year).  Things are getting really stressful for me, health-wise.  I'm having surgery next month to remove something that is related to my genetic condition which could require a two month recovery process for full recovery.  I've been to nothing but medical appointments since March.

[shapeshifter]

38 minutes ago, PRgal said:

Had a follow-up mammo today because they thought they saw something on one of my breasts post-MRI.  The mammo was immediately followed with a breast u/s.  Thank goodness things were normal (so I'm proceeding with my usual mammograms later this year).  Things are getting really stressful for me, health-wise.  I'm having surgery next month to remove something that is related to my genetic condition which could require a two month recovery process for full recovery.  I've been to nothing but medical appointments since March.

I can relate. Sometimes it seems we're all living on borrowed time. In another era, I would have died in childbirth instead of having an emergency c-section 45 years ago. 

When I was being treated for what should have been a terminal cancer diagnosis 8 years ago, walking on the beach of Lake Michigan made surviving worthwhile. 

Now I can't walk very far or very long, but even brief stops by the shore of Lake Ontario lift my spirits. I keep checking realtor.com for a home with a view that I could afford.

Tomorrow I'm schlepping off to a doctor for an injury from a fall a year ago that still hurts a little. It seems like a waste of time. But maybe it will be one of those doctors that has a healing vibe. If he's a jerk, I won't bother again.

 

[Yeah No]

1 hour ago, shapeshifter said:

I can relate. Sometimes it seems we're all living on borrowed time. In another era, I would have died in childbirth instead of having an emergency c-section 45 years ago. 

When I was being treated for what should have been a terminal cancer diagnosis 8 years ago, walking on the beach of Lake Michigan made surviving worthwhile. 

Now I can't walk very far or very long, but even brief stops by the shore of Lake Ontario lift my spirits. I keep checking realtor.com for a home with a view that I could afford.

Tomorrow I'm schlepping off to a doctor for an injury from a fall a year ago that still hurts a little. It seems like a waste of time. But maybe it will be one of those doctors that has a healing vibe. If he's a jerk, I won't bother again.

Ah, I can relate.  My back is sore right now.  Yet another issue to add to the pile.  Every once in a while it acts up.  I don't think it's sciatica but I could spend my life going to doctors for every ache and pain.  Hopefully like the other times it will get better.  Fingers crossed.

My husband and I just had that conversation about what we would have died from by now if not for modern medicine.  I probably would have died from a very bad arm break in 2016.  Both bones in my right forearm broke clean through.  I needed surgery and got pins and rods and months of physical therapy to regain the use of my hand.  If that didn't do me in it would have been my gallbladder in 2018.  More months of procedures and recovery because of stones still stuck in my bile duct post-surgery.

Hugs to both of you!!!

[PRgal]

14 hours ago, shapeshifter said:

I can relate. Sometimes it seems we're all living on borrowed time. In another era, I would have died in childbirth instead of having an emergency c-section 45 years ago. 

When I was being treated for what should have been a terminal cancer diagnosis 8 years ago, walking on the beach of Lake Michigan made surviving worthwhile. 

Now I can't walk very far or very long, but even brief stops by the shore of Lake Ontario lift my spirits. I keep checking realtor.com for a home with a view that I could afford.

Tomorrow I'm schlepping off to a doctor for an injury from a fall a year ago that still hurts a little. It seems like a waste of time. But maybe it will be one of those doctors that has a healing vibe. If he's a jerk, I won't bother again.

 

Breached baby?  I was breached.  My mom was supposed to have a c-section but I decided to appear on Labour Day weekend, so the doctor who was supposed to deliver was away.  That wasn't when I was SUPPOSED to appear.  But hey, most of us decide to show up at a different day anyway.  The subbing doctor was younger and said he could get me out without a c-section.  And yeah, in another era, my mom wouldn't have survived either.  And I might not have.  Also happened (almost) 45 years ago.

[shapeshifter]

1 hour ago, PRgal said:

Breached baby? 

Actually it was cephalopelvic disproportion. She has a really big head.
The OB NP thought it would be okay despite my being small, but apparently not.
It was a rural area lacking in newer equipment.
Like no fetal heart monitor.🫥

 

 

16 hours ago, PRgal said:

Had a follow-up mammo today…

I almost always have to have follow-up mammos. 
If I've moved or am a new patient, it's at least 2 follow-ups, if not more.

Edited April 25 by shapeshifter

[Bastet]

4 hours ago, shapeshifter said:

She has a really big head.

So do I.  And my mom has a narrow pelvic canal (which she found amusing, since she has wide hips).  So the doctor knew early on I was going to be arriving via C-section.  I was born a week before the scheduled surgery, but my mom's regular OB was available.

My grandma should have had a C-section with my mom, but they rarely did them back then; it wound up being touch-and-go for both her and my mom, but they were okay in the end.

[EtheltoTillie]

On 4/24/2024 at 9:25 PM, shapeshifter said:

Tomorrow I'm schlepping off to a doctor for an injury from a fall a year ago that still hurts a little. It seems like a waste of time. But maybe it will be one of those doctors that has a healing vibe. If he's a jerk, I won't bother again.

 

Whatever happened to your attempt to get an appointment with a neurologist?  I meant to follow up on that a couple of weeks ago.  Did you abandon that weird doctor matching site? 

[Yeah No]

22 hours ago, shapeshifter said:

Actually it was cephalopelvic disproportion. She has a really big head.
The OB NP thought it would be okay despite my being small, but apparently not.

I have a big head too.  The only saving grace for my mom was that I was only 5 lbs. 6 oz.  Today that would be considered underweight for a girl.  The average weight for females is now 7 lbs. 2 oz.  My mother was only 4'11" so if I had been bigger she may have needed a C-section.  She also had a very skilled obstetrician which really helped and had me natural childbirth before that was a thing.  It didn't become one until the 1970s.  I was born in Manhattan at Columbia Presbyterian's Sloane hospital for women and of course my mother had to have the best of the best.  My obstetrician was famous and wrote books, LOL.  It was just like my mom to get him.  I was born in 1958.  My mother knew she was having a girl because he predicted it based on heart rate.  It wasn't perfect but he was right most of the time!

22 hours ago, shapeshifter said:

I almost always have to have follow-up mammos. 
If I've moved or am a new patient, it's at least 2 follow-ups, if not more.

I always have to have a follow-up ultrasound on the basis of dense breast tissue.  It's been that way since perimenopause.

[shapeshifter]

1 hour ago, Yeah No said:

My obstetrician was famous and wrote books, LOL.

Cool! Do you know his name?

 

3 hours ago, EtheltoTillie said:

Whatever happened to your attempt to get an appointment with a neurologist?

I have an appointment on May 28. 
So, stay tuned.

[Yeah No]

5 hours ago, shapeshifter said:

Cool! Do you know his name?

Landrum B. Shettles

He was a pioneer in in-vitro fertilization among other things.

https://www.pbs.org/wgbh/americanexperience/features/babies-bio-shettles/

https://www.nytimes.com/2003/02/16/nyregion/dr-l-b-shettles-93-pioneer-in-human-fertility.html

He wrote the famous book, now over 50 years old entitled, "How to Choose the Sex of Your Baby".

https://www.landrumshettles.com/

And here's the link to "From Conception to Birth: The Drama of Life's Beginnings".  I still have my mother's copy.  It was the first time I saw photos of a fetus in the womb.

 

[shapeshifter]

2 hours ago, Yeah No said:

Landrum B. Shettles

He was a pioneer in in-vitro fertilization among other things.

https://www.pbs.org/wgbh/americanexperience/features/babies-bio-shettles/

https://www.nytimes.com/2003/02/16/nyregion/dr-l-b-shettles-93-pioneer-in-human-fertility.html

He wrote the famous book, now over 50 years old entitled, "How to Choose the Sex of Your Baby".

https://www.landrumshettles.com/

And here's the link to "From Conception to Birth: The Drama of Life's Beginnings".  I still have my mother's copy.  It was the first time I saw photos of a fetus in the womb.

 

I may have read them.
I was having babies pre-internet.

[isalicat]

Just to share some good news! Had my diagnostic MRI last week (I had breast cancer, diagnosed in October of 2022, followed by a lumpectomy in November 2022 which was not entirely successful so then a full mastectomy in January 2023 of the right breast) and I'm still cancer free!! I am not sure if that feeling of dread about the test results will ever go away but the feeling of relief that they did not find anything is quite wonderful. Finished my herceptin infusions a few weeks ago so now going on some sort of anti-hormonal pills for the next ten years (or not...my doc has assured me if I don't like the side effects, I can just quit them anytime - he is so understanding with my position that its my body, my decision on everything, which is why I successfully nixed chemo without much argument). I've named my port Brad and my fake breast (not an implant...its one of those that fits in a special bra) is Barbara, and they are now in a cozy relationship, so I've opted to keep Brad and just need to get him flushed out every 8 weeks, which is no biggie. 😸

[Mindthinkr]

1 hour ago, isalicat said:

Just to share some good news! Had my diagnostic MRI last week (I had breast cancer, diagnosed in October of 2022, followed by a lumpectomy in November 2022 which was not entirely successful so then a full mastectomy in January 2023 of the right breast) and I'm still cancer free!! I am not sure if that feeling of dread about the test results will ever go away but the feeling of relief that they did not find anything is quite wonderful. Finished my herceptin infusions a few weeks ago so now going on some sort of anti-hormonal pills for the next ten years (or not...my doc has assured me if I don't like the side effects, I can just quit them anytime - he is so understanding with my position that its my body, my decision on everything, which is why I successfully nixed chemo without much argument). I've named my port Brad and my fake breast (not an implant...its one of those that fits in a special bra) is Barbara, and they are now in a cozy relationship, so I've opted to keep Brad and just need to get him flushed out every 8 weeks, which is no biggie. 😸

Sounds like you are doing well and I’m very happy for you 💛

[ginger90]

@isalicat great news! 

[shapeshifter]

2 hours ago, isalicat said:

Just to share some good news! Had my diagnostic MRI last week (I had breast cancer, diagnosed in October of 2022, followed by a lumpectomy in November 2022 which was not entirely successful so then a full mastectomy in January 2023 of the right breast) and I'm still cancer free!!

Excellent! While I never considered celebrating my similarly excellent results, perhaps a little dark chocolate is in order?

 

2 hours ago, isalicat said:

I'm still cancer free!! I am not sure if that feeling of dread about the test results will ever go away

I was diagnosed in January of 2016 with stage IV colon cancer. My annual test results since 2017 have all been C-free. The "dread" is still there, but much fainter. 

 

2 hours ago, isalicat said:

I've named my port Brad and…I've opted to keep Brad and just need to get him flushed out every 8 weeks, which is no biggie. 😸

I, OTOH, opted to have my chemo port removed ASAP (some time in 2017), much to my oncologist's surprise, but like your doctor, he respected my choices. It was on the right side of my chest, and very uncomfortable. I don't know of anyone else who had this negative experience, so I figured if I needed to get another port implanted in the future, the odds were good that it would be more comfortable.

I lift my cup of ginger root tea in a toast of celebration to your results, @isalicat!

[Yeah No]

1 hour ago, shapeshifter said:

Excellent! While I never considered celebrating my similarly excellent results, perhaps a little dark chocolate is in order?

 

I was diagnosed in January of 2016 with stage IV colon cancer. My annual test results since 2017 have all been C-free. The "dread" is still there, but much fainter. 

 

I, OTOH, opted to have my chemo port removed ASAP (some time in 2017), much to my oncologist's surprise, but like your doctor, he respected my choices. It was on the right side of my chest, and very uncomfortable. I don't know of anyone else who had this negative experience, so I figured if I needed to get another port implanted in the future, the odds were good that it would be more comfortable.

I lift my cup of ginger root tea in a toast of celebration to your results, @isalicat!

Awww, you should celebrate, you are a true survivor and you deserve it Congratulations to both you and @isalicat!

Speaking of dark chocolate, I have been fighting having a small piece of dark chocolate all evening.  I've already had my allotted snack for the day but it's been calling me and then you had to mention it!  Agggghhhh..... 😖😉

[EtheltoTillie]

I keep the chemo port in for superstitious reasons.  It doesn't bother me, so I might as well leave it in.  It's now been about 8 years since I've had a treatment.  I have it flushed every couple of months.  I have to see the doctor every two or three months to keep up with my oral medication prescription. 

I get blood tests every month and scans twice a year.  The dread never goes away, but I manage to live peacefully between times. 

[GHScorpiosRule]

Well this was a pleasant surprise yesterday.

CVS texted me that they now have Trulicity in stock (albeit it's only a month dosage) and just needed my doctor to put in a new prescription because the one on file was "too old." No  SHIT, Sherlock! It's because you've been out of stock for 6 months!

My doctor called it in, so at least I have this as a back up in case Mounjaro isn't available when it's refill time.

It's all a chess game through the end of the year. My hope is that the manufacturer has quadrupled production, thanks to people like Oprah, Sunny Hostin, and other celebrities and rich folks (who can afford to pay out of pocket) whose greedy doctors prescribe this to them because they want to lose weight and to hell with those that need this to control their diabetes or other health-related issues.

[shapeshifter]

Being overweight can be a serious health risk.
I heard an interview with Kelly Clarkson today saying she had lost weight with a medication (didn't name it) and that her doctor had been wanting her to try it for years for health reasons. Something about her thyroid.🤷🏻‍♀️

[GHScorpiosRule]

3 hours ago, shapeshifter said:

Being overweight can be a serious health risk.
I heard an interview with Kelly Clarkson today saying she had lost weight with a medication (didn't name it) and that her doctor had been wanting her to try it for years for health reasons. Something about her thyroid.🤷🏻‍♀️

Oh I know that and my ire is not for or toward them. 
But others like Sunny, who took Mounjaro to lose weight because she’d gained “COVID” weight.  She said 40 pounds but I didn’t see any weight gain and we know the camera adds pounds. Nice that her hubby is a doctor and could get it for her. If he did. She and others like her don’t think about the long term consequences.

But I’ve vented my spleen over this already. Just picked up my injections and WOOHOO! It’s a 3-month supply! So I am good through September. And hopefully when I order the refill, it will still be in stock and get me through the end of the year.

I can’t express how relieved I am. A huge load of stress off my mind and body.

[nokat]

I like to walk outside, but when the weather is bad I use a treadmill.  I'll do a mile at a 4 % incline, and it'll say I've used 120 calories.  Oh good, I can eat a potato chip. I need to stop going to picnics if I want to lose weight. I'm talking 15 pounds that won't budge.

[PRgal]

21 hours ago, nokat said:

I like to walk outside, but when the weather is bad I use a treadmill.  I'll do a mile at a 4 % incline, and it'll say I've used 120 calories.  Oh good, I can eat a potato chip. I need to stop going to picnics if I want to lose weight. I'm talking 15 pounds that won't budge.

Your body mass matters less than visceral fat though.  You could be at an appropriate weight for your height but have excess fat around your organs.  That's the "bad" stuff (for a lack of a better term).  Maybe your "extra weight" is muscle?  Do you do weights/strength training?

[nokat]

3 minutes ago, PRgal said:

Your body mass matters less than visceral fat though.  You could be at an appropriate weight for your height but have excess fat around your organs.  That's the "bad" stuff (for a lack of a better term).  Maybe your "extra weight" is muscle?  Do you do weights/strength training?

I actually do strength training after I walk. My blood work tells me I'm okay, as is my heart rate and blood pressure. Many of us gain a few pounds after menopause. I'm just not liking it.

[PRgal]

7 minutes ago, nokat said:

I actually do strength training after I walk. My blood work tells me I'm okay, as is my heart rate and blood pressure. Many of us gain a few pounds after menopause. I'm just not liking it.

Something I'm not looking forward to.  I'm "technically" menopausal but my hormones actually match up to my age (early-mid 40s).  My doctor thinks my lack of periods is could be related to medication I'm on or my genetic condition.  

[nokat]

2 minutes ago, PRgal said:

Something I'm not looking forward to.  I'm "technically" menopausal but my hormones actually match up to my age (early-mid 40s).  My doctor thinks my lack of periods is could be related to medication I'm on or my genetic condition.  

I didn't start to gain until covid hit. I was in my fifties and more sedentary afterwards. I was post menopausal in my late forties. Yes, the bad fat gathers around organs.  As women, it's not horrible to have some extra in your hips.

I like to be active. Once you stop it gets harder to get back.

[Yeah No]

Post menopausal women tend to gain weight in their abdomens rather than their hips and thighs regardless of their diet or exercise habits.  That's what happened to me.  And unfortunately that's where most visceral fat accumulates.  Unfortunately we don't get to choose where we gain or lose the weight.  As I get older every other part of me shrinks but that stubborn midsection persists.  It may shrink a little with weight loss but it gets even more out of proportion because it shrinks less than the rest of me does.  According to the medical sites I'm doing what they recommend to avoid gaining visceral fat but try telling that to my body.

The Mayo clinic says weight gain after menopause is due to a number of factors, including genetics and a slowing of the metabolism that comes with aging.  Because of that a woman would have to do MORE exercise than she was doing before menopause and/or eat LESS than she did before to keep from gaining weight.  It's not that we necessarily become more sedentary or eat more with age.

Also, we lose muscle mass as we age even with exercise which is typically replaced with fat.  Muscle burns calories faster and better than fat does so losing muscle can slow metabolism all by itself.  And if you have hereditary factors involved like I do it can be even more difficult to maintain a healthy weight.

@nokat, I think we were all more sedentary right after Covid hit because of the lockdowns and having fewer places to go.  I was also under a lot of stress because my father died of Covid early in the pandemic and I was his only family member left.  Stress can cause weight gain in multiple ways.  I had lost a lot of weight right before the pandemic and was maintaining it until Covid.  Then I gained most of it back.  I couldn't pay such close attention to my diet.  I didn't even change much of anything except getting less exercise, but I guess it doesn't take much and the stress itself could have been a contributing factor.

Last year I lost most of that weight gain again by following a reduced calorie, carb. and sugar diet.  I had already been cutting down on sugar but I took it a step further.  Same for reducing the carbs.  I lost 25 lbs. then gained 5 back over the winter.  Now it's all hell to get them off.  I lose them, they come back, I lose them again, rinse, repeat.  My thyroid condition is probably not helping either.  It's an uphill battle for any woman at my age but for me the hill is even steeper than for most.  It's crazy how much I do but it doesn't work.  I'd take a weight loss drug if I could tolerate it but it doesn't look like that's in the cards for me.

 

[nokat]

@Yeah No If I get sick that extra weight drops fast. I always worry about that. A male friend is a stick after undergoing chemo.

I'm sorry about your father. I do stress eating too. 

I'm doing the lose then gain it back dance too.

[EtheltoTillie]

On 4/26/2024 at 1:17 PM, shapeshifter said:

Cool! Do you know his name?

 

I have an appointment on May 28. 
So, stay tuned.

Shapeshifter any update on your neurology appointment?  I realize it was supposed to be a week or so ago. Hope this is not too invasive. 

[shapeshifter]

4 hours ago, EtheltoTillie said:

Shapeshifter any update on your neurology appointment?  I realize it was supposed to be a week or so ago. Hope this is not too invasive. 

Thanks for your concern.🥰

At least I liked him. He said I do not have signs of Parkinson's at this time, but given the family history and my genetic component, it was good to get baseline observations and he wants to see me in a year.
He encouraged me to go back to doing stretches, so I am. 

Meanwhile, the results of my sleep study came back as "moderate" sleep apnea, so they want me to get a CPAP machine. Ugh. They're much more compact now, but still… 
It seems like the CPAP machines are the nails and the tests to see if you need them are the hammer, if that makes sense?

So I have to figure out what's covered by insurance etc.  

[EtheltoTillie]

11 hours ago, shapeshifter said:

Thanks for your concern.🥰

At least I liked him. He said I do not have signs of Parkinson's at this time, but given the family history and my genetic component, it was good to get baseline observations and he wants to see me in a year.
He encouraged me to go back to doing stretches, so I am. 

Meanwhile, the results of my sleep study came back as "moderate" sleep apnea, so they want me to get a CPAP machine. Ugh. They're much more compact now, but still… 
It seems like the CPAP machines are the nails and the tests to see if you need them are the hammer, if that makes sense?

So I have to figure out what's covered by insurance etc.  

Thanks for the update.  Stretches.  I need to do those too.  I'm really feeling how age has changed my ability to move.

As for the CPAP, I know exactly what you mean.  It seems like everyone is getting a CPAP machine.  If i took a sleep study they'd probably recommend one too.  I'm one of those people who sleeps irregularly. 

[Yeah No]

11 hours ago, shapeshifter said:

Meanwhile, the results of my sleep study came back as "moderate" sleep apnea, so they want me to get a CPAP machine. Ugh. They're much more compact now, but still… 
It seems like the CPAP machines are the nails and the tests to see if you need them are the hammer, if that makes sense?

So I have to figure out what's covered by insurance etc.  

Sorry to hear that but thank goodness no Parkinsons!

At least with the CPAP you might be able to get a better night's sleep.

I have asked to have a sleep study done but I get told I don't need one every time and I don't know why, and this involves more than one doctor.  It's maddening.  So I've basically given up on that.  Although to be honest I don't relish the idea of using a CPAP.  If it helped me sleep better I might learn to love it, though.  My sleep is all over the clock these days.  I tend to sleep in 2 shifts which is one reason why I'm up posting here in the wee hours.  It works better for me than trying to sleep all the way through.