Health pt. 2

In the case of clinics, emergency rooms, etc, of course you take what you get--not only male, female, etc, but competent or incompetent.

That is my point. The piece I linked in above was about an intern at a clinic where everyone was treated by a pool of doctors, nurses, and students. The patient rejected a male student where she wouldn't have rejected a female student.

2510. Autodaffy - 3/16/2001 6:43:39 AM

arky,
If your comfortableness with a doctor doesn't have its basis in your knowledge, not prejudices, of his or her competence, then your racism or sexism is almost certainly at play. This is not, as far as I know, some legally priviledged area where personal bigotry is allowed to trump fairness to the provider. Do you get to demand a white postal worker at the counter when you buy stamps?

2511. JJBiener - 3/16/2001 6:47:43 AM

Autodaffy - Arky is right. This isn't about stereotypes or judging people's competence. It is about having the right to decide who will have intimate contact with one's body. I have had both male and female doctors and it isn't an issue for me. I respect the fact that it is an issue for others.

2512. arkymalarky - 3/16/2001 6:51:16 AM

A postal worker is a government employee, and postal delivery a government service--you get what they offer. I have a right to choose from whatever doctors are available for my personal physician, as a private service. At a clinic I don't have that choice. If my prejudices or prudishness or whatever cause me to stupidly or emotionally choose gender or anything else over competence, then that's my choice and my cost.

2513. JJBiener - 3/16/2001 6:51:31 AM

Auto - If your comfortableness with a doctor doesn't have its basis in your knowledge, not prejudices, of his or her competence, then your racism or sexism is almost certainly at play.

This is nonsense. We are talking about intimate contact. There is most certainly something else at play beyond competence or sexism. Why can't you see that?

2514. CalGal - 3/16/2001 6:53:26 AM

I respect the fact that it is an issue for others.


Then they can go to their own private physician instead of a hospital or clinic.

2515. JJBiener - 3/16/2001 6:54:04 AM

I don't see why a woman suddenly gives up her right to control who has contact with her body just because she goes to a clinic or an emergency room. If there is no doctor of the desired gender, I agree she is out of luck. But if there is a doctor there of the desired gender, why would you deny her that choice?

2516. CalGal - 3/16/2001 6:54:54 AM

I don't see why a woman suddenly gives up her right to control who has contact with her body just because she goes to a clinic or an emergency room.

Because she has opted for an environment in which doctors aren't assigned by preference, but on an as available basis.

2517. JJBiener - 3/16/2001 6:55:02 AM

CalGal - Then they can go to their own private physician instead of a hospital or clinic.

Why should they have to? Why can't they be accomodated? What harm does it do?

2518. JJBiener - 3/16/2001 6:55:50 AM

Cal - Because she has opted for an environment in which doctors aren't assigned by preference, but on an as available basis.

If she is willing to wait, what difference does it make?

2519. Shannon - 3/16/2001 7:03:10 AM

Well, wasn't the whole point of the article linked above that it was harming the interns by denying them sufficient experience? In the case of full-fledged doctors, a large number of patients who refused to see the ones they were assigned could have the effect of over-burdening the ones who were chosen.

2520. Autodaffy - 3/16/2001 7:04:17 AM

You know, Biener, that calling something nonsense is not a rational argument.

2521. JJBiener - 3/16/2001 7:11:10 AM

Autodaffy - That was an editorial comment. Read the rest of the post and the posts that follow it.

2522. JJBiener - 3/16/2001 7:15:27 AM

Shannon - Well, wasn't the whole point of the article linked above that it was harming the interns by denying them sufficient experience?

I have trouble swallowing this argument. Even if true I don't see that this trumps the rights of the patients.

In the case of full-fledged doctors, a large number of patients who refused to see the ones they were assigned could have the effect of over-burdening the ones who were chosen.

This may be true. No one should be able to force a doctor to see more patients than they are willing to handle. Until this becomes a problem, I don't see a reason to deny a patient's rights.

2523. Autodaffy - 3/16/2001 7:22:26 AM

When a patient presents for treatment a business situation exists: payment for services. In the civil rights era I think this was called a public accommodation, and if it existed you could not express your private prejudices within it. Turn the tables. Would we tolerate a doctor turning down a black patient solely on the basis of her color? So, what priviledges what no one here has tried to present as other than personal prejudice in a patient's choice of physician?

2524. JJBiener - 3/16/2001 7:36:02 AM

Autodaffy - We are not talking about personal prejudice. I have now posted this three times. This is not about judging the competence of a physician based on gender. It is about the right of an individual to control who has intimate contact with his/her body.

No matter how you try to explain this away, you aren't going to make the case that a person's body is a public accomodation.

And please stop trying to equate race with gender. I have asked this before. This is not about prejudice or racism or sexism. Address the arguments being presented.

2525. Autodaffy - 3/16/2001 7:42:30 AM

"It is about the right of an individual
to control who has intimate contact with his/her
body."

Please cite to me the basis in law or in the constitution for this phony right you assert. You sound like a liberal in this manufacture of "rights" that do not exist.

Does it extend to ambulance attendants? Pharmacy workers? Food hanldlers? Hair cutters? How is it delimited?

2526. SnowOwl - 3/16/2001 7:46:01 AM

JJ,

If the argument is about the right of an individual to control who has intimate contact with his/her body what is the difference between declining to see a physician based on his/her race and declining to see a physician based on his/her gender? Why can't we equate race with gender in this instance? It's still a question of an individual's preference.

2527. JJBiener - 3/16/2001 8:11:21 AM

Snowowl - I have no problem with someone declining to see a physician based on the doctor's race, but it is fundamentally a different issue. Gender relates to sex. Race doesn't. A woman may feel sexually violated by being examined by a male doctor where she wouldn't if examined by a female. I see no reason to deny a woman treatment for making that choice.

So far no one has presented a reason why a woman should be denied this choice. It seems bizarre in the extreme to say that a woman can control her body to the extent that she can have her fetus aborted, but if she goes to a clinic to have it done she doesn't have the right to choose the gender of the doctor who will perform the procedure.

2528. mgleason - 3/16/2001 8:16:47 AM

It is about the right of an individual to control who has intimate contact with his/her body.

If this is your standard, JJ, then the patient should be able to discriminate based on age, sex, race, ethnicity, religion, political persuasion, or any other identifying characteristic.

You present no compelling argument as to why a person should be able to refuse treatment from a physician solely on the basis of gender.

2529. JJBiener - 3/16/2001 8:18:22 AM

Auto - Please cite to me the basis in law or in the constitution for this phony right you assert.

Amendment IX, Roe v Wade, rape laws, sexual haraasment laws, et al. This isn't a phony right. It is a very real right.

You sound like a liberal in this manufacture of "rights" that do not exist.

If you don't believe this right exists, please cite a law or judicial decision which states this or even implies this.

Does it extend to ambulance attendants? Pharmacy workers? Food hanldlers? Hair cutters?

When was the last time you had intimate contact with your pharmacist?

2530. JJBiener - 3/16/2001 8:20:44 AM

mgleason - SEX!

2531. mgleason - 3/16/2001 8:25:11 AM

JJ, a female Klan member may feel violated by having a black female physician examine her intimately, for example. The point is that you cannot reduce this to gender only.

2532. JJBiener - 3/16/2001 8:35:08 AM

mgleason - That may be so. Considering the intimate nature of medicine, why shouldn't the patient's wishes be honored if at all possible? A woman may feel more comfortable with a man. She may feel more comfortable with a woman. Why should the choice be taken away from her? What can be gained by denying her this right?

2533. Jon Ferguson - 3/16/2001 8:38:49 AM

So in JJ's world I can demand a young hottie as my doctor?

Cool.

2534. Jon Ferguson - 3/16/2001 8:40:23 AM

Because, ya know, we can't have some guy or old hag messing with the crown jewels.

2535. JJBiener - 3/16/2001 8:43:35 AM

Jon - In your case, I am sure they are thinking, "Thank God for rubber gloves!"

2536. Jon Ferguson - 3/16/2001 8:44:23 AM

And while we're at it, I guess I can demand that she get half-naked too, because I have a real hang-up about clothed chicks gawking at my stunning physique.

2537. mgleason - 3/16/2001 8:46:28 AM

JJ, try to imagine the real-life implications of what you're saying. You cannot justify accommodation based on gender without opening the door to any other preference as well. What you propose is unworkable; there is no unique justification for discrimination based on gender.

2538. JJBiener - 3/16/2001 8:46:41 AM

Jon - Don't all doctors do that?

2539. AceofSpades - 3/16/2001 8:47:25 AM

I think you are wrong here, JJ.

there are two different issues:

1) Is the priviledge of choosing a doctor of one's liking a *good* thing, which health insurance companies *should* offer; and

2) Is it a "right"?

The answer to 1) is a no-brainer. Yes, it's a good thing. I think a company would have to be pretty dumb not to offer it.

But is it a "right"? Now, when we say "right," let us define it strictly: If you have a "legal right" to something, that means that you can sue for it in court, even if you signed a contract which did not give you the *contractual* right to this something, even if you bartered your ability to request this thing away.


Now, I have a "right" to have my prescription glasses covered by my health care plan. But if I do not barter for it, or if I accept a plan without such coverage, can I then turn around and sue for my "right" to eyeglass insurance?

2540. Jon Ferguson - 3/16/2001 8:47:55 AM

Do what, gawk at my stunning physique? Now that you mention it ...

2541. AceofSpades - 3/16/2001 8:51:00 AM

"Constitutional, legal rights" are what's in the bloody constitution.

If it's not in there, you don't have a "legal right" to it.

You may have a moral right, but that is not the same thing.

This is the sort of problem that can be resolved, and must be resolved, through contract. Not through assertion of yet another "constitutional right," created and enforced by the courts, contracts and free-will and self-help be damned.

2542. AceofSpades - 3/16/2001 8:53:43 AM

Okay, let me step back:

There are things called "contracts of adhesion," which are contracts which are not, and can never be, negotiated. Health care contracts are contracts of adhesion. You don't negotiate any terms; you either accept the contract as is or you don't.

I *think* courts are more willing to read in "rights" into contracts of adhesion because they are, by their nature, never really negotiated or "agreed to" in a real sense.

But still...

2543. JJBiener - 3/16/2001 8:57:51 AM

mgleason - Yes, there is a unique justification for discrimination based on gender. Sex! Sex is not an issue with race, religion, or anything else, but it is an issue with gender.

To clarify I believe a patient should be able to discriminate based on anything they want. Their body is not a public accomodation and they are not hiring an employee. They are purchasing services and they should be able to make that decision on any basis they feel comfortable with.

With that said, there is an additional issue with gender since medicine involves intimate contact unlike that of any other profession. When intimate contact is involved, gender becomes major issue for some people. It isn't about competence. It isn't about prejudice. It is about sex, and it does no good to pretend it doesn't exist.

2544. AceofSpades - 3/16/2001 9:02:07 AM

Well, you're right about all of that.

2545. SnowOwl - 3/16/2001 9:03:28 AM

So, a female comes into a hospital ER with a serious problem which is likely to kill her if she doesn't get immediate treatment. She demands a female doctor. No female doctor is available. Does the patient's "right" to choose her own physician override the physicians' duty to save lives wherever possible?

2546. Jon Ferguson - 3/16/2001 9:04:01 AM

Horse twaddle.

Some prude's sexual hangups are his/her problem.

Can I insist on a heterosexual doctor too?

2547. AceofSpades - 3/16/2001 9:04:34 AM

If it's "invidious discrimination" for people to prefer a doctor of the same sex (or opposite sex, if they like) touching them intimately, seeing them naked, etc., then I want to start a class-action lawsuit against the nation's gynecologists, who are disproportionately female.

It's not right that women prefer female gynecologists. Men should have just as much a right to practice gynecology as women. Ergo, the current overrepresentation of women in gynecology is flagrantly unconstitutional.

2548. Jon Ferguson - 3/16/2001 9:09:28 AM

In what sense of the word is it invidious?

2549. mgleason - 3/16/2001 9:10:24 AM

No, JJ. As I pointed out, a person may feel violated for a host of reasons which are totally unrelated to gender. Again, if your standard is that [i]t is about the right of an individual to control who has intimate contact with his/her body, you cannot determine which discriminatory preferences are suitable for protection, to your way of thinking. The bright line you're attempting to draw does not exist.

It isn't about prejudice. It is about sex, and it does no good to pretend it doesn't exist.

The two are not mutually exclusive.

2550. AceofSpades - 3/16/2001 9:11:20 AM

"Invidious" meaning illegal.

There is lots of discrimination in the world. Most of it is good.

Only some of it is "invidious."

If you are claiming it's "bad" discrimination for a patient to prefer a doctor of one's own sex, then I presume you favor a class-action against the nation's disprorportionately-female gynecologists...?

2551. JJBiener - 3/16/2001 9:11:38 AM

Ace - I believe Amendment IX says that the enumeration of rights in the Constitution does not mean that those are the only rights which the people retain. There are plenty of laws on the books based on the premise that a person has the right to control who can engage intimate contact. Since the practice of medicine involves intimate contact, the patient has the right to choose a doctor on any basis she chooses. If a woman goes to an emergency room and asks for a female doctor, there is no reason to deny this request as long as a female doctor is available. I believe that if the emergency room management takes the attitude that she gets the next doctor in line, take it or leave it, her rights are being violated. So far no one has presented a reason why her choice should not be honored.

2552. Jon Ferguson - 3/16/2001 9:12:27 AM

Not on the list.

The girls get the points.

2553. AceofSpades - 3/16/2001 9:13:46 AM

"you cannot determine which discriminatory preferences are suitable for protection, to your way of thinking."

Legally, you can. The law is not an ass. The law has always recognized, and continues to recognize, the fact that much discrimination based on sex is perfectly legitimate.

Discrimination based on sex is scrutinized less strictly than, say, discrimination based on race.

If I own a strip club, for example, I am perfectly within my rights to insist on only FEMALE strippers. I am not required to hire a male stripper, "if he's qualified."

2554. JJBiener - 3/16/2001 9:17:05 AM

Snowowl - Does the patient's "right" to choose her own physician override the physicians' duty to save lives wherever possible?

A patient has the right to refuse treatment. I don't believe a physician has a duty to save a patient's life against the patient's expressed wishes. If the woman demands an female doctor and there is one available, why would you not grant her request? Why is it even an issue?

2555. AceofSpades - 3/16/2001 9:21:38 AM

"Ace - I believe Amendment IX says that the enumeration of rights in the Constitution does not mean that those are the only rights which the people retain."

This is nonsense. You are making liberal arguments. The liberals have claimed for years that Article IX gives them justification for claiming whatever silly "rights du jour" they favor. Even they have abandoned it. It's a dry well.

If you want to rely on Article IX, then I defy you to explain why Liberals can't rely on Article IX in support of Roe v. Wade.

"There are plenty of laws on the books based on the premise that a person has the right to control who can engage intimate contact."

Uhhhhmmm... I guess. I'm not sure what you're saying.

"Since the practice of medicine involves intimate contact, the patient has the right to choose a doctor on any basis she chooses."

I actually agree with your point vis-a-vis Mgleason-- that I have the "right" to select whatever damn doctor I wish.

My disagreement came vis-a-vis what I THOUGHT was your disagreement with Cal, i.e., that if I have a health contract which does NOT grant me the right to choose whatever doctor I like, but rather I can only choose who is available, that I have a "right" to sue and get the doctor I want.

I agree you have the "right" to choose whatever doctor you like. I don't agree you have the "right" to file suit in order to force someone to grant you this particular "right" in the context of a health-care contract that does not grant it-- since you did not contract for it.

"If a woman goes to an emergency room and asks for a female doctor, there is no reason to deny this request as long as a female doctor is available."

Agree.

2556. AceofSpades - 3/16/2001 9:21:45 AM

"I believe that if the emergency room management takes the attitude that she gets the next doctor in line, take it or leave it, her rights are being violated."

Ummmmm... Maybe. I don't know. I would say that the doctors are violating their oaths in doing so, definitely.

"So far no one has presented a reason why her choice should not be honored."

Agreed. You know what you do when a mentally disturbed man comes in, screaming "I only want a white doctor touching me! I don't want no blackies touching me!" ?

You know what you do in that situation?

You give him a WHITE DOCTOR. His health -- and emotional health is a component of health -- is what matters. Not some bullshit PC agenda about "educating people."

2557. Jon Ferguson - 3/16/2001 9:23:26 AM

It's an issue because if you make it a right, rather than a courtesy, then hospitals everywhere will have to staff their hospitals with many doctors of both genders, all different ages, and all the colors of the rainbow, both gay and straight simply in order to satisfy their patients' right to choose a doctor to their own idiosyncratic specifications.

As I said before, horse-twaddle.

2558. JJBiener - 3/16/2001 9:24:48 AM

mgleason - As I pointed out, a person may feel violated for a host of reasons which are totally unrelated to gender.

As I said, I have no problem with a person using any of those reasons when determining if a physician will adminster treatment.

The bright line you're attempting to draw does not exist.

There is a line. The line is about sex. It makes discrimination on gender in matters of medicine unique. You and I have seen enough doctors and hospitals to become immune to this. Not everyone has our experience (thank God). There is no reason not respect a person's gender choice when assigning a doctor.

BTW, How are you feeling? I assume you are having trouble sleeping which is why you are up at this ungodly hour.

2559. mgleason - 3/16/2001 9:27:01 AM

I was speaking of JJ making a determination about which preferences a patient should be able to act upon, and making a distinction in favor of gender. The entire statement is:

Again, if your standard is that [i]t is about the right of an individual to control who has intimate contact with his/her body, you cannot determine which discriminatory preferences are suitable for protection, to your way of thinking.

It makes no sense when truncated.

2560. JJBiener - 3/16/2001 9:31:30 AM

Ace - The original context was about a woman at clinic who refused to be treated by a male intern when she would not have refused a female. Cal was claiming that she has no right to demand a female doctor even if one is available.

2561. Jon Ferguson - 3/16/2001 9:34:40 AM

Okay, for starters, define 'available'. Is a doctor finishing her shift on the way out the door 'available'?

2562. JJBiener - 3/16/2001 9:36:28 AM

Jon - Okay, for starters, define 'available'.

Define 'is'.

2563. Jon Ferguson - 3/16/2001 9:40:50 AM

You don't see my point, JJ? Is a doctor sitting at home on call 'available' for some ninny who insists on a doctor of that gender to have a look at her yeast infection?

2564. JJBiener - 3/16/2001 9:55:24 AM

Jon - I do see your point. It is irrelevant to this discussion.

2565. CalGal - 3/16/2001 4:44:41 PM

Cal was claiming that she has no right to demand a female doctor even if one is available.


Actually, my position was that if a hospital or a clinic should be legally obligated not to provide her a doctor of her choice. I am quite sure that at the present time a woman will be humored in her preference for a female gynecologist but not for a male one, a black person would be humored in a preference for a black doctor but not a white one, and a white male is, for the most part, shit out of luck. (A screaming looney might be humored long enough to get them under control).

I find it repellent that any person who walks into a hospital or clinic and refuse the first available doctor, given that those are the expectations.

Now, I wouldn't be surprised if right now this goes on all the time, in the situations I mentioned. But if it is a legal right for the patient to refuse a doctor of a particular gender, race, or age in that sort of setting, then it no doubt hurts minority and female doctors more than white male doctors.

I have a feeling that it's not a legal right, and that the hospital and clinics could refuse and just choose not to make an issue of it. And that's just wrongheaded.

2566. JudithAtHome - 3/16/2001 4:56:38 PM

against the nation's gynecologists, who are disproportionately female.

Is there some cite for this? How do you know there are more females?

2567. msgreer - 3/18/2001 12:43:24 PM

I suggest "Wit", showing on HBO, Saturday, March 24th. This is a story about a woman suffering from ovarian cancer. It not only shows her struggle but the treatment she receives from the medical profession. It is based on a true story.
Emma Thompson stars.

Since there has been discussion on picking one's own doctor for various reasons this may be a 90 minute view worth the watch.

2568. Jon Ferguson - 3/18/2001 5:54:24 PM

2566. JudithAtHome - 3/17/01 2:56:38 PM

against the nation's gynecologists, who are disproportionately female.

Is there some cite for this? How do you know there are more females?

I did a little research and indeed, it seems highly unlikely that even a bare majority of gynecologists is female given the following:

In 2000 63.7% of the ACOG membership was/is male. From ACOG membership data March 2001.

Mary A Hyde MSLS (mhyde@acog.org)
Public Services Librarian
Resource Center
American College of Obstetricians & Gynecologists
409 12th St SW
Washington DC 20024
202-863-2518 (ref desk) 202-484-1595 (fax)

2569. anomieme - 3/19/2001 5:39:13 AM

Forgive my jumping in off-topic, but I post so infrequently it may seem as if I've been unappreciative of some of your earlier comments and good wishes. This to JJ, Thoughtful, PsychProf, CalGal, and MsGreer. I've very much had your comments in mind. Some of what I post risks seeming a bit too self aware when others have more real and immediate problems. But it has been a learning experience for me to observe how the depression or apathy, or whatever this is runs its course.

I didn't get out the guitar, JJ, but I did pick up the camera and got out this weekend. It was fairly easy to push aside the blahs and I had a really good time. Occasionally that "what's the point?" attitude began to creep in, but I pressed ahead and it was really very easy.

Anyway, thanks to all and I'll return you now to the topic at hand.

2570. JJBiener - 3/19/2001 6:17:10 AM

anomieme - Posts like #2569 are never off-topic in this thread. They are the reason this thread exists. We may go off on a tangent from time to time, but this thread exists as a place where people can come and discuss their problems and receive support. Our host, MsGreer, is very clear on this point.

I am glad you picked up the camera. I hope you will post some of your pictures. I would like to see what you do. I love photography and would engage in it if I had the time and money. Right now music takes up all my spare time and any money I can squeeze from the budget.

2571. anomieme - 3/19/2001 6:27:27 AM

JJ,

Thanks. BTW, that link didn't work so I didn't hear your tracks. Now that you're back, can you repost that web page in Arts?

I'd like to post some pics. I'll have to get the html technique down soon. As with guitar, I'm a hack with the camera, and highly derivitive. But we all get a gem now and then.

2572. JJBiener - 3/19/2001 6:42:01 AM

anomieme - I don't know why that link didn't work for you. It works fine for me. I don't know what the problem is.

As far as being a hack photographer, perhaps you just need some perspective. Not even Mappelthorpe had a winner on every shot. Most photographers would be happy if they had one usable shot per role. I have written dozens of songs. Most of them suck. A few are pretty good. A couple are very good. It is a numbers game. Keep working at it and from time to time you will strike gold.

2573. anomieme - 3/19/2001 6:47:56 AM

It's those gems keeps us going....

I wish I had a dollar for every top ten song that sucked. Don't give away any copywrites. We're our own worst critics sometimes.

2574. JJBiener - 3/19/2001 6:53:38 AM

Anomieme - I know what you mean. I wrote a song in 10 minutes one morning in the shower. I wrote it down after I got out of the shower and played it for my band at the next practice. I didn't take the song too seriously, but they went nuts over it. It has been in our song list ever since. We have even started getting requests for it at shows. The song is Cold Woman Blues. It is on that web site if you can get it to play. You may need an mp3 player if you don't have one.

2575. christipeters - 3/20/2001 11:41:34 PM

Interesting discussion.

AFAIC, a doctor is an employee whom I am paying to provide a service. I feel I should have an absolute right to chose who to employ. In fact, I'm pretty sure I have that right.

Now I may not have the right to make my insurance pay for anyone I choose, but I can always dig the money out of my own pocket, change insurance plans, or go without medical care if I belong to an insurance plan that restricts my choice to a certain pool of doctors and I don't like any of them.

I may not have the right to force a hospital or clinic to bring in another doctor if I don't like the one available to treat me when I go in for treatment, but I can go to another clinic.

I realize I am taking this to extremes and in a rel situation where I need imediate care and my preferred doctor isn't around, I'll no doubt take who's available rather than continue to suffer.

It's just this talk of "rights" that gets me.

2576. ChristinO - 3/20/2001 11:44:15 PM

My co-worker just informed me that she's on a diet. I looked her over and asked her why. She said "My doctor told me I ought to lose 12 pounds."

"How's your blood pressure?"

"Great."

"Well what about your cholesterol?"

"Stellar. Even the Doctor says so. I told him I was amazed since I eat hamburgers three or four times a week."

"How tall are you, honey? 5'5? You wear a size 6, right? Where exactly are you supposed to lose this 12 pounds from?"

"He says I'm overweight for the BMI."

"Yeah, you've also got more muscle tone than most folks and any extra weight you carry is tits and black-girl butt. Tell your doctor he's full of shit and find somebody new to treat you."


This is the kind of crap pisses me off. K isn't "well-endowed" or "voluptuous" even. She's slender with tits and ass. She's got a body like Jennifer Lopez with better arms and abs. What the fuck is in this doctor's head with the "you need to lose 12 pounds" bit?

Need to? For what purpose. She's extremely healthy. She's in great shape and she looks fantastic. She needs to lose weight so that she matches a generic Body Mass Index churned out by non-medical professionals for the purposes of fixing insurance rates and selling diet products?

The man should lose his license since he obviously isn't paying attention to the actual health of his patient.

2577. christipeters - 3/20/2001 11:46:02 PM

ChristinO- I agree. She needs a new doctor.

2578. ChristinO - 3/21/2001 12:26:28 AM

I can somewhat understand the average layperson buying into the BMI, but not a healthcare professional. They get paid lots of money to know better. No wonder malpractice insurance is so high.

I'm significantly overweight "morbidly obese" they like to call it, however my blood pressure is excellent and my cholesterol is only high-normal even though high cholesterol and blood pressure both run in my family none of whom have ever rivaled my size. My cholesterol is more than 100 points less than that of my friend's bean-pole husband.

They keep insisting that fat is the main if not sole issue, but looking at all the skinny people who have cholesterol problems and heart disease and the fat folk who don't I think it's time to toss out the hard and fast rule that seems to obsess so many people.

There is healthy and there is unhealthy and fat or thin it varies from person to person. I'm not claiming that it is healthy to be fat, but it is not always un-healthy. It's past time for health-care professionals to look at their patients as individuals.

2579. christipeters - 3/21/2001 1:28:41 AM

Christin - I agree.

I have gone from morbidly obese to merely very fat. However, my blood pressure was high (marginally) when I was skinny, remained at about the same (non-medicated) levels when I was morbidly obese, and is still the same.

At the same time, my cholesterol levels have consistently run from the 140s to the 160s. Again, regardless of my weight.

I am working on losing weight because I have back and hip and knee injuries that would probably bother me less if I had a lighter load on them and because I like the way I look better when I am thinner.

Still, even at my present weight, I had no problems walking through Carlsbad Caverns for 5 hours last Friday and through Living Desert park for 2 1/2 hours on Saturday. My calf muscles were a little sore from the descent into the Caverns (my friend said we "burned ot our brakes" &:oD), but had fully recovered by Monday evening.

I also think the individual should be looked at more than the charts, which are just useful, limited tools.

2580. JJBiener - 3/21/2001 2:03:28 AM

Christin - I have seen pictures of you. How can you possibly be obese?

2581. ChristinO - 3/21/2001 2:16:31 AM

JJ,

That's very sweet, but my size isn't really a debatable thing. It varies from photo to photo depending on clothing and attitude.

Actually, I think most of it is attitude. Compared to many, my weight gain is relatively recent. I was never a fat child nor did I have any weight problems until after I graduated from highschool so my essential character wasn't shaped by being fat.

I even sometimes forget but luckily for me there are plenty of people willing to step up and remind me. Strangely enough many of them are men trying to get in my pants. I think their strategy is to make me believe I should be grateful for their attentions. I like to remind them that they're the ones apparently hard up enough to proposition someone they consider beneath them. It would be funnier if it weren't so tedious. Sometimes it's even painful but generally only when I get broadsided with such an attitude from someone I expected better of.

I don't consider myself a militant fat person or fat activist per se, but I won't deny that I can get worked up over stupidity and cruelty. There's some doctor whose name I can't remember that teaches a seminar to other doctors on how to not to be an asshole to fat patients. He actually makes them wear a fat suit out in public for a whole day so that they get some idea of what it's like for their patients on a day to day basis.

2582. JJBiener - 3/21/2001 2:23:43 AM

Christin - If I were trying to get into your pants the last thing I would do is insult you. That seems incredibly counterproductive. I would tell you how good you look. I am not not even trying to get into your pants I think you look good. That's my opinion for what it's worth.

2583. arkymalarky - 3/21/2001 4:29:41 AM

I'd rather be overweight than an idiotic asshole any day. Christin, I truly think you look great. I have a friend/colleague who's very heavy, but she always looks a lot better than I do on the job (I'm a natural slob). She dresses and carries herself beautifully, and is really a very pretty woman. Her main problem with weight is her back. She has severe problems that weight loss wouldn't fix, but would certainly make easier.

2584. Jon Ferguson - 3/21/2001 4:44:43 AM

JJ

Have you seen the same pictures I've seen?

I'd rather be honest than an idiotic (even well-meaning) prevaricator (a kind term for liar) any day.

And arky, the choice isn't between being fat and being an idiotic asshole. The choice is between being fat and not being fat. Between controlling your consumption of junk food and letting it control you. Between taking responsibility for your health and appearance and surrendering to your low self esteem. Between being alive and vital and being a sedentary slug. I at least have SOME sympathy for UGLY fat people. It's not like they'd look a whole lot better if they DID lose the weight. It's the pretty/handsome fat people that are truly pathetic.

And before MsGreer shoos me away, I bid you all adieu. You may return to your well-meaning, albeit dysfunctional (in that it merely serves to enable and reinforce destructive behavior,) group hug.

2585. anomieme - 3/21/2001 4:54:38 AM

It's been my experience that some people can improve themselves by just being nicer to fellow human beings.

We're people, not fitness machines.

2586. Jon Ferguson - 3/21/2001 4:58:34 AM

anomieme

It's one thing to refrain from criticizing others. As the old saying goes, we all have faults, why not start with yourself? It's quite another to lie to them so that they will feel better about themselves (or even worse, so you can 'improve' or feel better about yourself). I find JJ and arky's well-meaning pep talk to be patronizing and condescending. 'There, there honey, you're not fat. You're big boned. All 250 lbs of you.'

2587. arkymalarky - 3/21/2001 5:19:02 AM

You're putting words in my mouth, Jon. I truly do think Christin looks good. There are overweight people who don't and weight loss would help their looks much more than it would other overweight people. Also, from my good friend's experience and to a degree my own, I know that some people who are heavy don't have bad eating habits. They're moderate in their eating, and have more energy than I do and are more active.

I didn't weigh 100 pounds until after I graduated college. I've never carried excess weight (even a little) well, so if I am even ten pounds more than I should be I start to look lumpy/dumpy. Not so with some much heavier people who are proportioned well, dress well, carry themselves well, and are fit. And yes, you can be fit, active, eat right and still be overweight.

2588. anomieme - 3/21/2001 5:27:09 AM

Jon,

We're much too critical of our fellow man. We don't understand human nature and human motivations enough to think everyone can or even should refrain from certain behavior. Everyone has a differnt set of abilities and propensanties and it's not fair to project ours on another - and vice-verca.

And I'm sorry if I was rude to you.

2589. JJBiener - 3/21/2001 5:29:06 AM

Jon - I am afraid you have a very limited vision. I feel sorry for you. I have seen two pictures of Christin and it never occurred to me looking at them that she was terribly overweight. That is why her statement took me by surprise. I happen to think she is attractive, so I have to assume I am seeing something you are not.

I am also amused by your assertion that if a person is overweight it is because they gourge themselves on junk food and have low self-esteem. It shows such a profound lack of understanding on your part of why people are overweight. I have a little task for you. Go to a bookstore and page through a copy of the Physician's Desk Reference. Make a mental note on how many medications cause significant weight gain. Next pick up a book on genetics and read up on how much a person's physical makeup is determined by heredity.

Maybe once you have a little knowledge on the subject you can post something without looking like a complete idiot. One can hope anyway.

2590. Jon Ferguson - 3/21/2001 5:46:52 AM

anomieme

I didn't notice if you were. Sorry if I seemed like I thought you were being rude to me. (g)

I am a very critical person. It's been my biggest fault my whole life. If it's any consolation, I turn that critical eye inward more than outward.

arky

I have only seen one picture of Christin, so I wouldn't know. But we're not talking 20 or 30 lbs. overweight, we're talking morbidly obese. Sorry, that NEVER looks good. Some people carry their weight better than others, but when you're morbidly obese, you have a serious problem, both appearancewise and healthwise.

JJ

People are obese because throughout their lives they have consumed far more calories than they have burned. Christin stated that she didn't get fat until after high school. That rules out heredity. If she's on some kind of psychoactive drug that makes her fat, that's still a cop-out in my book, just a different kind of cop-out. It's a popular myth that fat people don't consume vast quantities of calories. And that's all it is, a myth.

2591. arkymalarky - 3/21/2001 6:01:13 AM

I have one colleague whom I'd define as morbidly obese (not the woman I was referring to) and one acquaintance who had surgery that has so far really been successful, and I agree with you wrt to health and appearance, though it's a terrible battle to fight and it's not like these two people are eating machines who never leave their couches. They're both active and moderate people. Christin looks nothing like either of them.

As far as weight gain from medicines, it does happen and very quickly. I was on one for migraines and gained ten pounds before I could turn around. A friend on the same medicine gained 25 in a very short time. I threw that shit away like it was something out of Alice in Wonderland.

2592. JJBiener - 3/21/2001 6:07:23 AM

Jon - People are obese because throughout their lives they have consumed far more calories than they have burned.

Nice theory. It just isn't true.

Christin stated that she didn't get fat until after high school. That rules out heredity.

No, it doesn't doesn't rule out heredity. I know of several families where the onset of obesity comes after childhood.

If she's on some kind of psychoactive drug that makes her fat, that's still a cop-out in my book, just a different kind of cop-out.

It is not just psychoactive drugs. Many kinds of drugs cause weight gain including prednisone and many diabetic medications.

It's a popular myth that fat people don't consume vast quantities of calories. And that's all it is, a myth.

Some people who are overweight are that way because they simply eat to much. The myth is that all or even most are overweight for that reason. If that were true diets would have a much greater success rate than they do.

You have just demonstrated what I said in my previous post. You know next to nothing about this subject. I suggest you learn something before you continue to post. I am sure if you went to yahoo you could find some useful information.

2593. Jon Ferguson - 3/21/2001 6:09:19 AM

Newsflash!

Americans take too many prescription drugs.

For every 1 fat person who has an unavoidable weight problem, I would be shocked if you find less than 9 others (probably closer to 90) whose weight problem is controllable through diet (not starvation, sensible eating) and exercise.

You show me any fat person who doesn't smoke, doesn't drink alcohol, keeps calories from fat below 15% of total calories consumed (I don't care how much they eat,) and does a moderate amount of exercise for half an hour 3 times a week, and I will share in your sympathy for their plight.

2594. Shannon - 3/21/2001 6:12:14 AM

Americans take too many prescription drugs.

Yeah, too damn many people taking prednisone for fun. That's a real problem.

Smoking makes people fat? I thought quitting was more likely to do that.

2595. Jon Ferguson - 3/21/2001 6:15:04 AM

JJ

In the interests of maintaining a civil thread tone, why don't you and I agree to ignore each other on this issue? Rest assured that my belief in your ignorance on this issue is just as profound as your belief in mine.

2596. arkymalarky - 3/21/2001 6:15:17 AM

I don't disagree with that post at all. The first disagreement, and my opinion is from meeting Christin, was about her specifically and her appearance. I would certainly hope no one judged my appearance on one picture, especially since I'm not often photogenic (And don't pipe in that it's because I'm ugly and cameras don't lie!).

2597. Jon Ferguson - 3/21/2001 6:16:41 AM

Smoking makes people less active (lower lung capacity, lower oxygen content in the blood). Inactivity leads to obesity.

Yes, in the short term, smoking tends to lead to weight gain.

2598. Jon Ferguson - 3/21/2001 6:17:59 AM

That should obviously be quitting smoking tends ...

2599. JJBiener - 3/21/2001 6:24:30 AM

Jon - You show me any fat person who doesn't smoke, doesn't drink alcohol, keeps calories from fat below 15% of total calories consumed (I don't care how much they eat,) and does a moderate amount of exercise for half an hour 3 times a week, and I will share in your sympathy for their plight.

I can show you dozens with just a couple of phone calls.

In the interests of maintaining a civil thread tone, why don't you and I agree to ignore each other on this issue?

When you agree to stop posting false and ignorant statements, I will be glad to ignore you. Until then I intend to correct you when ever you post nonsense. Since I have been civil through out this discussion, I believe the onus is on you.

2600. Jon Ferguson - 3/21/2001 6:30:25 AM

JJ

Okay Chief, make the calls.

arky

If you say that Christin is a hottie, that's good enough for me.

2601. pogie - 3/21/2001 6:51:07 AM

There are a fair number of fat people who have the problem of super efficient metabolisms, such that their bodies suck as many nutrients up out of small portions as someone with a less efficient metabolism who eats bigger meals. Sometimes it is their natural metabolism, sometimes it is a yo-yo diet side effect.

2602. JJBiener - 3/21/2001 6:54:04 AM

Jon - When can I tell them you will be in town?

2603. wonkers2 - 3/21/2001 2:31:22 PM

Supreme Court justices Scalia, Rehnquist and Thomas ended up on the wrong end of a 6-3 decision yesterday which ruled that a South Carolina hospital violated the rights of pregnant women by testing them for drugs without their knowledge and turning the results over to the police.

The majority opinion by Justice John Paul Stevens was a strong statement that the facts of the women's pregnancy and of possible danger to their fetuses through illegal drug use did not change the basic constitutional analysis: in the abscence of either a warrant or consent, the drug tests amounted to unconstitutional searches.

2604. ChristinO - 3/21/2001 7:39:10 PM

Wow, what a can of worms I opened. JJ, Arky, thanks for the compliments. It really wasn't my intent to go on a fishing expedition for praise but I appreciate your kind words.

Jon,

It's more than likely pointless to address you but you're playing into exactly the kind of ignorance and prejudice that I was describing. You state that I'm unhealthy and make assumptions about what my lifestyle and psychologizal hangups must be with no knowledge other than what you saw in a single photograph.

Had you read my post you would have noted that my blood pressure and cholesterol are not unhealthy---are in fact better than many people half my weight. Additionally, it's difficult in this forum to escape the knowledge that I own a dog. A dog which I excercise with more than six hours a week.

As for my psyche, judging by your seeming constant need to belittle others I'd bet that my self esteem is considerably higher than your own.

So, the only thing that you can claim with any authority about me is that I am very fat and you personally find me physically repulsive.

I just can't tell you how devastated I am.

2605. ChristinO - 3/21/2001 7:41:59 PM

BTW, smoking decreases appetite and speeds up the metabolism it's why so many supermodels smoke like chimneys----it helps keep them thin.

2606. PsychProf - 3/21/2001 8:26:49 PM

Jon...nicotine is an appetite supressant, independent of motor activity. Good to see you back here.

2607. CalGal - 3/21/2001 10:22:25 PM

I agree with Arky--some fat people really look fat and unhealthy. Christin is not one of them. She looks healthy, holds her weight extremely well, and gets a great deal of attention from men, which is evidence not only of a "good personality" but of the fact that Arky and I aren't the only two who think she's attractive. She also doesn't overeat--we've dined together on several occasions, and I am very alert to that squicky feeling I get when I see an extremely overweight person eating too much. It's one of the few things that can cause me to lose my appetite.

The one reason I hope Christin can lose weight eventually is for the same reason I focus on keeping my weight down, even though I can hold quite a bit before I look "fat"--it's hard on the body. Not blood pressure, heart, or lungs--that can all be offset by exercise. But over time, small frames just aren't suited to carry that much extra poundage. It starts with the skeletal structure and the problems move off in various directions from that point--or so my doctor told me, and he had no reason to scare me. I was there to lose weight.

I think that many people are overweight not because they eat more than others, but because they eat more--in response to simple hunger--than their body requires. Their set point is lower than someone else. Lots of thin people can eat like horses and aren't depriving themselves at all. Likewise, lots of heavy people eat reasonably in response to hunger, don't overeat in comparison to others, but eat too much for their body. It's the hunger that's off. That's why appetite suppressants can work for some people--at least that's why they've worked for me for four years now.

2608. Jon Ferguson - 3/21/2001 11:19:15 PM

Christin

It's more than likely pointless to address you, but you're playing into exactly the kind of ignorance that JJ was exemplifying.

Your weight problem WILL lead to serious health problems in the long run. Guaranteed. I don't give a fuck how great your blood pressure and cholesterol are. As CalGal notes, carrying an extra 100+ pounds around for 40+ years takes its toll.

I make assumptions about your lifestyle and/or psychological hang-ups? If I have done so, please show me where. I said something like 'if she's taking psychoactive medication ...' that is not an assumption of facts, that is a hypothetical. If you are not taking any such medication, that's fine. It just rules out one of JJ's 'excuses' for fat people (prescription medication.)

I really don't care how strong your psyche is or why you perceive that I have a 'constant need to belittle others.' Neither is relevant, whether true or not. I don't suffer fools gladly. So what?

The only things I can state with authority about you is that you are very fat, and you have trouble carrying on a rational discussion. So you improvise by creating straw men and tearing them down. Nowhere do I state that I find you physically repulsive, in fact, I state just the opposite: If you say that Christin is a hottie, that's good enough for me. The much used 'I just can't tell you how devastated I am' retort only works if somebody is insulting you, which I wasn't. I was questioning JJ and arky's decision to empower you to continue your self-destructive behavior. That's all. It really wasn't about you.

Many fat people make a show of eating little in public settings and gorge themselves in private. I suspect you are one of those people. But again, if you are one of the elite few who eat responsibly, exercise, don't smoke, and don't drink (or drink in moderation,) and still weigh way too much, I sympathize with your plight.

2609. Jon Ferguson - 3/21/2001 11:27:28 PM

PP

It's good to be back. For however long it lasts.

Whether or not smoking/nicotine acts as an appetite suppressant or stimulant, I still find myself very susceptible to the 'squicky' feeling that CalGal describes when I see a fat smoker.

Particularly here in Canada, where we have to pay for these people's health care, it absolutely disgusts me that these people can completely let themselves go like that and impose the consequential financial burden of their health care onto others.

But smoking is a tangential issue and for the sake of argument, I withdraw it from my earlier comments.

2610. Jon Ferguson - 3/21/2001 11:41:40 PM

JJ

Jon - When can I tell them you will be in town?

You can tell them I'll be in town when you call them. (I think that was the point of calling them, wasn't it?)

2611. Shannon - 3/22/2001 12:14:56 AM

'if she's taking psychoactive medication ...' that is not an assumption of facts, that is a hypothetical. If you are not taking any such medication, that's fine. It just rules out one of JJ's 'excuses' for fat people (prescription medication.)

Newsflash: There are prescription medications which are not psychoactive medications. I'd venture to guess most of them, in fact.

2612. JJBiener - 3/22/2001 1:16:53 AM

Shannon - I already pointed that fact out to Jon as well as several other facts which contradict his position. He is choosing to ignore them so he can continue to proclaim his discredited position. It is sad, really.

2613. JJBiener - 3/22/2001 1:18:03 AM

Jon - You can tell them I'll be in town when you call them.

I called them. They are ready to go. Have you made you plane reservations yet?

2614. JJBiener - 3/22/2001 1:20:46 AM

Jon - It just rules out one of JJ's 'excuses' for fat people (prescription medication.)

Let's do an experiment. Spend a year taking 40 mg of Prednisone a day, then we will discuss your weight. We will see if you have had a change of heart.

2615. Jon Ferguson - 3/22/2001 1:32:59 AM

Irrelevant quibble noted.

I should have said 'if she's taking prescription medication that tends to cause weight gain ...'

You might note, however, that she has made reference to her stellar physical health. It is not unlikely, given her self-reported physical health, and her demographic profile, that whatever medication she might be on (other than the pill) would be of the psychoactive variety.

And NO prescription drug has MORBID obesity as a common unavoidable side effect, so it's rather a moot point in this particular case, regardless.

2616. Jon Ferguson - 3/22/2001 1:38:02 AM

2615 was for 2611

Prednisone is for what, arthritis and to avoid transplant rejection?

You can always find horror stories where someone has suffered through so much pain or whatever that the fact that they are fat is almost trivial. That doesn't refute my argument that these people constitute a tiny fraction of the obese population.

2617. Jon Ferguson - 3/22/2001 1:46:26 AM

I think it's funny how much compassion JJ has for fat people. How unaccountable he lets them be. How many excuses and 'unavoidable reasons' he lets them dream up for their condition.

But if a criminal tries the same tactic (with far more validity in most cases, I might add) to explain his criminal behavior, let's see how far JJ lets him get.

And no, I'm not equating being fat with being a criminal. But I've got a lot more sympathy for some poor black kid with no father, no education, and no money who robs a convenience store than I do for some middle class fat prick who sits at home scarfing Doritos and Oreos and blames 'genetics' for his disgusting appearance.

2618. CalGal - 3/22/2001 1:50:56 AM

Prednisone is for what, arthritis and to avoid transplant rejection?


It is an anti-inflammatory medication that is ruthless in its impact on the body.

Weight is almost entirely determined by genetics. Relatively few people are morbidly obese because they stuff themselves in the manner you describe. Some are, but it's the exception.

2619. JJBiener - 3/22/2001 1:54:36 AM

Jon - That doesn't refute my argument that these people constitute a tiny fraction of the obese population.

This isn't an argument, it is a statement. No matter how much you may want to believe it, it simply isn't true. Prednisone is a common drug used to treat a vast array of illnesses and conditions. Large doses result in a condition called Cushing's disease "which results in obesity, a moon-shaped face, and muscle wasting." (From WebMD)

Also from WebMD, "Genetic factors influence fat metabolism and regulate certain hormones and proteins that affect appetite and may play some part in 70% of obesity cases." In other words eating properly and excercising may not be enough for 70% of the obese people to maintain a normal weight.

Also, "Genetic factors may also play a direct role in some cases of very severe obesity."

Your simplistic attitude about obesity is based on ignorance. As I said earlier, if you are going to present an opinion, at least present an informed opinion.

2620. JJBiener - 3/22/2001 2:01:28 AM

Jon - But I've got a lot more sympathy . . .

No, I don't think you have any sympathy for anyone but yourself. Your ignorance on this subject is only exceeded by your arrogance. If you are so sure of yourself, take up either of the challenges I have laid out for you. I would love to see you take 40 mg of Prednisone for a year. It would be a riot seeing you try deal with an 80 lbs weight gain.

2621. Jon Ferguson - 3/22/2001 2:04:04 AM

So the fact that Americans have the most unhealthy eating habits in the industrialized world as well as the highest incidence of obesity is just a coincidence?

You really think that couch potatoes who are addicted to junk food would be just as fat if they ate healthy and exercised?

Or you don't think that couch potatoes are all that common?

Anyway, nobody has produced any hard, non-anecdotal evidence, so this is almost completely unproductive. I firmly believe that the vast majority of fat people are fat because of their poor eating habits and lack of exercise. You don't. Fair enough. I do not dispute that genetics certainly play a role. But that role need not be decisive, nor does it play nearly as large a role as choices people make every day about what to eat, how much to eat, and how much to exercise.

You might as well argue that some people are predisposed to be couch potatoes because of their genetics, which I'd also agree with. Genetics predisposes us to many traits, but it is seldom seen as a valid excuse. No reason it should be seen as one in this case.

2622. Jon Ferguson - 3/22/2001 2:08:44 AM

JJ

Your 'challenges' are retarded. Please stop making them.

I challenge you to bring all your fat friends to Ottawa and show them to me as you said you would.

I challenge you to sniff glue for a year so that you can experience what it feels like for others to make sense of your arguments.

I challenge you to refrain from taking a dump for a month. It would be a riot to see you realize that you really ARE full of shit.

Enough childish challenges, Chief.

2623. JJBiener - 3/22/2001 2:10:28 AM

Jon - Anyway, nobody has produced any hard, non-anecdotal evidence, so this is almost completely unproductive.

I posted relevant quotes from WebMD which (as usual) you choose to ignore.

I firmly believe that the vast majority of fat people are fat because of their poor eating habits and lack of exercise.

God forbid you let any facts passed your defenses.

One thing that is instructive is that the only one talking about excuses is you. We have been talking about causes. Apparently you are more interested in blaming people than in understanding the issue. This is your standard MO, so I am really not surprised. When you get passed your need to place blame and are interested in understanding, then maybe this discussion can be completed.

2624. JJBiener - 3/22/2001 2:14:11 AM

Jon - Your 'challenges' are retarded. Please stop making them.

You are the one who made the first challenge. I just called you on it.

I challenge you to bring all your fat friends to Ottawa and show them to me as you said you would.

It is your challenge. You come here. You won't because your challenge was bullshit from the beginning.

I challenge you to refrain from taking a dump for a month.

This is actually very funny, but you wouldn't have a clue as to why.

2625. Jon Ferguson - 3/22/2001 2:17:30 AM

Cushing's disease sufferers.

Exempt (part of the 1 in 10 I mentioned).

Please find me a % of the population who suffer from Cushing disease. If it's more than one hundredth of one percent of the population, I'll be shocked. If it's more than one tenth of one percent of the population, I will concede this argument entirely.

Genetic factors may play a role ...

Do you know what 'may' means, JJ?

2626. ChristinO - 3/22/2001 2:19:42 AM

Jon,

Do you just not pay attention to what you say? I haven’t contradicted myself nor have I denied any facts and yet you continue to do both.

From 2608

Your weight problem WILL lead to serious health problems in the long run. Guaranteed. I don't give a fuck how great your blood pressure and cholesterol are.

This makes no sense, Jon. If a person’s blood pressure and cholesterol levels are healthy then it’s pretty damn difficult to have a heart attack unless he suffers from a congenital heart defect. Dave Letterman, on the other hand is neither overweight, nor inactive nor does he suffer from a congenital heart defect and yet he required a quadruple bypass last year.

I make assumptions about your lifestyle and/or psychological hang-ups? If I have done so, please show me where.

Let's start with Message # 2584

Between controlling your consumption of junk food and letting it control you

Translation = Fat people are compulsive over-eaters of highly caloric food with no nutritional value.

Between taking responsibility for your health and appearance and surrendering to your low self esteem

Translation = Fat people are fat because they have low self-esteem

Between being alive and vital and being a sedentary slug

Translation = Fat people are stuporous layabouts who don’t exercise.

As a fat person I could only assume that you meant me as well. Since none of your “facts” describes my life-style or me I felt it was important to point that out to you. Had you said “some” or “many” fat people then I wouldn’t argue with you, but you didn’t say that. This is the very thing I was ranting about earlier on the part of health-care professionals who don’t treat “people” they treat “fat”.

cont.

2627. ChristinO - 3/22/2001 2:20:09 AM

cont.

It just rules out one of JJ's 'excuses' for fat people

Why in the world would fat people need to be excused? It’s not a crime or a character flaw.

and you have trouble carrying on a rational discussion

What’s irrational about requiring health professionals to look at actual facts and deal in patient specifics rather than trying to give out a single diagnosis to a hundred million people? Are you perhaps confusing my posts with someone else’s?

Nowhere do I state that I find you physically repulsive, in fact, I state just the opposite

My apologies if I over-stated your position but this statement:

I at least have SOME sympathy for UGLY fat people. It's not like they'd look a whole lot better if they DID lose the weight. It's the pretty/handsome fat people that are truly pathetic.

and this one

I have only seen one picture of Christin, so I wouldn't know. But we're not talking 20 or 30 lbs. overweight, we're talking morbidly obese. Sorry, that NEVER looks good. Some people carry their weight better than others, but when you're morbidly obese, you have a serious problem, both appearance-wise and health-wise.

don’t really jibe with your assertion. Neither do many of your past comments to me. If your comment to Arky was sincere then I apologize for having misunderstood you, but you can hardly blame me for the confusion in light of your vehemence on the disgusting nature of fat people.

cont. to end

2628. ChristinO - 3/22/2001 2:20:20 AM

cont.

Many fat people make a show of eating little in public settings and gorge themselves in private.

So do many thin people.

I suspect you are one of those people.

Why? Because it just isn’t possible for me to be fat unless I’m a closet binger? Sorry to disappoint, but I’m far more likely to binge when out to dinner in the company of friends.

If you are one of the elite few who eat responsibly, exercise, don't smoke, and don't drink (or drink in moderation,) and still weigh way too much, I sympathize with your plight.

Spend your sympathy on the people who need it. People who lose their organs to quack medical advice and their health and often lives to bad diet-gurus and ignorant health professionals. People so demoralized by the cruelty of casual strangers that they can’t even leave their houses much less go to the gym. People whose doctors insult them and humiliate them because it’s easier to buy into the idea that fat people are just lazy and pathetic than it is to treat individuals.

2629. ChristinO - 3/22/2001 2:20:49 AM

Prednisone is also used in the treatment of severe asthma.

2630. Jon Ferguson - 3/22/2001 2:21:09 AM

Here is my statement that JJ interpreted as a 'challenge.'

You show me any fat person who doesn't smoke, doesn't drink alcohol, keeps calories from fat below 15% of total calories consumed (I don't care how much they eat,) and does a moderate amount of exercise for half an hour 3 times a week, and I will share in your sympathy for their plight.

This was not intended as an offer to fly off into the wild blue yonder to visit JJ and his fat farm.

Does anybody else share JJ's interpretation?

2631. Jon Ferguson - 3/22/2001 2:22:49 AM

Ciao for now.

2632. CalGal - 3/22/2001 2:24:33 AM

So the fact that Americans have the most unhealthy eating habits in the industrialized world as well as the highest incidence of obesity is just a coincidence?


Actually, I think the French eat quite unhealthily in comparison? Can't remember.

In any event, it is quite possible that Americans eat unhealthily and have a high incidence of obesity for entirely unrelated reasons. Which would indeed make it coincidental. Not only possible, but likely, actually, given that far more people in America are eating unhealthily than are obese.

2633. ChristinO - 3/22/2001 2:24:58 AM

Morbid Obesity defined

Definition

The point reached where the degree of obesity begins to interfere with normal physiologic functions such as breathing.

Common Causes
- excessive caloric intake
- Cushing's syndrome
- Prader-Willi syndrome
- Laurence-Moon-Biedl syndrome

Note: There may be other causes of morbid obesity. This list is not all inclusive, and the causes are not presented in order of likelihood. The causes of this symptom can include unlikely diseases and medications. Furthermore, the causes may vary based on age and gender of the affected person, as well as on the specific characteristics of the symptom such as quality, time course, and associated complaints. Use the Symptom Analysis option to explore the possible explanations for morbid obesity, occurring alone or in combination with other problems.

2634. ChristinO - 3/22/2001 2:29:44 AM

CG,

I'm convinced that Americans are unfit because we have to drive so much and spend so much time sitting on our asses at white-collar jobs.

The French eat incredibly fatty foods---land of cheese and cream sauces let's not forget---however they drink mass quantities of red wine which combats cholesterol and they--like most European countries---WALK.

They also tend to eat less pre-packaged food so their fat calories aren't quite so worthless as much of what makes up the staple American diet.

2635. ChristinO - 3/22/2001 2:30:12 AM

Oh, and let's not forget how much the French SMOKE.

2636. msgreer - 3/22/2001 2:48:07 AM

Jon

Please feel free to post anything you want in this thread. However, the word "retard" or "retarded" are not allowed in this thread. Got me?

2637. Jon Ferguson - 3/22/2001 3:10:44 AM

Re 2626

From 2608

Your weight problem WILL lead to serious health problems in the long run. Guaranteed. I don't give a fuck how great your blood pressure and cholesterol are.

This makes no sense, Jon. If a person’s blood pressure and cholesterol levels are healthy then it’s pretty damn difficult to have a heart attack unless he suffers from a congenital heart defect. Dave Letterman, on the other hand is neither overweight, nor inactive nor does he suffer from a congenital heart defect and yet he required a quadruple bypass last year.

If heart attacks were the only serious health problem attributable to being morbidly obese, this counterargument would make a certain amount of sense. But they aren't. So it doesn't.

As far as whether I meant 'some' or 'many' or 'most' when I made generalizations about fat people, I have stated repeatedly that I am talking about a (vast) majority, for the sake of argument, 90%. I have also stated repeatedly that maybe you, ChrisO, are that 1 fat person in 10 (approx.) who has absolutely no say in how fat you are. So if you wish to take those generalizations personally, fine. But like most generalizations, they were meant to convey an opinion about a specific group, while allowing for certain exceptions within that group.

2638. Jon Ferguson - 3/22/2001 3:12:35 AM

Re 2636

Sure thing, tardo. (g)

Was that a warning or did I inadvertently use that word? (probably in reference to JJ)

2639. Jon Ferguson - 3/22/2001 3:33:42 AM

Why do fat people need excuses?

So they don't have to be accountable for being so goddamn fat, that's why.

Repulsiveness

If I find all fat people physically repulsive, why do I refer to pretty/handsome fat people?

I stated that being 100 lbs overweight NEVER looks good. That's quite a stretch to 'physically repulsive.'

I don't recall making any statements to you to the effect that you are physically repulsive. I have referred to you as 'Tubby.' That, to me, is synonymous with 'Fat.'

Thin people who gorge themselves in private? You mean bulimics (glad I checked, thought it was bulemics)? If you would consider someone who is morbidly obese to have a problem/disorder similar in degree to your average bulimic, then we don't really disagree.

As far as when you binge, I don't really care. The fact that you do binge is all I needed to support my argument, thanks.

This is really going nowhere, but I'm happy to continue as long as need be.

2640. Jon Ferguson - 3/22/2001 3:39:21 AM

Re 2633

Could somebody please translate 'Excessive caloric intake' for JJ?

And while you're at it, get the stats on what percentage of the population suffers from those 3, rather obscure, 'syndromes.' If it's more than 1 tenth of 1 percent of the population (for all 3 combined) I'll be shocked. If it's more than 1 percent of the population, I'll concede the argument entirely.

2641. Jon Ferguson - 3/22/2001 3:53:46 AM

Well, I turn 30 in 3 hours (well, really 10+ hours, but legally 3 hours) so I'm outta here.

2642. msgreer - 3/22/2001 8:06:44 AM

Jon

This has nothing with JJ. Find another word, got it? You don't like my rules, take it to higher authorities.

2643. msgreer - 3/22/2001 3:30:22 PM

My apology to all other Moties posting on weight issues. It is a very important discussion. However, I find myself unable to NOT to say something when the word "retard" or "retarded" is used. I do not apologize for these feelings. So, please, don't let what I said to Jon Fergeson get in the way of the discussion. I'm at work and do not have the time to get into the dialogue. I hope to this weekend. I will say one thing. If Jon or anyone else thinks the majority of people are overweight because they sit home eating pon-pons and watching soap operas they are misguided and judgemental.

2644. PsychProf - 3/22/2001 4:27:55 PM

OBESITY

click on image

2645. JudithAtHome - 3/22/2001 4:37:06 PM

It's the pretty/handsome fat people that are truly pathetic.

Not nearly as pathetic as someone who makes a remark like this one.

2646. jadegold1 - 3/22/2001 4:37:33 PM

Bravo, JF.

An outsanding series of posts. You are to be commended.

2647. JudithAtHome - 3/22/2001 4:48:07 PM

Yes, JF...you ARE quite nimble with words. I'm sure it's a talent you've developed over time.

How do you feel about people with those disgusting hairy backs or those noses which curve down a little too much? Or how about bald people? Do they offend your eyes so much you must turn away?

2648. JudithAtHome - 3/22/2001 4:49:59 PM

But I do appreciate your looking up the stats on female gynecologists...thanks!

2649. jadegold1 - 3/22/2001 4:52:07 PM

Judith:

I believe you must read what JF has written. Most obesity not genetic. It is a result of poor eating and exercise habits.

2650. JudithAtHome - 3/22/2001 5:27:39 PM

Jade:

I did read what Jon wrote. I read back to the beginning of the discussion. I find Jons opinions to be very rigid and his manner to be rude; he used the word "disgusting" in connection with fat people so many times I lost count...and mostly because they offended his sight.

I don't care how people become overweight...for someone to act as though a fat persons very existance is an affrount to his sensibilities shows an extreme attitude and a lack of tolerance I find unhealthy.

Jon brags about being introspective...I don't see it bringing about positive results.

And for what it's worth, I happen to know for a fact that many medications add weight...contraceptives can do it, as can pain meds and numerous others.

2651. Jon Ferguson - 3/22/2001 5:36:01 PM

Thanks JG

Sorry I hit too close to home, JAH

Thanks for the statistics on Cushing's syndrome, PP. Ten people per million. Or 1 thousandth of one percent of the population.

I think we can safely eliminate that red herring.

2652. jadegold1 - 3/22/2001 5:36:54 PM

Judith:

Obesity is unsightly. It also drives up healthcare costs for everyone. It is also, in most cases, preventable.

We're not talking about a problem somebody is born with. We're speaking about a problem a person develops through their actions or inactions.

I'd suggest the effects of medications and drugs are not as prevalent as you suggest. Be aware we're talking about obesity, not someone who is carrying around an extra 10 pounds.

2653. JudithAtHome - 3/22/2001 5:38:54 PM

Sorry I hit too close to home, JAH

Look, sweetheart, you aren't even in the same neighborhood much less near "home".

2654. JudithAtHome - 3/22/2001 5:43:47 PM

Be aware we're talking about obesity

I think seeing the term "morbid obesity" was the clue that we were talking about obesity.

2655. jadegold1 - 3/22/2001 5:43:59 PM

I would add parents who have obesity problems, due to poor diet and exercise habits, are quite likely passing these same problems on to their children.

2656. christipeters - 3/22/2001 5:51:53 PM

Jade - my doctor disagrees with that. I have posted this before in other places. He told me that there are several studies showing done using adopted kids showing that kids raised in an adopted family of healthy eating exercise-nuts whose biological parents were overweight end up as overweight adults. Conversely kids raised in adopted families that are sedentary junk-food junkies, but whose biological parents were thin, end up as thin adults. He said when the studies were started, they expected the opposite result. He also said that there have been quite a few studies to indicate that genetics has way more to do with the adult weight of the vast majority of people than is commonly accepted. He doubted that these studies will ever get much media attention because no one can make much money over the fact that you are fat because your parents and grandparents are fat.

Of course, he added that it doesn't mean that there is nothing that can be done about being overweight. It does mean that it is much more difficult than is commonly thought, that it is unreasonable for the person with overweight ancestors to expect to maintain a weight "according to the charts", and that doctors need to look at the individual and their specific weight and health in context.

So, for example, someone whose parents and grandparents are all overweight may have to work very hard to maintain a weight of, say 20 lbs "too much" (re:the charts), may easily maintain a weight of, say 30-40 lbs "too much", and may only be able to reach their "ideal" (chart) weight through drastic measure which are themselves damaging to their health.

BTW, JF, I do not smoke or drink, I eat 1500 calories or less each day, and I walk for 30 minutes 5 or more days a week. However, I am 90 lbs over what that chart says I should weigh and 70 lbs over what my doctor and my past experience say is a good weight for me.

2657. Jon Ferguson - 3/22/2001 5:53:17 PM

Judith, try not to be so emotional.

Here's what you wrote:

My opinions are rigid.

So what? Are JJ's and Chris' any less so? Is having rigid opinions either a bad thing or particularly uncommon around here?

My manner is rude.

It can be at times, but it hasn't been particularly so in this conversation. Both JJ and particularly MsGreer have been far ruder. So what? It's a subject that animates people. If others wish to be rude, good for them.

I am not particularly disgusted with how fat people look, I am disgusted with anybody who actively seeks to avoid responsibility for the choices they make by blaming factors beyond their control. I'm sorry you can't seem to see the distinction.

You say you don't care how fat people become overweight. Well, honey, maybe you missed it, but that's exactly what we've been arguing about. If you don't know or don't care, perhaps you don't have a lot to contribute to the discussion.

Nowhere do I brag about being introspective. I say I'm my own worst critic. Why would I brag about that?

Where has anyone disputed that certain medications tend to stimulate appetite or lower metabolism? As JG says, we're not talking about 10 or 15 extra pounds. And I've repeatedly said that there is a very small group of obese people who have a valid 'excuse'. Most don't.

2658. christipeters - 3/22/2001 5:56:54 PM

JF - I do not think MsGreer was rude to you. She merely asked that you not use certain terms when posting on this thread. She is the moderator for this thread and has the right to make decisions on what is and is not allowed.

2659. Jon Ferguson - 3/22/2001 6:22:16 PM

Christi

Please stop tearing down arguments I haven't made.

As the moderator, she can indeed make decision on what is and is not allowed. Nowhere do I say otherwise.

Her tone was rude. She has an irrational hang-up about a certain word. I had forgotten that and wasn't even aware that I had, in fact, posted the word. She should adopt a more pleasant demeanor when enforcing her hang-up. But she has every right to be rude.

It would be like if I said:

Christi you are a fucking liar. No human adult non-amputee on earth can consistently consume only 1500 calories a day over an extended period of time, while staying active and exercising regularly, and maintain a body weight that is considered 70-90 pounds in excess of ideal.

But see, unlike some people around here, I have way too much class to do that.

2660. christipeters - 3/22/2001 6:33:08 PM

Well, saying "it would be like if I said.... and then saying it and adding you have "too much class to do that" isn't very classy at all. You just did say it. Your bracketing comments don't change that.

See, that's your problem, JF. If someone states something that doesn't match your predjudices, they must be a "fucking liar". I am not a liar and your calling me one does not make it so.

2661. christipeters - 3/22/2001 6:36:02 PM

BTW, how on earth is:

"Please feel free to post anything you want in this thread. However, the word "retard" or "retarded" are not allowed in this thread."

Was it just the "Got me?" at the end?

Would it have not seemed rude if she had left that off or said "Understand me?" instead?

(just wondering)

2662. pogie - 3/22/2001 6:41:09 PM

There are people who cannot lose weight eating 1000 calories per day, which just goes back the theory that their bodies are just too darn efficient at using calories.

Random inquiry: about what size is a chick five six and 130ish?

2663. jadegold1 - 3/22/2001 7:08:54 PM

JF is correct, though he might have emphasized his point more tactfully.

If you are eating 1500 calories per day (less than 30% of which are fat calories) and you're exercising a half hour three times a week or more, you will lose weight.

I've heard similar tales from people, only to discover their exercise is non-existent and their 1500 calorie/day diet only extends to 2 or 3 days per week.

2664. JudithAtHome - 3/22/2001 7:12:23 PM

That sounds like a good weight for a female that height...maybe a little underweight.

But I suppose there are those who would consider anything but 100lbs soaking wet in heavy wool clothes to be morbibly obese.

Naturally, those people are probably thin.

2665. jadegold1 - 3/22/2001 7:12:24 PM

A fitness trainer friend told me of a similar story involving one of is clients.

The client was exercising 4 times a week under the peurview of the trainer and claimed to be eating fewer than 2000 calories each day. He wasn't losing weight.

Turns out, the client neglected to mention the sixpack he was drinking every night.

2666. jadegold1 - 3/22/2001 7:49:50 PM

Most people are woefully uneducated about diet.

Probably the biggest mistake I see in people trying to watch their weight is the trip to the salad bar. They think they're health-conscious because they're eating salad and a few veggies. But they're also loading up fat calories when they add the bacon, cheese, croutons, crunchies, and a couple of ladles of dressing.

2667. JudithAtHome - 3/22/2001 7:53:34 PM

Jade:

People who are serious about their calorie counts know this...they also know alchohol has to be counted.

If they are serious about weight maintainence or loss, they will also count carbohydrates and fat grams.

2668. JudithAtHome - 3/22/2001 7:54:20 PM

alcohol...see, I get careless just thinking about it!

2669. Jon Ferguson - 3/22/2001 8:04:57 PM

Judith

You can't spell. We all know that. It's not the typos 'morbibly' and 'alchohol' that you need to worry about any more than I worry about leaving the 's' off decisions in 2659.

Concentrate on words like 'maintenance'.

2670. Fielding - 3/22/2001 8:06:39 PM

Looks like Mr. "self-evident" has a pedantic streak.

2671. christipeters - 3/22/2001 8:07:10 PM

riiiiight

JF and JG know more about my life and lifestyle than I do.

Uh huh.

While what you say may be true of most people, it is not true of all people. It is not true of more people than what those who make money off the diet and fitness industry would like us to believe.

However, a conversation with people who assert that what I post about myself must be lies is less than futile.

Bye.

2672. jadegold1 - 3/22/2001 8:11:16 PM

Judith:

You'd be surprised. I've seen people, supposedly dieting and using the little food scales, who drink 4-5 cokes a day. Or think all condiments are calorie-free.

Personally, I think calorie-counting is detrimental to the successful diet; it just focuses people on what they cannot have.

My advice is to use the plans suggested by Dr. Gabe Mirkin or Bill Phillips.

2673. Jon Ferguson - 3/22/2001 8:11:39 PM

And Christi, if you're a dwarf (an exception I overlooked,) sorry for what I might have said if I didn't have so much class. (g)

Just out of curiosity, how tall are you?

2674. jadegold1 - 3/22/2001 8:14:35 PM

CP:

If you have some kind of thyroid or medical problem, maybe you can't lose the weight.

Otherwise, based on what you've said, you have to be losing weight.

2675. Jon Ferguson - 3/22/2001 8:16:07 PM

Fielding

I don't know you and I don't know why you enjoy embarrassing yourself by your constant refrain that self-evident has no meaning or that my usage of it was improper. It's in the dictionary (click on the Merriam-Webster link on the home page):

One entry found for self-evident.


Main Entry: self-ev·i·dent
Pronunciation: -d&nt, -"dent
Function: adjective
Date: 1671
: evident without proof or reasoning
- self-ev·i·dent·ly adverb

Now run along.

2676. Fielding - 3/22/2001 8:20:19 PM

Now that you know what it means, you can try to use it properly. At the very least, you might reconsider your posts correcting others.

2677. JudithAtHome - 3/22/2001 8:21:31 PM

Jon:

I think possibly everyone knows I can't spell...it is evident in my posts, just as some things about you are evident in yours.

2678. Jon Ferguson - 3/22/2001 8:24:03 PM

Now that you know what it means, go back and read the post in which I used it.

Attempting to prove that your stupidity might be exceeded by your stubbornness is an interesting tactic, but I don't think it will succeed.

2679. Jon Ferguson - 3/22/2001 8:26:48 PM

Judith

Isn't that what I just said? Perhaps you missed my point, in which case I'll spell it out for you a little more explicitly.

You needn't feel obligated to correct every typo that you make, particularly when such typos are greatly outnumbered by legitimate spelling errors that you consistently overlook.

2680. JJBiener - 3/22/2001 8:27:41 PM

Jade & Jon - Did either of you happen to read the link PP provided in 2644? If you have I don't see how you can persist in your positions. You may believe that diet and lack of exercise are the primary causes of obesity, but the scientific studies say otherwise. If you would like to refute the facts offered by that link, then by all means do so. If you can provide a source of information that supports your beliefs, then please provide one. Simply restating your misguided beliefs does nothing for this conversation. You have been show scientific evidence that refutes your position. Are either of you going to provide a shred of scientific evidence or are you going to continue to stamp your feet and insist you are right.

2681. JudithAtHome - 3/22/2001 8:27:56 PM

Thank you so very much. I appreciate your concern.

2682. JudithAtHome - 3/22/2001 8:29:37 PM

That last post was to Jon...I won't attempt to spell his full name as I don't want to butcher it.

2683. jadegold1 - 3/22/2001 8:35:22 PM

Wiener:

I read PP's link. I don't believe you did.

It very clearly points up the fact that taking in more calories than you expend leads to weight gain. It also mentions that small fractions of people may suffer medical disorders where they gain weight despite sticking to rigid diet and exercise regimens.

In virtually all cases, however, obesity is caused by poor diet combined with a lack of exercise. It's amazing you cannot grasp this very elementary idea.

2684. jadegold1 - 3/22/2001 8:39:14 PM

Further, you claim to need "scientific evidence" to see this elementary idea. Yet, you blithely accept CP's and CO's claims as to their diet and exercise regimens and base most of your findings upon whether or not a man would want "to get into her pants."

Excuse me, Doctor Salk.

2685. Jon Ferguson - 3/22/2001 8:39:28 PM

JAH

Interestingly enough, you have butchered it in the past. You've called me Jonathon. (shudder)

JJ

Here's a great piece from PP's link (emphasis mine):

Q: How common is PWS?

A: It is estimated that one in 12,000 to 15,000 people has PWS. Although considered a "rare" disorder, Prader-Willi syndrome is one of the most common conditions seen in genetics clinics and is the most common genetic cause of obesity that has been identified. PWS is found in people of both sexes and all races.

So the most common genetic cause of obesity that has been identified (rather than imagined) affects less than 1 hundredth of one percent of the population and yet JJ claims that obesity is invariably and unavoidably caused by bad genes.

How interesting.

2686. Jon Ferguson - 3/22/2001 8:40:25 PM

JG

2684 was priceless, thank-you. (g)

2687. jadegold1 - 3/22/2001 8:43:05 PM

No, thank you, JF.

2688. JJBiener - 3/22/2001 8:52:48 PM

Jade - In virtually all cases, however, obesity is caused by poor diet combined with a lack of exercise. It's amazing you cannot grasp this very elementary idea.

Maybe if you read past the first paragraph you won't look like such an idiot. You obviously missed this paragraph:

Twin and adoptee studies indicate that there is a strong genetic basis for obesity. Studies on large populations of adopted children show that there is no relationship between body weight and adoptive parents, but a close correlation with biological parents. Studies on monozygotic (identical) twins show a much stronger correlation in body weight than between other siblings or dizygotic (fraternal) twins. Researchers vary in their opinion on the weight genetics plays in energy regulation, but genetic factors can account for as much as 80 percent.

If you had bothered to click on the link for genetics you would have read this:

The size and shape of the human body, like hair color and eye color, is greatly influenced by heredity. The proportion and amount of fat on the body is part of evolutionary adaptation to the environment. Being fat is not, as some would have us think, a "disease," but is instead caused by a combination of hereditary traits and the body's natural response to the environment.

And this:

Many studies have shown a consistent correlation between heredity and fat. These studies show that where both parents were fat, 80% of their children, even if not raised by their genetic parents, were also fat. Only 9% were fat when both parents were lean. When only one parent was heavy, 40% of the children were heavy too (Roberts 1988, Stunkard et al. 1986). Another study found that twins, regardless of whether they were reared apart of in the same home environment, were about 70% likely to weigh the same (Stunkard et al. 1990).

2689. JJBiener - 3/22/2001 8:53:25 PM

And this:

The myth that a person who is fat eats more or differently has not been proven by studies. In fact, at least twenty studies have tried to show fat people eat more, or less nutritionally. Nineteen found that fat people eat the same or less than thinner people. Only one study found a higher consumption by fat participants (Dyrenforth et al. 1980:45). Although over-eating does exist, there are thin and fat people who overeat or binge and there are many fat people who eat less than thin people (Bennet & Gurin 1982; Dryenforth et al. 1980, Polivy & Herman, 1985).

And this:

Given what we know about the genetic nature of the natural weight range and its positive role in helping humans adapt to harsh climates, dieting is at best unproductive and often dangerous. It is not that a person is necessarily "born to be fat" but that the metabolism of some persons is more efficient. It is this mechanism that we believe causes the eventual weight gain in yo-yo dieting. In this context, being fat is not a "disease" or malfunction, but is, instead an adaptive response to the environment with some positive side-effects.

None of this supports your claim. Do you want to persist or are you willing to admit you have been mistaken?

2690. JJBiener - 3/22/2001 8:56:08 PM

Jon - You have an amazing ability to see only what you want to see. Please read 2688-9 and explain how that supports your claims.

2691. jadegold1 - 3/22/2001 8:58:22 PM

Wiener:

I read the link. Posting it in its entirety does not support your erroneous position.

A genetic predisposition does not necessarily guarantee a person will become obese. Some say alcoholism is gentically-based; I guarantee one will become alcoholic if they don't drink alcohol.


Similarly, if you pay attention to a diet and exercise regimen, you will not become obese barring any medical problem.

2692. Fielding - 3/22/2001 9:00:53 PM

JF:

Now that you know what it means, go back and read the post in which I used it."

You're too lazy to get it yourself, so I'll post it here.

"It is self-evident that less than 1% of the U.S. population would be African American if not for slavery." (Note this is from yesterday's Current events thread.)

The definition that you quoted is

"evident without proof or reasoning"

Thus, self-evident does not mean "a fact which JF is too lazy to prove".

"Self-evident" means a fact that is evident from the statement itself (something like "WASPs are white") or something that is taken as a philosophical given ("We hold these truths as self-evident") or something that is taken on faith ("I'll take Fielding's distaste for pedantics like JF as self-evident"). It does not mean a hypothesis that you could probably prove if you were reasonably intelligent.

Face it, you are dead wrong.

Now stop correcting other people's spelling you lazy hypocrite!

2693. JJBiener - 3/22/2001 9:03:56 PM

Jade - The information above says otherwise. Gee, who am I going to believe, the researchers who have studied this problem for years, or you?

There is far more than genetic predisposition. This has been documented in numerous studies. If you want to stick your head in the sand you are welcome to do so.

2694. jadegold1 - 3/22/2001 9:04:16 PM

There should be a 'not' between 'will' and 'become' in my last.

2695. jadegold1 - 3/22/2001 9:05:57 PM

Wiener:

You may continue to eat Ho-Ho's until they extrude from your ears and you can blame your weight problem on genetics.

2696. ChristinO - 3/22/2001 9:06:10 PM

Excuse me, but I have made no claims whatsoever about my diet not making me fat. What I said was that the deadly blood-pressure and high cholesterol bogeymen are not a hard and fast rule of being fat and that the moronic insistance of people in a position to know better has seriously jeopardized the health of countless people.


I never claimed that I don't consume more calories than my body needs. What I said was that I don't sit around bingeing day in and day out and sitting on the couch. My blood pressure is excellent, my cholesterol is fine and yet it's my skinny friend who's on the fast track to a heart attack.


I think less people would be defensive about being fat if it weren't such a priority on the part of others to attack them for being fat.

Skinny un-fit folks don't get accosted on street corners and the subway and told that they're disgusting because they have no muscle tone. They aren't called losers for not going to the gym. They can be as un-fit as fat people and yet it's the fat folk who get the epithets.

There's no rationality to such behavior. It's plain old prejudice and ignorant cruelty. Such idiocy is irritating in laypeople but completely unacceptable in health-care professionals.

2697. Jon Ferguson - 3/22/2001 9:08:51 PM

Fielding

Why do you think I used 'self-evident' in that context?

Because the assertion I was making is unprovable, you shmuck. We can only speculate about what might have happened if slavery had not existed. I can't prove the assertion. It has nothing to do with laziness. It has to do with my unfortunate inability to create alternate universes in which I can test my theories.

My usage was perfectly proper. Your criticism is almost incoherent. Your insults are laughable.

Now please, run along, or take this to the Inferno. You've embarrassed yourself enough for one day.

2698. jadegold1 - 3/22/2001 9:09:12 PM

I find it amusing that flaming Repugs like Wiener will disparage minorities and the poor for being lazy and unwilling to pursue success.

Yet, when Wiener looks down and can't tell what color his shoes are, it's 'genetic.'

2699. ChristinO - 3/22/2001 9:15:45 PM

Some say alcoholism is gentically-based; I guarantee one will not become alcoholic if they don't drink alcohol


Alchoholism isn't determined by whether one drinks or doesn't drink. It's a disease determined by the effect of alcohol on the individual. An abstaining alcoholic is still an alcoholic. It's why you don't get to ever say you're "cured" but rather a "recovering alcoholic" even 30 years after you get your first chip.

2700. jadegold1 - 3/22/2001 9:20:10 PM

A different point altogether, CO. I suspect you understand that.

2701. mgleason - 3/22/2001 9:20:51 PM

From the OED:

self-evident a. requiring no proof or further explanation; obvious; axiomatic.

2702. ChristinO - 3/22/2001 9:23:04 PM

Sorry, jade, was 2700 in response to 2696 or 2699?

2703. jadegold1 - 3/22/2001 9:36:21 PM

2699, CO.

Naturally, I take issue with 2696 as well. Health problems caused by excessive weight are not always immediate or apparent through common benchmarks as blood pressure or cholesterol readings.

2704. Fielding - 3/22/2001 9:52:56 PM

"Why do you think I used 'self-evident' in that context?

Because the assertion I was making is unprovable, you shmuck. We can only speculate about what might have happened if slavery had not existed.

You keep getting this wrong. Before I thought you were being boneheaded, but now I see that you're just stupid.

Self-evident does not mean "unprovable". The following facts are unprovable, but are not self-evident: The 2001 year end Dow Jones Industrial average; The name of the first person to use fire; The number of black holes in the universe; The menu for the second-to-last meal; The number of brain cells left in your head.

Moreover, the fact that you stated as "self-evident" is open to analysis. An intelligent person could make a very compelling argument based on immigration patterns and demographics that if not for slavery, the population of African Americans would be less than 1%. Self-evident doesn't mean "something I'm too lazy to try to prove".

In any case, you used it wrong. Which would be no big deal if you weren't at the same time a pedantic and an irritant.

2705. jadegold1 - 3/22/2001 9:58:13 PM

Is this really appropriate for this thread, Fielding?

Doesn't Jenerator require your fawning obsequiousness somewhere?

2706. Fielding - 3/22/2001 10:00:28 PM

I wish.

2707. JJBiener - 3/22/2001 10:46:18 PM

Jade - You may continue to eat Ho-Ho's until they extrude from your ears and you can blame your weight problem on genetics.

I haven't even mentioned my weight, and I am not even sure what a Ho-Ho is.

I find it amusing that flaming Repugs like Wiener will disparage minorities and the poor for being lazy and unwilling to pursue success.

I have disparaged no one.

Yet, when Wiener looks down and can't tell what color his shoes are, it's 'genetic.'

I have never claimed anything about my weight. Genetics has a great deal to with my weight just as it does with yours. My weight was caused my Cushing's syndrome. Since I have been off prednisone I have lost 70 lbs without changing my lifestyle or eating habits.

It is nice to see that you are still true to form. When it becomes obvious that you can't support your claims you resort to lies and insults. You are a truly pathetic individual.

2708. jadegold1 - 3/22/2001 10:54:08 PM

I have a syndrome.

Don't you love it when Repugs engage in victimology?

2709. Jon Ferguson - 3/22/2001 10:55:45 PM

Fielding

An intelligent person could make a very compelling argument based on immigration patterns and demographics that if not for slavery, the population of African Americans would be less than 1%.

That's exactly why it's self-evident (at least, to me), you imbecile. It is still unprovable. And nowhere do I say that 'unprovable' is synonymous with 'self-evident', so please stop arguing against something I have never asserted.

MsGreer

Sorry to continue this off-topic demolition of Fielding. I have asked him to take it elsewhere and yet he persists. Feel free to move this discussion to Language or the Inferno. Thanks.

2710. JJBiener - 3/22/2001 10:56:08 PM

Jade - Victimology? From a medication? What an absurd person you are.

2711. jadegold1 - 3/22/2001 10:57:17 PM

I may be absurd, Wiener.

But I'll never be obese.

2712. JJBiener - 3/22/2001 11:03:52 PM

Jade - I may be absurd, Wiener. But I'll never be obese.

Take 40 mg of Prednisone for a year and get back to me on that.

2713. JudithAtHome - 3/22/2001 11:10:31 PM

Why is it assumed that anyone engaged in this discussion is obese? Can't people talk about the subject without being overweight? Or does that only apply to Jade and Jon...the rest of us are fat because we disagree with them?

2714. arkymalarky - 3/22/2001 11:22:28 PM

I am a slug. I eat lots of junk food. I consider it exercise to trek up the stairs to the computer. I'm not obese, though.

2715. Fielding - 3/22/2001 11:22:30 PM

JF:

"That's exactly why it's self-evident (at least, to me)"

Words have meanings, dipshit. You can't just make them up as you go along.

2716. Jon Ferguson - 3/22/2001 11:27:29 PM

Hi arky.

Could you please explain what self-evident means to Fielding?

I think you have more experience (given your state of residence) communicating with delusional inbred hillbillies than I do.

Thanks.

2717. JudithAtHome - 3/22/2001 11:30:42 PM

Why don't you read mgleasons defination from the OED, Jon? It makes the meaning self-evident.

2718. Jon Ferguson - 3/22/2001 11:32:25 PM

I obviously know what it means, Judith. I explained it to Fielding. I then explained why it makes perfect sense in the context I used it. He still doesn't get it.

I need to bring out the experts in the clean white coats now.

2719. arkymalarky - 3/22/2001 11:33:32 PM

Hey Jon.

No way am I getting dragged into that one. Besides, the delusional inbred hillbillies in AR are quite a bit north of here.

2720. seadate - 3/22/2001 11:33:49 PM

Arky,

Maybe you should explain who the great people of New York voted as a new resident.

2721. JJBiener - 3/23/2001 1:01:27 AM

I think Jade and Jon suffer from pocrescophobia. It would explain their irrational response to the subject of obesity.

2722. Fielding - 3/23/2001 3:17:48 AM

JJ:

"I think Jade and Jon suffer from pocrescophobia. It would explain their irrational response to the subject of obesity."

Its self-evident!

2723. JJBiener - 3/23/2001 5:35:59 AM

Fielding - Indeed!

2724. JadeGold1 - 3/23/2001 11:35:35 PM

I think Jade and Jon suffer from pocrescophobia.

No. I have a syndrome. It causes me to retch involuntarily at the sight of fat boys who get Xmas cards from Hostess and haven't broken a sweat in 20 years.

2725. JJBiener - 3/24/2001 5:44:01 AM

Jade - Most people would be ashamed to admit they are as petty and shallow as you are. You seem to wear it as a badge of honor. How truly sad for you.

2726. msgreer - 3/24/2001 8:16:08 PM

In our Sunday paper, the article above the fold reads "Arrests are rare in abuse of elderly. "The arrest of an Englewood assisted living adminsitrator on elder abuse charges was a rare
case of an employee, especially one in such a high position, being charged with a crime. Officials charged with regulating elderly care home in Florida say they can't recall a similar case. A spokesman with the Association of Florida Trial Lawyers agreed. Elderly victims usually can't say who hurt them or how and nursing home employees rarely turn on one another.

2727. msgreer - 3/24/2001 8:24:12 PM

If abused or neglect is charged, employees who administer care, such as nurses aides, usually are blamed. Providing their actions are criminal is rarely pursued. The matter usually is settled with a fine, a citations or an order that prohibits the employee from working in health-care facilities. But prosecutors say Torchwood Assisted Living Home administrator Lynda Cox is responsible for what happen to Donald Holden on Dec. 10. They arrested her last week, charging her with neglecting the 89 year old Alzheimer' patient. Prosecutors say when Holden fell and broke his hip, aides left him on the floor for five hours before moving him into a bed, where they left him for another five hours before calling his son, who lived nearby. Holden died four days later of surgical complications. The nurses aides - the main witnesses against Cox - said their boss repeatedly told them to leave Holden on the floor instead of calling 911."

And it goes on. The lawyer for Cox says the aides should have known to call 911 without an okay from her. However, Cox eventually made it to Torchwood to see Holden, then had 911 called.

2728. thoughtful - 3/27/2001 5:40:28 PM

jj, thought of you yesterday as I was reading the health section in the Washington post which noted a study on the use of infliximab (Remicade) and the treatment of Crohn's disease. Full study available at http://www.east.elsevier.com/ajg/frames/thismnth.htm

2729. bloodnfire - 3/29/2001 3:13:39 AM

MsGreer. "Wit", the T.V. Movie with Emma Thompson concerning the terminal cancer patient, started fifteen minutes ago as I type. It looks outstanding. It's on H.B.O.(P). Thanks so much for the recommendation.

2730. wonkers2 - 3/29/2001 4:25:09 AM

Wish we had HBO. Emma Thompson's great.

2731. bloodnfire - 3/29/2001 4:56:11 AM

That was as magnificent performance as I have ever seen. Great direction by Mike Nichols as well. It so clearly illustrated the callous indifference of the clinical doctors, which was MsGreer's point in her original recommendation, as I remember.

2732. msgreer - 3/29/2001 5:38:49 AM

blood

Emma wrote the screenplay with Nichols. I thought it was brilliant. I wanted to give Jason a hit in the head.

2733. msgreer - 3/29/2001 5:40:53 AM

Emma was brilliant. It is on HBO tonight. wonkers, if you know someone with HBO have them tape it for you. I think you would like it.

2734. JJBiener - 3/29/2001 5:46:04 AM

MsGreer - I still haven't decided if I can watch it. It sounds like it's heavier than I want to deal with right now. I will probably watch it eventually. I am just not sure when.

2735. msgreer - 3/29/2001 5:49:36 AM

JJ - It will be around for awhile. It is "heavy".
It takes one on quite an emotional ride. The healthcare professionals she has to deal with should all be hung up by their b****.

2736. JJBiener - 3/29/2001 5:57:29 AM

Having had more than my share of experience with healthcare "professionals", I can relate all too well. Do you remember the old joke?

What is the difference between a doctor and God?





God doesn't think he's a doctor. (G)

2737. JudithAtHome - 3/29/2001 6:42:58 AM

I watched it and thought it was extremely realistic...some of the chemo scenes made me cringe. There were some posts about it in the Movies & Television thread yesterday. I thought the scenes of Emmas illness after chemo and beyond were devastating because I'd been through it with my son.

2738. msgreer - 3/29/2001 4:39:37 PM

Judith and other Wit viewers

I was just as disappointed with the behavior of the oncology nurse as I was Jason. She came over as sympathetic with facial expressions and afew touches of kindness. However, she never went face to face with the doctors. She never called them on their insensitivity. The best she did was to share a popsicle that the patient offered her.

All nurses are their patient's advocate. Shame on her for not advocating for her patient. Shame on her for not having the pain meds in order before the pain came to this patient.

Shame on her for continually closing the doors and pulling the drapes..how convenient for SOME oncology nurses.What you don't see you don't have to deal with. The isolation of this patient..well I found it devastating.

2739. PsychProf - 3/29/2001 4:43:46 PM

Sometimes I think there are two worlds in life, one with health and one with sickness, and at any specific point in time we can only be in and understand one or the other.

2740. Indiana Jones - 3/29/2001 4:46:31 PM

I agree, PP. Especially when it comes to serious and terminal illnesses.

2741. mgleason - 3/29/2001 4:50:37 PM

Intimations of mortality are always unwelcome.

2742. JudithAtHome - 3/29/2001 4:53:14 PM

msgreer:

You know more about these things than I but the nurse seemed compassionate to me, the viewer...I suppose in comparison to the doctors, she struck a positive note in my eyes.

I've heard of feisty nurses standing up to doctors and I've also heard of nurses looking for new jobs...

2743. PsychProf - 3/29/2001 4:56:54 PM

I think many of the disagreements on this page are fueled by the notion that "being ill" is not understood by some, and this causes palpable and predictable anger. There is a least a possible solution, and we have a word for it.

Main Entry: em·pa·thy
Pronunciation: 'em-p&-thE
Function: noun
Etymology: Greek empatheia, literally, passion, from
empathEs emotional, from em- + pathos feelings,
emotion -- more at PATHOS
Date: 1904
1 : the imaginative projection of a subjective state into
an object so that the object appears to be infused
with it
2 : the action of understanding, being aware of, being
sensitive to, and vicariously experiencing the feelings,
thoughts, and experience of another of either the past
or present without having the feelings, thoughts, and
experience fully communicated in an objectively
explicit manner

2744. msgreer - 3/29/2001 5:06:59 PM

Nice post PP. Thank You.

Judith a nurse can discuss a situation with any doctor without getting fired. It is too bad it takes so much ego building before you can bring up a subject to some doctors..male and female I might add. I have always believed everyone in the healthcare profession should have to check into a hospital every year, as part of their CEU's, for ten days. Without knowing what is wrong with them they would go through 10 days of testing. Ten days of cold food. 10 days of med mixups. Ten days of ringing the call bell to ask for assitance to the bathroom and wait 15 minutes before anyone comes. Let them have 10 days of vital sign q 4 hours so they are woken up all night. You get my idea.

It is tough in the healthcare profession. We are understaffed and the coming shortage of nurses will only complicated the situation.

2745. msgreer - 3/29/2001 5:09:05 PM

Judith

One way to ask a doctor a question "What would you do if this was your wife/husband/son/daughter?"

It does not require aggressive behavior for the family/nurse. Assertive yes, aggressive no.

2746. mgleason - 3/29/2001 5:15:32 PM

Prof,

You've hit the nail on the head. Unfortunately, empathy for the pain and suffering of others is the last thing many people wish to experience. Ostriches flourish among us, after all.

2747. JudithAtHome - 3/29/2001 5:29:54 PM

I saw a movie with William Hurt once where he played a doctor who was hospitalized...it made him a better doctor. That would be a good idea, msgreer....but I think 5 days would do it.:-)

2748. Shannon - 3/29/2001 5:39:02 PM

It's a shame there's no way to make medical professionals have to deal with taking their kid to the hospital, too--short of putting the kid through that misery, which of course you don't want to do. You'd think people who go into pediatric specialties would have some clue about kids.

2749. JudithAtHome - 3/29/2001 5:44:58 PM

Shannon:

When my son was ill, we had such good luck with the doctors and nurses who cared for him. The people I admire the most are the pediatric oncologists; it takes a special type of person to go into that field of medicene.

2750. Shannon - 3/29/2001 5:58:09 PM

That's great, Judith. Seems like most people I know who have had to deal with oncologists of any sort have liked them.

Really, it was just our neurologist who I had problems with. I comlained about her once to an old friend of mine who's a child psychologist and works with severely disabled children--she said neurologists were, in her experience, the worst child specialists in terms of basic consideration for the fact that they're dealing with little kids.

The NICU nurses were great, as was the neonatologist she saw in the hospital.

2752. JudithAtHome - 3/29/2001 7:08:34 PM

CalGal, people can have a difference of perspective and opinion without being insulting. You seem to be more harsh in your judgements of many of us lately.

2753. JJBiener - 3/29/2001 7:27:02 PM

CalGal - please don't confuse MsGreer's polemic with the movie

Just as they shouldn't confuse your polemic with MsGreer.

a respect and awareness that MsGreer apparently isn't capable of.

Respect and awareness haven't been your strong suit in recent days. I am not sure you should be throwing stones. I think you need to remove your own blinkers before you start criticizing others.

2754. mgleason - 3/29/2001 8:28:08 PM

And now for something completely different:

Phobias from A to Z

I have decided that I am a Walloonophobe, but only because I'm partial to the Flemings.

The Time article is called Fear Not!

2755. JudithAtHome - 3/29/2001 8:30:37 PM

I used to have braniffobia...fear of lost luggage; and dimplechinaphobia...fear of Kirk Douglas.

2756. vw - 3/29/2001 8:32:04 PM

My personal favorite is Aulophobia- fear of flutes.

2757. mgleason - 3/29/2001 8:33:41 PM

You're going to make me a badpunophobe, J.

2758. JudithAtHome - 3/29/2001 8:35:13 PM

Just doing my part. :-)

2759. seadate - 3/29/2001 8:41:50 PM

Hippopotomonstrosesquippedaliophobia

2760. seadate - 3/29/2001 8:43:27 PM

fear of long words

2761. mgleason - 3/29/2001 8:43:30 PM

I've invented one that's not on the list: pineaphobia (fear of pine cones). My husband gave them a wide berth as a child.

2765. Jon Ferguson - 3/29/2001 9:06:53 PM

I deleted your post, Cal. Sorry. (g)

2768. JJBiener - 3/29/2001 9:54:10 PM

Cal - And JJ, if you note, I didn't demand that the medical community deserved respect.

And if you note, I never said you did. I addressed specifically your comment that MsGreer was incapable of respect and awareness. The point of my post was that you shouldn't take others to task for behavior you are engaging in yourself.

Respecting context has nothing to do with how polite one is.

That is good news for you since your rating on the polite meter has been in the dumper lately.

2769. CalGal - 3/29/2001 10:45:38 PM

I addressed specifically your comment that MsGreer was incapable of respect and awareness.

But that's the point. I didn't say she was I incapable of respect and awareness. I said that she was incapapable of respect and awareness of the context, which is entirely different thing.

I was not taking her to task for being rude. I was taking her to task for being ignorant--of the context, of the point, of all sorts of things.

But not for being rude or disrespectful.

2770. JudithAtHome - 3/29/2001 10:47:58 PM

Good lord....let it rest.

2771. CalGal - 3/29/2001 10:53:11 PM

Fine.

Back on topic, I thought the movie avoided all the simplistic cliches about mean doctors.

2772. PsychProf - 3/29/2001 10:55:49 PM

I wish I could have seen the film...but if it elicits responses as seen here it must be of substance.

2773. PelleNilsson - 3/29/2001 10:56:26 PM

From a novel by Len Deighton:

Old Carruthers and I had a very straightforward relationship. We hated each other. That meant we were exceedingly polite when engaging in conversation.

2774. CalGal - 3/29/2001 10:56:42 PM

I imagine it will be on video shortly. You don't get HBO?

2775. CalGal - 3/29/2001 10:58:09 PM

Pelle,

In my case, there is no relationship between my rudeness and my relative affection or lack thereof for someone.

But that's a great quote.

2776. PsychProf - 3/29/2001 11:00:27 PM

No Cal...dark ages at PP's.

2777. msgreer - 3/31/2001 2:42:39 AM

I am looking for someone to co-host this thread. Actually two people. I have taken on a major contact which will occupy the next three years of my life. I spoke with wabbit. wabbit suggested getting one or two Moties to co-host with me. Judith, are you out there? I was hoping you would be one Motie willing to take this on. If anyone is interested in co-hosting please let me know. Many thanks.

2778. msgreer - 3/31/2001 2:44:55 AM

Thoughtful and Rick..would either of you consider taking on co-hosting?

2779. msgreer - 3/31/2001 2:55:04 AM

I am around this weekend but back to a full schedule during the week. I will check this thread
in the evenings. Thanks again, folks.

2780. RickNelson - 3/31/2001 3:07:27 AM

Hi msgreer,

I'm not sure how good I would be with health issues msgreer. I'm interested in health, but I've no core knowledge of its issues. Keep me in mind, but see what thoughtful thinks and Judith, both, and probably others may be better suited than I. I'll be around to see what developes, my best to you msgreer.

2781. msgreer - 3/31/2001 3:13:59 AM

Rick you would be an assest to this thread. You don't have to come with a wealth of medical information. You come with your life experiences. You have so much to add to this thread. Please, just think about it. I'm not leaving immediately and I would always be avaiable to you.

2782. Jon Ferguson - 3/31/2001 3:15:49 AM

If Rick doesn't want the job, Calgal and I could co-host. (g)

2783. msgreer - 3/31/2001 3:19:15 AM

Rick Joe Biener has made noises he would help out.

2785. Jon Ferguson - 3/31/2001 5:53:28 AM

I don't know about you, MsGreer, but that still sounds pretty insulting to me. (g)

2786. RickNelson - 3/31/2001 5:59:03 AM

Calgal I am late to whatever started the "context" issue, I'm sorry I'm so busy of late. What is it that makes the issue pressing, without regard to MsGreer?

2787. msgreer - 3/31/2001 5:59:42 AM

Surely you can post on Wit without using my name.
Give it another try. When you get it down your post will not be moved.

2788. msgreer - 3/31/2001 6:02:10 AM

Good night, all.

2789. Jon Ferguson - 3/31/2001 6:03:25 AM

Night, MsGreer (g)

2790. CalGal - 3/31/2001 6:11:29 AM

MsG,

You are saying that people can't post your name unless they are agreeing with you?

There is no insult in this post.

Thank the lord that "Wit" wasn't the tediously banal drivel that msgreer allowed to filter through her blinkers.

Rest assured, it's not a shrill indictment of the cold, cruel medical community. It's a marvellous series of observations by a fascinating woman observing the work of the medical community and realizing that committed professionals are the same in every line of work.

Nichols made a comment about how he wanted to demonstrate the insensitivity about the medical profession, but only with respect and awareness for the context--a respect and awareness that MsGreer apparently isn't capable of.

In any event, if you are considering viewing it please don't confuse MsGreer's polemic with the movie. The movie is far more perceptive.

2791. CalGal - 3/31/2001 6:13:14 AM

Whoops! That was the old one--copied the wrong one from the Inferno. Not that it matters, I'm sure she'll delete both. But here is the one without insult.

Thank the lord that "Wit" wasn't the tedious polemic that MsGreer describes.

It's not a shrill indictment of the cold, cruel medical community. It's a marvellous series of observations by a fascinating woman observing the work of the medical community and realizing that committed professionals are the same in every line of work.

Nichols made a comment about how he wanted to demonstrate the insensitivity about the medical profession, but only with respect and awareness for the context.

In any event, if you are considering viewing it please don't confuse MsGreer's description of it as anything approaching accurate.

2792. thoughtful - 3/31/2001 5:24:04 PM

Msg. Thanks for thinking of me as co-host, but I am reluctant to take on that role as my ability to post is often spotty given my travel schedule with work. I would rather see it done by those with more time to devote to it, especially for handling those "contentious" times...you need someone around to see that they don't get out of hand. Rick, J@H and jj are all excellent candidates.

2793. RickNelson - 4/1/2001 7:51:21 PM

MsGreer,

I'll help out, contact the powers that be.

Best
Rick

2794. CalGal - 4/2/2001 3:33:43 AM

Yet another reason why employer-provided health care is a bad idea:

When patients go to Dr. Stephen Brenner, an internal medicine specialist, for a routine exam, their bills can vary by 45 percent. The uninsured pay the most and patients with insurance plans are charged the least.

It is not his doing, said Dr. Brenner, who practices in New Haven. He explains that it is because health insurance companies insist on hefty discounts. "It's a take it or leave it situation for doctors," Dr. Brenner said. But he said he knew that the insured paid much less than their share. For the insured, he said, "it's almost like getting a BMW or Mercedes at half price."


Of course, it's not solely the uninsured--that just makes it more dramatic. It's those who are in HMOs or PPOs who have negotiated lower prices. So if you want to pay your own fee and choose your own doctor--for any reason--you pay more.

Rather disgusting, actually.

2795. JJBiener - 4/2/2001 4:18:34 AM

Cal - Why is that disgusting. It is standard business practice to give discounts for bulk purchases. That is all that is going on here. I guarantee you that you pay more for a car than Hertz does when they buy a fleet. Why should healthcare be treated differently?

2796. Jon Ferguson - 4/2/2001 4:32:53 AM

It's disgusting because price discrimination (I believe that's the term in economics, but it's been several years ...) in health care is morally wrong.

We're not talking about renting cars. We're talking about people's lives and health. We're talking about those in whom we put our faith and trust to safeguard our health preying on us if we aren't fortunate enough to have medical insurance.

I don't know if I'd go so far as to say the practice should be illegal, but to call it disgusting isn't much of a stretch, if at all.

2797. JJBiener - 4/2/2001 4:44:22 AM

Jon - in health care is morally wrong

According to whom? You?

We're talking about those in whom we put our faith and trust to safeguard our health preying on us if we aren't fortunate enough to have medical insurance.

No, we are talking about people who are providing a service for a fee. There is nothing magical about health care. A doctor is running a business every bit as much as a Hertz is. Perhaps if you realized this, you wouldn't be inclined to make such sweeping statements.

2798. Jon Ferguson - 4/2/2001 4:48:16 AM

JJ

Anytime somebody says 'morally wrong', there's obviously a value judgment there. Yes, according to me.

You see health care as purely a business. Many others, myself included, would disagree with you. If we were talking about almost any other commodity, I would strongly agree with you, but we aren't and I don't.

Nor do I particularly care to hurt your feelings by discussing this at length, so have the last word and then you can take it up with Cal.

2799. JJBiener - 4/2/2001 5:52:34 AM

Jon - Anytime somebody says 'morally wrong', there's obviously a value judgment there.

Most people will preface their comments with something like, "I think that . . ." You prefer to frame your opinions as facts.

You see health care as purely a business.

I see doctors as individuals with the same rights as anyone else. They have the right to negotiate for their services just like anyone else does. They don't lose that right just because they decide to become physicians. They don't lose that right just because you think there is something magical about medicine.

If heathcare isn't a business, then what is it? Why is it different? Because it deals with life and death? The same argument could be applied to food, shelter, clothing or any of a number of things which are required for life. It is funny that I never see that argument made. Could it be that since many doctors are wealthy they are a target?

I realize it will take some introspection on your part to answer these questions so I am not optimistic that you will really answer them. I would just like for you to consider why you believe the way you do.

2800. Jon Ferguson - 4/2/2001 6:10:01 AM

JJ

Hmmm. Thank-you for keeping the ad hominems to a minimum. We'll see if we can discuss this reasonably.

First, I say again, anytime somebody says that such and such is morally wrong, there is clearly a value judgment there. I think that's self-evident (stay away, Fielding.) I state my opinions with confidence because I have confidence in my opinions.

One major difference is that it is much harder for people to comparison shop when it comes to doctors. Information is far from perfect. Therefore, it is not a free market. On that basis alone, regulation of the medical industry can certainly be justified. I would be happy to exempt any doctor who routinely provides a price list for various procedures to all of his patients in which it is clearly indicated that those with insurance pay less (or more, whatever.) It is the deceptiveness (or sliminess) of the practice that I most strenuously object to. And again, that's a value judgment of mine that can be neither proven nor disproven.

Absent that price list, it makes a helluva lot of sense (again, imo) to regulate a doctor's ability to covertly practice price discrimination.

To answer your questions:

Yes, to a certain extent, healthcare is a business. But it differs from most businesses in many significant ways.

One of the main differences, as stated above, is the lack of readily available information to prospective patients who want to find out about a certain doctor's qualifications and fee schedule.

The fact that it deals with life and death is also a factor. And it deals far more directly with life and death than food, shelter or clothing retailers. I don't really address that in my economics argument, but I do address it in my first post where I state my opinion about the immorality of the practice.

I don't think the wealth of doctors plays a role in this argument.

2801. JJBiener - 4/2/2001 6:27:00 AM

Jon - One of the main differences, as stated above, is the lack of readily available information to prospective patients who want to find out about a certain doctor's qualifications and fee schedule.

There is no difference between a doctor and anyone else who provides a service. There is never perfect information whether we are talking about doctors, plumbers or electricians. This doesn't mean that it isn't a free market. We can still chose our doctor and our plumber.

Plumbers and electricians use different fee structures just as doctors do. If they come out to work on your house, they will charge you more per hour than they will charge a builder who contracts with them for long-term work. Do you believe it is deceptive and slimey for plumbers and electricians to use different fee structures, or is it only slimey for doctors?

99% of the time doctors do not deal with life or death issues. Even someone with as many health problems as I have, it is very rare for a medical condition to be life threatening. I don't see how it is reasonable to treat doctors differently because on very rare occasions they deal with life and death issues.

Thank-you for keeping the ad hominems to a minimum.

The ad hominems were your department, not mine. The most I did was suggest you gain some knowledge about the subject at hand before posting.

2802. RickNelson - 4/2/2001 4:23:26 PM

That was then.

This is now.


HMO's are nothing more than a place to run around a playground, with money as the toys.

2803. msgreer - 4/2/2001 4:29:59 PM

Rick

Good Morning. It is good to see you. Thanks for the okay on co co hosting. Joe signed on last night. I will contact Judith and see what she has to say.

2804. RickNelson - 4/2/2001 4:34:31 PM

sounds good. Did Joe want to do this solo? He can email me from my host link in Poetry so we can get together on this. Let me know what I can do, I'll be glad to co-host.

2805. JudithAtHome - 4/2/2001 4:34:50 PM

msgreer:

I don't think I'm qualified to lead a discussion on health policy since I know nothing about it...I can talk about vitamins and herbs and keeping healthy but as for policy, I'm out of the loop. I've only been to the doctor about 5 times over the past 4 years and 3 of those were recently.

2806. msgreer - 4/2/2001 4:39:30 PM

Judith

Okay. How about looking in on this thread and add to the herbs and vitamin discussions. That in itself would be a big contribution. Just be around here like you usually are, Judith.

2807. JudithAtHome - 4/2/2001 4:41:23 PM

Oh, I'll gladly contribute, msgreer. I think this is a good thread and will do all I can to keep it going.

2808. Oceans11 - 4/2/2001 4:42:44 PM

I'd like to hear more about vitamins and herbs.

I'm particularly interested in standardization.

2809. msgreer - 4/2/2001 4:46:32 PM

Thanks, Judith. I took my B vitamins this morning..speaking of vitamins. I am back in court this afternoon on my case. The guy is asking for a new trial and that motion will be heard at 4pm. If the court says no it will be my time to address the court. I am sipping chamommile tea also. My nerves are on edge.

2810. JudithAtHome - 4/2/2001 4:55:29 PM

Most people who are interested in standardization are fairly skepical about the efficacy of herbs. It's true there are differing standards in regard to herbals but there are different fiats laid down by the FDA about what drugs are safe for the public, too...with recalls on drugs they've passed all the time.

I've lived in countries where the local herbalist used nothing more than a practiced eye and crude scales to measure out herbal "medicene" and haven't seen any deaths from sensible use of those remedies. I realize this is extremely narrow anecdotal "evidence" and I'm not recommending anything without the caveat "check with your healthcare professional" first.

I notice, however, that pharmaceutical companies are coming out with their own herbal remedies which are standardized, of course, and cost 4 times what the same thing costs from regular herb suppliers.

2811. Oceans11 - 4/2/2001 5:05:14 PM

Thanks, JaH.

The reason for my question is I've encountered many of the same type of herbs at varying prices.

For example, I'm a big believer in garlic; my dad had moderately high cholesterol (233) and I started him on Kyolic garlic. After 12 weeks, his cholesterol had dropped to 174 without any other lifestyle changes.

If you're familiar with Kyolic garlic, you know it is kind of pricey. The reason for this, I was told, was the Kyolic's standardization standards. I'm wondering if I can get the same "bang" for a few less bucks.

Garlic isn't the only herb with confusing standardization issues.

2812. JudithAtHome - 4/2/2001 5:16:36 PM

You're right; most herbs are erratic in the standardization area and I'm not so sure that the pricier ones are any more effective than the cheaper ones.

For instance, I take the cheapest glucosimine/chondroitin I can find because it is frightfully expensive. I've soent more and I've spent less and the results are the same, as far as I can tell.

By the way, my cholesterol is low and though I take garlic everyday, I credit the fiber tablets I take with doing most of the job. I used to have frightenly high readings and I was taking garlic at the time....the addition of fiber tabs is the only change I've made and my last readings were a pleasant surprise to both me and the doctor.

2813. JudithAtHome - 4/2/2001 5:18:00 PM

frightingly....it's early yet!

2814. Oceans11 - 4/2/2001 5:32:10 PM

It's very confusing.

The price differences are not insignificant; you can pay $20 for 200 caps of Kyolic garlic or you can pay $5 for 100 tabs of Brand X garlic.

I'm also looking for a good multi-vitamin. My herbalist recommended a multi-vitamin pack (Daily Food) that suits my lifestyle (active), but it runs about $100 a month.

2815. JudithAtHome - 4/2/2001 5:55:44 PM

Oceans:

Does your herbalist sell that vitamin pack? I mean, like does he/she vend it through a store? Because a guy I know who is very good at recommending things for specific problems set up a deal for me with multiple products from his store that were running me to the poor house and when I checked the individual items on the Internet, I found I could get the same things for 1/3 the cost.

I can sympathize with people who have these franchises wanting to make money...so long as it isn't mine.

As to daily vitamins, you would faint if you knew how many things I take.

2816. thoughtful - 4/2/2001 5:57:34 PM

Interesting article in today's NY Times science section about the fellow who is starting to do scientific testing on the most popular alternative medicines -- with much criticism from both the alternative guys and the medical guys. (Unfortunately I looked for the article on line and can't find it.) He's starting to do large double-blind studies of such things as ginko and alzheimers as well as the controversial coffee-enema/strict diet treatment for terminal cancer patients. Should be interesting to see the results.

2817. JudithAtHome - 4/2/2001 6:00:16 PM

Oh, I posted too soon: how many pills are in that daily pack? What you have to consider is how much each of those would cost daily if you bought bottles of each one. It might add up to less or it might add up to about $100 a month.

I buy my stuff in bulk and figure the cost per pill and then add the pills per day times 30...it adds up to a lot per month but I am super healthy and feel and look good so it seems worth it to me.

2818. Oceans11 - 4/2/2001 6:02:38 PM

I've checked on the internet for the multi-vitamin packs, the prices are comparable. Some of the other stuff I take is found at discount on the internet.

I'm very happy with my herbalist and I know he is happy with my continued financial support.

I still have questions about standardization. My herbalist is adamant about the need for standardization.

2819. CalGal - 4/2/2001 6:03:33 PM

I see health care as a business and I don't object to doctors being forced to change their prices.

Nor do I find it surprising that insurance companies would throw their weight around to get lower prices--that, too, is good business practice.

What I do find disgusting is that insurance companies have inflated user bases and distorted costs because they are not operating under reasonable market conditions.

Take away employer provided insurance and watch how quickly many insurance companies would need to reduce costs.

2820. JudithAtHome - 4/2/2001 6:12:23 PM

Oceans:

I'm sure standardization is on it's way; I'm just wondering how places like China, Japan, and Germany have managed this long without it and seem to be doing quite well...

2821. mgleason - 4/2/2001 6:19:59 PM

Thoughtful,

Here's the NYT piece: Separating Remedies from Snake Oil.

I found it very interesting.

2822. thoughtful - 4/2/2001 6:49:58 PM

thanks mg. We need to bring some real science to this stuff ... I've read articles that canola oil is both good for you and incredibly toxic. I've read that comfrey tea is good for you and toxic. That green tea is beneficial and isn't. And on and on.

2823. thoughtful - 4/2/2001 6:52:30 PM

I also recall one study that suggested that most people opt for medical answers first then turn to alternatives when medicine has let them down...and that many pursue both simultaneously. No wonder. I remember years ago when drs. regularly pooh-poohed any link between heart disease and nutrition or cancer and nutrition. Now of course with overwhelming evidence they are finding that what you do to your body on a daily basis has more impact on health than most anything else.

2824. thoughtful - 4/2/2001 6:54:35 PM

I heard a nutritionist speak the other day who started her pitch by asking everyone in the room to stand (40 or so people) -- then sit if you or your family had cardiac illnesses, cancer or diabetes. Only 3 people were left standing. She pointed out that all of those diseases can be impacted by proper nutrition.

2825. mgleason - 4/2/2001 7:00:34 PM

Too often we neglect to take a holistic approach to our well-being. The idea of mens sana in corpore sano has been around for a very long time, but Western society perpetuates a very unhealthy mind/body split.

(And even if your corpore isn't so sano, your mens can definitely affect how you cope.)

2826. JJBiener - 4/2/2001 7:02:59 PM

Cal - Take away employer provided insurance and watch how quickly many insurance companies would need to reduce costs.

Take away employer provided insurance and watch how many people will no longer be able to afford health insurance or health care. The major cost to insurance companies is claims. They have reduced those costs by negotiating better rates with physicians. If you take that away, the cost of insurance will go even higher and even fewer people will be able to afford insurance or health care. I know this is your pet peeve, but I fail to see how anything beneficial comes from it.

2827. CalGal - 4/2/2001 7:35:16 PM

Take away employer provided insurance and watch how many people will no longer be able to afford health insurance or health care.

Oh, they'll be able to afford it. They just won't want to afford the cushy policies they have now, but that's too bad. They'll have coverage.

Claims are always the major cost of insurance companies. But in the case of medical insurance, customers have no incentive to keep their claims low. Their feet aren't held to the fire by market forces.

If you take away employer provided health care, fewer people will be choosing HMO as an option, which will give them less power to negotiate ruthless prices. There will be more people who will have major medical only, or fee for service--and now that they will be paying the doctor fees, they'll be price sensitive.

Everyone can afford insurance and health care. It would just restructure how they pay for it. They would go to the doctor less often, they would pay for doctor visits directly, and their monthly insurance costs would probably be more than they are now, while getting a lot less for it. On the plus side, people who aren't insured now--or who can't afford as much insurance--will have more options. It will level the playing field for everyone.

At the same time, the tax subsidies would be changed. Employers wouldn't be deducting insurance premiums paid to employees, but all individuals could deduct all health costs. Lower income taxpayers and people with chronic conditions could have their insurance costs subsidized in part (with credits).

So it would certainly stop being a gimme for employees, but they would still get coverage. It would just be based on what they could afford.

As an added plus, it would make employment less expensive.

2828. JudithAtHome - 4/3/2001 2:30:20 AM

thoughtful, Maria:

I hadn't seen my doctor in 3 years until this past January and after he talked to me about my knee, he said he had a suggestion for me about something that might help a lot: glucosimine and chondroitin. I was pleased to tell him I had been taking it for 4 years and credited it with giving me what little mobility I still had...I didn't remind him of how he'd pooh-poohed it 3 years before when I'd told him I was taking it.

The medical community is slowly coming around. But I'm sorry...they are too slow for me.

2829. JJBiener - 4/3/2001 6:37:56 AM

Cal - You keep ignoring the facts. Health insurance is based on being able to spread risk over a large group. The larger the group, the better the risk can be predicted and managed. It is the foundation on which insurance is founded. If you eliminate the group you will ultimately eliminate insurance.

I am sure you took statistics in college, so this should be obvious to you. In any group of people there will be individuals who present a variety of risks. The larger the group, the more accurately actuaries can predict the risk of the group as a whole. What insurance does is spread that risk over all of the individuals in the group. Low risk people end up spending a bit more and high risk people end up spending significantly less. Since insurance is usually provided by an employer, low risk people do not generally opt out.

If we eliminate employer based insurance there will one of two results. The first possible result is that individuals will be charged based on their individual risk. It will be extremely cheap for low risk individuals, and it will be prohibitively expensive for the people who need it the most.

The second possibility would be that government intervenes and says that insurance companies cannot take individual risk into account and must charge everyone the same. This would make insurance more expensive for low risk individuals. Many low risk individuals will start to opt out because they are paying rates out of proportion to their risk. As they opt out, the insured population becomes higher risk. As the risk rises, so do premiums. As premiums rise, more low and moderate risk individuals opt out. Insurance quickly becomes too expensive and ceases to exist. Once again, the people who need healthcare the most no longer have access to it.

2830. JJBiener - 4/3/2001 6:38:10 AM

At this point the Socialists take over and the government runs the healthcare system like it does the post office, the license bureaus and the IRS. All this because you don't like employer based insurance.

If you can come up with a plan that allows insurance companies to manage risk over large populations like they can now, then you might have something worth discussing. People like me cannot simply do without healthcare in order to save money. If I stop taking my medication I will end up in surgery. If my doctor stops monitoring my blood chemistry, the medication I am on can cause serious harm.

People like me cannot get insurance outside of a group. If the law forced companies to offer it, they would have to charge more than I could possibly pay. Without insurance I cannot pay for the medication I need let alone the doctors and medical test I require on a regular basis. Without medical care, I can't work, I can't support my family and I will die an early death. Maybe you don't give a shit about that, but I do.

If you are going to propose a solution to what you perceive as a problem, at least propose one that has some hope of addressing the needs of the people who use the healthcare system.

2831. Shannon - 4/3/2001 6:49:12 AM

Since insurance is usually provided by an employer, low risk people do not generally opt out.

Yup. My employer (the state) provides insurance, but only pays half the cost. In addition to the HMO's, there's a state-run insurance system. It's losing money at the rate of about $3 million a month. One proposal I've heard to save it is for the state to pay a larger portion of the policy cost for employees. The idea behind that is that more young healthy employees would sign up if it were cheaper for them. I've read that about 1/3 of all employees opt out of the coverage. Current cost to employees is about $100/month for single coverage. Family coverage is $250 or so. There's an option for employee and one dependent, which is somewhere between those two. Just under $200 I think.

2832. MsIvoryTower - 4/3/2001 6:53:52 AM

Insurance quickly becomes too expensive and ceases to exist.

While this is within the realm of possibility, it is only one of several possibilities that could occur. And even were it to be the one that emerges, there's an even greater margin for error in your next inference:

At this point the Socialists take over and the government runs the healthcare system like it does the post office, the license bureaus and the IRS.

Another more distinct possibility is that price hits a ceiling with respect to medical services. If people can't pay, doctors can't find patients, and if they can't find patients they don't survive in the profession. It's entirely possible that were insurance to be eliminated, it would act as a depressant on prices for medical services and both quality and variety of services offered would become more restricted.

I'd say it's more likely that the medical research pharmacutical/industrial complex would be the casualty if the insurance industry left the medical field than that the government would take over the health care system.

2833. JJBiener - 4/3/2001 6:58:19 AM

Shannon - Thanks for your post. It demonstrates on a small scale what would happen if employer based insurance was eliminated. As someone who is dependent on our medical system, it scares the shit out of me when healthy people start pontificating on how insurance should be run, and how I would spend less if I had to bear the cost. Sure I would spend less. I would be dead. All this because Cal thinks it is my fault she pays too much for health insurance.

2834. JJBiener - 4/3/2001 7:09:26 AM

MsIT - The demand for health care is relatively inelastic. The demand among people like me with chronic illness is extremely inelastic. I don't have a lot of choices. I can take my medication at a cost of several hundred dollars a month or I can end up in the hospital on medication and undergoing surgery at a cost of tens of thousands of dollars. I don't have a lot of choice.

I understand your position, but my problem isn't primarily doctor bills. It is the cost of regular tests, medications and medical supplies. There aren't low cost alternatives. It isn't the price ceiling that is the issue. It is the cost floor. Sure we can eliminate expensive procedures like x-rays and cat scans, but then we are back using medieval medicine. We may as well use cupping and leeches.

2835. CalGal - 4/3/2001 7:21:47 AM

Health insurance is based on being able to spread risk over a large group.

Yes, I know.

If you eliminate the group you will ultimately eliminate insurance.


And yet, we have car insurance. Life insurance. Disability insurance. Homeowner's insurance. All done based on the individual's risk, not group.

How is it that you think health insurance is different?

The first possible result is that individuals will be charged based on their individual risk. It will be extremely cheap for low risk individuals, and it will be prohibitively expensive for the people who need it the most.


No, it will be prohibitively expensive for people with chronic health problems. Everyone needs it "the most" when they have a catastrophic accident or illness, but if they were low risk up to that point, it won't be prohibitively expensive.

However, this is indeed the proper outcome and is highly desirable.

The second possibility would be that government intervenes and says that insurance companies cannot take individual risk into account and must charge everyone the same.

This is by no means the only other way the government could get involved. I mentioned a much better way that the government could get involved, which is to provide a tax credit for people who are diagnosed with a chronic illness. Then insurance companies could charge based on risk and the government could protect those whose risk is prohibitive by subsidizing their insurance payments--not their health care.

2836. CalGal - 4/3/2001 7:22:26 AM

The government could also prevent insurance companies from gouging due to risk. For example, just because someone gets cancer does not mean their insurance costs skyrocket. They can increase, but if the person was healthy at the time they got the insurance, the insurance company can't up the cost just because they got ill. Likewise, if a person had only major medical insurance and took the risk of not getting coverage for their deductible, their subsidy from the government would not offset the fact that they chose not to pay for more insurance. That will do a fair amount to ensure that people won't underinsure and expect the government always to make up the difference if they get ill.

So you are completely incorrect in assuming there are only two possibilities. Insurance companies could assign risk just as they do in other areas. People like you would receive a subsidy to cover your more expensive insurance premiums--but your policy would still be less generous than what you get as an employee (unless you wanted to pay a huge amount), because that's something that you probably wouldn't buy anyway, if buying your own insurance were up to you.

So employees would pay more for less, but not anything outrageous. This would make them equivalent with everyone else, and cause everyone to be more price sensitive. And the government could still have a role in protecting individuals from insurance abuse, providing credits and other deductions for health care, and so on.

2837. Shannon - 4/3/2001 7:53:51 AM

My experience with car insurance is that rates vary tremendously for the exact same coverage. We just got a huge decrease (40% or something) for going 5 years with no claims or some such. Presumably, if we need to file a claim, it'll go right back up. When I was younger it was much more expensive. Young men pay even higher rates. Rates in different states are different (which is probably partially due to different state regulations).

Much as I bitch about my current insurance, I don't think making it work like car insurance is any better.

2838. MsIvoryTower - 4/3/2001 8:01:27 AM

MsIT - The demand for health care is relatively inelastic.

Yes it may be, but the demand for medical services is also correlated with the supply of such services. There will be some people who can't avoid purchasing the services, but there will be large numbers of individuals who will opt out of any medical services, or will greatly reduce their demand if their costs dramatically increase.

The inelasticity of demand for medical services is also time dependent; the greater the medical emergency, the more inelastic the demand. However, if people have options to avoid medical costs, they will. This means the longer run demand for medical services can be more elastic.

I'd say that if we stopped subsidizing both medical research and medical services through the spread of costs across many, the response of a large number of individuals would be to reduce their demand both in the short run and longer run.

2839. CalGal - 4/3/2001 8:01:52 AM

You wouldn't get me disagreeing that car insurance could do with some more government protection--but overall, it works a hell of a lot better than health insurance.

So yes, I think it'd be better working like car insurance. However, keep in mind that it would also need some of the following:

• Guaranteed coverage
• Subsidies for working class, poor, and chronically ill
• All health insurance is deductible and medical deduction ceilings drop from 7.5% of AGI to something like 1%.
• Everyone must have health insurance. Link it to tax returns or something.

2840. JJBiener - 4/3/2001 8:03:41 AM

Cal - And yet, we have car insurance. Life insurance. Disability insurance. Homeowner's insurance. All done based on the individual's risk, not group.

Life insurance and disability insurance are mostly offered by employers. I would never be able to get individual life or disability policies. They aren't offered to people with my medical record. They differ from heath insurance in that they have a much lower risk of payout. Car and homeowner's insurance are based on individual behavior and location. These are things I can control. Health is not something I can control. One more thing. I can go without car, homeowner's, life and disability insurance if I have to. I can't live without health insurance.

I mentioned a much better way that the government could get involved, which is to provide a tax credit for people who are diagnosed with a chronic illness. Then insurance companies could charge based on risk

This sounds nice, but it doesn't work. No insurance company would accept a risk like me outside of a group. They aren't too thrilled with me even in a group.

The government could also prevent insurance companies from gouging due to risk.

I don't think you understand the issue here. Over the last 20 years, my medical expenses have been over a half million dollars. My medical expenses are guaranteed to be over $5k per year if everything I have stays under control. If I end up in the hospital again, the cost is easily $40-50k on top of that. How do you determine what constitutes gouging when that is a serious risk?

but your policy would still be less generous than what you get as an employee

How less generous? How many thousands of dollars a year do you think I should pay?

2841. JJBiener - 4/3/2001 8:03:55 AM

So employees would pay more for less, but not anything outrageous.

Why should I have to pay more? Because you don't like it? You made a choice to be self-employed. There are groups you can join in order to get group insurance, but you choose not to. This comes down you not liking the results of your choices and you wanting to change the rules to suit your personal situation.

This would make them equivalent with everyone else, and cause everyone to be more price sensitive.

My choice of career and employer factored in the cost of insurance. If you chose not to do that, don't take it out on the rest of us.

Let me state one more time in case you missed it. I can't be more price sensitive. People who have chronic illnesses cannot be price sensitive. You keep addressing this as if everyone is basically healthy like you are. The problem is that the people who make the most use of the health care system are not like you. You can't use your own experience as standard by which to judge.

2842. JJBiener - 4/3/2001 8:08:02 AM

Cal - If your interested, in addition to the costs paid by my insurance, I pay about $3000 per year out of my own pocket. Talk to anyone with a chronic illness, and you will find they will quote you similar figures.

2843. CalGal - 4/3/2001 8:18:29 AM

Life insurance and disability insurance are mostly offered by employers.

This is absolutely untrue for life insurance. A bit more true for disability insurance, but disability insurance is not in the same league as health insurance for prejudice against the self-employed--but it's getting there.

I would never be able to get individual life or disability policies.

Probably not, unless you had gotten it early on, long before your health problems started.

However, the reason you wouldn't get life insurance now is in part because insurance companies have a built in revenue stream from employers, so why should they bother with the few amount of self-employed people with health problems? This would change somewhat if all of a sudden they lost their guaranteed revenue from employers and always had to sell directly to individuals.

That said, I still think there would probably need to be guaranteed coverage--even if it was more expensive--and subsidies for the chronically ill.

No insurance company would accept a risk like me outside of a group.

They would have to. As I said, insurance companies don't bother with you right now because employers are their cash cows. However, even if they were forced to cover you, your policy would be expensive and that's where subsidies would come in.

Over the last 20 years, my medical expenses have been over a half million dollars.

Yep. And someone's paying for that, JJ. By and large, it's your employer, who is getting hit with huge premiums. It's also being paid to some extent by people like me, who aren't able to get insurance unless we're employed, if we aren't in perfect health, because they're already taking a loss of sorts on people like you, who they have to insure because of their agreement with the employer.

2844. CalGal - 4/3/2001 8:23:06 AM

How less generous? How many thousands of dollars a year do you think I should pay?


Don't know, but as I have said several times--and you've ignored--your costs would be subsidized with tax credits to some extent, since you are chronically ill. However, once a program like this was in place, someone like you would have had insurance long before they were ill, and the insurance company wouldn't be able to get out of control on the increase.

Why should I have to pay more? Because you don't like it?

No, because employees are protected from the costs of your consumption, and that's the root cause of the problems with insurance costs. Or at least one of the top 3 contributors.

If I wanted to make things equitable for the self-and unemployed, there are other ways to do it. For example, employees could be taxed on the cost of their bennies, which would cause them to squawk. Or the self- and unemployed could get tax credits and a lower ceiling for medical costs, for starters. So there are other ways to make things equitable. I'm not particularly interested in equity, though, I'm interested in fixing a broken system. Employer provided health insurance is a disaster.

If your interested, in addition to the costs paid by my insurance, I pay about $3000 per year out of my own pocket

That's all? Good lord. That's diddly, pal. I have regularly gone over 7.5 of AGI on medical costs, and that's with income over $100K--although in the past few years as my income has increased even more, I haven't qualified.

So if you're hoping to shock me with that $3K, you'll have to try harder. Insurance alone costs me more than that.

2845. CalGal - 4/3/2001 8:26:09 AM

Let me state one more time in case you missed it. I can't be more price sensitive.

Let me state one more time since you have managed to ignore it: you would have to rely on government subsidies, in the form of tax credits, to pay for a portion of your insurance. You would always have to pay a bit more, although if we were starting from scratch people with chronic health problems would not have to pay all that much more because they would have health insurance based on when they were healthy.

So if your insurance premiums were $4000/year, you might get subsidies for $2000 of it (I am making these numbers up) and remember, in my new world, all your health costs would be deductible over 1% of AGI.

2846. Shannon - 4/3/2001 3:42:50 PM

people with chronic health problems would not have to pay all that much more because they would have health insurance based on when they were healthy.

That assumes a time when they were healthy.

I'm not sure I'd agree that car insurance works better than health insurance. For one thing, people don't use it nearly as much; as with life and disability, the payout rate is lower. Even so, it's not that uncommon to have problems with claims, disputes over what kind of parts to use, etc. I haven't filed an auto insurance claim of any sort in my adult life. Someone who files a few claims a year would be considered "high risk" for car insurance, wouldn't they? And no doubt their rates would be astronomical. Health insurance gets used a lot more, and a "high risk" person might well use it daily for months or years on end. Even a low-risk person would probably file a claim or two a year.

Also, tax credits/deductions as subsidies only work well for people who can afford to pay for it until they get their tax credit. Many people can't afford to pay thousands a year and take comfort in the fact that they'll get the money (or part of it, in the case of a deduction) back the following year.

2847. thoughtful - 4/4/2001 5:43:10 PM

Actually I don't know that health care is that inelastic. Granted it's been about 15 or 20 years since I modeled demand for healthcare, but as I recall the model was very sensitive to income.

2848. thoughtful - 4/4/2001 5:45:17 PM

judithah, just beware that there is some early evidence that glucosamine can trigger diabetes in those prone (family history) to the disease, so be sure to watch for things like blood sugar, thirst, weight loss. I won't take it because of a strong family history of diabetes (grandmother, father, brother).

2849. JudithAtHome - 4/4/2001 6:23:25 PM

Thanks, thoughtful...I have no problems in that area. I was recently tested and the doctor know I'm taking it so I think I'm covered.

Did you read about that pill that is showing results in certain types of luekemia? It came out in one of the medical journals today; can't recall which one...maybe New England?

2850. thoughtful - 4/4/2001 7:14:49 PM

No I haven't but I try not to let these things raise any hopes....it is so often a false lead and/or years of testing before they're even available. Still...for those who suffer. Remember hope was the last thing out of Pandora's box.

2851. rubberducky - 4/4/2001 7:17:55 PM

'chronically ill'? according to who?

i have sinus headaches once a month, how much of a credit do i get?

2852. JudithAtHome - 4/4/2001 7:51:48 PM

I just received some lousy news...my Family Practice doctor is being listed as a specialist (sports medicene) and my insurance is making me get a new doctor. Oh well, at least I got my knee treated before they decided this so I guess it's not all bad.

And maybe my new guy can refer me to my old doctor if or when I need help with my knee again. I chose my new one from a list by where he is located; they assured me I can switch to someone else if I don't like this new one. It was either pick one from the list or let them pick...either way, it's the luck of the draw since I knew none of them.

That's how I got this last doctor; chose him by location, and he was fine for as little as I see a doctor and he really came through for me with my knee, which was my only real problem.

2853. labwabbit - 4/4/2001 9:40:44 PM

my Family Practice doctor is being listed as a specialist (sports medicene) and my insurance is making me get a new doctor

Now THAT makes sense. I'll take "Half-Assed Doctor" for "co-payment value" Alex...


Then my doctor must not be a specialist...comforting.

2854. thoughtful - 4/4/2001 10:09:11 PM

judithah, If I were you I'd talk to the knee doctor you liked and see if he would recommend a primary care guy -- a better shot than just an ABC.

labw, I don't find any doctor comforting since they all practice which I presume means none of them ever get it right -- that's why they keep practicing.

2855. CalGal - 4/4/2001 11:07:27 PM

Someone who files a few claims a year would be considered "high risk" for car insurance, wouldn't they?

But keep in mind that health insurance is not like car insurance in that a certain number of claims per person are expected and normal.

Health insurance doesn't cost thousands a year for most people--it costs hundreds a year. That will give employees far less coverage than they're used to, but it will be perfectly adequate.

I would see tax credits for the chronically ill being like EITC, where you get the money each month.

That assumes a time when they were healthy.

True, but then, that's a good percentage of the chronically ill.

2856. CalGal - 4/4/2001 11:08:28 PM

i have sinus headaches once a month, how much of a credit do i get?


None. I was thinking of cases like JJs, for example. Or people who get arthritis, or cancer, or something to that effect.

2857. thoughtful - 4/4/2001 11:36:12 PM

judithah and others, I found this site: American Board of Medical Specialties where you can at least verify if the guy your looking at is certified in any specialty. For example, my doc is both internal medicine and geriatric medicine (though I don't need him for the latter just yet!)

2858. thoughtful - 4/4/2001 11:45:07 PM

mg et. al., there's an interesting piece on NPR tonight on the use of stem cells in the treatment of auto-immune disorders. Still very small number of patients and only tried on the illest, it does sound like a therapy that is worth following.

2859. ranheim - 4/7/2001 6:48:14 PM

I had a look at medicine from the patient's view (for the first time in my life) recently.

Coming home from New Orleans on one of LA narrow 2 lane hiways, we were forced off the road into a ditch. I spent the next week in a hospital (Lourdes in Lafayette).

I arrived at Lourdes via ambulance at about 1 in the morning so my choice of doctor was limited to who was on call.

I found that the team of doctors that took care of me were all excellent; caring; and took time to explain what was known and what was planned. Yes! All knew that I, too, was an MD and that may have made a difference. But, my one experience with the medical system as a patient in my adult life revealed to me how skilled some of my fellow physicians are.

At 1AM one has no choice of doctors. I, now, cannot understand all of the complaints of those of you who have an initial choice.

If the HMO (whatever) that covers your medical expenses provides only lousy doctors, make a one-time appointment with a Specialist you know is an expert. (That should be under $500 even in New York City). Then follow his/her advice, using your HMO doctor as a "donkey". (i.e. the HMO doctor writes the Rx for the medications the Specialist wants; the lab tests he wants; the x-rays; etc.).

2860. JudithAtHome - 4/7/2001 6:55:17 PM

Was your healing at Lourdes a miracle, Ranheim?

;-)

2861. ranheim - 4/7/2001 6:59:03 PM

It is run by the Fransican nuns; but, I was not aware of any "puttin on of hands."

2862. arkymalarky - 4/7/2001 8:51:45 PM

Glad you're ok, Ran. I've had a couple of trips to the ER locally, and Bob has too, and we've had great luck, but know of nightmares in the same small-town ER, including my grandmother, who had an acute kidney infection which the ER doctor tried to say was nerves and sent her home. He got removed and they don't use him any more.

Regarding HMOs, I live in a small community and all the drs I went to already are on the list. The HMO is BCBS and I've had no trouble, and have seen specialists and had tests run with no delay. So far I have the option of going to standard deductible BCBS if I want to.

2863. christipeters - 4/8/2001 7:09:32 PM

I had a nightmare in the ER last year. The nightmare continued pretty much throughout my 4-day stay in the hospital. However, when I followed up with the hospital with a written complaint, I got results and an apology.

When I took LD to the ER April 1st, our experience was very positive. (She's ok, turned out to be just a sprained wrist, not a break)

2864. rubberducky - 4/8/2001 7:22:34 PM

Re: Message # 2856, CalGal.

None. I was thinking of cases like JJs, for example. Or people who get arthritis, or cancer, or something to that effect.

and that's exactly why your taxcredit-for-some-illness shouldn't and won't work irl.

2865. CalGal - 4/8/2001 7:34:26 PM

Not true. I'm not talking about tax credits for illnesses but for increased costs of insurance based on illnesses. Your sinus problems won't increase your insurance costs. You'll just have to decide how much money you want to spend going to the doctor, as opposed to paying more for a policy that covers all sorts of doctor visits.

Some illnesses increase the cost of coverage dramatically.

If the lowest policy you can get costs more than X% of your income, subsidies could kick in. That won't happen for your sinus infection.

2866. JJBiener - 4/8/2001 8:05:38 PM

Cal - Rather than trying to destroy a system that works for a great many people, why don't you just make better use of the current system. There are organizations related to your business which allow you to purchase health insurance at group rates. If you incorporate, you should be able to buy your insurance through the corporation and deduct it from your taxes as a business expense.

BTW, I know your numbers were made up, but for someone with a chronic illness like mine premiums for individual health insurance would more like be on the order of $25 to $30 thousand a year, not $4 thousand. My medications alone are about $1000 per month. If you include regular doctor visits, periodic tests, and medical supplies that brings the yearly total up well over $15 thousand. If you figure that there is a high risk of hospitalization and surgery anything less that $25-30 thousand would be unfeasable. Someone like you would see a $25 thousand premium and cry price gouging.

Do you think it is reasonable to burden the taxpayer with a $23 thousand subsidy? I don't. Especially not when we have a system which already works.

2867. CalGal - 4/8/2001 8:41:46 PM

Uh, JJ, the taxpayers are burdened with that subsidy. It comes right off your employer's taxes.

2868. CalGal - 4/8/2001 8:52:41 PM

As for the discussion about how expensive your premiums are, you are talking about in the current system. Had you been paying for health insurance since you were a child, independently, and insurance companies were prohibited from raising prices significantly due to any illness you developed, it wouldn't cost as much. Also, you wouldn't get all of your tests covered by insurance. You'd be paying for a lot of them yourself, and deducting some of them from your income taxes. I don't see why it is you think that $3K is a lot of money for you to pay, but it's not. I see no reason why, based on income, you shouldn't cover up to $10K of your own health expenses.

The current system doesn't work for a lot of people. For one thing, the people who have insurance are, for the most part, misusing it because they are held largely immune from the cost of their decisions. People like you disproportionately benefit, obviously, at the expense of the unemployed and the self-employed. But if someone has a health problem and isn't employed, they are out of luck.

So the notion that it's working is flat out foolish. Also, unlike you, I am not arguing from self-interest. I am unlikely to suffer in any event--I deduct medical costs, pay cash without any sense of resentment, and only worry that the stupidity of the current system will potentially limit my ability to get insurance at some point, since the insurance companies have no need to be interested in my business.

Also, unlike you, I don't want to cost the government more than a welfare mom in subsidies. I'm not looking for a better deal. I think linking insurance to employment is absurd. More importantly, I think health care consumers need to be subject to the full import of their decisions.

In both cases, the government will be subsidizing health care costs. It's just that my method will be more evenhanded about it--and will eliminate a lot of consumer profligacy.

2869. JJBiener - 4/8/2001 8:52:47 PM

CalGal - Uh, JJ, the taxpayers are burdened with that subsidy. It comes right off your employer's taxes.

Nonsense. Health insurance premiums are deducted like any other business expense. They are deducted from gross income, not from taxes owed. They are no more a burden on the taxpayer than rent, salaries, office supplies or any of the hundreds of things which are considered business-related expenses. It is dishonest of you to keep refering to deductions as subsidies. They are not the same thing.

As it is, the cost is currently absorbed by the group, the employer and the insurance company. Under your plan that burden would be shifted to the taxpayer for no good reason other than you don't like your insurance.

2870. Shannon - 4/8/2001 8:59:44 PM

Who are these people who misuse insurance because the employer pays for it? Most people I know don't enjoy going to the doctor enough to do it just for kicks, even if it is free or cheap to do so.

2871. bubbaette - 4/8/2001 9:06:12 PM

I think that there is more of a tendancy to go to the doctor if all it costs is a nominal co-pay. If the full cost of a doctor visit came directly from their pockets, people might use health care a bit less. But then I suspect that the high cost of health care is in some measure attributable to health insurance. If we were paying out of pocket for health care, there wouldn't be the disconnect between those who receive the services and those who pay.

2872. JJBiener - 4/8/2001 9:10:29 PM

Cal - Had you been paying for health insurance since you were a child, independently, and insurance companies were prohibited from raising prices significantly due to any illness you developed, it wouldn't cost as much.

This is silly. Someone is going to be paying for my healthcare expenses. If everyone has a health insurance plan that they had from childhood and rates can never go up, insurance companies will fold up like little origami swans.

I don't see why it is you think that $3K is a lot of money for you to pay, but it's not.

That is in addition to the insurance premiums I pay, the insurance premiums my employer pays, and any expenses incurred by the rest of my family.

I see no reason why, based on income, you shouldn't cover up to $10K of your own health expenses.

That would result in a serious change in my standard of living. You will excuse me if I don't jump at that opportunity.

For one thing, the people who have insurance are, for the most part, misusing it because they are held largely immune from the cost of their decisions.

This is a myth. Most people avoid using the health insurance. In case you haven't noticed, most people hate going to doctors.

People like you disproportionately benefit, obviously, at the expense of the unemployed and the self-employed.

This is more nonsense. I benefit because my employer and I pay for that benefit. The unemployed and the self-employed are not inconvenienced in the slightest.

2873. JJBiener - 4/8/2001 9:10:40 PM

Also, unlike you, I don't want to cost the government more than a welfare mom in subsidies.

I have been through this with you a dozen times and I am getting tired of this bullshit lie. My heath insurance does not cost the government a dime and it is fucking dishonest of you to keep insisting otherwise. I pay enough in taxes to keep a family of 4 above the poverty line. If you think I cost the government anything, perhaps you need some work in remedial math.

More importantly, I think health care consumers need to be subject to the full import of their decisions.

Well maybe if you had ever actually had a serious medical condition you wouldn't be prone to making such idiotic statements.

2874. Shannon - 4/8/2001 9:13:28 PM

Oh, I think there probably is more tendency to go to the doctor if it costs less. But I'm not at all convinced that leads to abuse by the insured; I think the problem is at the other end of the spectrum. People who need to go to a doctor are apt to delay too long if they have to pay a lot out of pocket.

And I'm hardly one to go to the doctor for every little thing. Prior to the past few years, I went for my annual pap smear and that was about it. When I had plantar fasciitis, which was the first symptom which led to my arthritis diagnosis, I limped around for at least 2 or 3 weeks before I called my doctor for an appointment. I probably should have gone in sooner. But if I'd had to pay the full cost instead of $15, I probably would have put it off a bit longer. And I can really afford a single office visit pretty easily.

2875. CalGal - 4/8/2001 9:13:38 PM

JJ,

It is subsidized. You are not taxed on the income you receive. I'm not getting into this discussion again; it's a fact. The government subsidizes health insurance, but only for those who are employed.

Shannon,

I said profligacy, not misuse. Probably the single biggest reason for the move to HMOs was the fact that doctors and their patients both had no reason to worry about expenses--someone else was paying. So employers began turning to providers that cared about expenses. And here we are.

Bubba's post also captures the way things are even today.

2876. JJBiener - 4/8/2001 9:15:23 PM

Bubbaette - Do we want sick people to avoid using medical care? I don't think so. It may save a little up front, but it will cost many times more when minor illnesses left untreated turn into serious medical conditions requiring expensive medications, procedures and hospital stays. I think this what they use to call penny-wise and pound-foolish.

2877. CalGal - 4/8/2001 9:16:16 PM

My heath insurance does not cost the government a dime and it is fucking dishonest of you to keep insisting otherwise.

Yes, it does. At the very least, you should be paying taxes on the cost of the insurance premium. As should all other employees. Since you are not, it is costing the government a fair amount of revenue, JJ, and that's all there is to it.

Shannon,

I am not talking about abuse; I am saying that employees get far more insurance than they would get if they were paying for it on their own. They also use it without regard for the increase in premiums that might come about based on use because they are exempt from those increases.

2878. JJBiener - 4/8/2001 9:22:13 PM

CalGal - It is subsidized.

Bullshit

You are not taxed on the income you receive.

I am not taxed on lots of things that could be considered income. That doesn't make it a subsidy. A subsidy is a payment from the government to an individual. I receive no such payments.

I'm not getting into this discussion again;

Good, because you are wrong.

it's a fact.

It is bullshit.

The government subsidizes health insurance, but only for those who are employed.

The government subsidized health insurance for the poor and elderly, Medicaid and Medicare. This is paid for by the employed. You have it exactly backwards.

The decision not to tax something is not the same thing as a subsidy. Your argument has been bullshit from the very beginning. So get over you indignation and resentment and stop trying to get others to pay for your decisions.

2879. CalGal - 4/8/2001 9:23:17 PM

. If everyone has a health insurance plan that they had from childhood and rates can never go up, insurance companies will fold up like little origami swans.


I said "significantly". In other words, you couldn't all of a sudden have premiums increase to $30K a year just because you got cancer. You wouldn't be changing policies, but that's a different issue.

That would result in a serious change in my standard of living. You will excuse me if I don't jump at that opportunity.


Of course you wouldn't. As I've said, it's the fact that the system subsidizes people so completely that they are unaware of it that prevents any meaningful change. Although the amount of contractors in the workforce may start that changing. But the fact is, your health problems would cost you a fortune if you weren't employed. A system that protects you from the cost of living hit that you realistically should expect, given your health problems, based only on the fact that you are employed, is a bad one.

This is more nonsense. I benefit because my employer and I pay for that benefit. The unemployed and the self-employed are not inconvenienced in the slightest.


Not true. Since you aren't paying as much in taxes as you should, given the very real income you receive, the unemployed and self-employed are paying for you.

In the short term, I think those who aren't employed should receive somewhere in the neighborhood of a $2000 tax credit and make health insurance and disability premiums tax deductible just to come close to evening things out. That will eliminate the fairness issue--but the fact that the system is a bad one is the real problem.

2880. Shannon - 4/8/2001 9:23:54 PM

Cal,

They also use it without regard for the increase in premiums that might come about based on use because they are exempt from those increases.

But doesn't that still come down to saying that people use their insurance more than necessary?

And what's your feeling on other tax exemptions? My having a mortgage and donating to charity costs the government money too, in the sense that the money spent on those things is not taxed.

2881. CalGal - 4/8/2001 9:29:09 PM

JJ,

The argument is not bullshit. Employee benefits of all sort--health insurance premiums, education and training, life insurance, disability insurance--they are all a form income to the employee and never taxed.

"Subsidized" has a specific meaning and a general meaning. You already know that I am referring to it in the general way. You and all employees receive a significant chunk of benefits that equate to anywhere from $5-15K in value that you don't pay taxes on, even though the cost is deducted from the company who provides them.

I don't resent this, for the simple reason that I make far more money than any employee for a quarter of the effort and half the time, even given the fact that I have to pay for my benefits. So again, unlike you, I am not speaking out of self-interest. I think the change is needed to force insurers and individuals to deal with each other directly, without an agent involved.

2882. CalGal - 4/8/2001 9:38:59 PM

But doesn't that still come down to saying that people use their insurance more than necessary?


I don't think people abuse their insurance; I just think that everyone would behave much differently if they were buying their own insurance. Whether it's "necessary" or not is always going to be tough to define. For one thing, most people making under $50,000/year would not get anything other than major medical because it would be difficult to afford.

My having a mortgage and donating to charity costs the government money too, in the sense that the money spent on those things is not taxed.


Absolutely. Of course, renters benefit from the mortgage deduction too, in that it is factored into their rent.

In the case of employment bennies, I don't think the subsidy is deliberate--it is a relic of the post-WWIi era, when almost everyone had a job with a large corporation. The imbalance that occurs now is unintentional and should be examined.

2883. CalGal - 4/8/2001 9:40:32 PM

Also, employment bennies and the fact that they aren't taxed is skewing not only the employee health care decisions, but also company decisions--health care loads the costs of employees considerably these days--and much of government legal actions involving temps is done because they want to force companies to hire temps. Why? Because then temps will get health care benefits. Why do corporations use temps? Because they're cheaper, no need to pay health care benefits. (actually, all benefits come into play, but health care insurance is the most expensive).


Also, it disproportionately loads the costs of employees. Why do you suppose so many companies began to outsource services like janitors and security guards and so on? In large part because these were low-income employees whose benefits far outweighed their value to the company.

So the whole nature of employer-provided health insurance skews not only health care decisions (the major problem) but also employment law and employer decisions about the type of employees they want, given the cost they represent.

2884. bubbaette - 4/8/2001 9:48:17 PM

JJ

Do we want sick people to avoid using medical care? I don't think so. It may save a little up front, but it will cost many times more when minor illnesses left untreated turn into serious medical conditions requiring expensive medications, procedures and hospital stays. I think this what they use to call penny-wise and pound-foolish.

Not always -- and not even most of the time. Most of the time, it's just penny wise. But then I may have a stilted point of view because when I was coming up you only saw a doctor if there were bones sticking out. As a consequence, I know that most run of the mill illnesses go away by themselves. The exceptions are lingering illness, prolonged high temperature, seizures, broken bones and the like.

I wonder what proportion of a G.P.s schedules are made up of patients with cold or flu? Mike is always instistant that I go see a doctor when I get a cold or the flu. To my point of view the doc can't really do anything to cure it, but I can pass it on to others in the doctor's office. In general, my motto is wait a while and see what happens.

2885. JJBiener - 4/8/2001 9:51:29 PM

Cal - At the very least, you should be paying taxes on the cost of the insurance premium.

Why? To make you happy? I don't think so.

Since you are not, it is costing the government a fair amount of revenue

This is the fundamental flaw in your reasoning. It doesn't cost the government anything. Your reasoning assumes that since the government CAN tax premiums, it costs them revenue if they CHOOSE not to. If you use this logic you can claim that since the government CAN tax you at 100%, everything that they CHOOSE to allow you to keep under the current tax law is a subsidy. This means that the government in fact owns everything. Are you willing to make this claim?

Even if we allow your absurd reasoning to pass unexamined and we agreed to tax health insurance premiums, you are talking about the tax on a couple thousand dollars of additional income. To compare this to the cost of a welfare mother is deliberately dishonest.

If you would like to continue with the subject on a factual basis, fine. Otherwise quit spamming this thread with your bullshit.

2886. JJBiener - 4/8/2001 10:03:47 PM

Cal - "Subsidized" has a specific meaning and a general meaning. You already know that I am referring to it in the general way.

No, you are using it in a dishonest way to equate two things which otherwise have no relationship to each other.

For one thing, most people making under $50,000/year would not get anything other than major medical because it would be difficult to afford.

No shit. What happens when one of these families is faced with normal childhood illnesses? Should they choose between food and medicine? Should they take comfort in their hunger knowing that they get a tax credit next year? Health insurance exists the way it does for a reason. Perhaps you should try to understand why things are the way they are before you try to tear it down. Perhaps you should consider the consequences of your ideas before you start proclaiming their value.

Why do corporations use temps? Because they're cheaper, no need to pay health care benefits.

Here is just one more thing you are mistaken about. Temps are not cheaper. They are more expensive. They are used to fill short term needs. That is why they are called temporaries.

2887. thoughtful - 4/8/2001 10:05:53 PM

What happens when one of these families is faced with normal childhood illnesses? Should they choose between food and medicine? Should they take comfort in their hunger knowing that they get a tax credit next year?

Careful there, jj. I might just mistake you for a democrat! ):-)

2888. JJBiener - 4/8/2001 10:08:46 PM

Bubbaette - Most of the time, it's just penny wise.

How much pound-foolishness will you accept as an acceptable loss? How many children with flu-like symptoms should be allowed to die of meningitis in order to be properly frugal? The consequences of being penny-wise with health care carry a very high cost. I don't think it is worth gambling with.

2889. JJBiener - 4/8/2001 10:11:21 PM

thoughtful - Not likely. I am proposing a free market solution, not a government-based solution.

2890. thoughtful - 4/8/2001 11:25:38 PM

scary story on the today show this a.m. about a little girl who died....seems family went to a Sizzler and only had the salad bar. Over 20 other children also got ill with e-coli on the watermelon. Seems a careless worker must have used the same knife to cut the watermelon that was used to cut raw meat without cleaning it in between. That's how simply it can be passed. Yikes.

2891. PsychProf - 4/8/2001 11:34:49 PM

THOUGHTFULS STORY

click on photo

2892. CalGal - 4/8/2001 11:54:03 PM

Why? To make you happy? I don't think so.


No. To allow you to say that you aren't subsidized by the government when, in fact, you are.

What happens when one of these families is faced with normal childhood illnesses?

What happens now if they are a working family without health insurance? Same difference--except, possibly, doctor visits would be cheaper. Right now the people who don't have an HMO pay much more for doctor visits because doctors are forced to accept excessively low payments.

Besides, there is a difference between saying that they couldn't afford luxurious health insurance and saying that they'd have to pay for health care on their own. An income of $50K will still cover some routine doctor visits.

I've said twice that the credits could be handled like the EITC, so your dramatics about "waiting next year" will have to be put aside--again.

Here is just one more thing you are mistaken about. Temps are not cheaper. They are more expensive. They are used to fill short term needs. That is why they are called temporaries.


Don't be ignorant. Temps are far cheaper. The loaded costs of employees are substantially higher than those for temps. Temps are only sometimes used for short-term needs. Large companies have a whole class of positions that are only to be hired by temps and even in smaller companies temps are used to cut down on costs.

It doesn't cost the government anything.

Sure it does. Mortgage deductions cost the government. Child care credits cost the government. All sorts of things cost the government, whenever they choose not to tax certain types of income.

This isn't a bad thing by definition. But it's certainly true.

2893. mgleason - 4/9/2001 12:22:38 AM

The use of temps to bypass the high cost of providing employee benefits is very common, especially in the tech world. Remember the Microsoft case?

2894. CalGal - 4/9/2001 12:29:30 AM

Exactly. The IBM case of the 70s was actually the original temp case. The Microsoft case was about getting them stock benefits.

Mind you, I think the government's position is untenable in making temps largely indistinguishable from full-time employees. But there's no question that temps are used to avoid the expense of employing them.

2895. mgleason - 4/9/2001 12:37:38 AM

I used to be a benefits administrator in my former life. There's no end to the gyrations companies will go through to define 'employee' as narrowly as possible in order to raise the benefits bar, so the IRS has been cracking down for years.

2896. JJBiener - 4/9/2001 12:48:15 AM

CalGal - Sure it does. Mortgage deductions cost the government. Child care credits cost the government. All sorts of things cost the government, whenever they choose not to tax certain types of income.

Stamping your feet and insisting it is true, does not make it true. Income belongs to the taxpayer, not the government. Income that is not taxed belongs to the taxpayer and at no time does it belong to the government. You can't claim the government loses money it never had.

You are still operating under the assumption that just because the government CAN tax certain income, they are losing money by NOT taxing that income. This is a false assumption. You can't give someone something that is already theirs and you can't lose something that is not yours to lose. The mere ability to tax does not immediately grant ownership of that revenue.

You are trying to equate things that are not the same. A subsidy requires that money pass from the government to an individual or organization. No matter how you twist and torture the definition of subsidy, the failure to tax certain income does fall under that definition.

2897. CalGal - 4/9/2001 12:49:33 AM

Actually, the interaction between the IRS, the Labor Department, and the Justice Department has always confused me.

The IRS focuses on people like me who are perfectly happy working directly for companies as temp workers. But the IRS doesn't give a damn about benefits, apparently. I've been told more than once that the IRS wants to force as many people into employment of some sort as possible (with or without benefits) because they don't really like self-employment. It is more work for them to track down whether or not self-employed people have paid all of SocSec and all their taxes. I find this incomprehensible and would question its accuracy except that I've heard it many, many times by people (including IRS auditors) who offer this up as if it makes some sort of sense. I would be delighted to hear that it is actually some other reason.

So I believe (but again, am not sure) that the IRS only checks the relationship of individuals or single person corporations working for a company directly--the consultant vs. employee test. I don't think they care about benefits.

I believe it is the DoL that cares about temp workers and their benefits, and they turn it over to Justice if it's severe enough?

2898. CalGal - 4/9/2001 12:50:20 AM

Most of the new laws that supposedly benefit temps go through Congress. I've never really seen them benefit temps, though, because corporations just work around them by shortening the temp's time with the company.

Many temps, and the people who make the laws, think the choice is between "working as a temp for 3 years" or "working as an employee forever". But they forget that all laws will have a basement--usually six months. So that adds another choice to the list "working as a temp for 6 months and then having to find another contract". And then, it turns out it's not their choice, it's the company's choice. Guess which one they'll pick?

If the temps knew that this would be the result, how many of them would have opted for the enforced "benefits"?

It's a tough call. The idiocy between temp and full-time, which is caused entirely by the benefits expense, is another reason why I think most people would actually benefit if they had to pay for their own benefits.

Actually, this portion of the conversation should probably go to SI.

2899. CalGal - 4/9/2001 12:54:21 AM

JJ,

Fine. So long as we agree that you are benefitting in the same way that you would if you had a mortgage deduction, we're in agreement.

So instead of calling it a subsidy, I will now refer to it as a huge government entitlement program. It is as big--if not bigger--than the mortgage deduction. Certainly it's bigger than welfare. So you just keep on justifying your entitlements.

Government entitlement programs, by definition, cost the government money.

2900. mgleason - 4/9/2001 1:02:35 AM

Companies consider payroll taxes benefits, too.

You've got the right idea about the interaction between the various gov't. agencies. The IRS focuses on independent contractors because they're viewed as payroll tax dodges on the part of companies, the DOL concentrates on the part-time vs. full-time shell-game companies engage in to avoid paying out other benefits, and the DOJ on employment discrimination of any kind.

The IRS also monitors who's allowed to participate in pension, profit-sharing, stock, and deferred comp plans.

2901. JJBiener - 4/9/2001 1:10:03 AM

CalGal - Entitlement? You amaze me. Orwell must laughing his ass off in whatever little corner of Hell he finds himself in.

How can the government NOT taking something that belongs to someone be the same as the government giving something to someone that isn't theirs to begin with? You never answer this question. Does personal property and ownership mean nothing to you? I can't imagine how you continue with this silly argument.

If you think the amount of money in either the mortgage deduction or the health insurance premiums or even both together is greater than that spent on welfare, you are in serious need of remedial math help.

But that is beside the point. Address the fundamental issue. Explain how not taxing income is the same as a subsidy. You have been asserting it for months. Defend your bullshit, or quite posting it.

2902. rubberducky - 4/9/2001 3:57:36 PM

Re: Message # 2900, mgleason.

Companies consider payroll taxes benefits, too.

really? how so?

2903. Ronski - 4/9/2001 4:57:29 PM

Fat May Yield Stem Cells (temp. link)

2904. CalGal - 4/9/2001 5:57:17 PM

Explain how not taxing income is the same as a subsidy.

Well, I turned to that bastion of communism, the Encyclopedia Brittanica.

Tax expenditures

It has been shown that preferential treatment can be extended to selected private activities in either of two ways: Tax revenues can be collected and then spent to support the activities as part of the normal budget process, or preferential treatment of the activities can be built into the tax system, as with the deductions allowed for home mortgage interest. In either case the advantages granted can be seen as subsidies provided by the government. This way of viewing the issue leads to the concept of tax expenditures, which can be thought of as the expenditure equivalents of deviations from an ideal tax base. Each year the budget of the U.S. government includes a tax expenditure budget, as well as the traditional budget for appropriations; other countries follow similar practices.

Tax expenditures have the disadvantage that they do not receive the scrutiny accorded appropriations. They are considered by tax-writing committees, rather than by appropriations committees. Once enacted, they take on a life of their own. Moreover, they undermine the perception that the tax system is fair in a way that ordinary expenditures do not.

2905. Ronski - 4/9/2001 6:00:28 PM

Bastion of Communism it may no longer be, but perhaps that shoe once fit.

Remember the scandal some years ago where it was revealed that the entries on the Soviet states were written by Soviet propagandists?

2906. CalGal - 4/9/2001 6:03:09 PM

Ducky,

FICA and Medicare have to be paid in full, even if you're self-employed. If an employer is paying it for you, it's a benefit. Hence deductible.

Medicare is the one that is slapping me time and again. I keep on forgetting that it is 3% of all income, no cap.

Maria,

The IRS focuses on independent contractors because they're viewed as payroll tax dodges on the part of companies, the DOL concentrates on the part-time vs. full-time shell-game companies engage in to avoid paying out other benefits, and the DOJ on employment discrimination of any kind.


Actually, I think it's not so much they are viewed as "payroll tax dodges" as it returns to the whole notion of withholding. Withholding is one of the concepts that ensures taxpayer compliance, and if companies pay the withholding, the IRS doesn't have to spend time on the taxpayer. In short, it's not to protect the taxpayer or the employee, it's to maximize involuntary tax compliance and make life easier for the IRS.

2907. CalGal - 4/9/2001 6:04:35 PM

Ronski,

Ha! No, I didn't know. But it's okay, I found some other sources anyway.

I don't know how long the Encyclopedia will be around, btw. I hear they're closing down their free site.

2908. JJBiener - 4/9/2001 6:31:58 PM

Cal - What do you think it means when EB uses terms like "can be seen as" and "This way of viewing"? It means that there are people like you who view tax deductions as subsidies. It doesn't mean that tax deductions really are subsidies.

the expenditure equivalents of deviations from an ideal tax base

The idea of an "ideal tax base" is completely arbitrary. This is the flaw in your case. Your claim is based on your arbirary assumption of what the ideal tax base should be. My ideal tax base includes a 100% tax on people who use the name CalGal on the internet. Therefore you are being massively subsidized at the expense of the poor and homeless.

We are left with the idea that the government can spend money it never had and that it can subsidize a person with his own money. Neither of these statements are valid.

I know (and EB knows) that there are people like you who believe that allowing people to keep their own money is a gift from the government. Just because you believe this (and EB recognizes that you believe this), it doesn't mean that it is an appropriate way of dealing with the situation. Deductions and subsidies are not the same thing. Treating them as the same thing deliberately distorts the discussion in order to justify absurd positions like yours.

2909. thoughtful - 4/9/2001 6:33:47 PM

Also an interesting story in today's NY Times about self delusion -- seems we delude ourselves into thinking we are improving all the time.

Heck, I know I am!

2910. PsychProf - 4/9/2001 6:39:45 PM

HERE YA GO THOUGHTFUL...TAYLOR IS A FORMER STUDENT OF MINE

2911. CalGal - 4/9/2001 6:51:35 PM

It means that there are people like you who view tax deductions as subsidies. It doesn't mean that tax deductions really are subsidies.


No. It means that there are warring philosophies, which I've pointed out many times. People like you, who consider all money their own, tend to resist this point of view and see expenditures on their behalf as righteous money that ought never to have been taken from them in the first place. I've even been careful to acknowledge your point of view.

However, you have consistently denied that such a position even exists, that it is something I've made up all on my own. I will take your acknowledgement of the position itself as the most you can manage, under the circumstances.

However, the EB agrees with me. But maybe a Soviet propagandist wrote it.

2912. thoughtful - 4/9/2001 8:28:22 PM

Thanks PP. I saw an earlier reference in the times to Taylor's work about self-delusion being an important part of self esteem, and this study takes it further to deluding ourselves into thinking we are always improving. Amazing stuff. Maybe that's why so many elderly are depressed...the deterioration in their physical and mental state are such that they can no longer delude themselves into thinking they are improving, forcing more realistic self assessments, and thus depression sets in.

2913. JJBiener - 4/9/2001 8:33:06 PM

Cal - It means that there are warring philosophies, which I've pointed out many times.

When have you ever mentioned warring philosophies? All I remember is you accusing me of costing the government more than a welfare mother because you don't think I pay enough taxes.

People like you, who consider all money their own, tend to resist this point of view and see expenditures on their behalf as righteous money that ought never to have been taken from them in the first place.

All the money I earn is mine. All the money that is left after I pay taxes is mine. That money never belonged to the government. It was never taken from me as you claim. For you (and all the others who think like you) to claim that money is a subsidy from the government is Orwellian in the extreme.

However, the EB agrees with me. But maybe a Soviet propagandist wrote it.

Nothing in the EB agrees with you. It merely states that such people as you exist. It doesn't say you are right.

2914. PsychProf - 4/9/2001 8:37:48 PM

Thoughtful...excellent point.

2915. thoughtful - 4/9/2001 8:50:31 PM

Of course, PP, you and are are like fine wines, still improving with age, eh?

Be interesting to think of the role of fashion in all this....look back at old pictures and maybe you look younger, but the hairdos, the clothes. Yuck. Can't help but reinforce how much better you look today.

2916. thoughtful - 4/9/2001 8:51:34 PM

Unless of course you are Claudette Colbert who wore the same hairdo all her adult life....worked very well as she aged as everyone thought she hadn't changed an iota over 40-50 years, cause in a sense, she hadn't.

2917. mgleason - 4/9/2001 9:12:36 PM

RD,

CG answered your query about payroll taxes.

CG,

By referring to the use of independent contractors as a 'payroll tax dodge' (in the IRS view), I mean that this classification is a way for companies to avoid paying those pesky taxes, among other things. The IRS just wants them paid, true, and the easiest way to ensure compliance and timely payment is through payroll deduction on the part of a captive audience.

2918. MsIvoryTower - 4/9/2001 9:58:21 PM

If you think the amount of money in either the mortgage deduction or the health insurance premiums or even both together is greater than that spent on welfare, you are in serious need of remedial math help.

Well, it depends on what you include in the housing subsidy, and welfare....

Data from the Statistical Abstract, 1999.

Table 549: Tax Expenditures Estimates (defined as lost revenues attributable to federal tax laws), in billions of current dollars.

For the year 1998

Housing
-deductability of mortgage interest.....51,700
-deduct. of state and local taxes.......17,770
-cap. gains exclusions on home sales....17,475
-other (see Table 549 for details)......10,860
Total...................................97,805

Health
-current law tax expenditures..........80,545
-Exclusion of empl. contrib............67,920
-other.................................10,435
Total.................................158,900

Compare to

Table 609: Social Welfare Expenditures...
For the year 1995.

Public Aid...........................170,260.


While it's true that welfare expenditures are larger than either of the above two subsidies, it is not true that their combined value is exceeded by what is spent on public welfare.

Note: public aid includes only those programs going to the poor, not other forms of social welfare programs like SSI, Veterans, and Heath programs.

Note also that the years are not strictly comparable, but given the low inflation that occurred between those years, I think you can assume that public aid held fairly steady, perhaps increasing 2-3% per year, certainly not enough to be more than the combined housing and health exemptions allowed in the tax code.

2919. MsIvoryTower - 4/9/2001 10:10:13 PM

by what is spent on public aid, not welfare...

total welfare expenditures were arount 900 Billion in 1995.

2920. MsIvoryTower - 4/9/2001 10:10:28 PM

around...

2921. CalGal - 4/9/2001 10:56:24 PM

All I remember is you accusing me of costing the government more than a welfare mother because you don't think I pay enough taxes.


You probably do cost more than a welfare mother when considering your premiums and health expenses, but I didn't make the accusation because I don't think you pay enough taxes. If you'd paid any attention at all, you'd realize that all I'm doing is proposing that the government expenditures on health care be reallocated based on all individuals, rather than whether or not one happens to have a particular tax status.

Even if you didn't have an insurance policy that covered all your expenses you would probably still cost the government quite a bit of money. If you spent $30K a year on medical bills you'd be able to deduct almost all of that.

See, the thing is, JJ, that you're going to be a burden on the system no matter which way it goes--because you have poor health. You're a problem that is largely covered up--not fixed, mind you, just masked--by the fact that your company and others are overpaying by individual. And of course, individuals who aren't employed are paying for you as well.

So people like you are always problematic--if you're lucky enough to get hired, you can pass on your costs to the rest of us, otherwise they suffer terribly by not being able to get insurance at all, and not being able to afford the uninsured medical costs. But give them money for insurance or medical costs? Blasphemy! Subsidy!!

Right.

People like you aren't the issue, really--the chronically ill always going to burden the system, no matter which equitable system is chosen.

But I'd rather the government subsidize their care--including yours--disproportionately, by subsidizing the generally healthy but employed a lot less. They are getting far more than they would ever buy if it was their own money being spent.

2922. CalGal - 4/9/2001 10:57:24 PM

Ms,

Thank you very much for those numbers.

What's the difference between "public aid" and "welfare? (re 2919)

2923. labwabbit - 4/10/2001 12:46:08 AM

What's the difference between "public aid" and "welfare?

Welfare is for persons whom are out of work. (for whatever reason)

Public aid is for a town, area, or system that is not working.

2924. MsIvoryTower - 4/10/2001 2:13:45 AM

Actually

Public Aid consists of what we consider to be the welfare programs for the poor, Aid to Dependant Families, Food Stamps, Supplemental Security Income, Medical Assistance payments (medicaid payments), and other (refugee assistance, surplus food for the needy, low-income energy assistance programs, work-experience training programs under the Comprehensive Employment and Training Act).

Total public welfare includes social security, other social insurance programs, hospital and medical care, materinal and child health programs, school health programs, education welfare programs, veterans programs, vocational rehabilitation programs, institutional care, child nutrition, child welfare, and a host of other programs.

2925. labwabbit - 4/10/2001 3:06:57 AM

Well actually....yes.


(I just took 150 words less) (g)

2926. labwabbit - 4/10/2001 3:09:32 AM

Holy spaced out Ms....fell asleep on the space bar?

2927. MsIvoryTower - 4/10/2001 4:01:50 AM

Ha! I must have...

I have no idea how that happened

2928. JJBiener - 4/10/2001 4:19:49 AM

CalGal - You probably do cost more than a welfare mother when considering your premiums and health expenses, but I didn't make the accusation because I don't think you pay enough taxes.

Let's take a little quiz. How much do you think my health insurance premiums cost my employer? Based on that number, how much would my tax liability be if the government chose to tax that benefit as income? If you think that tax liability is in the neighborhood of $10-12k you need to take some remedial math courses.

If you'd paid any attention at all, you'd realize that all I'm doing is proposing that the government expenditures on health care be reallocated based on all individuals, rather than whether or not one happens to have a particular tax status.

That's nice, but considering the fact that the government is not spending any money on my health care, your premise is still false.

Even if you didn't have an insurance policy that covered all your expenses you would probably still cost the government quite a bit of money. If you spent $30K a year on medical bills you'd be able to deduct almost all of that.

Can you really not see the difference between the government paying my health expenses, my deducting my health expenses from my taxable income and the government not taxing the cost of my medical insurance premiums? These represent three very different sums of money. I'll give you a hint, they are listed in descending order.

See, the thing is, JJ, that you're going to be a burden on the system no matter which way it goes--because you have poor health.

2929. JJBiener - 4/10/2001 4:20:59 AM

See, the thing is, Cal, that you're still full of shit. I am not a burden on the system because my insurance premiums are paid for by myself and my employer and no one else. Until you can grasp this elemental point, you will continue to speak nonsense.

You're a problem that is largely covered up--not fixed, mind you, just masked--by the fact that your company and others are overpaying by individual.

There is no problem.

And of course, individuals who aren't employed are paying for you as well.

Paying with what? Their good looks? You are being absurd.

So people like you are always problematic--if you're lucky enough to get hired

Lucky? I was hired because I produce far more value than I take in salary and benefits. Luck has nothing to do with it.

you can pass on your costs to the rest of us

Please show me the part your health insurance bill that is my fault. I know this is terribly disillusioning for you, but you are paying for your own insurance. Not mine. I would bet we aren't even insured by the same company.

But give them money for insurance or medical costs? Blasphemy! Subsidy!!

If you had been paying the least bit of attention you would have learned that being given money for insurance or medical really is a subsidy. That is what subsidies are. They are money that the government gives to individuals to buy things.

People like you aren't the issue, really--the chronically ill always going to burden the system, no matter which equitable system is chosen.

2930. JJBiener - 4/10/2001 4:21:28 AM

That is yet another flaw in a long list flaws in your logic. People like me are exactly the issue. We are the ones who use the healthcare system the most and are therefore the most dependent on it. This would be easy if everyone was healthy. You can't overhaul the healthcare system without considering those who use it. It would be like overhauling the mass transit system and only considering the needs of people who have cars.

People like me are not a problem when they are a part of a group plan like I am. They will become a problem when you take that option away and force them to go to government for assistance.

They are getting far more than they would ever buy if it was their own money being spent.

No shit, Sherlock. However, the alternative for people like me is severe illness and possibly death. You will excuse me if I find your solution to be a bit Machiavellian

2931. JJBiener - 4/10/2001 4:25:54 AM

Cal - Let's try one more little math problem. Which number is bigger: the amount of lost revenue from not taxing a relatively small premium for a group health insurance policy or the full premium of an individual health insurance policy for a chronically ill person like me?

2932. ranheim - 4/10/2001 5:01:50 AM

As a physician, I find those on Medicaide most abuse the system by coming to us doctors with insignificant complaints. One that particularly gripes me is "my baby has a cold"; for how long? "since last night"; does the baby have a fever? "No". Now what in Hell am I supposed to do with an URI-type illness that is not 24 hours old and is without fever in an infant?

Next on my list are federal/state employees that consider their health insurance a part of their salary. Therefore, they use their insurance for the most trivial of complaints.

When something is given away free, the recipients rapidly lose respect for it. I would propose a system in which the Medicaide recipient must pay a minimal fee (e.g. $1) to see the doctor. I estimate that would eliminate 10% of patient visits by those receiving Welfare.

For all others I would like to see a pool of some sort. Everybody (at what age do you want to begin? Upon finishing 8th grade? Graduation from High School?) starts paying an equal premium for Health Insurance and H.I. would no longer be a deductible expense for companies. It WOULD be deductible for the tax payer; whether he/she itemizes or not.

The paper work generated by this system would have to be minimal. When Medicare first began (sometime in the '60s?) a very simple form was filled in by the Patient! Now huge amounts of medical staff time is spent filling out endless forms. Medicare officials found that patients' mistake rate was very high and so shifted the burden of paper work to the physician.

Seems to me that statisticians could use actuarial tables and come up with a fee that would take care of office visits; hospital E.R. visits and admissions to the hospital; surgery; lab and x-ray tests of all kinds; vaccinations; medication; etc. The only things excluded would be cosmetic surgery and the medication used in cosmetic surgery.

2933. Shannon - 4/10/2001 5:40:18 AM

Next on my list are federal/state employees that consider their health insurance a part of their salary

State employees? In this state? That's funny.

As a state employee, I pay $250 a month for family coverage. Individual policies are around $100 a month. Health insurance is not, for us, some freebie that we never think about. Given the fact that State Group Benefits is in a "death spiral" as described by one of their own officials, I'd wager most of us think about it quite a lot.

Fully 1/3 of state employees don't carry any policy from the state, which likely means it costs more than they can/want to pay, or they get better benefits through a spouse. Granted, a few are probably like me--hubby and I both work for the state, and he carries the policy, so I'd show up in that 1/3. However, of the six people who work in my section, 3 are on their spouse's insurance through another employer, because it's better.

Oh, and we also have copayments (of more than $1, even!) for our office visits, so those aren't free either. Last time I went to the opthamologist, I was in line behind about 8 other people. Every single one of them had a lower copayment than mine. So I'd guess every single on of those non-state-employees are more likely to use their insurance frivilously than I am.

2934. Shannon - 4/10/2001 5:41:02 AM

single on=single one

2935. CalGal - 4/10/2001 6:13:01 AM

I am not a burden on the system because my insurance premiums are paid for by myself and my employer and no one else.

JJ, your premiums are far cheaper than they would be normally. Your employer pays one rate for all employees--far more than most would be charged if it was based only on their health. You cost far more than your employers pay in premiums. The insurance company probably takes a loss on people like you, anyway--and make it up by increasing income in other ways.

Paying with what? Their good looks? You are being absurd.


No, they're paying in higher insurance costs, they're paying in higher payments for doctor visits because insurance companies force doctors to accept a ridiculously low price for their covered people and the doctors make up for it by overcharging those not on the policy. Why do insurance companies do their best to stiff the doctor? For many reasons, including employee overuse. But your high costs are certainly part of the reason.

People like me are exactly the issue. We are the ones who use the healthcare system the most and are therefore the most dependent on it.

Sure. And the government could subsidize you--which, as I said, they do now through expenditures (not charging you for the income you get in benefits). But "people like you" are both employed, self-employed, or even unemployed--and often uninsured. It's just a fluke that you're employed.

So you'll still be dependent on the system. You'll just be getting a more direct government handout, rather than deluding yourself into thinking you pay your own way. And coverage for the people who burden the system, like you, will be handled for everyone, not just those who happen to be employed by an employer who provides insurance.

2936. wonkers2 - 4/10/2001 6:13:48 AM

Doctor Ranheim, I can't resist pointing out that many providers also defraud the Medicare system by billing for services never performed.

Are doctors required to treat patients for imaginary illnesses? I wasn't aware that hypochondria was confined to Medicare eligibles. I once had a secretary who spent, it seemed to me, half her life going from doctor to doctor for mostly imaginary minor ailments. She was covered by private health insurance provided by our employer. Do you have any data showing that the problem is greater for people covered by Medicare? Or is it a function of all insurance or just hysteria or whatever the proper term is, regardless of insurance coverage?

2937. CalGal - 4/10/2001 6:19:51 AM

Of course, you do realize that people like you are fired all the time in order to save on insurance costs. I imagine your employment options are fairly limited, since if an employer wasn't providing a ton of other premiums to cover your costs, an insurance company would up the rates considerably--unless they got rid of you.

However, the alternative for people like me is severe illness and possibly death.

No, it just means you won't be able to pretend that you're paying your own way, rather than being an extremely expensive system cost. The alternative would be an acknowledgement that you are expensive and be treated accordingly.

BTW, I just did my taxes and I spent $5000 on uncovered medical expenses. This isn't a complaint. It's just that you threw out that ridiculous $3K out of pocket number like it was some dramatically huge amount. Not at all. People who pay their own way without subsidy regularly pay that much--even when they are healthy.

So your sad tale is nothing of the sort. You burden the system and you aren't paying your way--in fact, you pay a ridiculously low amount. Others are paying it for you. That will always be the case, no matter the system. I just think that everyone with your health problems should be subsidized at true cost, rather than forcing the system to cover you at less than true cost and making up the difference elsewhere (including others who have the same sort of health you do).

Of course, what's really amusing is that you call this solution "free market". Right. It's government mandated coverage, funded by government expenditures, based only on whether or not one is employed--and then only based on what sort of employment one is lucky enough to get.

Definitely a market based solution.

2938. wonkers2 - 4/10/2001 6:26:30 AM

JJ, draconian, not Machiavellian!

2939. CalGal - 4/10/2001 6:41:40 AM

As a state employee, I pay $250 a month for family coverage.

I don't know if Blue Shield makes their premiums available online, but I would wager a reasonable amount of money that their HMO plan costs a lot more than that per month, per family. The rest of it is paid by your employer--my guess is about two thirds of it, but maybe it is only half. If it's less than half, you've got really cheap insurance in LA, which is cool.

I think you know what my point is, but just to be clear--you aren't taxed on the rest of the money your premium costs, and yet that is functionally income, since otherwise you would be paying it yourself.

Suppose you didn't have the policy, and you needed to insure your family. Suppose, for the sake of argument, that the family premium is $600. But you could get four individual policies for major medical and a $2000/deductible for under $200 total.

Which would you take? The HMO would be extremely expensive, but you probably wouldn't have much in the way of other medical costs. The other plan would cover you for hospitalization (100%) but you'd pretty much be paying for all doctor visits out of pocket for everyone.

So unless you are paying $450/month for doctor visits, it's arguable that you'd go with the cheaper insurance, even though it's much less coverage.

Those are the sort of decisions you aren't being forced to make, as an employee. I don't hold with ranheim's notion of "irresponsibility"--it's entirely normal. Employees do think they are paying a fortune in insurance. They're just wrong--they're being protected from a lot of the costs and would almost certainly make different decisions if they had their own policy to buy.

2940. CalGal - 4/10/2001 6:42:13 AM

Wonkers,

Yeah, I knew there was something wrong with that adjective--usage wise, I mean.

2941. JJBiener - 4/10/2001 6:57:37 AM

CalGal - You are still full of shit and I am tired of trying to get some facts through your impenetrable skull. If you want to persist in your delusions, nothing I write is going to make an impact. Frankly, you aren't worth the effort.

2942. JJBiener - 4/10/2001 6:59:23 AM

Wonkers - Machiavellian, as in The Prince. Being willing to do anything for a political cause regardless of who it harms. Her plan is draconian as well, but I prefer Machiavellian.

2943. Shannon - 4/10/2001 7:20:41 AM

The state pays half of our premium. And I fully realize that I have it far better than someone who doesn't have any employer-provided coverage. But since I live in the same state as Ranheim, I had to object to his characterization of state employee insurance as more of a "freebie" than other employer-provided insurance. It's not. The portion of coverage paid by the employer is relatively low, and the copayments are relatively high--and other than labwork, everything has a copayment of some sort with my plan (and I think the others as well).

I'm actually not taxed on any of my premium cost, since we have a cafetria plan. And FWIW, I think that anyone should be able to deduct the full cost of health insurance.

As for whether I'd choose the HMO, I probably would, at least for myself. I've probably had a few months where my costs were at least $300 or so. Given my health, it would be pretty risky to go without.

2944. CalGal - 4/10/2001 7:36:34 AM

Shannon,

The cool thing is that you can mix and match. Family policies are very expensive, individual policies often are where you can get the best price.

I know that you were responding to ranheim; I was just making the larger point.

And FWIW, I think that anyone should be able to deduct the full cost of health insurance.


Sigh. According to my tax software, I can't. I'm not sure that's true, though, so I'm checking. It's astonishing, though, the bias that exists.

2945. arkymalarky - 4/10/2001 11:53:26 PM

"I would wager a reasonable amount of money that their HMO plan costs a lot more than that per month, per family."

Actually, BCBS is cheaper for my daughter if I pay for it independently than if I pay for it through my state-subsidized plan, which is also BCBS.

2946. CalGal - 4/11/2001 12:33:10 AM

As an individual or a family policy? It's often cheaper to get individual policies.

But it sounds like your employer isn't subsidizing you much.

2947. arkymalarky - 4/11/2001 1:37:33 AM

Individual. That's why it's cheaper, because they charge the same family rate whether you have one kid or twenty. The state paid half, but I don't know if it still amounts to that much or not. We have the cafeteria plan like Shannon, so our part is untaxed as long as we participate in the plan.

2948. CalGal - 4/11/2001 3:01:30 AM

Right. Just so's you know, in my post to Shannon I was referring to a family policy.

I think your benefits are untaxed anyway, aren't they? No employee bennies are taxed, so far as I know. Except vacation and sick leave.

What's really odd is that you'd think the government would want to give the self- and un-employed an incentive to provide for their own insurance--like maybe allow them to deduct it?

2949. msgreer - 4/11/2001 5:13:42 PM

Hosptial Bills

According to a study by Modern Maturity and GAO patients will be overcharged to the tune of 10 Billion Dollars for hospital stays.
How to protect yourself:
1. Hospitals give you a summary bill. Ask for an itemized bill. They hate to give it but by law they have to.
2. Obtain a complete medical record of your hospital stay.
3. Rememeber, if your doctor did not order a procedure or a medication and the hospital does it anyway, you are not responsible for that charge.
4. Oftentimes a surgeon will do two procedures at one time. Whether this is in the OR or at your bedside the hospital can only charge for one procedure. This means the person, whether a surgeon or nurse can not charge twice for their time. It is the time not the extra procedure.
5.When you see a charge for "cough support device" check it out. It often means you were given a teddy bear to the cost of $57. This is not a joke.
6. Human Error: if you get an X-ray or MRI someone may not record it accurately. You may end up getting charged twice for the same procedure.
7. Modern Maturity suggests hiring an advocate to help with your bill and deal with the hospital directly. They said most advocates take 50% off the top. Damn, where have I been? I've been dealing with hospital billing personnel for 15 years and never taken 50% of what I saved my clients.
8. Oh, bring your own deoderant to the hospital.
Charge at the hospital for one stick $18.

2950. msgreer - 4/11/2001 5:21:02 PM

As for fraud in the Medicare and Medicaid system.
If you find fraud in the Medicare system and turn it over to the government AND if they investigate and collect, you get 25% of all monies collected.
So ranheim, I set up what I call my 25% account.
Every 25% I have collected for turning in doctors/clinics/hospitals/home health medical aid stores (ie wheel chairs)ARNP's and the likes goes into that fund. I have done very well with the government paying me that 25%.
As for fraud in Medicaid, of course it exists.
But I do not agree with you when you say there is more fraud with the poor folks on Medicaid than the people using Medicare.

2951. msgreer - 4/11/2001 5:31:45 PM

or more poor folks on Medicaid abusing the system.
I think you were saying mothers bring their children in for colds with no fever. I understand. It happens in all offices and ER's. I still go back to my basic feeling: EDUCATION AND PREVENTATION in health care will cut costs for all of us.

2952. MsIvoryTower - 4/12/2001 2:10:20 AM

Just caught a report on some new research indicating that older men who have children are significantly more likely to have children with schizophrenia than younger fathers. Apparently the likelihood of schizophrenia is twice as likely among children conceived by men between 45 and 49 (than among children whose fathers were under 45 when they were conceived), and three times as likely when their fathers are 50 and older.

The study adds to the growing body of research on the relationship between older fathers and genetic defects in children.

The moral of the story for men?

Have your children when you're under 45.

2953. ranheim - 4/12/2001 2:10:32 AM

How does one educate a car full of women and children?
Day 1 : The grocery store
Day 2 : WalMart
Day 3 : The garage - there is always something wrong!
Day 4 : The doctor's office
Day 5 : Just ridin' around
Weekends : The men of the house use the car

This is a routine due to the fact that they are bored out of their minds. Additionaly, they have all they can take of their kid's noise. They feel they have to get out of the house.

So their kids raise Hell in my waiting room. My wife has removed any toy that makes noise. She limits the magazines to National Geographic and The Sporting News. (Otherwise she has to clean up.) It would never occur to one of these mothers to clean up after her children.

In 30 years in one town, I have written registered letters to about a dozen to patients, kicking them OFFICIALLY out of my practice. In the last year, I have heard my wife tell at least that many people "Look at the mess your children made. It would not bother me if you never returned to this office." She is much tougher on patients than am I; but, then, she is the one that takes all the smart mouthing. I very rarely get that; they may really need ME someday.

2954. ranheim - 4/12/2001 2:16:12 AM

I am well aware of doctors cheating on both Medicaide and Medicare. I believe the worst examples occur in the poorer sections of cities where Medicaide Mills are run.

Some of the Mills have had the stupidity to have written instructions. e.g. before the patient sees the doctor he/she must have a blood test; a urinalysis; a chest x-ray. This is such damn foolishness that I did not believe at first. But, it has happened time and again. The few that get caught are usually tapped very heavily with fines and interest; occasional jail sentences; and, in most states, the doctor/s loses his medical license for a time or permanently.

2955. arkymalarky - 4/12/2001 5:18:25 AM

Bob's dad was diagnosed with throat cancer yesterday. He's never smoked or drunk alcohol, so it came as a shock. We thought he had an infection and tonsilitis. Anything anybody knows about that kind of cancer would be helpful. I hate reading that stuff--phobic, I guess--but I did when Dad got bladder cancer and he got a very good prognosis and the cancer hasn't reappeared since they found it two or three years ago. We won't know the extent of Bob's dad's cancer until next Tuesday.

2956. ranheim - 4/12/2001 6:01:58 AM

arky

I am sorry to hear about your father.

Did he dip snuff or chew tobacco?
Was his occupation one in which he could have inhaled toxic compounds?
Extremely spicey foods "seems" - not definitely proven - to be a factor in Orientals and one of the cancers in the mouth; less so in other races.

As I am sure you are already aware, the majority of people with CA of the throat have used tobacco at some time in their lives.

My best wishes to you and your family.

2957. RickNelson - 4/12/2001 6:13:17 AM

Arky,
It's hard to deal with the uncertainty of cancer. My best wishes to your father inlaw and all the family. I found these two links somewhat useful for quickly educating myself about throat cancers. I hope you will want to browse them, or that a Motie might share.

Here is Medifocus which lists some medical journal articles.

Here is Oncology Channel which is monitored by board-certified oncologists.

2958. CalGal - 4/12/2001 6:14:52 AM

Arky,

My best to your father in law and your whole family. I hope it all turns out well.

2959. SnowOwl - 4/12/2001 1:31:04 PM

Arky,

I'm so sorry to hear about your father in law. I hope things go well.

I'm actually away from home staying with my sister at present. She was diagnosed with small cell lung cancer shortly before Christmas. 2 weeks ago she was found unconscious in her car, and in the ambulance on the way to hospital had several seizures. A scan has shown that the cancer has spread to her brain. The prognosis is very poor - the only thing unknown is the time remaining to her. It may be just a few weeks, or it could extend to a few months. Nobody knows.
She is on leave from hospital over Easter and if all goes well she'll be discharged on Tuesday. She begins radiotherapy on Wednesday, just to shrink the tumors and reduce her symptoms. It's shit.

2960. arkymalarky - 4/12/2001 2:12:12 PM

Oh my, Snow. My aunt had the same type of cancer which began in the lungs, but she didn't even know she had it until it was in her brain. I'm so sorry. The only thing I can think to say that might be of help is that treatment (and surgery in her case) did ease her symptoms, especially the headaches, and reduced her pain and discomfort quite a bit. Your family will be in my thoughtss and prayers.

Thank you all so much for the kind words. The links will be very helpful, Rick.

Ran,
Bob's dad has never touched tobacco to my knowledge, but he probably inhaled toxins as a farmer. Thanks for sharing the info on causes.

2961. SnowOwl - 4/12/2001 3:40:59 PM

Thanks Arky. Unfortunately my sister's tumors are inoperable but so far at least she is not in very much pain. In fact, as awful as the whole thing is we are having a lot of fun. It's not often my sisters and I are able to get together and we're spending a lot of time laughing which is going to leave us with a lot of happy memories.
I'm sure we've scandalised the staff and other patients with our raucous carryings on, but we need plenty of laughter as well as tears so their shocked looks don't bother us at all.

2962. msgreer - 4/12/2001 5:17:06 PM

SnowOwl

Oh my. I read your post and tears streamed down my face. You and your family are in my prayers. I recently lost a cousin who eight years ago had a breast removed from cancer. She was fine for eight years. Then all of asudden it showed up in her brain and lungs. I feel at a loss for words...but I'm in here,Snow. msgreer@home.com. If you find yourself up some night and want to talk my pc is always on.

2963. msgreer - 4/12/2001 5:17:45 PM

arky

Check your email. Jennifer and I are off for the day. I'll check Health later tonight.

2964. JJBiener - 4/12/2001 5:22:20 PM

MsGreer - If you are still there, check your email

2965. RickNelson - 4/12/2001 5:36:51 PM

SnowOwl,

It's good news to hear that sisters are being close during the time you describe. Saying what one feels of memories, today and goodbye is a good event for everyone.

Best wishes to you and your family,
Rick

2966. RickNelson - 4/12/2001 5:40:42 PM

msgreer,

My condolences to you and your family for the lose of your cousin.

Best wishes,
Rick

2967. JudithAtHome - 4/12/2001 5:56:35 PM

Gosh, what sad tidings...Arky, Snow Owl, msgreer...so sorry about all the bad things happening to such good people in your families and to all of you, too.

2968. JJBiener - 4/12/2001 5:56:42 PM

Snow and Arky - I can tell you from personal experience that serious illness can either pull a family together or pull it apart. I have seen both happen in my family. When people are emotional and stressed out, they often do and say things they don't really mean. Stay focused on what is important and don't let disagreements or perceived slights get in the way. Give your family members as much slack as you can and forgive them immediately if something they do doesn't sit right. This is a difficult time and it is important to remember what everyone else in the family is going through.

2969. JudithAtHome - 4/12/2001 5:57:40 PM

Amen to what JJ said...

2970. arkymalarky - 4/13/2001 7:13:37 AM

Thanks for all the good words of wisdom. Bob's family is very close, and his siblings have done beautifully with Bob's dad's heart surgeries. And while Bob's parents never had much materially, they've always been rich with friends and family. They're much loved people in this area.

Snow,
I'm glad you're enjoying visiting your sister. My aunt lived over a year after her diagnosis and though she lived several hours away she was able to come visit us and we had several wonderful visits with her at her home in that time.

2971. CalGal - 4/13/2001 8:28:20 PM

Snow,

I'm so sorry. I know you've been worried about your sister's lung cancer for a while now. My best to you both.

2972. thoughtful - 4/14/2001 1:27:38 AM

Oh dear. I'm so sorry to hear all the bad news in the thread today and at the holiday times. My heart and thoughts go out to all of you in your various stages of distress over this horrible disease.

I recall my Dad's battle with cancer and it seems to me the worst was riding that emotional roller coaster...or actually two. One is over the medical condition...sadness and disbelief on diagnosis, hopefulness of treatment, then bad news, then good again and then all that worry and concern as to how it's going to end. Then roller coaster number two is wanting to help the person with cancer, wanting to share good times at the end, but recognizing their need to express their anger, sadness, and fear. Not wanting to waste time with short tempers....and not being able to help oneself with the stress, worry and sleeplessness.

I'm sending my thoughts and best wishes your way that you all my find the strength and energy you need to cope with your current trials.

2973. thoughtful - 4/14/2001 1:30:28 AM

Ranheim....there's one thing I've never understood and perhaps you can shed some light...how does one know when to go to the doctor? Are there reasonable rules of thumb as to how high a fever? How long a fever? Pain severity? Other things. It seems despite all my attempts to be as med-savvy a patient as I can be, I find myself on both ends of the scale -- having drs. say why didn't you come in sooner....and having drs. say give it another few days and it will go away.

2974. Autodaffy - 4/14/2001 8:37:56 AM

I queried my twenty-two month old son's doctor recently on how to view his fevers, which have been high quite often since he went to daycare for half days about eight months ago. She told me that a fever of 102 or 103 didn't spell danger to her if the child was acting close to normal and eating. That fever and abnormal other behaviour would worry her.

I gather that her office staff screens out patients calling for appointments if the fever is less than three days old and the child shows no other negative symptoms.

My son has had two bouts with ear infections that caused spiking high fevers. Otherwise he was fine. Only the duration of the fevers for over the time limit marked him for attention.

2975. SnowOwl - 4/14/2001 9:29:32 AM

Thank you for all the good wishes, I appreciate them very much. We're actually having a lot of fun which surprises me. As I live at the other end of the country from my sisters I wasn't sure what to expect and I had been prepared for a lot of sadness and despair, but instead we're having a really good time together. My #3 son and his girlfriend are over from Australia for the weekend and it's just great to have so many of us together at one time - a rare occurrence in our spread-out family.

Thoughtful,

One of my kids is a doctor. He said he would rather see 1000 patients who have nothing wrong with them than miss one who really does need medical attention. He says you should go to the doctor whenever you are at all concerned about your health.

2976. msgreer - 4/14/2001 4:56:00 PM

I happen to agree with Snow wrt going to one's doctor.

Fevers are not a bad thing. It's the body working to fight off an infection. Having said that, a fever of 102 or above in a child would get me to the doctor immediately. If I couldn't get into see the doc for any reason I would go to the ER.

2977. msgreer - 4/14/2001 5:00:00 PM

Snow

I understand the good time you're having with your sister and family members. I sat with my mother the last four days of her life. She was in her home. We shared stories and secrets for hours at a time. And I mean secrets. It was very hard on me I must admit. But you know what, I have four sisters and none showed during those four days. Of course they knew of mom's condition. So in a way, I felt very lucky. I had four wonderful days with my mother. And I was there to hold her hand when she drifted away.

2978. ranheim - 4/14/2001 6:07:37 PM

#2973 thoughtful

In the Pediatric age group, I have always told young, first time mothers to find a copy of the book by Dr. Spock. I found that he was very good on the routine things that all kids have at one time or another. e.g. rashes; bites; constipation/diarrhea; colds; bruises; fever; etc. I also told them to completely avoid Spock's section on discipline. He was completely wrong so far as I was concerned; and possibly the conduct of the youth of today can, in a small way, be attributed to Spock.

In my office, I try to ferret out the first time mothers. They are like an author facing a blank piece of paper. If I can teach this mother some common sense about the health problems of her child, maybe it will be easier for her future children. I just assume that they know nothing; and try to get as many "old wives' tales" out of their heads as possible.

URI symptoms and fever (add diarrhea) with the concomitant worry about dehydration in hot and sweaty Louisiana seem to be the most common 'phone problems my wife faces in my office. She is a tremendous help to me as she is a very smart woman who has raised three children herself. In general, if my wife feels that the mother cannot be assuaged by advice over the 'phone, she tells the mother to bring the child in. I think that URI symptoms frequently carry with them fevers if 102.5 and I don't worry too much. Again, if the mother is worrying too much, bring the child in.

Men going to a doctor. Forget about it; unless you can put a "Full Nelson" (is that still used in the wrestling ring?) on him and drag him in; let sleeping dogs lie. I have seen more serious fights between husbands and their wives over the subject of seeing a doctor than I care to remember. That scene can become ugly! And quickly!

2979. msgreer - 4/14/2001 6:16:32 PM

ranheim

I know you were kidding when you said where do we educate mothers wrt children's healthcare and when to go to the docs, but WalMart's is a great idea. That's where the moms go with their kids. If we could get public health nurses in WalMarts to answer basic healthcare issues maybe they wouldn't be showing up in your office with a cold, no fever and ripping up all your magazines. Btw, I am curious about one thing. Who the hell do you see that tears up the mags and leaves your office in such a big mess? The peds group my daughter went to had a kid's safe office.
They had Nintendo, kid's books, safe toys. Yes, I know the parent should keep their child under control or atleast clean up any mess but that is not always the reality. Maybe there is something you can do to solve your own problem. Sorry to post and run. Will check in later tonight.

2980. ranheim - 4/14/2001 6:23:35 PM

Continued from #2978

Women, for me, are easiest. Possibly because they are the ones having the babies; the PAP smears and the mammograms; and they are usually the ones who bring in the sick kids. They are less fearful of doctors than a male patient.

By the time an adult woman 'phones a doctor's office, she has usually used her acquired "bag of tricks". In this case, I am quick to tell her to bring the sick kid in (husbands are a seperate problem!).

If she is the patient, at times, we can together solve the problem over the 'phone. But, again, she has usually tried the common sense remedies and she needs to be seen. If not by me, the appropriate Specialist.

I know all of this is very general. However, it has to be. There are law suits out there today. All of us doctors have to have lawyers in the back of our minds when offering 'phone advice. And that situation, which has occurred during my 40 year career, is a pain in the ass!

In 40 years I have found that nothing can substitute for common sense. On the part of the patient as well as the doctor. That is assuming that the doctor knows his limitations. The most impportant single piece of information I can obtain in my office is "this is beyond your competance, Dick; refer!"

2981. ranheim - 4/14/2001 6:26:11 PM

msgreer

Over 1/3 of my Pediatric practice is Welfare.

Enough said! If I say more, I will only anger some of our readers.

2982. PsychProf - 4/14/2001 6:27:45 PM

Ranheim...post away.

2983. msgreer - 4/14/2001 6:45:55 PM

so welfare equals folks with no manners? all welfare mothers are a pain in the ass? if most of your practice is welfare, i suggest you change it or start looking at people as individuals. i am now in my 35th year of nursing. i have met just as many difficult and ill-mannered clients who were with HMO's, PPO's. now i am going to the beach.

2984. msgreer - 4/14/2001 6:48:49 PM

ranheim

I find if I just spend time listening to my client that is worth ten trips to the doctors. Sometimes people can figure out the answers for themselves. They just want the safety their doctor or nurse brings. Bye.

2985. ranheim - 4/14/2001 7:11:10 PM

msgreer

You may have forgotten that friends of mine have told me that my politics are to the right of Ghengis Khan.

It has been my impression after 30 years of living in rural LA that people are on welfare for a reason.

Lack of discipline - in all areas of life - is very high on the list of reasons why.

2986. JudithAtHome - 4/14/2001 7:29:13 PM

Yes, and lack of opportunity and lack of common sense and lack of luck and lack of all sorts of things. I think you have to judge each case on its merits...if someone is on welfare because they have grown up in a welfare family and have learned the idea that having more kids brings more welfare money, then that is lack of discipline. But if someone is on welfare because their husband died and they lost their home and they need a little help til they can get a job, food, housing, etc. arranged and get on their own two feet, then that is not lack of discipline but it is bad luck.

2987. arkymalarky - 4/14/2001 9:32:03 PM

Bob's dad had been feeling bad for a while and thought he had a bad cold. He began spitting up a lot of blood and when he went to the emergency room, the ER dr thought he had tonsilitis because he saw a "clot" on his tonsil. He got on antibiotics and when it didn't get better he went to his GP which is when they looked in his throat and saw the cancer, which is probably what the ER dr saw but couldn't see well because of all the blood. The whole process has been a couple of months worth.

OTOH, when my dad had bladder cancer it was discovered through a routine urine test and the tumor was large when the dr removed it. It's just hard to know when something needs further investigation or when it's just a routine problem, and with a disease like cancer the fear is letting it go too long before realizing that's what you're dealing with. If dad had not been scheduled for tests anyway and had waited until symptoms occurred, etc, the wall of his bladder may already have been penetrated and his prognosis could have been a lot worse.

2988. thoughtful - 4/15/2001 10:16:00 PM

Thanks for the input, but I guess I'm still unsatisfied...and perhaps necessarily.

The incident -- hubby was ill all weekend. He woke up about 3 a.m. on Friday with chills and shakes and cramping in his gut, low down, close to his groin. His fever was about 101. He had little bowel movements but lots of rumbling. No vomiting. By Sat. he was no different. With the holiday weekend on, I figured I'd better get him to the doc while I had a chance. The doc (a rheumatologist) who was covering that looked him over and listened. Did a lot of abdomen pressing which caused pain, especially when he let up. I'm thinking all this time a mild case of diverticulitis and I wanted to get antibiotics. After exam, doc said he probably doesn't have diverticulitis because he'd be a lot sicker if he did. He wouldn't prescribe antibios but suggested a liquid diet and tylenol.

Today hubby is somewhat better -- less cramping and a lower fever...I'm figuring it's due to the liquid diet...and I'm stuck hoping if it is an infection, his body will get rid of it soon. I'm kicking myself for not pushing harder for the antibios. No way am I going to be able to get hubby to see a doc a second time.

It's hard for me to know as I don't know what the basic rules of thumb are for when you should see a doc. And that makes it even harder for me to convince him it's what he should do.

2989. thoughtful - 4/15/2001 10:21:31 PM

I'm not posting this looking for a diagnosis so much as guidance in understanding what are and aren't key signs that say, "get thee to a doctor." Not being exposed to sick people all day it's hard for a lay person to judge how sick "sick" is. Is sick so sick that you can't get out of bed to get to the drs?

Another example was my brother (in his 40s at the time) had the flu and ended up with a very high fever of 104. Is that high enough to warrant a dr. visit even if it is the flu? Or should we not bother unless we see it higher?

Or is the question just too complicated to warrant any specific rules of thumb.

2990. thoughtful - 4/15/2001 10:26:09 PM

Of course, knowing the patient helps. My husband's aunt (in her 70s) once collapsed in my bathroom. She's laying on the floor unable to get up, feels feverish to me, her pulse is racing and I ask if she's ok. She says, "I'm fine."

Needless to say there was no question in my mind on that one and I called the ambulance. Turned out she had a severe blood infection (probably started as a UTI) and ended up in the hospital for several days on IV antibios.

2991. thoughtful - 4/16/2001 12:13:10 AM

We have a book at home from United Health care that is about 1" thick and tries to help you decide what kind of care is warranted. The whole thing is a gigantic flow chart with yes/no questions that either lead you to more questions or a suggested solution. Sometimes the solution is call a physician immediately...other times it's call a physician if symptoms don't clear in x days. The problem is that the symptoms I see are seldom there or listed in a way that I consider helpful. So if that's why it's difficult to come up with rules of thumb, I understand, but am left frustrated.

2992. JJBiener - 4/16/2001 1:48:59 AM

thoughtful - I used to be terrible about calling the doctor when I didn't feel well. Doing this with a chronic illness is incredibly stupid, and it ended up costing me.

I can't give hard and fast rules because I don't think they exist. Is it a pimple or is it skin cancer? Is it a cold or is it bronchitis? It is hard to tell without a proper examination. I think a lot depends on gut feel. Listen to your body. If you aren't sure, be safe. The worst thing that can happen is you will be a few bucks poorer and you will suffer the wrath of CalGal for abusing your medical benefits. Neither one of those is worth taking a risk with your health.

2993. CalGal - 4/16/2001 1:55:47 AM

Oh, please. The fact that the system is flawed does not mean I accuse anyone of abusing the system. I haven't even accused you of anything. You just get unhappy when someone mentions that you're subsidized.

In fact, I have the same issues as thoughtful does. I get very tired of going with a legitimate problems that doctors couldn't help and then being lectured when I don't run to a doctor the minute something little goes wrong--if it's something "little" they can fix. It really wasn't until I started going to acupuncture that I had a health care provider who actually fixed the things that were broke.

2994. ranheim - 4/16/2001 4:09:27 AM

thoughtful

I believe I mentioned above that all bets are off when dealing with men. A very large majority just WILL NOT GO a doctor! I used to think that this was on the "macho business". Some of it is; but, recently, I am beginning to wonder if much of it isn't just plain fear.

An acceptable reason for a male going to the doctor is a fishook stuck in his back; a wrenched knew following a slide into second base; obvious blood pouring out of a wound. There aren't too many 'illnesses' listed above; and that was by purpose. Men always treat an injury in a different manner than an illness.

Most people reading the Mote are intelligent people with at least some common sense. If your illness has gone on for too long + you are beginning to feel uncomfortable about your symptoms, it is, likely, time to go to your doctor. On injuries, I was taught the "72 hour"
rule. Assuming you don't see a ragged end of a bone sticking out through the skin, give your injury 72 hours to heal. Generally speaking, a significnt injury is too swollen in those first hours to allow casting, so if you wait 72 hours you have lost no time that the Orthopedic Surgeon would have had you in a cast. Attempt to reduce swelling with ice and take anti-inflammatories (assuming your stomach can tolerate aspirin).

2995. JJBiener - 4/16/2001 5:36:46 AM

CalGal - The fact that the system is flawed does not mean I accuse anyone of abusing the system.

Really? I could have sworn that you were complaining because people are too eager to use medical benefits and if they suffered the true cost of those services they would use them less. Wasn't that you?

You just get unhappy when someone mentions that you're subsidized.

I just dislike people lying about me like you do. I am not subsidized. It doesn't matter how much you stamp your feet and whine otherwise.

2996. RickNelson - 4/16/2001 6:13:29 AM

thoughtful,

Thanks for sharing your concerns about visiting a doctor. I agree with those who state one of the better ways to make decisions in favor of seeing the doctor is to take an inventory of your body. We know our bodies best, is an ache new, did we bruise so easily before, are we a bit yellow, our urine has been dark for to long, we cannot keep food down, extended high fever, etc.... I've found considering what I feel and what I see as cue to call my clinic's on call nurse. I've found that describing my symptoms of concerns to the nurse helps to work out what I'm feeling or seeing and guide my decision to go further or stop.

I suppose the above could seem patronizing to some who consider this to be obvious common sense, but I'm just sharing my experience. Nothing here to judge, it's my way, that's all there is to that.

I've recently learned what ignoring symptoms can do. The lessons are from two relatives, my sister and my aunt. My sister's kidneys failed two years ago, and it turned out to be Lupis and might have been avoided if she had addressed her many symptoms. She made it via a kidney donated from another sister. My aunt died from her poor health, she had an undiagnosed, benign tumor and developed menengitis. Her brain swelled and coupled with the tumor, the pressure was to great. She avoided the doctor will feeling her flu like symptoms and the menengitis could not have been discovered and given treatment. That would have been her only chance for survival. It's hard to decide when going is just overreacting to symptoms. I've learned that it's not easy, but it's harder on those who suffer through our dieing or extended illness, when I ignore what my body is telling me.

best wishes,
Rick

2997. thoughtful - 4/16/2001 4:01:21 PM

Ranheim & Rick, I agree about listening to what our body is telling us, and I tend to be fairly good at that for myself. However, it's hard to be an objective judge of how/what others, especially loved ones, feel. My husband accuses me of "grilling" him when I try to get him to be specific about his symptoms. It's also hard when, like my husband's aunt, she was always fine -- even with a gaping wound.

In my husband's family there were a few interesting psychological perspectives that kept them from going to the doctors. Some of it was an old country superstitious mentality: If you said it, it would happen. Don't ever mention how well your car is running as it will make it break down. Don't ever admit your not feeling well as it will make you really sick.

Some of it was just plain pig-headedness. My FIL refused to go to a dentist for 20 years. Why? If I go to the dentist, he'll just pull out all of my teeth. He finally went and guess what? He had a bunch of teeth pulled out. Duh.

Some of it was fear for sure which is often masked by a macho veneer. And that doesn't go away until the fear of what ails them surpasses their fear of the doctor...that's when the pain is bad enough or they start bleeding from body orifices.

2998. thoughtful - 4/16/2001 4:04:02 PM

Then again, there were my grandparents for whom any event meant a trip to the doctor. Grandma once thought she was dying as she was bleeding from the mouth...rushed to the ER only to be told it's because she bit her tongue! Then again Grandma made it to 98 and Grandpa to 99.

But some of that was understandable. Grandpa was the youngest of 10 children, and only 3 made it to early childhood, so his mother was overly protective for sure.

2999. RickNelson - 4/16/2001 5:37:25 PM

I see your point thoughtful. Your husband and some of his side have built a virtual wall around the issue of health. Your concern exhibits the love you intend. Grilling your husband might be how he sees it. I've learned that what I had hoped was teaching to my daughter, she took to be putting down and resented me for it. At 16 she's decided that to be told to keep the door shut during winter is a slam to her concept of common sense and good intention. Sharing this about my daughter is my way of getting to the attitudes and other influences upon those we care the most about.

You have already noted that your husband's family includes a superstitous approach to health and material. So, he was raised differently, that's a tough nut to crack. It might involve letting it go, which is mostly what I'm forced to do, unless teenage angst is OK with me.(g) I'm deciding what my important concerns are now, redefining where my boundries are. It's tough, it's letting her go, and I hate it. There, I've found something I hate. Losing my daughter to growing up, or other worries, which I cannot control.

Back to health, I watch her for signs. Coughing, tired a lot, easily grumpy, red faced or jaundiced, overly puffy eyes, aches she complains about, and if she forgets to flush, it's not bad to just look to see that the color is light. She drinks a lot of water(thankfully) for which I think she has had very little teen illness.


If my point is lost, it's to be concerned, but let go. The best I can do is to watch, love and hope. I believe my pushing builds barriers which I might regret later. I handle this mostly through prayer.

Best wishes,
Rick

3000. RickNelson - 4/16/2001 5:44:35 PM

What do I do when I see what I believe to be a health concern and she doesn't bring it up? I ask her how she is, feels or what she might want to talk about, I make it clear I want to listen. If I need to, I will call the nurse and describe the symptoms to get another opinion. I'll take her in for an appointment when she agrees, or I can still push that point and she will likely go. For you I don't know, but I think you could add calling a nurse on call at your clinic. Maybe they have a nurse practioner, which would be even better to get hard facts. That's my angle on this issue. I know that my call shows concern and love, and it might have meaning beyond that.

3001. thoughtful - 4/16/2001 6:23:56 PM

Thanks for the input, Rick. I've been married to my hubby for a long time and have known him and his family all my life. So I'm well aware of what I'm dealing with. However, dealing with a defiant teen -- which is largely a stage of life through which we have all been -- is a bit different from dealing with an adult, a spouse. He trusts my judgment especially in medical areas...but that only makes it worse for me as that means I'm responsible for being right in my judgment. And that's what has led me to the question in the first place.

You only need to face the teen thing for a few years. I can remember how "smart" my parents became when I married and started facing all these adult things that I hadn't faced before. My parents went from being the dumbest to the smartest almost overnight...amazing!

3002. arkymalarky - 4/17/2001 1:19:25 AM

Well, Bob's dad got a very good report. He won't have to have surgery, as this type of cancer is a very non-dangerous type that doesn't spread (sorry about the medical jargon here). He'll have to have chemotherapy, which won't be fun, but he should be fine.

3003. JudithAtHome - 4/17/2001 1:49:10 AM

That is great news, Arky...tell Bob how happy we are for him and for all of you!

3004. arkymalarky - 4/17/2001 1:51:41 AM

Thanks, Judith, I will.

3005. JJBiener - 4/17/2001 2:03:30 AM

Great news, Arky!

3006. arkymalarky - 4/17/2001 2:36:09 AM

Thanks JJ. It makes going into the end of the school year a lot better.

3007. RickNelson - 4/17/2001 5:17:17 AM

That's great arky, glad to hear the good prognosis.

3008. ranheim - 4/17/2001 5:26:21 AM

Do you recall what they named it, arky?
Carcinoma in situ?

3009. arkymalarky - 4/17/2001 5:31:16 AM

Thanks, Rick.

No, Ran, I don't. I'll find out and post it.

3010. CalGal - 4/17/2001 5:34:34 AM

Excellent news, Arky!

3011. labwabbit - 4/17/2001 5:36:19 AM

Less granted...an irony of life that comes when we realize the wisdoms of not doing so.

3012. arkymalarky - 4/17/2001 5:50:04 AM

Thanks, Cal. Bob called his parents this afternoon and he was mowing the lawn.

3013. SnowOwl - 4/17/2001 10:14:37 AM

arky,

That's great news about Bob's father and I'm sure you're all rejoicing. Re the chemo - different people react in different ways, so it may not be as bad as you're expecting. My sister had no problems at all with her chemotherapy and, in fact, continued to work throughout the course of treatments. Others having the same treatment got very sick. On the other hand, she reacted very badly to her first course of radiation and was very sick for a while. She's about to begin more radiation so we're hoping that she has a better reaction to it (it's to her brain this time, not her chest, so we're not really expecting the same sorts of reaction, but we're prepared for a bad couple of weeks).

3014. thoughtful - 4/17/2001 4:03:32 PM

arky, so pleased to hear the news...let's hope there's nothing but good news for him from here on out.

3015. arkymalarky - 4/18/2001 2:22:29 AM

THanks, Thoughtful.

Snow,
Thanks for the info on chemotherapy. It's looking like that's all Bob's dad will have, though when the dr first looked in his throat he acted like surgery, chemo and radiation were all almost certain.

I've been thinking about you and your sister. I hope the radiation helps her without being too uncomfortable.

3016. thoughtful - 4/18/2001 8:29:39 PM

for those facing chemo (I can't remember if it includes radiation or not) I remember from awhile back that some research was being done as to the timing of treatments with a persons circadian rhythm....when timed properly the side effects were minimized. Don't know how rigorously it was studied or if any follow up has been done, but if I were facing it, I'd certainly try to investigate that aspect further. Just thought I'd mention it.

3017. Ronski - 4/19/2001 8:06:20 PM

Should People Sell Their Kidneys?

3018. CalGal - 4/19/2001 9:18:24 PM

No. But I'm not sure why it is that we can only take organs from the dead if they've given permission.

3019. msgreer - 4/19/2001 11:56:32 PM

thoughtful

You are right. People taking chemo need to go by their circadian rhythm. It has to do with sleep if I recall the study correctly. One's sleep pattern is the most important during chemo.

3020. msgreer - 4/20/2001 9:43:38 PM

Many women are afraid of their first mammogram, and even if they have had them before, there is fear. But there is no need to worry. By taking a few minutes each day for a week preceding the exam and doing the following practice exercises, you will be totally prepared for the test, and best of all, you can do these simple practice exercises right in your home.

3021. msgreer - 4/20/2001 9:45:40 PM

Exercise Number 1: Open your refrigerator door and insert one breast between the door and the main box. Have one of your strongest friends slam the door shut as hard as they possible and lean on the door for good measure. Hold that position for five seconds. Repeat in case the first time wasn't effective.

3022. msgreer - 4/20/2001 9:47:59 PM

Exercies 2: Visit your garage at 3am when the temperature of the cement floor is just perfect. Take off all your clothes and lie comfortably on the floor sideways with one breast wedged under the rear tire of the car. Ask a friend to slowly back the car up until your breast is sufficiently
flattened and chilled. Switch sides, and repeat for the other breast.

3023. msgreer - 4/20/2001 9:49:40 PM

Exercise 3: Freeze two metal bookends overnight. Strip to the waist. Invite a stranger into the room. Have the stranger press the bookends against either side of one of your breasts and smash the bookends together as hard as he/she can. Set an appointment with the stranger to meet next year to do it again.

3025. PelleNilsson - 4/20/2001 11:40:51 PM

The three preceding posts are among the most tasteless it has been my misfortune to read.

3026. JJBiener - 4/20/2001 11:44:55 PM

Pelle - And unfortunately they are pretty accurate.

3027. msgreer - 4/21/2001 12:15:00 AM

When was the last time you had a mammogram, Pelle?
This is far from "tasteless". It is the truth with abit of comic relief for those of us who experience this procedure each year.

3028. labwabbit - 4/21/2001 12:39:30 AM

Reason number 5,241 for why I could never be a gynocologist. #5,242 would be I just might get used to doing it.

My methods would be completely too umm...personal shall we say?

3029. CalGal - 4/21/2001 12:40:58 AM

Gynecologists don't do mammograms.

3030. labwabbit - 4/21/2001 12:46:47 AM

..perhaps, but they prescribe them. (Couldn't be a radiologist either smartie pants.)

3031. arkymalarky - 4/21/2001 1:01:15 AM

I've posted this before, but the worst thing about my first mammogram was that the mother of one of my students was the one doing it. Not only that, but I'd had to come down on her little darling pretty hard just the week before. Lucky for me either she didn't know it or she didn't hold me responsible or she just wasn't the vengeful mom type. She's the best, though, and I don't mind them a bit now.

In fact, year before last I got one at the mobile clinic that comes to my old school twice a year to do them and I will never do that again. I'm going where they take care of me--not for pain and discomfort, though it's never bothered me, but with personal attention from the x-ray technician and the radiologist.

It's funny, I had to have mine redone and mag-views taken after the mobile unit because they tagged a couple of spots, and when the radiologist, whom I hadn't yet met, called me back he had several sets of mammograms on the wall, and I just pointed and said, "Those are mine." He explained a lot to me and showed me what they looked for, etc.

3032. PelleNilsson - 4/21/2001 1:14:59 AM

msgreer

When was the last time you had a mammogram, Pelle?

Never as you well know. JJ seems to have more experience.

There is any number of extremely unpleasant medical procedures. I don't see the point of referring to them unless required by the context, much less to add "comic relief".

3033. labwabbit - 4/21/2001 1:32:44 AM

Not fer the constitutionally weak.

Next subject: Vasectomy

3034. JudithAtHome - 4/21/2001 8:05:31 PM

I received a copy of that mammogram post from msgreer via e-mail. I forwarded it to some of the women in my address book. Afterward, I had a moments regret about doing so because you never know what might have happened to that old friend from high school with whom you've been out of touch for a few months...

What I found out this morning after reading her e-mail thanking me for the post and telling me to be sure and get a mammogram annually is that she has breast cancer and it was discovered after her annual mammogram in March. She's scheduled for surgery on Thursday.

She has been my friend since the 10th grade and we've gone through a lot together...and this will be another thing. She has the best sense of humor in the world and that post about mammograms didn't offend her, Pelle...

3035. JJBiener - 4/22/2001 12:33:36 AM

Pelle - JJ seems to have more experience.

No, not experience. Empathy. I can understand that squashing a woman's breast flat can be painful without ever experiencing it. A woman can understand that getting kicked in the balls is painful without ever having balls.

3036. JJBiener - 4/22/2001 12:34:52 AM

Judith - She is lucky to have a friend like you. I am sure you will be there for her through out her ordeal.

3037. JudithAtHome - 4/22/2001 12:43:52 AM

Since I wrote the other post, I've talked to her and the surgery this week will be the second one and it IS malignant...I am so bummed over this.

Thanks, JJ...

3038. msgreer - 4/22/2001 12:45:28 AM

It's not just the pain. It is the fear that goes along with a mammogram. After you have it you are told to wait to make sure the tech got a good reading. Then you wait to hear the results. There are few things more frightening than hearing "we found something suspicious." Breast cancer is a fear for every women. Like arky I have a radiologist who has read my mammograms for the past 20 years. She too spends puts the mammogram up for me as we examine it together. She always pulls the last three mammograms so we can compare them. It adds a feeling of safety in an area of female healthcare which provokes such fear. Cancer is scary enough. But when a woman loses a breast to cancer it is devastating. The images of the "perfect women" slammed in our faces via television, movies, models in magazines and recently on theMote only adds to a sense of insecurity for us. So when men debate breasts, which are real or which are not, all I say is thank God I have two healthy breasts

3039. msgreer - 4/22/2001 12:50:26 AM

Judith

I am sorry your friend is facing breast surgery. I will keep her in my prayers. What a way to connect with an old friend. But atleast you can be there for her. Knowing you I am sure the support you give your friend will be meaningful and helpful. I too wondered about sending it to you and afew other Moties. At first I laughed and said how true. Then I said Judith and the others I sent it to will get it. And as you know, Judith, along with the other Moties I forwarded it to, I left out what I thought was inappropriate for this thread.

I sent it to a woman whose mother died of breast cancer and she thought it was "histerical."

3040. msgreer - 4/22/2001 12:52:19 AM

btw, I made it to my destination on time. All is well here.

3041. JudithAtHome - 4/22/2001 1:13:32 AM

Thanks, msgreer...the women I've heard back from all thought the forwarded message was fine. And they know I rarely, if ever, forward things. Even my friend who has had such bad news appreciated it.

Glad you are doing well...good luck.

3042. msgreer - 4/22/2001 1:25:58 AM

Thanks, Judith.

3043. JJBiener - 4/22/2001 1:29:05 AM

Hi MsGreer. Glad you arrived safe. Check your email later tonight.

3044. thoughtful - 4/23/2001 8:31:05 PM

On breast cancer...

MsG, I'm surprised you posted those "jokes" as I didn't find them particularly funny and I recall quite awhile ago you admonishing someone for posting similar jokes about mammograms as you feared it might discourage women from getting them. Be that as it may...

On today's news they said women who get regular mammograms experience a 60% lower death rate from breast cancer than those who don't.

Also, it is so important not to neglect doing breast self-exams even if you get regular mammos. Why? Because you have breast tissue around the side under the arm pit, in the center between the breasts higher on your chest and deep inside where the machine doesn't go. Also, mammos can be misread as even radiologists are only human, but they will do an extra careful job if you point out an area of concern to them...which you can do if you are doing regular self-exams and find a something suspicious.

I never did them as I didn't know what I was looking for. I discussed my concerns with a nurse who gave me a video and a kit to borrow which not only demonstrated how to do a breast self-exam but which included models for you to practice on that included lumps so you could learn how to find them and what you are supposed to be finding.

Also, to minimize discomfort, make sure you schedule your mammos around your cycle as at different times of the month, your breasts can be painful -- not a good time for a mammo.

3045. thoughtful - 4/23/2001 8:34:10 PM

Interesting article in today's NY Times health section on the benefits of omega-3 fish oil that go far beyond cardiac disease to include depression and Crohn's disease and arthritis.

3046. JudithAtHome - 4/23/2001 8:43:02 PM

We may be losing this thread as it has been suggested it be axed...if so, we can discuss health matters in the Cafe, I guess.

I take both fish oil and flaxseed oil capsules and eat as much fish as I can stand, which is quite a bit.

3047. JJBiener - 4/23/2001 8:55:03 PM

Judith - Who suggested this thread be axed? As a cohost I have not heard any such discussion. MsGreer hasn't mentioned it either. There are always suggestions to get rid of this thread yet it continues to exist. I will vigorously fight any attempt RIP this thread. I think it is an important part of the Mote.

3048. labwabbit - 4/23/2001 8:57:46 PM

Who suggested this thread be axed?

banks..

I will vigorously fight any attempt RIP this thread

Not necessary...wasn't considered seriously.

I think it is an important part of the Mote.

Stays on "intent" more than any other thread...

3049. JJBiener - 4/23/2001 9:02:34 PM

Thanks, Lab.

3050. JudithAtHome - 4/23/2001 9:05:27 PM

JJ:

Sorry to be such an alarmist; it's just that Banks made several suggestions which seemed to be immediately set for implementation and who knows around here what will be done next...first, there are too many threads and next, there will be two more new ones. (I think the Welcome thread is a good idea and have never understood why the push for fewer threads.)

I spoke out of turn...

3051. thoughtful - 4/23/2001 9:35:15 PM

j@h, you take fish oil...but a pretty subjective question is, does it help? I don't take it, but I was thinking of starting after this article.

I used to take lots of vitamins and then I stopped. Now I take them again. The only objective difference I noticed, though, was that after about 6 mos or so of no vitamins, I started getting white spots in my fingernails. I take vitamins (someone once told me the spots were a sign of zinc deficiency) and then the white spots grow out and I don't have them anymore. Other than that, I take them because I know they're supposed to be good for me, but don't really notice any difference.

The things that really seem to make a difference in how I feel are weight loss, exercise and drinking lots of water.

3052. thoughtful - 4/23/2001 9:36:08 PM

...and if banks doesn't like this thread, he doesn't have to visit. For those of us who frequent it, there's no need to get rid of it.

3053. JJBiener - 4/23/2001 9:51:40 PM

Judith - Don't worry. Those of us who value this thread take such threats seriously. If it had come from Wabbit or Ms. No, then it would have been a problem. While some of Banks' suggestions may be implemented, he is not likely to get rid of this thread. The PTBs understand the value this thread provides and the contribution our principle host makes to the Mote as a whole.

Thank you for your interest and your contributions.

3054. JJBiener - 4/23/2001 9:54:59 PM

Thoughtful - I think vitamins and minerals only become an issue if the level in your body falls too low. If your body has an appropriate level, additional vitamins don't really help and some of them can actually be harmful in large doses.

3055. JudithAtHome - 4/23/2001 9:58:56 PM

thoughtful:

I can notice a huge difference in taking and not taking the things I do...for instance, I take a mixture of herbs in a capsule which helps with arthritic pain; if I miss taking it, I hurt more. I take silica and another herb for my hair and nails...I decided to stop taking them for about 2 weeks and my nails started flaking and my hair became less managable and didn't shine the way it usually does.

I feel lethargic if I miss my vitamins...I really do. But I take a humongous amount of them, too.

I agree that weight loss and drinking water is of prime importance; also exercise. I drink tons of water every day and never drink carbonated sodas, which I believe leach calcium out of your body.

3056. thoughtful - 4/24/2001 10:09:01 PM

That's interesting J@H...that you've tried experimenting and have noticed a difference. I'm glad it helps you.

JJ, I agree that if you don't need them, they won't help...the problem is there seems to be a wide discrepancy between the minimum RDA -- which is enough to keep you from getting scurvy and beriberi -- and what a body can use to be at its healthiest.

3057. thoughtful - 4/24/2001 10:10:04 PM

There also seems to be a discrepancy between the benefits from vitamins we get through a healthy diet and those in pill form....it may be the combo of vitamins, enzymes, etc. that do us the most good.

3058. JJBiener - 4/24/2001 10:21:04 PM

Thoughtful - What you say is very true. I used to take vitamins all the time. Lately though I am taking so much medicine, I don't feel like swallowing any more pills. I take a total of 7 different medications, 11 pills every morning. I also take 5 medications, 6 pills every night. Adding vitamins and suppliments to that is just too much for me to swallow. (G)

3059. thoughtful - 4/24/2001 10:37:33 PM

JJ, I love you! Keep up that consumer demand! (I own stock in several drug companies. ;-)

Actually I know what a pain it can be to take all those meds and then have to deal with the side effects and interactions. It's not easy. My thoughts are with you.

By the way, I don't think I ever finished my kidney story, which I think has come to an end. Doc seems to think that the type of kidney inflammation I had was a side effect to the Celebrex I was taking for my aches and pains. Though rare, it has been reported that non-steroidal anti-inflammatories can cause kidney problems. My kidneys and blood work are now thankfully back to normal. Quick return to normal as doc says it can sometimes take up to a year. I attribute it to the sharp thinking of my doctor who took me off the meds as soon as the kidney problem became apparent. Nothing beats a good doc.

3060. JJBiener - 4/24/2001 10:49:13 PM

thoughtful - I love you too, but we better keep it quiet or people will talk.

My pharmacist loves me like you wouldn't believe. Between me and my insurance company, we cover his rent and utilities.

I am thrilled that your kidney condition is better. That was a scary one. I was looking at some of the possibilities, and none of them looked very good. I had never heard of Celebrex having that effect, but NSAIDs can be brutal. SAIDs are even worse, but NSAIDs are no picnic. I am glad your doc figured it out before any permanent damage was done.

3061. thoughtful - 4/24/2001 10:58:36 PM

LOL. You sound like a friend who insists that he paid for his dentist's inground swimming pool and mercedes.

3062. JJBiener - 4/24/2001 11:09:33 PM

Thoughtful - Don't get me started on dentists.

Your friend may have done what he claims, but I pay my tribute to my pharmacist every month. I am not complaining. It beats ending up in the hospital every 2-3 months.

3063. thoughtful - 4/24/2001 11:20:08 PM

Speaking of hospitals and meds...before I went in for my biopsy, I'd read where you should bring your own meds with you. I always thought they wouldn't allow you to take your own meds, but I brought them and took them...and it was a good thing as I was able to take them in a timely fashion and when they brought me meds, I told them I already took my own and they said nothing. What I don't know as I haven't seen a bill given the insurances is whether or not the hospital charged and the insurance co. paid for the meds I didn't take.

3064. JJBiener - 4/24/2001 11:31:13 PM

Thoughtful - In my case anyway, the docs told me specifically not to bring my own meds. But then, I was usually on bowel rest and completely NPO. They gave me all my stuff IV, so my oral meds would no doubt have screwed things up.

3065. thoughtful - 4/24/2001 11:48:04 PM

Of course, I didn't take them without my doc's permission. He asked if I brought my own. I said yes and he said I could take them. He also ordered other meds that I could take like sleeping and pain meds, but I didn't take any. After all, I was there because of a side effect of meds...no wonder I want to avoid them if possible.

3066. ranheim - 4/25/2001 2:33:10 AM

I would imagine that I am well known in this forum as one who is very suspicious of government.

One of the first incidences occurred during med school days. The FDA outlawed Imferon (injectable iron). The Ob-Gyns/Surgery Dept. in general made an aggressive complaint to the FDA. No one could ever be certain whether the FDA read that official complaint - or not.

Later, in England, a study was released - using the same rats or guinea pigs as used in the USA (that resulted in Imferon being banned.) The English study pointed out that the experimental animal was bred genetically to form sarcomas (the tumor that the USA study claimed was caused by Imferon injections.) The English study carried on a second step further : they, simply, used an EMPTY syringe on the animal. Same amount of sarcoma as in the USA study. The third step in England was to use actual Imferon injections. Again, the same % of sarcomas.

The conclusion of the English study was that empty syringe or Imferon filled syringe made no difference. The experimental animals developed the same % of sarcomas. And, as they were bred to form sarcomas, the tumors were genetic in nature.

Again, complaints to the FDA. After a face-saving amount of time, the FDA again released Imferon to be used in the USA. As I recall, there was no announcement by the FDA. One day Imferon was just available again. Magic!

I have never put much stock in anything said by the FDA since.

BTW The FDA knows less about vitamins in the 2000s than they did about Imferon in the 1950s. Don't count on them for any valid information anytime soon.

3067. JudithAtHome - 4/25/2001 3:05:05 AM

A lot of the herbals I take have been used by the Chinese for centuries and by the Germans for maybe not quite as long. But I've read lots of things about these herbs and they seem to work for me. I hear from friends about what a nutcase I am for taking what I do...I may be a nutcase but they are the ones going to the doctor all the time with one illness and another and they are the ones with high cholesterol, not me! And they are the ones complaining of lack of energy and lethargy, not me!

3068. ranheim - 4/25/2001 5:24:59 AM

Judith

I thought you would assume from my #3066 that I have been taking a good look at "Alternative Medicine".

I take at least 25 vitamin/mineral/herb tablets daily. That plus at least 1/2 dozen fiber capsules.

The FDA didn't know their butt from 1st base about Imferon in the 1950s and they know less about vitamin/minerals/herbs in the 2000s. That was my only point. Don't believe what those clowns at FDA say -about anything!

3069. JudithAtHome - 4/25/2001 6:15:50 AM

Ranheim:

I take 12 to 18 fiber tablets a day and think that is part of the reason for my low cholesterol reading...and I think I take twice as many vitamin/mineral/herbs as you. I take them in the morning and at night and can toss down 10 at a whack so it doesn't seem like very many.

I distrust the FDA for reasons too numerous to mention. I really didn't assume you were alluding to anything other than what you said, though...I mentioned the herbs I take because I think the proof is from generations of Chinese, not from the FDA.

3070. JJBiener - 4/25/2001 7:06:29 AM

Judith - I take 12 to 18 fiber tablets a day

No shit? (Perhaps I should rephrase that)(G)

If I took that much fiber, I would be in the hospital.

3071. msgreer - 4/25/2001 1:22:49 PM

thoughtful i don't remember coming down hard on another for a mammogram joke but you know what,it sounds like me. So maybe I have learned something about myself. Perhaps I could check my anger and disgust at our present healthcare system and ligthen up abit. Oh, I will try. So I apologize if my post offended you. One good thing did come from the post, a big discussion on mammograms and breast cancer. Btw, I was delighted to read you are feeling well. Celebrex reaction. I will pass that on to other healthcare professionals I work with.

As for vitamins, herbs and enzymes, I take three enzymes a half hour before each meal. After each meal I take 11 vitamins/herbs. I drink alot of tea all day. But the biggest part of taking care of myself is water water water...which I know I have posted here before. Exercise, meditation and yoga added to a gallon of good drinking water a day gets me going.

3072. msgreer - 4/25/2001 1:34:22 PM

Oh, let me say I eat several small meals throughout the day. I tend to like an early light dinner. I can't stand to go to bed after a big meal. And Judith, my favorite food in the world is salmon. I must eat it four times a week. There is a restaurant within walking distance of where I live that makes this great salmon and spinach dish. I take Essential Oils and Omega after each meal. Sometimes I wonder if I need the Omega everyday considering the amount of salmon and other fish I eat every week. When you come to this side of the Gulf I will treat you to that salmon dish. It will melt in your mouth.

Have a nice day. It is close to 6:30am and I am out of here. Healthcare work, one thing it does do is get you up and out early.

3073. thoughtful - 4/25/2001 3:41:21 PM

msg, if my post gets you to lighten up, I would be most delighted. I don't know how you do what you do every day without a good dose of humor to see you through....as essential to good living in my book as water and nutrition.

Let me recommend if anyone has not seen any of them Loretta LaRoche. She has done a number of very funny videos about using humor to de-stress life. I have a couple at home and enjoy them a lot. She's been on PBS during fund drives too. Learn more at her web site.

3074. Wombat - 4/25/2001 3:53:07 PM

Ranheim:

Yup, the Brits really did a good job on testing the dangers of Thalidomide. And the stupid FDA did not approve it for use as a tranquilizer in the United States. That was incredibly ignorant and shortsighted of them.

It never ceases to amaze me how many people would trust a TV pitchman selling get-better pills over a government agency that is tasked with testing drugs for their safety and effectivness.

3075. Wombat - 4/25/2001 3:59:22 PM

Lest anyone here think that I am the soul of rationality, I had my first dental exam in 15 years (don't ask). To the dentist's amazement, my teeth held up very well (still no cavities), although they are a bit diminished by having all the gunge scraped off of them. She was less impressed with the state of my gums, and I am undergoing "deep cleaning" to try and arrest the periodontal disease that is present.

3076. JudithAtHome - 4/25/2001 5:30:31 PM

The dentists are never impressed with anyones gums...I think they are taught to suggest "deep cleaning" and scraping, scaling and planing on everyone over a certain age in dental college.

The FDA has done some good things but surely you can't deny they have a very close relationship to pharmaceutical companies...they've done some stupid things, too.

3077. JudithAtHome - 4/25/2001 5:32:07 PM

I should have said, "...are taught in dental college to suggest...." rather than the awkward way I phrased it.

3078. ranheim - 4/25/2001 6:04:22 PM

#3074 Wombat

I had a strong suspicion that the thalidomide business would come up. And am happy that it did.

I was in Moscow for 2 1/2 years (as the doctor at our Embassy) - a good bit of that time concomitant with the thalidomide scare.

The physician that I sent patients to in Helsinki for work-ups impossible for me to do in Moscow liked thalidomide as a tranquilizer (not as a sleeping pill). He did not like the way it reacted with alcohol (in his opinion). The fact the Embassy personnel attended great numbers of cocktail parties as a part of their job is the only reason that kept me from using that drug in my practice at the Embassy.

Then the congenital malformations began to be reported and I thanked the Good Lord for my fortunate choice.

NO!! The FDA gets no credit from me in the thalidomide case. It was simply bureaucracy - at its slowest pace - at work. As a drug developed and tested in a foreign country, thalidomide had to receive a permit to be imported and used in the USA. What happened was a typical bureaucratic bushwhacking.

I have forgotten her name, but, some FDA "worker bee" sat on her ass and did nothing in regard the request for importation into the USA. No studies were made; no testing was done. She just sat on the request and did nothing. Then the reports of malformations started coming in and the FDA hailed the thalidomide case as a great victory for the "care" the USA takes in introducing foreign products into this country.

A great public relation coup for the FDA all due to the fact that one of their personnel sat on her ass and did nothing.

3079. JJBiener - 4/25/2001 6:05:26 PM

Wombat, Judith - I have never had a dentist say anything negative about my gums. I have had other problems, but nothing with gums.

3080. JudithAtHome - 4/25/2001 6:08:58 PM

JJ:

You must not be "of a certain age" yet....

3081. JJBiener - 4/25/2001 6:13:05 PM

Judith - Maybe not. I turn 40 this August. As far as I am concerned it is not the age, it's the mileage. Unfortunately the odometer on this body has turned over a couple of times. That makes me much older than me years.

3082. JJBiener - 4/25/2001 6:14:09 PM

uh, the last me should be my. I don't speak with an accent.

3083. JudithAtHome - 4/25/2001 6:16:35 PM

And here I thought you were Irish!

3084. JJBiener - 4/25/2001 6:27:57 PM

Judith - LOL! My wife told me she wants to get me a special t-shirt for St. Pat's day. It would say: What? Me Irish? You've got to be kidding!

3085. Wombat - 4/25/2001 6:41:02 PM

Judith:

The FDA also comes under intense political pressure to approve products that a congressman who has ties to pharmaceutical or alternative medicine companies is pushing. Interesting that when FDA is less than enthusiastic about the product, said congressman starts criticizing the FDA and urging its privatization.

3086. JudithAtHome - 4/25/2001 6:44:17 PM

Very true...it's sort of damned if it does and damned if it doesn't, I guess.

3087. Wombat - 4/25/2001 11:10:20 PM

You are a real piece of work, Ranheim. To go by your description of the Thalidomide, culled no doubt from crackpot web sites, you'd get the impression that the scientist given the Thalidomide folder spent a year or so polishing her fingernails and drinking coffee instead of acting on it.

The scientist had real concerns about some aspects of how the drug worked, and some of its documented side effects, so she held up its approval. During this time studies in Europe began to show a direct link between Thalidomide and birth defects. Was luck involved? Yes. It was lucky that a concerned scientist was not satisfied with the information that was made available about the drug.

If Thalidomide had been approved before its link to birth defects became apparent, no doubt you would deride the FDA for not doing what it was supposed to do.

3088. ranheim - 4/25/2001 11:19:51 PM

The only "crackpot website" that I occasionally read is the Mote.

My information comes more from my Finnish colleage and what he knew from the Finnish authorities. Additional information came from DoD and State Dept. personnel then posted to Moscow. The various agencies of government do talk about each other!

3089. arkymalarky - 4/26/2001 2:20:41 AM

I have always had problems with my gums and Bob, who rarely goes to the dentist and is 8 years older, never does. It's actually somewhat hereditary, according to the dentist. My mother had gum surgery when she was 18, and she still has a mouth full of beautiful teeth.

Which reminds me of how naive Bro can be, because this happened long after he should have known better. We were at my grandmother's house and Bro commented on how pretty, white, and straight her teeth were. Without missing a beat or batting an eye, she said, "That's because I bought mine."

3090. labwabbit - 4/26/2001 2:58:23 AM

Maalox and nosedrops and needles for knitting',
Walkers and handrails and new dental fittin's,
Bundles of magazines tied up with string,
These are a few of my favorite things.

Cadillac's, cataracts, hearing aids, glasses,
Polident, Fixodent, false teeth in glasses,
Pacemakers, golf carts and porches with swings,
These are a few of my favorite things.

When the pipes leak, When the bones creak, When the knees go bad,
Then I remember my favorite things and then I don't feel so bad.

Hot tea and crumpets, and corn pads for bunions,
No spicy hot food or food cooked with onions,
Bathrobes and heating pads and hot meals they bring,
These are a few of my favorite things.

Back pains, confused brains, and no fear of sinnin',
Thin bones and fractures and hair that is thinnin',
And we won't mention our short shrunken frames
When we remember our favorite things.

When the joints ache, when the hips break, when the eyes grow dim,
Then I remember the great life I've had, and then I don't feel so bad.

3092. thoughtful - 4/26/2001 9:25:48 PM

Cute, labw.

If there are any ladies in here, I was just at a meeting with an OB-GYN and complained about the extreme variation in how docs perform breast exams -- you go for an internal and they're all about the same...go for a physical and they're all about the same. Go for a breast exam and you can have anything from barely being touched to being kneaded like bread dough. I mean it's ridiculous....I can't imagine medical practitioners getting away with doing an exam that's so important so carelessly in any other area. The doc admitted that docs may rely more on mammograms than on breast exams and some docs really feel uncomfortable doing the exam. But after talking with him, I don't think I've ever had one done correctly, even though I have had suspicious lumps, questionable mammos and ultrasound exams. No wonder the medical field pushes the importance of self exam...don't expect the docs to get this one right. I was especially convinced after this doc said the majority of cancers occur in the upper outer quadrant and it can be up high enough where a mammo machine doesn't even go.

3093. arkymalarky - 4/27/2001 12:33:06 AM

Another gem from Bro. It's long, but I thought it was hilarious.

"Dosage: Take two tablets every six hours for joint pain.

Side Effects: This drug may cause joint pain, nausea, headaches or shortness
of breath. You may also experience muscle aches, rapid heartbeat, or ringing
in the ears. If you feel faint, call your doctor. Do not consume alcohol
while taking this pill; likewise, avoid red meat, shellfish and vegetables.
Okay foods: flounder. Under no circumstances eat yak. Men can expect painful
urination while sitting, especially if the penis is caught between the
toilet seat and the bowl. Projectile vomiting is common in 30 percent of
users - sorry: 50 percent. If you undergo disorienting nausea accompanied by
migraine with audible raspy breathing, double the dosage. Leg cramps are to
be expected; up to one knee-buckler per day is allowable. Bowel movements
may become frequent, in fact every ten minutes. If bowel movements become
greater than twelve per hour, consult your doctor, or in fact any doctor, or
anyone who will speak to you. You may find yourself becoming lost or vague;
this would be a good time to write a screenplay. Do not pilot a plane,
unless you are in the 10 percent of users who experience "spontaneous test
pilot knowledge." If your hair begins to smell like burning tires, move away
from any buildings or populated areas and apply tincture of iodine to the
head until you no longer hear what could be considered a "countdown."
-cont-

3094. arkymalarky - 4/27/2001 12:34:22 AM

"May
cause stigmata in Mexicans. Do not sit on pointy conical objects. If a
fungus starts to grow between your eyebrows, call the Guinness Book of
Records. Do not operate heavy machinery, especially if you feel qualified
for a desk job; that's good advice anytime. May cause famine and pustules.
There may be a tendency to compulsively repeat the phrase "no can do." This
drug may cause visions of the Virgin Mary to appear in treetops. If this
happens, open a souvenir shop. There may be an overwhelming impulse to shout
out during a Catholic mass, "I'm gonna wop you wid da ugly stick!" You may
feel a powerful sense of impending doom; this is because you are about to
die. Men may experience impotence, but only during intercourse. Otherwise, a
powerful erection will accompany your daily "walking around time." Do not
take this product if you are uneasy with lockjaw. Do not be near a ringing
telephone that works at 900 MHz, or you will be very dead, very fast. We are
assuming you have had chicken pox. You may also experience a growing
dissatisfaction with life, along with a deep sense of melancholy - join the
club! Do not be concerned if you arouse a few ticks from a Geiger counter.
You might want to get a one-month trial subscription to Extreme Fidgeting.
The hook shape of the pill will often cause it to get caught on the larynx.
To remove, jam a finger down your throat while a friend holds your nose to
prevent the pill from lodging in a nasal passage. Then throw yourself
stomach-first on the back portion of a chair. The expulsion of air should
eject the pill out of the mouth, unless it goes into a sinus cavity or the
brain. WARNING: This drug may shorten your intestines by twenty-one feet.

3095. arkymalarky - 4/27/2001 12:35:33 AM

"Has been known to cause birth defects in the user retroactively. Passing in
front of a TV may cause the screen to moire. While taking this drug, you may
want to wear something lucky. Women often feel a loss of libido, including a
two-octave lowering of the voice, an increase in ankle hair, and perhaps the
lowering of a testicle. If this happens, women should write a detailed
description of their last three sexual encounters and mail it to me, Bob,
trailer 6, Fancyland Trailer Park, Encino, CA. Or e-mail me at "hot-guy.com"
Discontinue use immediately if you feel your teeth are receiving radio
broadcasts. You may experience "lumpy back" syndrome, but we are actively
seeking a cure. Bloated fingertips on the heart-side hand are common. Be
sure to allow plenty of "quiet time" in order to retrain the eye to move off
stationary objects. Flotation devices at sea will become pointless, as the
user of this drug will develop a stone-like body density; therefore, if
thrown overboard, contact your doctor. This product may contain one or more
of the following: bungee cord, plankton, rubber, crack cocaine, pork
bladders, aromatic oils, gum Arabic - pardon me, an Arab's gums - gunpowder,
corn husk, glue, bee pollen, English muffins, poached eggs, ham, hollandaise
sauce, and crushed saxophone reeds. Sensation of levitation are illusory, as
is the feeling of a "phantom third arm." User may experience certain
inversions of language: Acceptable: "Hi, are how you?" Unacceptable: "The
rain in Sprain slays blainly on the phsssst."

3096. ranheim - 4/27/2001 12:35:45 AM

That is to be expected, thoughtful.

One chest x-ray - by itself; one ECG - by itsef is not too useful. Unless there is an obvious problem.

It is when one can COMPARE this year's chest x-ray (or ECG) with a previous test that much more can be determined. And, in each case, one has a hard copy of the older test in hand for the comparison.

A doctor doing multiple breast exams has only his notes - no original test record - to rely upon. Makes it very difficult.

In self-exams, I suggest to the patient that she mentally divide the breast into 1/4ths. Start at the areola and examine each 1/4. I suggest that the quarter of the breast leading toward the axilla be left for last. The exam being done in the shower/tub with both the fingers and the breasts being soapy. In the standing/sitting position, the area immediately under the areola is also examined. The exam being done at the same time each month. Don't use medical terminology! Use your own. e.g. "I have a pea sized, non-tender lump in the upper/inner quadrant of the right breast which is moveable. I think that it the same size as at exam time last month. There have been no unusual discharges coming from the nipple of this breast." If the patient doesn't keep some sort of diary, it has been my experience that she doesn't remember what she found previously either.

3097. arkymalarky - 4/27/2001 12:35:58 AM

concl-
"Twenty minutes after taking
the pills, you will experience an insatiable craving to take another dose.
AVOID THIS WITH ALL YOUR POWER. It is advisable to have a friend handcuff
you to a large kitchen appliance, ESPECIALLY ONE THAT WILL NOT FIT THROUGH
THE DOORWAY TO WHERE THE PILLS ARE. You should also be out of reach of any
weaponlike utensil with which you could threaten friends or family, who
should also be briefed to not give you the pills, no matter how much you
sweet-talk them. Notice: This drug is legal in the United States only when
the user is straddling a state line."

3098. arkymalarky - 4/27/2001 12:36:29 AM

Sorry about the margins.

3099. labwabbit - 4/27/2001 12:43:08 AM

I really get a kick from these pharmaceutical commercials on TV that go something like that.
What is wrong with these people.
Yes you can be free of hot flashes by taking Procozepnak.
Warning: May cause pain, headaches, dizzyness, make sure your kidneys work, your liver may turn green. Been known to cause blackouts and depression. Do not take anything into your body without checking with your doc. In large doses has been known to cause rapid collapse of third-world economies.

Keeeey-Rice...
Hot flashes seem so much better...thank you.

3100. JJBiener - 4/27/2001 12:50:20 AM

Arky - That is funny. The one that gets me is the commercial for the pill that promotes hair growth, propecia. It says it may have some sexual side effects. A man would have to be incredibly vain to risk sexual side effects for a little hair.

3101. ranheim - 4/27/2001 12:55:11 AM

JJ

Have you seen the sales figures for a year after Rogaine went "over-the-counter"? HUGE!!

3102. labwabbit - 4/27/2001 1:00:11 AM

Sad it is...

...and the etical decline continues.

3103. labwabbit - 4/27/2001 1:00:30 AM

"ethical"

3104. labwabbit - 4/27/2001 1:12:39 AM

Arky

"Been known to cause birth defects retroactively..." is a gem.

It's good to know that the absurdity of it all is starting to hit home. Hopefully more so, for those who are suffering from nothing more than a getting up on the wrong side of the bed syndrome and think it's an ailment for which a little magical, happy-pill can make life so much more painless.

Funny piece anyway.

3105. arkymalarky - 4/28/2001 6:19:12 AM

Glad you all enjoyed it. It really cracked me up, and now I know why. I just talked to Dad and he said it came from the New Yorker, and was written by Steve Martin.

3106. wonkers2 - 4/28/2001 6:47:04 AM

I'm sending it to a relative who is a research director at a big "ethical" drug company.

3107. mgleason - 4/29/2001 2:38:53 AM

An interesting site: Quackwatch.

3108. JudithAtHome - 4/29/2001 5:27:12 PM

Someone sent this to me after a discussion on another site about the FDA:

I was told by an FDA press spokeswoman that all they do is check the research of the very drug companies seeking approval.

If I have tested a new drug and want to sell it, all I have to do is submit my research.

The FDA does require proper clinical test procedures, but the potential for abuse due to coinflict of interest is kind of scary to me.

3109. JudithAtHome - 4/29/2001 5:30:06 PM

I think we've been led to believe that the FDA runs massive amounts of independent tests to challenge the research done by the drug companies, right? So, do they or do they simply accept the results they're given by the people who stand to make the most from the product?

If so, that's a rather cozy arrangement...

3110. JudithAtHome - 4/29/2001 5:32:21 PM

Not to mention the government underwrites the cost of most of the research done by the drug companies...they make it sound as though they bear the brunt of all the cost but that's not so.

3111. JJBiener - 4/29/2001 6:34:52 PM

Judith - There is some room for abuse, but I don't think it is as lax as you might think. Drug companies have to be very careful with their research. If they screw up, the consequences are massive. The research also has incorporated a series of checks and balances which make it more difficult to fake the results. It still happens, just not very often.

BTW, while the government does provide a significant amount of funding for research, private companies outspend the government by about 10 to 1. Those were the last figures I remember seeing. Also most government funding is to universities rather than to drug companies. Drug companies benefit certainly, but they don't usually get the direct funding.

3112. thoughtful - 4/29/2001 6:56:17 PM

ranheim...then it begs the question as to why physicians do it at all.

3113. JudithAtHome - 4/29/2001 8:06:26 PM

Don't know if this belongs here or in Social Issues but since it concerns a pseudo-medical problem, or one that could develop into one, here it is:

Orthorexia Nervosa

Brown rice and purified water don't sound harmful, but for many people, healthful food can become a dangerous obsession.

My cousin has this, among other obsessive/compulsive traits. She has become quite the bore at family gatherings lecturing all of us on the evils of what we are eating while she nibbles her soy cheese and rice cakes.

3114. labwabbit - 4/29/2001 8:15:45 PM

but for many people, healthful food can become a dangerous obsession.

So can clean air, pure water, and clean sheets. If we're not careful we may demand nothing less than 100% all beef patties.

3115. JudithAtHome - 4/29/2001 8:18:44 PM

I don't care about the beef patties but I want my clean sheets, dammit!

3116. labwabbit - 4/29/2001 8:21:36 PM

but I want my clean sheets, dammit!

Messin' em up is more fun.

3117. ranheim - 4/29/2001 8:50:45 PM

# 3112

I am not sure that I am on the same page as you are, thoughtful.

Are you wondering how I (and other MDs) decide to use a new drug?

3118. labwabbit - 4/29/2001 8:53:06 PM

Payment.

3119. ranheim - 4/29/2001 9:14:34 PM

labwabbit

Don't you live in Alaska?

If that is how pharmaceutical companies induce Alaskan physcians to use a new drug, it is certainly different from what I have experienced in rural Louisiana.

When drug salesmen call on my office, I typically receive a few samples of some of that company's most recent drugs. My wife gets a few sticky pads and a few ball point pens. That it.

If that is what you mean by payment, you are correct.

3120. JudithAtHome - 4/29/2001 9:16:31 PM

Love those sticky pads!

3121. labwabbit - 4/29/2001 10:02:50 PM

Love those sticky pads!
Portable memory...


Ranheim
Whatever the payment...although I am very aware of the market leverage.

Doctor's get all levels of, I'll use the term benfit as it is most encompassing, as they become participants in "field research" as opposed to controlled studies performed by the FDA. I have a few good friends who are physicians of varying disciplines. A lot of pressure out there my man and don't you believe for a second that this is not true.

3122. labwabbit - 4/29/2001 10:07:11 PM

and PS Ranheim...

That is not unique to Alaska if that is your implication sir.
What long term rehabilitation efforts are preferred over the instant gratification and benefit of a magical potion?

3123. ranheim - 4/29/2001 10:48:07 PM

Do you mean that I have been too honest throughout my career? At 65 I am too old to change.

I use what I think are the best modalities for the disease that I am treating. If that is AA, that is what I suggest.

Rehab programs are too frequently run by sham operators. I have not used Valium in 15 years; but, a small dose a Valium would be greatly preferable to most of the rehab programs that have been available in my area over the past 30 years.

American medicine, as practiced by the establishment, is lousy for far too many chronic diseases. We, seemingly, have not progressed with arthritis or cancer since I graduated from med school in 1961. No one will ever make me believe that By-Pass surgery is the answer for serious cardiac disease. Something HAS to be discovered to better treat that entity.

I may be in the minority; but, I try to do my job as simply and as honestly as I can. Money always enters the equation! Just this morning, one of my patients showed me an Rx for Pepcid. $140 for a month's supply; which she could not afford. I gave her an Rx for Levsin; probably under $25. We are just going have to wait to see how it works.

Not all of us are in the business of making paupers out of our patients.

I remember too well a lecture we had at Baylor at the beginning of my junior year there. The professor was an elderly Urologist. He said -and this is close to word for word :
"Please remember this!
1)97% of the patients that walk into your office are well. Please don't kill them with un-need therapies.

3124. ranheim - 4/29/2001 10:58:21 PM

cont. from #3123 I pushed a wrong key!

2) 2 1/2 - 3% of your patients will die. And there is absolutely nothing you can do about it.
3) The other 2 - 2 1/2 patients are the ones you can help.

Your parents; contributors to Baylor; and the State of Texas are spending a large amount of money trying to train each of you to find this small % of patients that you will see. The above people are counting on you. You will serve them best by being observant and listening to the patient talk.

I have tried my entire professional life to live up to this professor's standards.

3125. JJBiener - 4/29/2001 10:58:42 PM

ranheim - The trick is recognizing the other 3% and treating them appropriately. If you automatically assume any given patient is in the 97%, some of your patients will suffer needlessly.

3126. marjoribanks - 4/29/2001 11:01:06 PM

Ranheim,

It's relatively difficult, nowadays, to find a doctor with common sense. Congratulations on being one.

3127. ranheim - 4/29/2001 11:01:50 PM

The % don't add up correctly, I know. But, that is how I recalled his lecture.

3128. Ronski - 4/29/2001 11:49:09 PM

ranheim,

Is levsin often prescribed for GERD?

3129. ranheim - 4/30/2001 12:10:00 AM

Ronski

Not under usual circumstances.

The new proton pump inhibitors are first choice : Prilosec and Prevacid to date. My understanding is that either of these two is approximately $130 - 150 monthly; depending on your drug store.

Levsin is a very old product. In its drop form, it can be used for colic in a baby. It was one of the few drugs we had for ulcer disease prior to the advent of Tagamet. It does not decrease the amount of stomach acid as much as Tagamet, etc. do.

Again, as in the patient I mentioned above, I can see no reason not to give it a try it if a patient cannot afford the more expensive, preferred product.

If you have GERD, have you been advised to elevate the head of your bed? A cement block under each leg at the head of the bed is close to the heighth (8 inches) that is commonly recommended.

3130. Ronski - 4/30/2001 1:21:10 PM

ranheim,

Many thanks for the explanation and the advice. I have been taking Prilosec, which, fortunately, costs a fraction of the price you mentioned owing to a good health plan. It is a terrible shame that the market is so distorted (through so many people's good intentions) that your patient, who apparently has no such plan, has to pay through the nose or go without the preferred treatment. I hope her condition improves. She certainly has a fine, caring physician in you.

3131. msgreer - 4/30/2001 1:59:53 PM

In the doctor's office I am now reorganizing, pharmaceutical companies cater lunch everyday. And it's not Burger King, folks. Each day a different company brings in enough good food for 25 people.
The rub is the phar. rep. gets to talk your ear off about his/her lastest product and why his/hers is better than the one you dined with the day before. Pens, sticky pads of course. Tickets to Busch Gardens, Disney, movie tickets, special day trips for doctors and their families. And now the nurses. Get to the nurse that works for the doctor seems to be the new trend. This particular office is stocked to the gills with med samples.
And if a doctor tells the rep he/she is using their particular med all the rep has to do is go into his/her computerto verify. They have it down to a science now. The phar. reps working with local pharmacies all over the country can now tell which doctor is writing a script for which medication. Big Brother is everywhere. If pharmacies are willing to help phar. reps this way one can only image how well they know which medications we are taking...

3132. msgreer - 4/30/2001 2:24:25 PM

In this month's Nutrition Action

Glucosamine and Arthritis

In a study of more than 200 people with arthritis of the knee, those who were given glucosamine sulfate (1,500 mg. a day) for three years showed no further degeneration, while those who took a placebo did. The glucosamine-takers' symptoms improved, while the placebo-takers symptoms worsened slightly. Glucosamine, which is found in the cartilage in knees and other joints, had not apparent side effects.

Nutrition Action says if you have arthritis, try taking 1,500 mg. a day to see if your symptoms improve. A glucosamine-chondroitin supplement may work better, but lab analyses have shown that the chondroitin is more likely to be poorly made.

3133. msgreer - 4/30/2001 2:27:32 PM

cont. NIH is launching a study to see if glucosamine plus chondroitin works better than either alone. If you're interested in participating, call 1-800-581-8300 or email daniel.clegg@hsc.utah.edu. The study is using Cosamin (manufactured by Nutramax of Baltimore), which is one of the better-made supplements.

3134. thoughtful - 4/30/2001 4:07:49 PM

Sorry to be confusing Ranheim....my remark about why bother had to do with drs performing breast exams.

Msg. I have read that in those prone to it, glucosamine can trigger adult-onset diabetes and it was recommended that if you are taking it and are at risk that you have your blood sugar checked regularly.

3135. Ronski - 4/30/2001 4:31:26 PM

Now that is interesting. I have read that glucosamine cannot trigger Type 2 diabetes because the molecules are too large or something.

I will have to look into this further.

I do know from personal experience (mine, my mother's) that the stuff tends to work wonders with early or advanced arthritis in some people. Jane Brody in the New York Times had a column a while back estimating that about two thirds of the people who try benefit from it.

I've talked to a several people my age on ski lifts about the stuff. One thing is clear, many people do not benefit from it because they take too little for their size, or they do not stick with it. It clearly takes several weeks or months before you feel the effects.

3136. Ronski - 4/30/2001 4:43:32 PM

Glucosamine and Diabetes: One Early Study

3137. ranheim - 4/30/2001 8:07:15 PM

Glucosamine and chondroitin don't work for everyone.

My advice on medications (such as these two) that have not been studied or on the market for some time is "start low - go slow".

Both my wife and I have tried it. In both cases, dose was Glucosamine 1.5 grams and Chondroitin 1.2 grams. It, almost immediately, made all of my wife's joints more painful than they already were. It made my fingernails so brittle that I was breaking one a day.

Both of us have discontinued use of these products. However, I have approximately a dozen patients who swear by this combination.

3138. ranheim - 4/30/2001 8:10:58 PM

#3134 thoughtful

There are people called lawyers out there.

If you can talk to your Ob-Gyn, I bet he'll agree with me : One is taught in med school that this one portion of an adult female's yearly exam + the fear that if one " doesn't fill in this blank" there could be trouble at a later date.

3139. christipeters - 4/30/2001 8:25:07 PM

After hearing how it helped Judith, I hopefully tried glucosamine/chondroitin. Unfortunately, it upset my stomach. So I'll never know if it would have helped.

3140. thoughtful - 4/30/2001 9:29:21 PM

Ranheim, re breast exam, I guess my point is that if it's done so poorly and a doc misses an obvious cancer, can't s/he be in just as much trouble? Like not looking for the peau d'orange which I understand occurs in more advanced cancers. I dunno. I just wish they would own up to the fact that they can't compete with either the self exam or the mammo, do what they can to teach patients to do self exams, check out anything if the patient points it out and then if they want to do an exam, look in the areas the mammo doesn't get to like on the chest up to the collar bone, under the arm pit, and between the breasts and ask if she's noticed any discharges or unevenness. That's all I'm saying.

3141. thoughtful - 4/30/2001 9:30:17 PM

I don't remember if I posted this, but I was surprised to read the ginko works as a blood thinner and if you are having surgery of any kind, just as they recommend not taking any aspirin, you shouldn't take any ginko either...or at least be sure to let the doc know you are taking it.

3142. msgreer - 5/2/2001 2:46:06 AM

JJ Still at the hospital. I am fighting to allow my client to die with dignity. What a battle I am having..and he has a Living Will. For anyone who has a living will, make sure there are no loopholes. Make sure all your doctors, your attorney, your spouse, children, sisters, brothers and good friends know your wishes. Make sure they have copies of your living will and if called upon will tell any healthcare professional, yes, I knew my friend to want this or that.

After today, JJ, this hospital wouldn't touch me if I was dying my way..of course I wouldn't be dying in a hospital if I could do it my way.

3143. JJBiener - 5/2/2001 5:52:27 AM

MsGreer - Fortunately you aren't dying any time soon. There will be plenty of time to worry about that when the time comes. In the mean time, don't forget to take care MsGreer.

3144. Shannon - 5/2/2001 6:39:20 AM

We had our annual pre-open-enrollment meetings today. No major changes in my insurance, and hopefully not even a rate increase to speak of, as the state will hopefully absorb it for this year.

The most notable change is that our prescription coverage will go to 50% as opposed to a 3-tiered copay system. At this point, I don't know if this will be good or bad for me. None of the drugstores here put a retail price on the receipt anywhere. That's always annoyed me some, just because I like to have a general idea of what I'm getting for my insurance money. I'll try to remember to ask next time I get refills.

3145. ranheim - 5/2/2001 4:55:16 PM

Shannon

In Central LA, all I have been hearing from State Group enrollees is that prescription benefits have been reduced.

One formerly was able to obtain a 3 month supply of Rx for medication used in chronic conditions (e.g. diabetes). A co-pay was involved. Now one can obtain only a 1 month supply for roughly the same co-pay.

And that is a fairly large change. Some of the newer high blood pressure medication; diabetes medication; and arthritis medication; etc. run about $2 a day (or more). Medicine, this expensive I am told, has a fairly high co-pay (some tell me $25). Now one will have 3 co-pays in 3 months where formerly you had only 1 co-pay.

As I am not personally involved, this information is all coming second hand from the teachers that consult me. And they are not happy campers!

3146. Shannon - 5/2/2001 5:07:45 PM

Ranheim,

Yes, lots of people are upset about the loss of the 90-day supply option. I'm actually with Ochsner, not State Group's plan. I think the prescription plans are quite similar, though (but we never had the 90-day option). Our current copays are either $6, $10, or $20, depending on the meds. SG has a 3-tiered system now, but the exact amounts might differ slightly.

I consider myself very lucky that I've responded well to old (therefore cheap) meds for my arthritis. I looked up the prices on drugstore.com, and based on their prices, I'll be paying a bit more than the $6 I now pay. But that's far better than the prices of a lot of new things. There is a $50 cap on the copay, so if you have something really expensive, you'll be helped there.

Not many happy campers in these parts either.

3147. ranheim - 5/2/2001 8:06:13 PM

I have never understood the vaious "Prescription Services Plans" - by whatever their names go. It is obvious to me that they HAVE TO lose money.

Following his retirement from teaching, my father and mother retired to the Denver area. He was 67 at the time. Over the next 10 years, various ailments common to aging began to appear in both my mother and he.

One day Dad realized that they lived in Denver; my bother and sister were in Minneapolis and I was in rural LA! They moved back to Minnesota.

They joined the HMO that was in place at my brother's clinic (he is a Cardiologist). When they returned to MN, each was taking 5 or 6 different Rx. The cost per month for the two of them was nearly $200. After joining the HMO, each Rx cost them $4 (this was in the late 70s)for each Rx.

Now look at the math. Assume 6 Rx each @ $4. That is $48 per month. They were paying almost $200 in Denver. Who picked up this difference? How can they make a profit when such a situation was the standard of that HMO. They HAD to be losing money on this!

As a solo GP in a rural setting, I know nothing (fortunately) about HMOs. I have no (zero) HMO patients. Those of you that understand the financial aspects of HMOs please explain to me how these Rx plans can work.

3148. Ronski - 5/2/2001 8:12:45 PM

I don't know too much about this so please feel free to correct me, but HMOs negotiate with drug companies (and providers, i.e., hospitals) for lower costs. Money is made on volume and on the predictability of a certain cash flow. This raises the price of drugs (and hospitalization) for people who are not in plans, however. Medicare and medicaid produce similar distortions in the marketplace, no doubt.

3149. Ronski - 5/2/2001 9:48:09 PM

It's Alive, It's Alive, It's Alive...

3150. CalGal - 5/2/2001 10:46:37 PM

Ronski,

Yes, that's true. It's not only HMOs, it's PPOs as well.

3151. ranheim - 5/3/2001 1:27:59 AM

So you are saying that drug stores in Denver were making a profit of approximately $150 monthly on my parents. And that $150 could be made up by mass purchasing by an HMO + "direct deals" with pharmaceutical companies.

That does seem a little bit beyond the HMO's powers to me.

But, all my input from patients about their HMOs is negative. And of course it would be negative. Else they would be going to their HMO doctor/s.

3152. wonkers2 - 5/5/2001 7:29:26 AM

Could part of the difference be attributable to switching to generic drugs? Don't some HMOs insist on generic drugs when they are available?

3153. ranheim - 5/5/2001 5:42:54 PM

I doubt it.

Remember this was in the '70s. There were some generics around at the time. But, not nearly to the extent that they are available today.

I don't belong to a HMO should should really comment for I have no personal knowlege. From what I read, most HMOs have a formulary of approved drugs. Should a physician wish to use a medication not listed in the formulary, he/she has to jump throught a bunch of hoops.

3154. msgreer - 5/5/2001 10:02:53 PM

wonkers

Yes, HMO policy is generic when possible. One one a doctor can get around a generic is to write on the prescription Brand Only followed by Medically Necessary. My daughter's neurologist does this for her seizure medication. When she started on Tegretol and Klonopin they were brand and their patent was in place. After 20 years other pharmaceuticals started to make generic Tegretol and Klonopin. Luckily he was wise enough to know the composition of generic Tegretol and Klonopin were not the same as the brand. Thus he would write Brand Only, Medically Necessary. Having said that a pharmacy in MA. where she lives sent the generics once. My daughter called me one early morning to say I am not taking my Tegretol. It is not the right Tegretol. I said fine, I will look into it today and call you later. She was right and the staff was wrong. It hasn't happen since.

Many cardiac meds, generic cardiac meds,are not the same as the brand. It's not only the composition but when it says 0.125 mg. it is not necessarily that strength.

3155. msgreer - 5/5/2001 10:14:09 PM

Ronski

About hospitals and HMO working together re medications. You are correct. Hospitals are making deals with HMO's. HMO's are giving lists of medications they approve to a hospital. Then they give another list of drugs which should a doctor order...they say yes, but this med we are giving to you can be substituted for that drug. I had an elderly client in the hospital. He order Ambien for sleep. Appropriate considering this women was in her 80's. Later that day I sat down to read her chart, checking the orders and med sheet. The first med I saw was Halcion..to be taken for sleep..
First, the doctor did not order Halcion. Any doctor in their right mind wouldn't give a older person Halcion unless they got their kicks watching someone hallucinate. I called the doc and asked why do you think this is happening? He really did not know. I said it is the Committe downstairs in the hospital. And I explained this how this hospital is in bed with HMO's and pharmecutical companies.He was outraged. He came over to the hospital spitting bullets. First he wanted to know how I knew and he didn't. I said that is not the issue. Now you know. Please do something about it so your client and mine gets the medication you ordered. He took alot of heat from the Committee but he did get the medication straightened out.

This happens everyday in every hospital in every state. One would hope the nurse caring for you in the hospital setting would advocate for you...and if she/he could not for whatever reason, atleast call your doctor.At the very least talk to you. Let you know your doctor ordered medication A but the hospital feels medication B is just as good. This way you can talk to your doctor and the two of you can make an informed decision.

3156. msgreer - 5/5/2001 10:18:03 PM

I remember when Valium was the medication du jour.
One doctor in Miami was so in bed with Roche he had prescription pads with Valium 5 mg and Valium 10 mg. already printed on the pads. All that doctor did was sign his name and write how the Valium should be taken. He kept those pads when he finished using them. I always felt he was sending them in toward frequent flyer miles or some junket the phar. are famous for.

Now, there are "safe" precription pads for doctors who want them.
Hopefully it will help the pharmacist know a real prescription from a conterfeit one.

3157. CalGal - 5/6/2001 2:09:51 AM

The Nun Study--Time cover story.

Great stuff. I confess I found that bottle of folic acid my mother gave me once and took a couple.

3158. JudithAtHome - 5/6/2001 2:22:02 AM

msgreer:

Thanks for the chocolate cake...it was delicious!

3159. Shannon - 5/6/2001 3:06:05 AM

My HMO will let me get brand instead of generic, but my copay is higher. For my eye drops, generics don't work. I have a $20 copay, whereas I'd pay $6 for generic. I've never had a problem from the HMO, although the pharmacy has screwed up and given me generics a couple of times.

3160. msgreer - 5/6/2001 1:50:28 PM

Judith

You're Welcome.

3161. JJBiener - 5/6/2001 11:07:29 PM

I would like to wish our nurse-in-residence, MsGreer, a very happy Nurses Day.

3162. thoughtful - 5/6/2001 11:20:51 PM

I have lots of meds left over from stopped Rxs or whatever, and I wish there was some way I could donate them to the needy. I know it's not possible since they are controlled substances and there's no way to do quality control....but still, with the price of Rxs, I hate dumping those expensive little pills out.

3163. thoughtful - 5/6/2001 11:21:56 PM

Happy nurses day, MsG! Does this mean you get to stick a thermometer in someone? :-)

There are many days at work when I wished I could stick it to someone!

3164. msgreer - 5/7/2001 2:04:35 AM

thoughtful

Right now I'd like to stick it to the doctor I am working with. Ask you doctor about the narcotics you have. Or call the Red Cross. I hate to see medication get thrown out. Over the years of nursing I have gotten alot of help from the Red Cross. There should be someway to contribute those meds to another.

3165. JudithAtHome - 5/7/2001 2:12:03 AM

Happy Day, Msgreer!!

3166. msgreer - 5/7/2001 2:13:07 AM

And thanks for recognition re Nurse's Day..actually it goes on for a week.

Thoughtful

Is there a HIV clinic in your
location? You could check with them re your extra narcotics.

3167. msgreer - 5/7/2001 2:14:12 AM

Judith

Thanks. It is nice to be appreciated.

3168. arkymalarky - 5/7/2001 3:12:59 AM

Happy Nurses' Day/Week, MsGreer!

3169. labwabbit - 5/7/2001 3:19:12 AM

Oh crap! That's right!
Happy nurses week to all who give comfort and compassion when it is most difficult to do so.

My hat's off, and a moment of reverence and appreciation for those who get so little in return.

3170. labwabbit - 5/7/2001 3:20:28 AM

My moher-in-law, two aunts, and a grandmother, (may her soul rest in peace), have devoted their lives to this humane cause.

3171. thoughtful - 5/7/2001 3:14:09 PM

Thanks for the tip MsG....I'll have to see if they would/could take them.

3172. Ronski - 5/7/2001 10:59:32 PM

Oh God, Yuck

(temp. link)

3173. JudithAtHome - 5/10/2001 1:34:47 AM

New cancer drug just talked about on the news will cost $24,000 to $29,000 a year...Medicare will not pay for it, either.

3174. msgreer - 5/10/2001 2:10:17 PM

Judith

Medicare won't pay for it? It was accepted by the FDA. I admit to being too busy to read much about it. I have gotten my news on the tube only. I don't understand why Medicare wouldn't pay for it. It is no longer an experimental medication. People can start buying it today.

3175. msgreer - 5/10/2001 2:17:32 PM

Judith

I'm listening to GMA and you are right.
Medicare will not cover this drug. They say private insurance will cover it. Big deal. And this new drug for leukemia has shown good results with stomach and lung cancer. Tommy Thompson will have a hard time selling this to the public..meaning Medicare not paying for the drug. I heard him on C-Span touting the wonders of this drug. After all, Mr. Thompson can make the decision to allow Medicare to pay for the drug. I suspect there will be a huge uproar in this country if Medicare and HMO's do not pay for this.

3176. JJBiener - 5/10/2001 6:27:39 PM

MsGreer - I imagine it is only a matter of time before Medicare and HMO's pay for the drug. They could be waiting until production ramps up and the price comes down. I can't imagine that they will be able to resist the political pressure for long.

If they don't we may know what your first litigation will be.

3177. thoughtful - 5/11/2001 12:20:52 AM

MsG, I saw my doc the other day and asked about the Rxs I have. He said that under no circumstance could any organization legally accept them. He's been working with nursing homes in the state and says they had to get special legislation passed to allow still blister-packed drugs to be legally redistributed among other residence should one not need them anymore. So I'm afraid it's out they go.

3178. JJBiener - 5/11/2001 12:24:19 AM

Thoughtful - That is a shame. I understand the risks involved and why it is not allowed, but it still seems like such a waste.

3179. JJBiener - 5/11/2001 12:26:56 AM

Thoughtful - Did you see MsGreer's announcement this morning? She has been accepted at the University of Michigan Law School. We are all thrilled for her and very proud of her. Can you imagine what she will be able to do with her background AND a law degree? I am sure the HMO's are quaking in their boots.

3180. CalGal - 5/12/2001 7:09:16 AM

Serial Killer Doc

This guy makes McVeigh look like a piker.

3181. thoughtful - 5/13/2001 8:52:43 PM

My heartiest congrats to MsG. Very impressive.

3182. msgreer - 5/14/2001 12:58:11 AM

thoughtful

Thank you very much. I'm going back to Ann Arbor. I am very excited.

3183. thoughtful - 5/14/2001 6:42:14 PM

Hmmm. Interesting follow on to my kidney episode. My hair is falling out. Seems that, like with malnutrition, if your body isn't getting enough protein, then 2-3 mos. later your hair follicles go into "rest mode" to preserve protein....hair is predominantly protein. It makes it very easy for the hair to come out...even with gentle combing or washing. The body can process about 3gs of protein a day, but I was losing up to 9 gs of protein a day...which I guess was enough to trigger this hair response. Hopefully that's the cause as it is reversible once the body starts getting protein again. I only hope that it stops falling out and starts growing in again before I look like Sinead O'Connor.

All you fellows out there doing that combover thing? You have my complete sympathy. I am becoming a master!

3184. msgreer - 5/14/2001 9:03:24 PM

thoughtful

Have you tried the Nioxin products for hair growth? I understand hair loss due to protein loss. Anyway, Nioxin has a shampoo/cleanser. Then a Scalp Therapy you apply in the shower and leave on for afew minutes. The third step is Nioxin Cytogen. You use it after the you wash your hair. It is a white foam you distribute throughout your scalp. Then just comb it in and dry your hair. Any good salon should be able to get the stuff for you. Don't let someone tell you the third step is Bionutriet Treatment. I mean that is good stuff and does add volume but it does not grow new hair follicles.

3185. msgreer - 5/14/2001 9:14:07 PM

thoughtful

Here's a number to call. 800-628-9890 or 800-770-994-1308 or visit there website www.nioxin.com. Nioxin uses a non-alcohol based delivery system. It states this system ensures the integrity of it bionutrients and botanicals.

I haven't looked at their website but would be curious to see what they charge online. It is not cheap.

3186. rubberducky - 5/14/2001 9:15:27 PM

800-770-994-1308 ?

is that in France?

3187. msgreer - 5/14/2001 9:19:25 PM

rubberduck

Couldn't tell you. These were the numbers I got for Nioxin.

3188. rubberducky - 5/14/2001 10:03:28 PM

oh - i thought it was a typo and i was trying to jokingly bring it to your attn

3189. thoughtful - 5/14/2001 10:05:06 PM

Thanks, msg. I hadn't heard of them before. I'll check it out.

3190. thoughtful - 5/15/2001 11:58:17 PM

In the news today...they've upgraded the standards for treating heart disease, especially for those with diabetes. It's about time...considering it is and continues to be the #1 killer of both men and women by far.

The big problem is obesity and what to do about it as excess weight and lack of exercise are key contributors.

Then they had this bs story about breast feeding and obesity...breast-fed children are only slightly less at risk of obesity than bottle-fed, and if the mother is obese is a much more significant indicator of the child's future weight....then they go on to push for breast feeding of infants. A red herring....why not focus on the mothers' weight and eating patterns and life style which will clearly be a more significant factor in the child's health. Sheesh!

3191. thoughtful - 5/21/2001 5:18:48 PM

Article in today's NY Times about a genetic link with Crohn's.

3192. JudithAtHome - 5/21/2001 5:31:42 PM

thoughtful:

I began to lose my hair after a prolonged flirtation with vegetarinism...so I took things like silica and B5. Then, fearing I'd soon resemble a monk, I went back to eating meat. My hair revived; I still take the silica and have very healthy hair...it's just not as thick as it used to be.

I was very scrupulous about proper food combining and ate dairy for protien, had eggs, ate beans a lot...I followed a plan for getting enough non-animal protein, had fish, etc. STILL I lost a lot of hair. People would say "Oh you just aren't eating the right things...." meaning they thought I wasn't eating a proper vegetarian diet. I did eat a proper vegetarian diet...the "right things" I wasn't eating were meats.

3193. thoughtful - 5/21/2001 8:15:14 PM

That's interesting J@H. I suspect that in my instance, diet has nothing to do with it just as diet had nothing to do with my cholesterol shooting up to 499 from <200. It was all related to the kidney issue which is now resolved. Hopefully, my hair will resolve as well. The fact that your hair recovered is very encouraging for me.

I haven't changed my diet in years, and though I eat a lot less meat than I used to, I haven't eliminated it entirely. And I also make sure that I get complete proteins in other foods. And I haven't ever had problems with hair falling out except once, many, many years ago which was related to hypothyroidism....once corrected, the hair grew back. That hair loss though was different -- came out in clumps. Yikes!

I'm hoping that, since it took a couple of months for the hair to react, it'll take a couple of months and then I should see big improvement after that.

3194. thoughtful - 5/21/2001 8:18:35 PM

I can't wait though for the itching/burning/sensitive sensation I have in my scalp to stop. I'll take that as a sign that I'm on the mend....that sensation started soon after my kidneys went awry and has stopped yet.

3195. thoughtful - 5/21/2001 8:18:58 PM

Dang. Why doesn't the hair under my arms fall out instead so I can quit shaving!

3196. JJBiener - 5/21/2001 8:28:44 PM

Thoughtful - Thank you for the link on Crohn's disease. They have long suspected a genetic link. Now that they found it, I hope they can come up with better treatments. My disease has been under pretty good control for the last few years, but there is always the fear that it will come back with a vengeance.

3197. thoughtful - 5/21/2001 9:04:03 PM

JJ, the weird thing is the connection with plant genes. I guess Kermit was right...it's not easy being green!

3198. ranheim - 5/24/2001 3:15:03 PM

Those of you who read the Mote AND have a "cholesterol problem" should buy a copy of the June, 2001 issue of Esquire (it stands out as the cover is graced by a nearly nude female).

I don't know that there is much in the article that gives advice as to what one should do - but, it surely debunks the idea that cholesterol is the sole (or main) cause of Coronaray Artery Disease CAD).

The companies making such drugs as Lipitor; Pravachol; etc. cannot be too happy to see such articles beginning to hit the main stream press.

I go back to what I have said in this thread in the past -ultimately, I believe dietary advice for CAD will be - simplified - "If God made it, it is probably OK; if man made it, be careful!"

3199. thoughtful - 5/24/2001 3:23:58 PM

ranheim, I heard a nutritionist speak a few weeks ago and her advice was, as you go through the grocery store, ask if your ancestors would recognize it. If not, (cheetos, cheeze-wiz, etc.) then don't eat it.

3200. thoughtful - 5/24/2001 3:30:01 PM

On a more disturbing note, my paper was late this a.m. so I went to one of my old New Yorkers I hadn't read, 3/19/01, to be exact and came across an article about the decline in autopsies being done and this frightening fact:

"How often do autopsies turn up a major misdiagnosis in the cause of death?....the figure is about 40%.....the most surprising fact of all: the rates at which misdaignosis is detected have not improved in autopsy studies since at least 1938."

Doctors at Harvard did a simple study of missed diagnoses in 1960 and 1970 before ultrasounds, cat scans, etc. and 1980 after the new technolgies were widely used. The results:

"Regardless of the decade, physicians missed a quarter of fatal infections, a third of heart attacks, and almost two-thirds of pulmonary emboli in their patients who died.

"In most cases, it wasn't technology that failed. Rather, the physicians did not consider the correct diagnosis in the first place. The perfect test or scan may have been available, but the physicians never ordered it."

The issue in my book is one of human fallibility: it's human nature to want to be right. We assess a situation at first glance, then look for the data that will support our supposition.

3201. ranheim - 5/25/2001 2:08:58 AM

#3200

After 40+ years in this field, that is one of the most difficult things to do (not make an assessment based on a first glance).

For once one starts down the wrong path, it is almost impossible to get back on the right track. As a GP, if I find my tests are not comfirming my original hypothesis, I refer. It takes too much of the patient's time and money for me to find the right path once again.

3202. JudithAtHome - 5/25/2001 8:28:29 PM

Something to think about:

Second Opinions: History winds up in the waiting room

If the story were presented as a formal medical case study, it might begin as follows:

S. is a thirty-five-year-old male of Middle Eastern ancestry with a long history of deceitfulness, physical violence, and other forms of unacceptable behavior. He is an only child; his mother had to be warned not to drink during pregnancy. The subject is known to be inordinately fastidious about his hair. His libido is powerful and indiscriminate. He is a nonsmoker. His life is believed to have culminated in a spectacular murder-suicide.

The case is that of Samson, son of Manoah, whose story is recounted in the biblical book of Judges, and it was cited not long ago in a letter to the editor of the Archives of General Psychiatry.

This article is a treat to read....the more things seem to have changed, the more likely they've just stayed the same.

3203. Jenerator - 5/31/2001 1:50:43 AM

thoughtful,

Did you and your hubby have to take care of someone with Alzheimers?

Granny seems to have forgotten that D and I are married. She came charging in the other morning announcing that one of us had to get out of bed before his daughter woke up.

I was extremely angry (it's literally impossible to get a solid night's sleep without her waking us up for various reasons) and I told her that neither of us had to leave because *we're married*!!!

Her reply was to smile and say, "Oh, I forgot." and leave the room but with the door open.

Yet, at the doctor's office today, she conveniently remembered D and I being married.

3204. JudithAtHome - 5/31/2001 3:34:41 PM

This sounds more like wanting to unseat the new bride....how long has he been living with her or taking care of her?

3205. joezan - 5/31/2001 3:44:02 PM

Reminds me of when my maternal gramma was living with my parents for her final 2 years in this life, when I was in my early 20's.

I went over one day for a visit while my dad was at work, and gave my mom a hug at the front door. As I headed off toward the kitchen (of course) a few minutes later, I heard gramma hiss at my mom:

"Ruthie! That boy could be your son - and you're a married woman!"

3206. thoughtful - 5/31/2001 4:12:08 PM

Jen, it's a long story. We didn't actually have any elderly people living with us but were responsible for their care. For my husband's aunt we managed to keep her in her own apartment for quite awhile (she was in NYC and we are not) being cared for 24 hrs. a day until that became unweildy and then we moved her into a nursing home near us. Similar with my husband's mother who was also in a NYC apartment though she made the intervening step into elderly housing (sort of like a holiday inn-- your own room with private bath and a central dining room where they served 3 meals a day) before she ended up in the nursing home. I've also supported my mother through the care of her mother and father which she managed for 9 years with the help of her brother. She too managed to keep them both in their own house up til about 3 mos. before grandma died....grandpa had already passed away several years earlier. I was most concerned about this situation as my grandparents were in their 90s and the care givers (mom & uncle) were in their 70s! I've also seen another uncle care for my aunt who was diagnosed with alzheimers and the hell he went through with that, so I've had more than enough exposure to the problems of aging.

3207. thoughtful - 5/31/2001 4:18:08 PM

I won't say that my mother in law (MIL) has alzheimers as I believe that is a specific disease that is diagnosed only be exclusion and can't be determined definitely except by autopsy. However, my MIL is clearly "doofy" as we call it. We had to move her into the nursing home when she could no longer keep track of time. Was wandering the hallways at 10 p.m. at the elderly housing place wondering why they weren't serving breakfast. Hubby's aunt did something similar -- out wandeirng the streets of NYC at 4 a.m. with no coat on in Nov. looking for ice cream.

My MIL is difficult to diagnose as she has a rare genetic disorder (pseudoxanthoma elasticum) which among other things promotes arteriosclerosis. So whether she has alzheimer's or is suffering from what we used to call "hardening of the arteries" or if she's had a series of minor strokes that have affected her cognitive functions, I don't know. (As an aside, my grandpa was rather "doofy" too but suffered from an inability to absorb B12 -- when he got B12 shots he would be rational for about 24-48 hrs and then deteriorate again.)

3208. Wombat - 5/31/2001 4:21:53 PM

Jen:

Sounds like you are in a bind. Whatever you do, don't make hubby choose between his mom and you. If he chooses you, he will resent you for the rest of his life.

Can't you get away for what the Brits call a "dirty weekend" every once in awhile?

3209. JudithAtHome - 5/31/2001 4:24:52 PM

Wombat:

It's his grandmother...

3210. thoughtful - 5/31/2001 4:25:51 PM

Regardless, my MIL is no longer rational. Once in awhile a gem of wisdom will come out -- recognize that this is a relative thing, like she remembers that I took a business trip last week. Most of the time though it's a rerun of things just said. We saw her last night and she asked at least 15 times if we were married, or if we were living together. That's very typical. The bizarre part is we always follow up by asking how long we've been married and 95% of the time she answers correctly -- 22 years.

She needs lots of reassurance...often repeating to my hubby, "You're my son." and he responds, "You're my mommy." which always puts a smile on her face. I've told her that that's forever and that reassures her. Yet other times, she'll be talking to him for 10 or 15 minutes and then not realize that she was talking to her son and accuse me of not telling her! It's very weird. I think of our visits as a hitchcock movie -- you're never sure how it's going to turn out. We are most fortunate though in that she is always pleasant.

3211. Wombat - 5/31/2001 4:25:56 PM

Oh. Still holds true, though.

3212. thoughtful - 5/31/2001 4:40:04 PM

Other things, like that my father isn't driving anymore seems to have touched her and she remembers that every time. Though other times, she forgets that her mother died -- which was about 24 years ago. (My grandmother did the same thing toward the end, asking to visit her mother.)
There aren't good days and bad days with her, but it changes from minute to minute. One she'll be with it, the next she's not.

One part of alzheimers which you may be experiencing is sunsetting-- seems the disease gets worse as night falls, making for many sleepless nights. That's why I'm a big believer in drugs for these folks if it will help them sleep through the night. Another uncle who's wife has the disease was really suffering all night with her until he got her on the right dose of the right meds. Now she sleeps through the night. Keep in mind that typically these meds take 2-3 weeks before they have any effect.

3213. thoughtful - 5/31/2001 5:08:45 PM

There are cognitive function tests that can be administered so her remembering whether you're married or not should not be the telling factor. They do things like give them 5 words to remember than go on to other things, then ask them to recall the 5 things. Stuff like that. Of course, the first thing is to make sure that there aren't other physical causes for her cognitive disorder, such as hypothyroidism. A regular physical should help determine these things.

3214. thoughtful - 5/31/2001 5:09:47 PM

The other thing is, get a lock on your bedroom door.

3215. thoughtful - 5/31/2001 5:44:14 PM

We decided after long conversations with many people not to have my MIL move in with us, though it was something we seriously considered. The advice we got was that, however hard you think it will be, it will be much, much harder. This is especially true for you, jen, as the person who needs care is not your relative, though you are in the role of primary care giver. (My aunt was extraordinarily resentful of caring for my grandparents -- her in-laws -- even though she had known them for 40 years and they did things like babysat for her children and so on. And you don't have a long history with this woman to look back on.) While wombat's advice about asking your hubby to choose may hold, if things deteriorate (which they inevitably will) then he will have to deal with your resenting him the rest of your life for allowing his gran to overburden your marriage and you personally -- his clearly choosing her over you. That's why it's absolutely essential that it not become a matter of choice for either of you, but a real partnership approach to doing what is best for you, him, and her.

We chose the nursing home route for many reasons, one key one being that we knew we could only give her inferior care to that of a nursing home which is designed to care for people like her...infrastructure like wheel-chair accessible showers and tile floors, full time nursing staff, back up care givers, and professional staff. The staff not only are trained for dealing with people who have these problems, but they are not personally involved with them so can provide a ton more patience and calmness than you ever could when you are "on" 24/7.

3216. thoughtful - 5/31/2001 5:54:39 PM

What I suggest you do now is prepare for the inevitable by having conversations with your husband where you lay out some of the things that may come (incontinence, no longer ambulatory, violent behavior, etc.) and discuss which ones you will/won't be able to handle and make plans for alternative care. These conversations should include things like adult day care to give you a break, or in home help to give you a break, nursing home care and whether or not you need to place her on waiting lists (essential in our area) should her condition deteriorate. Again this is not me or her, but rather a learning process around what may yet come and what all the alternatives are for caring for someone...there are many more alternatives available today than there were a few years ago.

You also need to discuss finances...there are things that can be done to preserve assets if done soon enough, and those are really controlled by state law so each state is different. If there are no assets to preserve, you will want to check out what kinds of care medicaid will provide (or whatever your state calls its eldercare assistance program) including in-home care possibilities. Even things like having medicare pay for podiatrists to trim toenails can be most helpful.

3217. thoughtful - 5/31/2001 5:56:13 PM

(I told you it was a long story!)
Those are just some elements of my best advice. I'll be happy to share more or even just listen if you need it.

May the force be with you!

3218. PsychProf - 5/31/2001 6:05:52 PM

Thoughtful...your post is excellent. I agree with your actions at every turn. You deserve your moniker.

3219. thoughtful - 5/31/2001 6:13:36 PM

Thanks pp....nothing generates empathy like having walked several miles in those moccasins!

3220. thoughtful - 5/31/2001 6:20:22 PM

Jen, go to amazon.com and check out some of the books available on "caring for your aging parents". They will help add tools to your tool kit for coping with this kind of situation.

3221. Jenerator - 5/31/2001 7:19:59 PM

thoughtful,

I thank you for taking the time to tell me so much. I have so much to say!

Wombat, Judith, JoeZan,

I thank you for your support and advice too.


D was raised by this woman, so in essence, she's his mother. He does have a relationship with his biological mother and she and I get along really well. She lives in Washington.

The house we live in was purchased by granny and grandpa (he passed away 15 years ago) in 1973. D grew up here and then moved to an apartment when he was 18, but one close by. She has *always* depended on him (D's father died when D was 3, so she transferred all of the feelings of sonship on to him), and she has always been somewhat emotionally manipulative.

Three years ago, he moved back in with her when she fell and broke her hip. She was still functional in that she was fully aware of what day it was, which medications she needed, going to the grocery store, etc. But physically, she was getting weaker. So, him being there provided the "man in the house" presence she wanted and needed.

She has a daughter who is 67 years old and is in fantastic shape. Virginia's physically quite beautiful, alert, funny, and doesn't look or act her age. She has five children and and seven grandchildren. None of them are close to granny. (A warning sign to me)

3222. Jenerator - 5/31/2001 7:20:31 PM

Virginia comes over once or twice a week to see her mom, but that is really all of the help we get. That makes D mad, but I can understand. Granny seems to have always preferred men, and I don't blame Virginia for being busy, she does afterall, have her own huge family that isn't mean and disapproving all of the time.

Anyway, when D and I were first dating, granny and I got along really well. She and I would sit and talk, have meals together, watch tv, and I would listen to her stories. When D would go out of town, I would always come over and stay with granny. It is so different now.

Granny has left the house to D and he made a promise that he would not put her in a nursing home. That's easy to say or think when she's sweet and passive, but she's not anymore. Not at all.

It seems that last summer is when it started to change. She had gotten sick and lost a tremendous amount of weight. She's 5'6" and her weight dropped down to 85 pounds. That is when she started getting weird with food.

She has anorexia, but it's more about exerting control over that aspect of her life than losing weight. No matter what we feed her, she will only eat "half" of what we present her with. We tried to increase the portion size, hoping she'd eat half of a large portion, but she still only eats half of a small portion.

Right before D and I were officially engaged (we'd been talking about it for a year prior), she started getting more and more infantile with her moods and she was keeping D hostage in his home...falling (on purpose), not eating, getting scared, etc.

Her moods became more agitated after we were engaged.

3223. Jenerator - 5/31/2001 7:20:52 PM

I know that some of it is the typical "no one is good enough for my boy" attitude, but it's gotten progressively worse. She likes to make every situation about her, she's like a selfish kid. She pouted the day of our wedding and then said she didn't want to go. She wound up coming and subsequently forgetting she had come.

I knew that we would all be living together, but maybe it was my mistake for being naive when it came to her situation.

3224. labwabbit - 5/31/2001 7:25:15 PM

Message # 3201

For once one starts down the wrong path, it is almost impossible to get back on the right track. As a GP, if I find my tests are not comfirming my original hypothesis, I refer. It takes too much of the patient's time and money for me to find the right path once again.

That is an excellent example to insight of the thought process that is far too quicly becoming extinct in the world of medicine as corporate business.

3225. JudithAtHome - 5/31/2001 7:33:36 PM

Gosh, do I ever agree with that, Lab...my sons doctor wasted so much time on a misdiagnosis and then, after turning the case over to others, still would drop in everyday to redundantly explain to me what they were doing. I finally told him I wasn't going to pay for him to come in everyday and tell me things I already knew...

3226. Jenerator - 5/31/2001 7:47:42 PM

D's daughter Brittani has come up for a month and this always seems to put granny in a flat spin. She gets neurotic about the girl, so being in thsi home is even more unbearable.

Without Britt around here, granny tries to keep D around as much as possible...whining, being scared, never knowing what day it is, always thinking she hasn't taken her medication, not eating and obsessively calling D's cell phone (13 time in 20 minutes). Everything I do is met with disapproval (the food is just one area) and it's never enough to make her feel secure. Simply put she prefers the pampering D gives her. I do not have the patience to play the choo-choo game with her and her insults irritate me.

With Brittani here, granny refuses to go to bed until Brittani does (the kid's on summer break, why should she have to go to bed at 8pm every night?) She is constantly pestering her with things to do..Brittani, come here, Brittani, get me a glass of water, Brittani, don't you love me anymore? You don't love me anymore do you Brittani? You'd be happy if I died wouldn't you Brittani.

All friggin' day.

So, D and I decided that this trip we weren't leaving Britt alone with granny at all.

Tell me what you think. Two days ago, granny had woken up at 7 am to check on Brittani for the umpteenth time in a 24 hour period and proceeded to wake her up. Granny then crawled in bed with her, so Britt got up and went into the living room. Of course granny pestered her non-stop. Are you hungry, why don't you eat? I'm going to make you steak and eggs. Are you hungry? Have some milk. Don't you love me? What day is it? Where's your dad? Are you hungry?

NON-stop.

3227. Jenerator - 5/31/2001 7:48:15 PM

Britt turned on the tv and was praying for me to wake up and provide relief. Then granny started talking about me. This is, and I quote, what she said to Britt.

"Jennifer is a terrible housekeeper. This house is a mess. She probably can't even wipe her own butt!"

Britt didn't know what to say except for defend me with, "Jen keeps this house clean and if you look around you'll see that any mess that's here is D's."

Granny, "Well, I don't care, she thinks she owns this house and that she lives here."

Britt, "She DOES live here, and she does NOT think she owns the house."

Granny, "She does not live here."

Britt, "Grandma, D and Jen are married."

Granny, "Well, she's a horse's ass."

3228. Jenerator - 5/31/2001 7:48:56 PM

I gave D the brief version of this and he said that there was nothing we could do, because we could not talk any sense into the woman so it was pointless.

I pulled Britt aside and reasssured her that granny didn't hate me, that she just wasn't making any sense and that unfortunately that's what happens sometimes when people get old.

She understood, but I'm angry that I'm the one home al day now having to deal with this crap and tip-toe around where I live.

D seems to be patient with her, but his lack of support is driving me nuts.

He doesn't want to get a lock on the door and says that I am the one who needs compassion.

Am I wrong for wanting some privacy????

The doctor yesterday didn't officially diagnose her with AD, but we talked about the differences between that and dimentia. The fact that she meets all base requirements for the disease, that she's 85, and extremely agitated seemed to be enough for him. Of course the lady was a complete saint in his office, but he knew that she was putting on a front.

I can't tell you what a relief it was to know that the doctor understod and could see through it.
that's when he prescribed trazodone. If that doesn't work, we'll try RimRon.

I'm somewhat pessimistic, because she will refuse taking any medicine that she doesn't feel like taking, claiming that she doesn't need it, or that nothing's wrong, etc. The fact that this must be administered right before bed because it can be a sedative, will make her suspicious.

I hate it here. It doesn't feel like a home.

3229. Jenerator - 5/31/2001 7:49:07 PM

Did you know that we can't even bring over our wedding presents because moving her stuff will "upset" her? I want to do things like throw away broken glasses and I can't. I want to do things like buy a new hutch to store china in, but I can't. The cheap-ass 1960 plywood hutch covered in dust and filled past capacity with junk (broken cookbooks and so on) must stay, because to move it would "upset" her.

Granted, I understand that I can't come in and throw everything away, this IS her house, but if I'm living here too, I'd like to make it my home as well.


I'm going crazy and I do not know what to do.

3230. thoughtful - 5/31/2001 8:00:25 PM

Jen, Yes some of this is clearly emotional and to be expected when a new hen is introduced in the hen house. For years my MIL thought of me as the "witch" who married her son....and that was despite all the things I've done for her over the years. Remember I grew up next door to hubby so I've been "part of the family" for over 40 years. And she and I always got along. Further, with her genetic disorder she gradually lost her sight...stopped driving when she was in her 40s so hubby and I spent a lot of time doing things for her she couldn't do for herself, especially after hubby's dad died. Gran sounds like a meaner form of MIL. I can remember once when I gently tried to remind MIL that I take care of her too...not just hubby, and she snarled, "What do you do for me!" with such bitterness. I just let it drop. Then I primed hubby that he needs to counteract that for me...that he could remind her of some of the things I've done as she'll hear it from him. That helped smooth some of the tensions. My reassuring her that hubby will always be her son also helped a lot.

3231. thoughtful - 5/31/2001 8:09:37 PM

oh dear, jen. I figured it was bad, but it's too soon to be this bad.

Let's start with the dr. visit...did he check her thyroid? the weight loss may a clear sign of many diseases including thyroid disorder (which can also show up as dimentia in the elderly). Many times when the elderly don't feel well, they won't tell you what's wrong, they just get ornery. My aunt has AD and she had a thyroid disorder and it led to anorexia. But with proper diagnosis and medication, she was much improved.

3232. thoughtful - 5/31/2001 8:26:10 PM

Once you get her physically up to snuff and properly drugged, the next step is to get D's support. Hard to do, but necessary. Sometimes guys don't give "support" as they don't know how or what to do. They also have high resistance to "rocking the boat" especially when they have someone like you who is much easier to deal with than the nasty-gran so they'll push all the adjusting on you, just because it's most likely to work. In my view there are two ways of handling this...discuss calmly the things you need to if you are to have any hope in surviving this situation including laying any guilt trips necessary about how much you are doing for gran...or become the more difficult object to appease so its easier for him to get gran to adjust. That's my mean-manipulative approach. The business management approach is to determine the positives and negatives behind any course of action and then work to eliminate the negatives. The positives will then take over and change will occur.

Regardless, you have every right to expect some privacy, to expect some private space that you can call your own and it's his responsibility to see that your needs are met. He married you which means he's as responsible for meeting your needs as you are for meeting his. You have a right to have your own things in your own space, and you have the right to insist on them. You also need some space to retreat to when Gran gets to be too much. If he refuses to let you have any space in Gran's house, then you might start a campaign to get your own house nearby -- entirely up to D if he wants to live with you or Gran.

3233. JudithAtHome - 5/31/2001 8:27:03 PM

Jen, you poor kid...I can't tell you how distressing it is to hear this. What does your mom say?

3234. JudithAtHome - 5/31/2001 8:31:32 PM

Thoughtful...if you aren't a professional listener, you should be. Good job here today...and often, in fact.

3235. thoughtful - 5/31/2001 8:38:08 PM

You were absolutely right to assure Britt the way you did. And unfortunately D is right about some things. The woman is not all there and can't be held totally responsible for her actions. Also change is especially upsetting to AD patients so changing a lot of things is not a good idea. That's why I think the private space -- like a room to call your own with a lock on the door -- is essential.

But that does NOT mean that you must tip toe around in your own house. While the woman is not all there, she's certainly there enough to hear you and listen and toe the mark on behavior you don't find acceptable. If D doesn't like you asserting yourself around her, fine....do it when he's not home, but you need to come up with better power balance with Gran. She needs to understand that you are not her slave, that she is dependent on you and had better start cooperating and showing some respect. This is essential not only for your mental health, but also her physical health. She must be obedient in key areas like taking medication. To help achieve that, you need to use whatever you can. With hubby's aunt, she would kick and yell and swear with the one's who took care of her at home...but not in the nursing home. They found out she liked to be in the congregate areas with the other people. When she misbehaved, she had to stay in her room. Within about a week, she always behaved. Is there something you do for Gran that she especially likes? Shopping? Walks? Candy? When she misbehaves you take that away from her. She may be losing it, but it doesn't mean that all cognitive function is gone...and even at that, there's always pavlov.

3236. labwabbit - 5/31/2001 8:47:11 PM

...the next step is to get D's support. Hard to do, but necessary. Sometimes guys don't give "support" as they don't know how or what to do.
I just can't support that claim thoughtful.


They also have high resistance to "rocking the boat" especially when...

...the fish are biting.

3237. thoughtful - 5/31/2001 8:51:58 PM

Now about the promise not to put her in a nursing home...that's out the window immediately. That promise not to put her in a nursing home translates into taking the best care of her that you can for the rest of her life. If that means being in a place that gives 24/7 care with professionals including medical professionals, then that too is a way of keeping that promise.

Obviously you don't want to sign over the house and boot her out on the street...that's what that promise meant.

Now there is another financial question which D needs to deal with. You say gran left him the house...in a will? That means the house is currently in her name? Depending on a lot of things, if she ends up in a nursing home or even needing a lot of at home care which can be expensive, you won't be able to get $$ assistance unless you sell the house. If the house is in D's name, then it's not her asset and you won't risk losing the house. In our state, the total net worth my MIL can carry in order to receive medicaid is $1,600. She financed her stay in the nursing home on a private pay basis for several years, but at $72,000/year, it didn't take long to chew up the assets.

3238. thoughtful - 5/31/2001 8:56:50 PM

Will D go to see the doc with you? Perhaps hearing a diagnosis and prognosis from the doc is what D needs to hear to help him transition from "child" to "parent" vis a vis gran. Sometimes a family member will hear from a professional what s/he can't hear from a family member. And if he won't accept that level of responsibility, you need to try to get him to agree not to stand in your way.

Remember, a lot of the difficulty you have with gran, he just doesn't see. My husband was completely unaware of the barbs and slings MIL would throw at me even though he was in the room and part of the conversation. Only by my raising his awareness about these issues did he come to see how difficult it was for me in dealing with her.

3239. thoughtful - 5/31/2001 9:00:59 PM

Final bit of advice. If you can't enlist D's help, and you can't get help out of any of gran's children/grandchildren, then you absolutely must seek help for yourself.

When I was at wits end with MIL and my tool kit ran dry, I spent several sessions with a psychologist (I'm fortunate to have that as part of my company benefits) explaining the situation and gaining her perspective on what was going on and how to better handle it. She refilled my tool kit and gave me great advice like, "She will want you to wait on her hand and foot 24 hours a day. If you want to be her 'Johnny on the spot' you've got the job. There's no one else in line for it. She won't sets limits for you, so you have to take responsibility and set limits for yourself."

3240. thoughtful - 5/31/2001 9:04:07 PM

Reread you post and wanted to add this....D can say that you can't change gran and there's nothing he can do, but that's wrong...he can't change Gran, but there are things he can do to accommodate your needs and make it easier for you to deal with gran, and he owes you at least that much.

3241. Fielding - 5/31/2001 9:12:05 PM

Jen:

I feel for you and your family. This is indeed a difficult issue for you.

You have gotten some great advice, and I have little to add. The one thing I can think of is to take a long view. Sadly, this woman is going to die at some point. When you feel that you are starting to resent her the most, try to keep in mind that you and especially D will miss her dearly when that moment occurs. She is treating you very badly, but her reality is different than yours. Hopefully perspective will give you added strength.

3242. thoughtful - 5/31/2001 9:39:40 PM

Interesting point about gran's behavior and my aunt's too. Note that she behaved well in the doc's office because she knew that inappropriate behavior was not acceptable. So she certainly is aware enough to control it there, so she can control it at home too.

My aunt was very mean and nasty to my uncle and would yell and scream and swing out at him over the most minor things. We never knew this until he told us because whenever anyone else was around, she would control her temper. You could even see her heating up sometimes, but she would control it in front of "company." If she could control it for others, she could control it for him too, but he was such a "saint" that he would just respond by bending over backwards to appease her in anyway he could. Some may think him a saint, but I saw it as being far too nice for his or her good. He put up with a lot of s**t he didn't have to if he chose to control her behavior, but he didn't...easier to control his own. That was his choice, but it wouldn't have been mine.

3243. thoughtful - 5/31/2001 9:41:01 PM

sorry....I left out the point that that aunt was in fact diagnosed with AD.

3244. thoughtful - 5/31/2001 10:30:16 PM

Sorry to keep going on and on, but there's another issue that needs to be brought up on the legal aspects of her care. In our state, we had a power of attorney for MIL (being blind she couldn't handle her own paper work or banking) and were upset to find that wasn't enough. A power of attorney is only good as long as the person is competent to say it is good. We had to get a "durable" power of attorney which is in force even if they are no longer competent. Also a good idea is to try and get a living will so here wishes can be met should she become terminal. These issues are probably not something you can deal with as it will look like you are trying to take over *everything*. This is really something for her daughter to take up with her and D, though you may have to do the behind the scenes set up to get them to understand how important it is and to approach her on the subject.

3245. thoughtful - 5/31/2001 11:08:53 PM

j@h, thanks for your kind words. Helps offset the many times I've been called "thoughtless" in these thar threads!

3246. Jenerator - 6/1/2001 7:09:57 PM

To all of you who have offered sympathy and empathy, I thank you. I can't tell you how good it feels to know that you understand and that I'm not alone.

It *is* very hard being a newlywed dealing with this.

thoughtful,

Let me start with last night and then I will get onto all of the points you made.;-)

D had to leave last night for a late-night photo shoot, so before he and his assistants left, I reminded him about the new drug. He was excited about it (which made me happy.) We both agreed that we need to tell her it's for her "breathing". She has emphysema and takes a couple of inhalers and she's always complaining about not being able to breathe, so, we knew that this would be less suspicious. She took 25 mg (the doctor said to start light because it can knock out some people, and she only weighs 100 pounds). Not even five minutes later she told Britt it was bedtime - this was at 9pm. I told granny that I would put Britt to bed in a little while and then offered any help if SHE needed any getting ready for bed. She scowled at me and told me that she wasn't going to bed.

The three of us were in the living room watching movies with granny occasional asking if Britt was hungry, where's dad, etc. At midnight, Britt and I mved into the family room. She wanted to camp out and sleep in her sleeping bag on one of the couches; which was fine with me. We stayed up til 1 am making a fort and watching cartoons. I heard granny starting to make her move toward the room, so I turned off the tv and pretended to be asleep. She came in checked on Britt, saw that she was asleep and then went to bed.

I stayed up for another 30 minutes or so, snook out and went to my bedroom. At 3 am I woke up and noticed that the 500 watt hall light was on and that the family room door was wide open. So, I knew that she had gone back in to check on Britt and then turned on a light for her.

3247. Jenerator - 6/1/2001 7:10:06 PM

I went back to sleep and woke up at 8 am when granny was looking for D (who is *still* on assignment). Britt was also up and upset with me wanting to know why I had left her.

Evidently, after I went to sleep, granny came in over 5 times, moved some of the furniture around and then crawled onto the couch to sleep with Brittani. (!!) When Britt tried to leave at 6 am and go into her room, granny woke up and wanted to know where she was going, following her into her room and checking on her every half hour.

Here's what bothers me about this.

1) Granny doesn't treat me as an adult, she believes that only she is capable of caring for Britt. (I am her step-mother, *I* am in charge!)

2) She never goes to bed. She never sleeps. She will not give us time alone, ever. She feels some need to keep a constant vigil.

3) She pesters all of us and I feel bad for Brittani. It is so annoying for her to have to dodge this overbearing woman.

3248. Jenerator - 6/1/2001 7:19:02 PM

OKay.

thoughtful,

They tested her thyroid a couple of years ago, but not lately. I'll have them check it soon. The office manged to lose the blood they withdrew from her this week, so she has to come back in anyway.

The doctor was testing her for an intestinal bacteria that might have been diminishing her hunger. My real belief is that the woman is just showing control over food. She's always hungry but cannot eat a full dinner. She loves her desserts though. It's amazing that she can't eat one taco but she can eat a pint of ice cream.

There are no treats that we can take away from her. I wish she liked to walk or shop. She prefers to sit in her chair and bitch about sitting in a chair all day. Whenever we try to make organized attempts at getting her out for exercise, she doesn't cooperate. She's suddenly weaker, slower and will not do it. Yet, when she thinks she's alone, she's walking around, wandering, going through everyone's things.

This is another area that D and argue about.
He thinks that when she's hurting we should show her some sympathy. I say that the more we baby her, the more she's going to continue creating injuries and aches and pains.

3249. Jenerator - 6/1/2001 7:30:29 PM

The doctor said that the reason she's on her best behavior at his office is because she's like many people who try to make their doctors happy by lying about what they do at home. He knows that she's not exercising and that she tells him everything's okay to please him, to appear as though everything's in order.

Last week when granny had said something nasty about me to D, I tried to talk to her about it the next day. I asked if she remembered the previous night and she did, then I repeated what she said and she denied ever saying it. Then she defended what she said by explaining why she said it, placing blame on someone else. Two minutes laster she started crying claiming that she never said anything ugly to me and that she desn't remember anything. I stayed on her and told her that she had remembered just two minutes prior. Then she snapped back, "Well, you just don't understand what it's like to not know what you're saying sometimes. I'll be 85 soon!"

Maybe I had lost my patience by then, but I told her that she WAS 85 (her birthday's Apr. 6), and that I wanted to help her remember what she says and does.

She denied being 85 and said that writing things down wouldn't help.

It's my opinion that if she'd write down when she took her medicine, where we went, what day it was, etc. she'd remember more. She doesn't believe us when we tell her she's had her medicine, but she trusts her own writing.

She refused to do this.

3250. Jenerator - 6/1/2001 7:41:47 PM

The house will be left to D when she passes away.

D has promised to talk to an attorney about the matter. He's under the impression that if she needs some form of constant care, medicaid will pay for it and not seize her assets so long as her stay is under the guise of being temporary.

I was hoping to get a Quit Claim form signed by her and notarized for back-up purposes, but he wants to wait.

I'm sorry to be complaining so much, I feel like a pessimist.

I am hoping that the sedative (that will be increased to 50 mg tonight!!) will start working and that the rest will help her. I am trying to not complain too much to D and allow granny's actions to speak for themselves. I mean, hopefully, he'll clue in when he realizes that even his daughter hates being here because of granny. I'm going to buy a lock for the door, and I am going to contiue to pray.

All of what you have shared with me is good, and I hope that I can have some breakthroughs with my husband, because I can not do all of this alone. Without his help, I cannot handle it, but the hardest part is that I cannot make him help me.

So, I'm trying to have more hope that I will see some results soon.

Marshame thinks that within a year, granny will not be an issue. Of course this sounds great, but I fear it/she will last another 10 years!


I'm keeping all of your advice on file, it has helped me already more than you know!

3251. Jenerator - 6/1/2001 7:57:42 PM

One last thing, we have "threatened" granny with various consquences.

I.e. If you don't eat more, you're going to have to go back to the hospital where they'll feed you. If you don't stop being so ugly, we're going to leave for the night. If you don't stop turning the air conditioner on 95 degrees, we're going to put a lock on it.

Every time, her reaction is the same, "Well you go on ahead, I don't care. All I've done for you and you treat me like this. I hope I die and then you'll be sorry. I've raised you and look how you treat me."

If we leave, she'll start calling and calling and calling; claiming she doesn't remember anything that happened. Then D goes back out of duty, not wanting anything bad to happen to her.

Needless to say, you know how I feel.

If we tell her she has to eat dinner before dessert, she'll get up and get it herself. As an exeperiment, I didn't make or buy anything sweet for two weeks to see what she'd do or if she'd eat more dinner.

No. She still had dessert by making herself "sweetmilk". Which is milk with sugar added to it.

If we use Brittani as the consequence.....Brittani cannot come up here with you saying ugly things about everyone...., she gets really sad and claims to not remember and deny anything ugly she has said and done.

Then, *WE* are tortured.

Where's Briitani?
Why isn't Brittani here?
When's Brittani coming up?
How come you don't do more to have Brittani here?
When's she coming up?
I miss my baby, where's Briitani?
I know why Brittani's not here, beause of HER (me, as though I'm responsible!)
If she'd go home, Brittani would be able to come here.
Where's Brittani?

3252. arkymalarky - 6/1/2001 8:32:20 PM

Jen,
If her stages are anything like my grandmothers's, she'll get more combative until she begins to lose more of her mental function and memory, and one source for my grandmother's hostility was partly that she knew she was losing control of her mind and that her independence would go, and she lashed out at the ones trying to take it from her, in her view--my parents--who in her mind took her house, her car, and eventually locked her up with a bunch of strangers, just to be mean to her. She's in the nursing home now and generally docile, but is much more out of reality and in the past than in it. She's been violent on occasions there, and though those instances have been fewer and farther between, she bit an attendant the other day. I just can't imagine my grandmother biting somebody!

It will be hard since you have your family--my parents were retired with grown kids and had time to deal with my grandmother, and Mose sees her enough to love and enjoy her as a sweet old lady who's not quite all there any more. She didn't witness the ugliness, for the most part.

I hope the best for you, and you can't get any better than Thoughtful's advice, imo. It's tragic when someone you love loses their mental capacity like that, especially dealing with the stubbornness and hostility that seems to often accompany it.

3253. JudithAtHome - 6/1/2001 8:33:00 PM

Jen:

Have you decided whether or not you're going to teach next year? Who looked after Granny while you were at school this past year?

You poor kid...it sounds as though you're being made miserable by this woman at home and by the kids at school while there. You must be feeling like you have no haven of relief wherever you turn lately....

3254. JudithAtHome - 6/1/2001 8:36:21 PM

Arky:

As you know, I live in fear of becoming one of these old ladies raging against the dying of the light and my biggest fear is being aware that it is happening to me...I can understand someone reacting that way to this loss of control and so I'm hoping I go out in a (fast) blaze of glory.

3255. CalGal - 6/1/2001 9:16:08 PM

I basically agree with Thoughtful, but I'd go a bit further.

Throw the broken glasses away. Move anything of yours in--assuming that it can't be damaged. Put the lock on your door. Live your life exactly as you choose in your home.

Quit arguing with her. In fact, I'd do the opposite. "You're mean!" "You're right. I'm not only mean, I'm a bitch. I decided I didn't want to wait until I was old like you did."

What the fuck, she's going to forget it anyway. Enjoy it. I don't mean get angry and abusive, I mean be flip and light and insouciant and utterly unfazed. Think of it this way: What the hell are you doing arguing with the old bag? Don't you have better things to do with your day?

As for getting adult daycare to "help you out", I'd say the opposite. Get whatever help is needed for others to take care of her. Then you'll "help out" on occasion.

The one thing I do suggest, though, is that you quit making food an issue. If she wants to eat icecream all day, let her eat icecream. She wants only candy, fine. She's old. Why the hell should she have to eat her damn vegetables? Worst case, she dies of insulin shock. If that's what she wants, let her do it.

Also, if you let her eat as much icecream as she wants and quit making it a control issue, chances are she'll loosen up a bit on the other stuff. Don't fix her special meals or anything, obviously.

About your husband: The only thing that will force him to change is if you stop putting up with it. The odds are good that he will listen to your complaints, remind you of how tough this is for him, beg you to be patient, and continue to benefit from the fact that you are more solicitous of his feelings than he is of yours. It's not something people do on purpose, but it is extremely common.

I also agree that if you still can't be happy living with the harpy that you just rent your own place for the two of you.

3256. joezan - 6/1/2001 10:10:11 PM

Jen:

Sorry - just got caught up on this.

You have my sympathy, but I have to say that if you want your marriage to survive for longer than a year, you two cannot live with that woman.

She will not change.

Your husband must be made to understand that you are coming from a whole different place in this than he is.

Frankly, I don't see any objectivity or sense of fairness - or consideration for you, for that matter - in anything he's done so far.

Putcher foot down!

3257. PsychProf - 6/1/2001 11:13:25 PM

Jen...why not sit down with your husband and decide a series of actions that are acceptable to both of you.

3258. arkymalarky - 6/1/2001 11:43:11 PM

A lawyer or counselor knowledgeable about geriatrics might help to make some of those decisions.

3259. PsychProf - 6/1/2001 11:55:45 PM

Jen...try to make this a decision that involves both of you, rather than a confrontation that results in typical control issues/anger.

3260. thoughtful - 6/2/2001 8:24:20 PM

Jen, my dear, vent all you want here. That's one thing we can do to help you through this.

Consider showing these posts to D. including the ones that express how miserable you are. He needs to hear it and sometimes it's easier to hear it this way than for you to tell him verbally.

About the "temporary medicare" thing, if he believes that he's living in a fool's paradise. As medicare only gets more expensive and more subject to fraud they are cracking down more and more on such things. They are making the requirements you need to meet to get specific benefits and you don't, you get schmatz. Depending on circumstances, you can also be barred from reapplying for aid for a year or more.

I also recognize in gran some of the same things I felt about MIL. It took me a long time to come to accept that many of the things that she said and did to specifically hurt me really weren't so....or if they were, it didn't matter because being intentionally hurtful when you're not all there is not the same thing as cold rational malevolence. The things she says and does are all mixed up in there and they come out in bizarre ways. I know that where you are now and living with all of this, it is difficult for you to believe and accept that, but it is true. Once you are ready to accept it and figure out a way to deal with it inside, it will make your life much easier.

My uncle who took care of his wife with AD all those years and put up with all her anger, somehow knew that it wasn't really the same woman he had been married to for over 50 years..the woman who raised his children and didn't have a mean thing to say to anyone and had such a wonderful sense of humor. Takes incredible strength, not easy, but it can be done.

3261. thoughtful - 6/2/2001 8:29:17 PM

Also, this desire for sweets by gran is very interesting. My grandfather also had intense sweet cravings. As I said he and grandma were living in the house by themselves with either Mom or uncle stopping in to take care of them 2-3 times per day or more. Many times Mom would show up and find that grandpa had been literally "drinking" maple syrup. He would do that with other sweets as well. He was the one with the b-12 problem, so if you can get gran to have a b-12 check that might be a good thing to add to the list with dr.

It is clear to me in your posts that Britt (how old did you say she is?) is looking for and needing protection from gran. When you're putting locks on your door, better put one on for Britt too...and if d isn't home, why not have britt join you in the "safe" room behind closed doors? Don't think gran won't come knocking, but at least she won't get in or snap on lights and such. The fact that she's chasing Britt around all night as she does with you and D should help you recognize that the woman is not all there and not behaving out of malevolence but irrationality.

3262. thoughtful - 6/2/2001 8:34:01 PM

Oh, I meant to add about the house and transfering it, there is a look-back period where they can go back in records to see if there was a transfer of assets. If there was, they can void the application for medicaid. So the sooner the transfer happens, the sooner you will be able to apply if you need it. I suggest checking with a lawyer about all these issues. While some people shy away from it as lawyers are expensive, my view is if you have assets like a house that is valuable enough to want to preserve, then you can afford to pay the lawyer to see the asset is saved. As I said each state's laws on this are different and you need to do what you can to preserve the assets you can -- so gran can keep her end of the bargain to give the house to D.

Also, you didn't mention that much about your relationship with gran's daughter, but it seems to me that if she cares enough to visit a couple of times a week despite her meanness, you may have an ally there you are unaware of. You might want to sound her out some more about your situation.

Let us know how things are going.

3263. Jenerator - 6/3/2001 5:10:53 AM

thoughtful,

I love you friend, thank you!

I only have a brief couple of minutes, as I am on granny-patrol.

Today, the daughter Virginia came over at 11 am. Within 20 minutes, she came into my room with a depressed look. She and I chatted about her mom and how hard it was for Virginia to come over. I was sad for her but understood. I was right suspecting the history of disapproval from granny wrt her daughter and even now ( 60 years later) it still hurts the daughter. Granny doesn't say two words to her the entire time she visits. She only asks, "Where's Brittani, where's Donny?" Literally every ten minutes!

She refuses to do anything including get dressed or brush her hair. Imagine spending every Sunday all day doing this. She is indeed an ally, and I feel for her. At least I'm an outsider, I would be so hurt if my mother treated me this way.

thoughtful, I agree that she is becoming increasingly irrational, but I can't help but think that her true character is coming out more. It's as though all of her controlling issues, emotional manipulation, and jealousy she's had her whole life, are becoming magnified with AD -- or whatever it is she has. She hasn't always been the sweet innocent old lady...

3264. Jenerator - 6/3/2001 5:11:03 AM

Today, she called Brittani's mom and told her that some stranger had taken Brittani. I took her swimming this afternoon. The mom was justifiably concerned! So, I had that to deal with.

Just two minutes ago, granny told Brittani, "You'll be sorry when anything happens to me!" as a threat. Just like her, "I'll kill myself and you'll be sorry!" I sat down next to her and asked her if she said that (I knew she did, I just wanted to establish her memory of it) she said ,"yes."

I told her that those kinds of threats were not good for Brittani and that she shouldn't say those kinds of things to a 10 year old. She told me that it wasn't bad and that Britt's old enough to understand. I told her that her threats were unacceptable and that if she continued to talk to Brittani that way, her mom was going to come up and take her.

"Well tell that horse's ass to go ahead!!"


What am I supposed to do??


I have to go, I can hear her stirring in the kitchen knocking things over...

3265. CalGal - 6/3/2001 5:28:09 AM

Jen,

The discussions are pointless. At a certain point, your insistence on talking to her is actively contributing to your problems.

Also, I'm not sure what you see as "understandable" about the mother's concern. If the only thing she is concerned about is whether or not her daughter was kidnapped, then she's a dim bulb indeed. If she knew about the woman's illness, then why believe her? If she didn't know about the woman's illness until now, then I suggest that D be concerned about what the mother will do.

The issue isn't that the harpy "shouldn't say these things to a 10 year old", the issue is that a lot of parents won't be as, er, openminded as your husband is about letting their kids hang around unbalanced people. AD is one thing, vicious and cruel behavior is another. I would not allow my son to be around a person like that, and if my ex would not ensure that Spawn were completely protected (as in, never having to see the old bag) then I'd tell him he could get a lawyer because there'd be a custody battle. I suspect I'm not terribly unusual.

Why is it that people can't understand that quite often being patient with a bad situation is not only wrong, it can be actively harmful? The grandmother isn't responsible for her actions. Any pain that your grandmother causes Brittani is her father's responsibility.

3266. Jenerator - 6/3/2001 5:40:18 AM

CalGal,

I've been meaning to get back to you and everyone else regarding comments from last time. I appreciate them and your opinions.

The discussions are pointless. At a certain point, your insistence on talking to her is actively contributing to your problems.

You're probably right. It's honestly just hard *not* talking to someone who is rational some of the time.

Also, I'm not sure what you see as "understandable" about the mother's concern. If the only thing she is concerned about is whether or not her daughter was kidnapped, then she's a dim bulb indeed. If she knew about the woman's illness, then why believe her? If she didn't know about the woman's illness until now, then I suggest that D be concerned about what the mother will do.

She knew that granny was getting older but did not know how bad she was getting. She doesn't live here and her and D don't talk that much. Remember, he tends to "minimize" things because they don't bother him as much as they do me.

The issue isn't that the harpy "shouldn't say these things to a 10 year old", the issue is that a lot of parents won't be as, er, openminded as your husband is about letting their kids hang around unbalanced people.

3267. Jenerator - 6/3/2001 5:40:30 AM

I understand, but D wants to have his daughter stay with him. At this point, he doesn't think that granny's behavior is that bad, or that she is treat to anyone (including herself).

AD is one thing, vicious and cruel behavior is another. I would not allow my son to be around a person like that, and if my ex would not ensure that Spawn were completely protected (as in, never having to see the old bag) then I'd tell him he could get a lawyer because there'd be a custody battle. I suspect I'm not terribly unusual.

Well, Pam (the ex) is not going to say that Britt can't see her grandmother unless she's locked up or that she can't stay with her dad until granny's away from the house.

Why is it that people can't understand that quite often being patient with a bad situation is not only wrong, it can be actively harmful? The grandmother isn't responsible for her actions.

But I think that she *is* responsible for some of them. the fact that she can switch into good behavior mode around certain people proves it to me.

Any pain that your grandmother causes Brittani is her father's responsibility.

I agree.


I'll rent her cheaply if you want to torture your ex.

3268. Jenerator - 6/3/2001 5:41:50 AM

At this point, he doesn't think that granny's behavior is that bad, or that she is a threat to anyone (including herself).

3269. joezan - 6/3/2001 5:59:15 AM

Jen:

I suspect your husband's failure to own up to what needs done here may be colored - just a bit - by what he may stand to lose financially if his relationship with gramma turns sour.

You have considered this.

Maybe you need to let your husband know that to you, it's not worth it.

3270. CalGal - 6/3/2001 6:07:36 AM

Jen,

No, my ex is a generally good dad who would never allow his kid to suffer in order to make his own life easier. Better the grandma torture your husband, who has a lesson or two to learn about daddying.

Well, Pam (the ex) is not going to say that Britt can't see her grandmother unless she's locked up or that she can't stay with her dad until granny's away from the house.

I wouldn't be too dismissive of the idea. It's possible, of course, that she's dumb as a bag of dogshit and was more fussed by believing a whackjob about her daughter being kidnapped than the fact that her daughter is exposed to such a person. But your husband's ability to have his daughter around is dependent on that stupidity, or lack of caring, and that's a big exposure.

But I think that she *is* responsible for some of them. the fact that she can switch into good behavior mode around certain people proves it to me.

That doesn't make her responsible. And the fact that you don't consider her responsible is made obvious by the fact that you treat her like a child. ("Now granny, we're supposed to be nice to little girls, not say mean things, remember?")

But even if she is responsible and is actually a vile old woman who knows everything she does, it really doesn't matter in terms of assigning blame. Pride of place goes to the hub, who is allowing his daughter to visit in a somewhat abusive situation and is more caring about his own comfort than yours or Brittani's. A spot in second place is being held open for you, because you haven't much longer to go before your failure to deal with this by completely bowing out of the house puts a large portion of this shit on your plate.

Didn't you mention the grandmother before the marriage? I could swear I remember saying that something was a huge warning sign, but I can't remember if it was her or some money issue.

3271. Jenerator - 6/3/2001 2:50:21 PM

CalGal,

I want you to try and remember this, granny raised D. He loves her and feels indebted to her. I mean, he really, genuinely loves her. He cares for her and doesn't know what to do now that she's begining to get really get difficult. This is something he has never had to deal with before. Also keep in mind that D was only 20 when he had his first child. Granny of course was there to help. Brittani and granny were extremely close up until fairly recently.

When I first started dating D (July 99), Britt was staying over 4-7 days/nights a week. Although granny was annoying by always trying to feed the girl, she seemed to be completely sane. Britt didn't move until a year ago August, so it's been less than a year for Britt to be to *not* be around her granny full-time.

I wouldn't be too dismissive of the idea. It's possible, of course, that she's dumb as a bag of dogshit and was more fussed by believing a whackjob about her daughter being kidnapped than the fact that her daughter is exposed to such a person. But your husband's ability to have his daughter around is dependent on that stupidity, or lack of caring, and that's a big exposure.

No, I think that neither she nor him believes it to be really that "bad". She knows that I'm at home with Britt and she knows that granny is starting to go senile. I guess in her mind, having to deal with the grandmother hen is just part of it all when she goes to see her dad. Afterall, the dad doesn't make it out to be that bad, I'm always here and what could an 85 year old do, anyway.(?) I'm guessing this is what she's thinking. Plus, she had to deal with her when they were married, and her bad attitude isn't that far off from when she was mentally normal.

Plus, Pam doesn't want to seem like the "bad guy" if she takes Britt, because Britt would be upset for not being around dad.

3272. Jenerator - 6/3/2001 2:51:32 PM

I *do* think that gran is responsible for some of or most of her actions, but at the same time, I struggle with not-knowing which actions she's responsible for. She seems to make sense a lot of the time. She fully understands what you're saying when you talk to her. She can rationally speak and argue. It's her reactions sometimes that are not appropriate, and that's what I'm struggling with not knowing how to deal with.

She *knows* that she shouldn't talk to a 10 year old that way. However, she will *always* defend her actions, because she *always* has. Always. She doesn't act this way around strangers or her doctors, but when she's at home, she's rude and always grasping for control. I speak to her simply because I believe it's easier for her to completely understand, and no matter how badly she annoys me, I try to show some form of respect.

I would love to say, "Listen you old hag, DO NOT TALK to Brittani that way ever again. What you say is inappropriate and wrong, and you should be ashamed. You might think that guilt-tripping your 10 year old great grand daughter is good, but I think it shows you for the selfish, controlling, manipulative, evil woman that you are!!!!!"

But I cannot talk to the woman this way. Firstly, because I do not feel it's my place to put down my husband's grandmother this way (it's not fruitful, nor does it really remedy the situation), and secondly, it would create fiction between us (Me and D).

Pride of place goes to the hub, who is allowing his daughter to visit in a somewhat abusive situation and is more caring about his own comfort than yours or Brittani's. A spot in second place is being held open for you, because you haven't much longer to go before your failure to deal with this by completely bowing out of the house puts a large portion of this shit on your plate.

Let me split this up into two parts.

3273. Jenerator - 6/3/2001 2:52:21 PM

1.)Pride of place goes to the hub, who is allowing his daughter to visit in a somewhat abusive situation and is more caring about his own comfort than yours or Brittani's.

I do not think that D sees it this way. I think he feels stuck because he wants his daughter here, and is hoping that we can all go along in spite of granny deteriorating health. I do not think that he has consciously decided to have it this way because he doesn't care about anyone else's comfort but his own.

2.) A spot in second place is being held open for you, because you haven't much longer to go before your failure to deal with this by completely bowing out of the house puts a large portion of this shit on your plate.

Bowing out of the house is not an option for me at this point. I do not believe that moving out on our 3 month marriage is something that is going to resolve the situation. Does it all annoy me to death? Of course. Do I struggle with feeling alone in this battle? Yes. Do I want this situation to be taken care of by my husband? Of course. Do I think that walking away is going to solve the problem? No.

I'm trying to work as a team CalGal. Even when he fails in that department (which I think he has regarding granny) I'm trying to be supportive. Running away isn't an option for me, whether or not I feel like it at this point.

3274. Jenerator - 6/3/2001 2:52:33 PM

I shared this with thoughtful because she had some patient and wise insight to this matter. It's hard, and whether or not you've experienced anything like this, you should know that deep down, there are many other factors involved. I can't simply walk in to this house, declare it mine and move granny out. I can't be a bitch to her. I can't walk away from my husband or move out when it doesn't go my way.

I have to work it out. I have to find some way of adapting to caring for and living with an elderly woman who's not related to me except through marriage. Her bizarre behavior from Alzheimers is what makes it so difficult. If she was completely insane, it would be easier, but she's not. I'm trying to figure out what to do and what not to do, and it's hard.

3275. Jenerator - 6/3/2001 2:56:55 PM

joe,

Honestly, I think that D is trying to "stick by his grandmother's side" out of duty. He doesn't like this house any more than I do except for the few memories associated though his childhood.

I don't think that he's really even thought through the financial aspect of it all.

In some ways, he's still burying his head in the sand, but really, the value of this house is unimportant to both of us. Neither of us want to live here forever.

3276. thoughtful - 6/3/2001 3:49:11 PM

Jen,
I would love to say, "Listen you old hag, DO NOT TALK to Brittani that way ever again. What you say is inappropriate and wrong, and you should be ashamed. You might think that guilt-tripping your 10 year old great grand daughter is good, but I think it shows you for the selfish, controlling, manipulative, evil woman that you are!!!!!"

I agree you can't talk that way to gran, but I would suggest that you can say, "Do not talk to Brittani that way ever again. What you say is inappropriate and wrong, and harmful to her. You must not do it again." I think it is very appropriate for you to draw lines on what is acceptable behavior and what is not...remember her judgment is going so she needs someone like you to help enforce it because she can't. Hard as it is, she is becoming the child and you need to become the parent. I can't begin to tell you how difficult this was on my mom -- my grandfather used to scream that she was killing him when she was just giving him a shave...he used to bite her (fortunately he had no teeth) when she would try to wash him...changing socks was always a huge battle. There is no easy way here. But you NEED your own space to recuperate.

3277. thoughtful - 6/3/2001 3:49:33 PM

I agree that she is becoming increasingly irrational, but I can't help but think that her true character is coming out more. It's as though all of her controlling issues, emotional manipulation, and jealousy she's had her whole life, are becoming magnified with AD -- or whatever it is she has. She hasn't always been the sweet innocent old lady...

Yup, I've seen it. I believe that as we age, whatever we are, we only become more so. What happens is that we are what we are and we also work at maintaining a shell around ourselves to shield our true nature. As we age, we either become less interested, less able or less willing to maintain that shell and all of the emotional, irrationality and bizarre aspects of our personality that were kept under cover start to emerge.

Gran's preoccupation with Britt reminds me of a story about a woman in the nursing home my mother frequents....woman would spend all day and all night every day asking for Rose. Rose, where are you Rose? I need you Rose. Nonstop. So finally the family managed to bring Rose to the nursing home, the woman takes one look at her and says, "Who are you?"

My MIL calls out my hubby's and my name nonstop. When we go into the home, everyone knows our name as they hear it all the time. But that doesn't stop her from failing to recognize him or confuse him with someone else half the time.

3278. thoughtful - 6/3/2001 4:09:39 PM

I disagree with Calgal's hard-line approach which probably comes as no surprise to anyone.

Whether you are living with D with gran in that house or not, it won't change his relationship with gran, the fact that he feels the emotional attachment that he does to her and the fact that he feels responsible for her care. He is not going to abandon her and it wouldn't be fair, nor is it necessary to expect him to choose. It is, however, IMO, important for him to recognize that the situation is bad, deteriorating and options need to be explored now. The longer he waits, the fewer the options become. Sounds like Virginia and D need to get together and discuss more thoroughly what needs to be done. D doesn't sound any different to me than my family or my husband's family (and most of human nature) that it's much easier to deny and postpone than grab the bull by the horns...especially when you don't want the bad stuff yet to come and you have no experience with how bad it can get or how to deal with it.

Jen, don't underestimate the value of the house. You may not want that house, but it may help you get the home of your own that you want in the future. It's not being mercinary, but after all the work and emotional strain that you will have faced for this woman, she owes it to you to give you something in return. You have already given her more than she could ever repay.

There was something else, but I can't remember now. I'll check in again later. Hang tough, kiddo.

3279. thoughtful - 6/3/2001 4:24:02 PM

One more thing, though this isn't what I can't remember....start asking around for places that provide counseling services for eldercare. There are all kinds of support groups for people dealing with AD patients...and you might find them through churches, community service groups, or even through area hospitals. You need to start talking to people who are coping with the same situation and learn what tools seemed to have helped them and to learn that, even if D can't/won't/doesn't know how to support you, it doesn't mean you can't get the support you need. I am fortunate that through work I have access to an eldercare counseling group and used them to help us through many of the situations I've briefly alluded to in my family. Truly invaluable when you need it...and it sounds to me like you need it bad.

3280. Jenerator - 6/3/2001 6:49:26 PM

Thank you thoughtful.

CalGal's hardline approach doesn't work for me either and her trying to assign blame to me and my hubsand for the "shit" on my plate or whatever she says doesn't make me feel hopeful either.

So, I am going to see if I can find a local AD support group and really apply your advice.

Thank you again, you've really helped me already!;-)

3281. thoughtful - 6/3/2001 9:02:34 PM

jen, one more very important thing as you struggle with this dilemma. Forgive yourself. It is so important to cut yourself tremendous slack. You are doing the best job you know how and are giving it far more effort than even gran's own children are. There are times when you'll do it right, and no one will appreciate it. There are times when you'll mess up despite your best efforts. And given her disease, even something you've tried before that worked, may not work the next time. That's just how it is. But know that you are doing the absolute best you can. There is no manual for this situation...there are no steps or procedures to follow. It's seat of the pants and learn by doing the whole way. When you make a choice or decision, know it is the best one at that time. After all, there's no one doing that job better than you...you are doing it all. Congratulate yourself well and often. Celebrate every little victory, no matter how minor.

And as difficult as it might be, do try to keep perspective on this. You will outlive this woman. Just like cutting teeth, it hurts like crazy at the time, but it really is a temporary situation. With the learning and strength you gain here, what's to come to you yet in life will seem like a piece of cake!

3282. ChristiPeters - 6/3/2001 9:24:32 PM

My Mom is approaching 74, currently living alone, coping fine, and enjoying life. However, I noticed differences in hearing and memory on my recent visit and I know I and my brothers will eventually face decisions on how to care for her. So, while I do not yet face the precise situation being talked about here, I wanted to say I appreciate this discussion.

3283. thoughtful - 6/3/2001 9:52:54 PM

Christip, I'm glad you find the discussion useful. If you're the only daughter, chances are the most responsibility for mom will fall on you. Also, I consider my mother and I most fortunate in that we've only had to care for one generation at a time. Mom's kids were grown when she was caring for her parents, and I don't have any children so am able to focus energy on the prior generation. For so many parents, balancing work, child care AND eldercare all at once becomes a nearly impossible task. I'm a big believer in keeping and helping parents stay as independent as possible as long as possible. Don't borrow trouble...it will come to meet you soon enough. But in the back of your mind, keep a few of these issues in mind, start thinking about how you might handle it, and start talking to Mom about it--while she's able, she may have her own things to offer up about what she wants if she can no longer live independently. I'm sure she's already seen some things happen to friends of hers and I'm sure she'll have a lot to say on the subject.

3284. Ronski - 6/3/2001 11:14:05 PM

Get Moving

(temp. link)

3285. thoughtful - 6/3/2001 11:27:13 PM

Hah! Ronski, I was talking about SEDS just this a.m., but with a different meaning. Given the tax bill just passed, there's no estate tax if someone dies by 12/31/2010, but a hefty one if they die after 1/1/2011. So I figured that there will be a new disease: Sudden Elderly Death Syndrome where older wealthy people will be dying inexplicably in December 2010!

3286. janjon - 6/4/2001 12:24:36 AM

don't laugh. This crazy aspect of the new tax bill will of course be remedied. But, assuming that it isn't, you can rest assured that there will be any number of life supports lifted (and even suicides by some acute but feeble/in pain elders) at or around Christmas time in 2010. Merry Christmas and Happy New Year, eh.

3287. ChristiPeters - 6/4/2001 1:17:44 AM

"If you're the only daughter, chances are the most responsibility for mom will fall on you."

Yep, already been tried. Luckily for me, Mom can't stand the Texas heat.

"....start talking to Mom about it--while she's able, she may have her own things to offer up about what she wants if she can no longer live independently. .... I'm sure she'll have a lot to say on the subject."

Actually, the General - ooops, Mom - has already laid down the law to us troops .... um, her children. &:oD

We've been talking about these issues since my Dad passed away in 1997. My mother has acted as a grief counselor for her church, had the care of her own mother, and has helped a lot of her friends care for elderly parents. She has her plans all laid out.

She has dealt with the financial planning, has a durable power of attorney, and has a Living Will. Copies of everything are with all three of us kids and her lawyer.

Right now, she is content to live alone in the house she and my father bought when I was 19 and continue her busy social life.

Her next move will be to live in her own apt/assisted living/or retirement community near one of us kids. She made the rounds to check out each of our cities and picked out favored homes in each one.

She figures the next step is to move in with one of us and we have each prepared a room for her in our homes. That was the driving force behind my getting the size house I did.

Finally, she plans to end her days in a nursing home should she be unlucky enough to outlive her ability to care for her basic hygiene. (Her phrase, not mine) She said she put her Mom in a Nursing Home and sees no reason why we shouldn't do the same.

My Mom and I have had our differences, but I fully recognise that she has an awesome intellect and is great at foreseeing and planning for future possibilities.

3288. JudithAtHome - 6/4/2001 1:22:22 AM

She does sound as though she has everything well thought out. Congrats on having inherited good genes, Christi...I see certain of the same qualities in you.

I lost both my parents swiftly and am thankful for it every day. It was better for them and for me, though of course, I didn't think so at the time.

3289. ChristiPeters - 6/4/2001 1:30:07 AM

I hope and pray that I die suddenly when I die. I only have one child and I do NOT want to be a burden on her.

3290. CalGal - 6/4/2001 1:34:31 AM

Jen,

Actually, I said that blame goes to your husband for allowing his daughter to be exposed to an abusive person and for taking advantage of you.

He is uncomfortable with making hard choices, and so even though he knows you suffer he makes the more comfortable choice (taking advantage of you). That is putting his comfort ahead of yours. But as I said, if you choose to tolerate it then it becomes your responsibility as well.

The daughter issue is quite different, but it depends on just how abusive the grandmother gets. In any event, if he puts his grandmother's interests above his daughter's, that's a problem.

As for the rest, I'm not sure what you see about my approach as "hardline".

Thoughtful says, It is, however, IMO, important for him to recognize that the situation is bad, deteriorating and options need to be explored now.

Well, sure. And if he does, no problem. But he hasn't thus far. And what if he continues to deny or blame or hide his head in the sand? What if she lives 10 more years? Are you going to wait every day, hoping he snaps out of it?

All I'm saying is that in the short term, you will serve both yourself and him far better if you refuse to allow him to take advantage of you, and insist that his decisions be as solicitous of your feelings as they are of his grandmothers. This is by no means inconsistent with being supportive, and in fact it is far more supportive in the long run than allowing him to use you as a free grannysitter and whatever else.

Although this money thing is new. If he's hanging around because he knows he'll get a lot of money, then by all means ask him to document this in writing and then figure your time spent as an investment.

3291. ChristiPeters - 6/4/2001 2:20:20 AM

Jen - I agree with both CalGal and Thoughtful that you need to have a thorough discussion with your husband. He's not going to magically see how hard this is on you and on his daughter unless you tell him. It may take several talks of increasing firmness to get through. Human beings are very good at not seeing what they don't want to see. This is not a slam at your husband - we all do it and usually not consciously, either.

3292. arkymalarky - 6/4/2001 4:02:14 AM

Jen,
This sounds a lot like the early stages of my grandmother's dementia. Mose has had a great deal to do with her, but not nearly so much as your step-daughter. I would not have left Mose alone with her great-grandmother, but they have spent a lot of time together and love eachother dearly, and Mose has always understood (because she remembers Grandmother well before her first stroke) that Grandmother is delusional and can't help her behavior. It will amaze you how quickly they will flit from reality to delusion, and it's very difficult to handle when their physically strong. We've had to get my grandmother off the roof, out of the attic, take her car away, etc. When she first went to the nursing home she was aggressive and hostile. In her mind she was fighting with all her might against an enemy that was robbing her of her freedom. Actually, that is what's happening, but there's really no way around it in the long run. In all of this my parents were angry and hurt and stressed and got no help from my aunt and little from my uncle, both of whom live far away.

This situation is extremely hard, but it is temporary, and once you settle into a decision on how to deal with things and begin to implement it--for my parents it was the nursing home--things will begin to improve quickly; but there will be challenges as long as she is living.

It's hard for anyone who hasn't had to deal with such a situation to advise, and I've only had to very indirectly. Had your husband not been raised by his grandmother you would be in the same position I'm in and would not likely have to consider a similar problem until his daughter was grown. But as you say, he won't lose sight that she's his grandmother who loved him and raised him, and he shouldn't. He just needs to gain some perspective, and the only way to do that is if you two communicate with eachother and with people who are capable and qualified to help you.

3293. JJBiener - 6/4/2001 5:19:17 AM

Jen, I have been following the discussion in this thread. I haven't posted because you were already getting good advice, and I didn't think I could add anything. The only thing I can add at this point is to tell you that I feel for you and you are in my thoughts. You are in a difficult situation. I wish there was a simple solution but there seldom is. Honesty and communcation are the keys in my opinion. Be honest with your husband and yourself.

And hang in there.

3294. joezan - 6/4/2001 6:29:46 AM

(from Inferno)

8470. Jenerator - 6/4/01 8:03:59 AM

joe,

Where can I e-mail you? (from the health thread...)

Jen:

joezan1@hotmail.com

I haven't used it in months - even tried everything known to man to cancel it. But apparently it's mine forever, because it's got about a zillion unread messages in it, some from today.

3295. thoughtful - 6/4/2001 4:32:46 PM

ChristiP, you are most fortunate to have the mother that you do. The fact that she cared for her mother I'm sure makes her far more understanding of the situation. My mother, having cared for her parents, has already told me that she will most willingly go into a nursing home if she needs to...especially if it has a whirlpool tub and daily massages!

My MIL and my grandparents never had to care for anyone and had no idea what's involved in caring for the elderly. They made no plans except to force their children to promise they would die in their own beds. Not much of a plan in my book.

I think caring for the elderly is XXX times harder than child care: children are geared to be obedient to their parents; child care is far more predictable; child care lessens as the child ages and children grow and expand injecting life into the household; and children trigger that maternal/paternal instinct that makes them so much easier to love and do for.

3296. thoughtful - 6/4/2001 5:35:37 PM

Once more into the breach....

My dad survived lung cancer 10 years ago. Now he's going to be 81 and they found a spot on his lung. He has been a diabetic for almost 40 years and the disease is now impacting all of his systems: vision, kidney, heart, circulation, nerves.

I can't believe that we have to go through this again. You always sort of count on that 5 year window and don't expect it to start up again. While I fear for the worst, I'm hopeful in that it is only one spot and not that large so I'm hopeful that it hasn't spread. No one lives for ever and everyone has to die of something and 81 is a good long life considering how much punishment he's given his body over the years. Still, he's my Dad and I don't want to lose him.

Sigh. I'll let you know how things progress.

3297. arkymalarky - 6/4/2001 5:44:37 PM

I hope it goes well, Thoughtful.

3298. christipeters - 6/4/2001 6:20:04 PM

Thoughtful -

You are in my thoughts and prayers.

When my father died, he was 75, had done all he wanted to do in life, and he went fast - five weeks from initial diagnoses to death. All his family and friends rallied around him and made sure he had a chance to say good-bye to everyone and to have a last visit to his favorite fishing and hunting spots. So, it was as good as we could make it for him and for ourselves.

It still hurt like hell.

Intellectually, we all 'know' that the normal course of life is your parents will die before you do. However, no matter how old you are, how grown up you are, how prepared you think you are, it is always hard to lose your Daddy or your Mommy.

3299. thoughtful - 6/4/2001 9:15:54 PM

Thanks for your kind expressions. I hope it goes well too. I've tried to tell my parents and my in-laws that we only do one at a time, and now it's MIL's turn so Dad just has to wait....but somehow I don't think he'll listen (why should he start now?):-)

3300. thoughtful - 6/4/2001 11:17:06 PM

On a completely different topic, I think I have finally found a cure for toe fungus which is inexpensive and safe....white vinegar. I put white vinegar in an eye dropper bottle and put the vinegar on the affected toe nail--around the cuticle, cover the top and under the nail--twice a day. And I've had significant improvement. Only thing is you can't miss even once or the fungus will start to attack those cells again -- sort of like you are innoculating the new cells growing each time against the fungus. I haven't missed since February and now about 2/3 of the nail is clear. I'll keep it up for 9-12 mos total, just to be sure.

3301. JJBiener - 6/4/2001 11:41:03 PM

Thoughtful - There is an effective medication for that. It is a bit more expensive than white vinegar, but it works in a couple of months.

3302. Ronski - 6/4/2001 11:48:56 PM

It also does major warfare with your liver.

3303. thoughtful - 6/5/2001 3:29:33 PM

jj, I tried that medication and it did nothing for my toe, though it did help my husband's toes. Plus given my recent history with Rx drugs, I'm going back to my original bent and looking for natural solutions wherever possible. Kidney biopsies are no fun.

3304. thoughtful - 6/5/2001 4:52:32 PM

Diabetic or know someone who is? Check out the effects of cinnamon on insulin utilization.

3305. Jenerator - 6/5/2001 6:38:21 PM

thoughtful,

I'd give you a big hug right now if I could. I'm so sorry to here about your dad. Keep us posted on what happens.

I took the kid out yesterday to see "The Mummy Returns" and although I wanted to kill granny because she started threatening us with calling the police for "leaving her" and telling me that I'm not the kid's mother, I found five minutes of solice while looking at The Rock's body as he fought as the mortal Scorpion King.

Damn that man is hot (but I've been saying that for over a year!) ;-)

3306. thoughtful - 6/5/2001 6:55:08 PM

Thanks Jen.

I wanted to kill granny Time to brush up on your wild mushrooms? Here, gran, how 'bout some nice warm stew!

(I of course would never act on such a thing, but I do get such a psychological relief when I imagine such scenarios...maybe pp knows why....read too many grizzly murder novels?!)

3307. JudithAtHome - 6/5/2001 7:01:39 PM

I blame it on the proliferation of reruns of Unsolved Mysteries .

3308. Jenerator - 6/5/2001 7:01:46 PM

Britt and I are getting weird. Last night for dinner we stopped at Sonic to buy grandma a cheeseburger. We only get her the most basic meal because buying her the deluxe anything would be a waste of money. So, for secret giggles, we cut the burger in half then in quarters. We then gave her two pieces equalling one half of the cheeseburger (remember she only eats half of anything we give her to show control). Well, she only ate half of that! So, granny ate 1/4 of a mini cheeseburger, proving our point.

3309. ChristiPeters - 6/5/2001 7:10:29 PM

thoughtful - thanks for the link re cinnamon and diabetes. y'know, I've always liked cinnamon. &:o)

3310. JJBiener - 6/5/2001 7:14:14 PM

I met a stripper once named Cinnamon. I wonder if she would have the same effect. This probably belongs in the Sex thread, doesn't it?

3311. thoughtful - 6/5/2001 7:57:56 PM

jj, maybe, unless it was paint she was stripping...then it belongs in H&G thread!

3312. thoughtful - 6/5/2001 7:59:23 PM

Jen, does that mean if you server her 2 burgers, she'd eat one?

I actually think that's great. You're in this situation, so you and Britt might as well have as much fun with it as you can!

3313. PsychProf - 6/5/2001 8:07:05 PM

Thoughtful...I know why people fantasize scenarios, but it will cost you a beer in person to get the answer...hahahaha

3314. thoughtful - 6/5/2001 8:14:38 PM

You're a hard man, pp.

One of these days I'm going to surprise you and show up at your office and then you'll have to buy me a drink!

3315. PsychProf - 6/5/2001 8:21:09 PM

I would love it.

3316. JudithAtHome - 6/5/2001 8:25:24 PM

Thoughtful and Psych Prof, sittin' in a tree.....

:-)

3317. PsychProf - 6/5/2001 8:26:49 PM

She has ignored my advances for years...

3318. thoughtful - 6/5/2001 8:30:11 PM

Sorry, pp. You're as cute as a button, but, alas I'm already taken...and so are you!

3319. PsychProf - 6/5/2001 8:42:29 PM

Seriously, Thoughful, give me a call at the office sometime and we'll share some fun...

3320. thoughtful - 6/5/2001 9:46:05 PM

Will you look at this guy? Comin' on to me, and can't even spell my name right!
):-)

3321. Jenerator - 6/6/2001 7:40:52 PM

granny fell last night, hitting her face on one of the chairs. She smashed her glasses into her nose, cutting it across the bridge and bruising her cheek. She had been hamming it up last night with the sympathy routine, so Britt and I foreknew that she would most likely fake a fall or complain of pain from a non-existent injury. This fall was more forceful than her usual staged accident, but what's strange is that five minutes after it happened, I went to her room to check on her cheek and she had no recollection of falling. She flatly denied it.

I have been trying to get her into the doctor's today so that she could be admitted (she had been complaining of seeing double and is extremely weak -- when she fell we saw her secret stash of vitamins that she's been hiding instead of taking), but they just wanted me to park her in the ER waiting room.

I got a little more persuasive with them, and so now we're going to the doctor's office for the diagnosis.


It's Virginia's 68th birthday today and all granny could say was, "Who cares if it's her birthday, I'm sick."


Lord I hope she's admitted.

3322. thoughtful - 6/6/2001 8:26:55 PM

Jen, Wow. Gran's got real problems. Being weak and seeing double is no surprise if she's eating so little and not even taking vitamins. Whether her fall was staged or not, no doubt she doesn't remember it. The woman is not rational and clearly has significant problems with her short-term memory. I hope the doc admits her if for no reason than to get her well adjusted on meds that will help control her behavior.

3323. thoughtful - 6/6/2001 8:58:18 PM

When it comes to AD, important information isn't getting through: cnn article.

3324. Jenerator - 6/7/2001 3:35:18 AM

Took granny to the doctor's. He ordered chest x-rays and x-rays of her shoulder, urinalysis, and blood tests; all of which came back normal. She has lost five pounds since last week, but only because she's refusing to eat. She's not seeing double (lied about it) and has no concussion. While waiting to see the doctor after all of the tests were done at the adjacent hospital, she got an attitude with me. She forgot why we were even at the doctor's claiming she was fine. I asked her if her shoulder hurt, no. Her cheek, no. Her chest from coughing and spitting up, no. "I'm fine, there's nothing wrong with me." she replied. The doctor came in and she changed her tune, "Oh my arm is killing me!"

He sat down and told her that all of her tests came back normal and that she was in essence, fine (as far as the tests were concerned.) He asked her (and me) if she was eating and she smiled and said, "Oh I eat everything given to me." He looked at me, and I told him that the truth, that she barely eats or refuses to eat. She looked at me and told me to shut up.

That's when I started to get pissed off.

He then asked her if she was getting dizzy when she stood or walked, and she replied, of course, "No, I never get dizzy!" He looked at me and I told him that she had been getting dizzy when she stood up because she was not getting any exercise because she refused to and that she fell both at home and the doctor's office (right before he entered the room)complaining of dizziness. Heck, when the nurse took her blood pressure she complained about dizziness!

She looked at me and said, "You don't know nothing, so shut up! All you care about is getting me into the hospital."

I waited a few minutes, politely excused myself and called my husband. I had had it!

3325. Uzmakk - 6/7/2001 3:37:04 AM

Forget the hospital. Get that woman directly into the home.

3326. Jenerator - 6/7/2001 4:03:16 AM

It won't let me cut and paste the rest.

Basically, my hubby gave granny a good scolding and took her home, we came to Marshame's for relief.

D isn't sure whether or not to take Britt home tomorrow or what.

This might sound weird, but I'm glad he came through for me and that he got to see the nasty side of her. The more she pushes him to the edge, the more he's ready to do something.

He promised to see the attorney next week and get the papers ready for a nursing facilty.

Praise God, let it be so!

3327. joezan - 6/7/2001 7:09:34 AM

Great news, Jenn.

I mean, it's sad in a way. But if something drastic has to happen, at least it's happening to her.

3328. arkymalarky - 6/7/2001 5:52:20 PM

It's the inevitable, I think, from what you describe. Just don't be disappointed if it goes kind of slowly. It helps if all your husband's relatives are on board with the idea.

3329. Jenerator - 6/7/2001 6:05:07 PM

Thanks Joe and Arky.

It's 10 am here and now Britt and I are faced with going home. We spent the night at Marshame's last night night and had a blast. We made bracelets, played with the dogs, watched movies, ate junkfood and had a solid night's sleep. Now, we must saddle up and face the woman.

I'm sure she'll be "happy" to see us, but I dread it.

How would you all deal with that? Even when granny (she goes by Nen, which is short for Neneh/Nanny) is in one of her better moods, I have a hard time wanting to be around her. I avoid her as much as possible now. So, I don't want to be rude when she's on an up swing, but I simply cannot stand to be around her.

D has to leave town today and we're going to be stuck with Nen tonight, ALL night.

3330. Jenerator - 6/7/2001 6:13:20 PM

thoughtful,

I am starting to identify with that article! Having spent all afternoon in the doctor's office yesterday, I really witnessed his reluctance to even talk about Alzheimers. I truly believe that most senior care doctors have sort of an inherent apathy with regards to the elderly. As he told me twice, everything she's doing is to be expected because two things happen when people age that "we" cannot fix: mental illness and aging.
No discussion on treatment or empathy, just a "here's what's on the plate" type of mentality.

Also, I meant to tell you, he could not admit her yesterday because none of her tests came back abnormally. For medicare to pay for the costs, she has to be diagnosed with a treatable condition, or we would have to pay out of pocket and upfront. At $5,000 a day, Nen would have to come home. The actress!

3331. arkymalarky - 6/7/2001 6:17:24 PM

She's not your grandmother, so it's hard. I always had that and all the times Grandmother was so good to me--she never was anything but good to her grandkids before losing her mental faculties--for perspective when I was with her and she was "acting up." She would also call when my parents were gone (they got many calls every day when they were home, but she continued to live alone until she went into the home), and she would tell me all sorts of outrageous stuff. She wasn't making it up, her head thought they were true.

It would be so much easier if y'all didn't live in the house with her. Family members see that people in this mindset need to be babysat, and I guess they do, but unless they have full-blown alzheimers and wander away I don't know that it's not best all around to give them as much independence as possible and keep your own sanity until the very last minute. If they burn themselves and the house down, at least they had their independence to the end.

I don't know what to tell you about tonight, except take the easiest way by anything that comes up that you can. Just nod or smile or whatever, and if that doesn't work, take whatever path does work with the least resistance, for your own sanity and benefit, not hers. And just keep thinking "temporary."

3332. arkymalarky - 6/7/2001 6:20:59 PM

And what you describe with the doctor sounds very familiar. Grandmother's tried to help, but there wasn't anything he could do. Medication didn't work and there was nothing but full time nursing home care that would work, and no one was ready for that. They tried in-home care, but she was too unpredictable and hostile for that. She would think they were strangers who'd set up camp in her house without permission.

I think I told this before, but when she first went in the nursing home, she tried to run all the other old people out of the living area as they were watching tv because she thought it was her house and they'd all invaded her living room and she didn't know a one of them.

3333. Jenerator - 6/8/2001 8:16:24 PM

That sounds just like Nen. Her paranoia is really starting to kick in.

Tell me, what would you do if you were in my shoes and you believed that soon, you would have a physical confrontation with this woman?

This morning, she got an attitude with me because I had written on the gigantic dry-erase board the day's events. She didn't want to leave the board where she could see it. I gently reassured her that it was to help her so that she'd know where we were going, and so that she wouldn't have to worry. She called me some names and then got up and threw the board. I waited for a few minutes and put it back. She did this two more times. I had gone to the restroom and she hid it pretty well this time (it was only 7:45 am). I asked her where she put it and she wouldn't tell me. I told her that I'd have to get another one because D and I bought it to help her and we wanted her to have one. She said, "This is not your house jack-ass, I'll just throw it away."

I told her to go ahead and throw it away because I'm buying a bigger one and going to nail it to the ceiling.

She told me that I have should have my head nailed to the ceiling.

I tell you, this was a true test of patience. I silently prayed and prayed for peace. I wanted to yell at her. I told Brittani to get her things that we were leaving, and then she threatened us with the cops again.

When her attitude has gotten this sour before, she got up and scratched D severely. She has those calcified, 85 year old fingernails that are instruments of torture!

If she tore threw my arm like a fish-hook, I don't know what I'd do.

3334. CalGal - 6/8/2001 8:17:40 PM

You would call the cops, I trust.

3335. Jenerator - 6/8/2001 8:20:54 PM

I can't imagine them arresting a half senile 85 year old woman in her nightgown.

3336. CalGal - 6/8/2001 8:28:09 PM

Do you suppose that the cops ignore violent people because they are old?

I doubt she'd end up in jail, but if she was violent I imagine they would take some sort of action.

3337. arkymalarky - 6/8/2001 8:28:32 PM

My advice, fwiw (at least what you pay for it, as they say around here):

Don't have a confrontation with her over anything unless you have to. I would have just dropped the message board issue. Arguing will do nothing except escalate the situation and give her more justification in her demented state to assert control over "her home."

Restrain her as much as possible if she becomes violent and call the police if you need to to help get her under control (not to have Grandma carted off to jail in cuffs). I would also call her doctor. Immediately talk with your husband about this latest incident so that you to can develop an emergency plan. It's better to have a plan to act on than to react, imo. Set in motion any permanent plan you may be working on as soon as possible.

3338. CalGal - 6/8/2001 8:31:29 PM

Don't have a confrontation with her over anything unless you have to.

Yes, I've been saying this for a while as well. Jen should be smooth and unflappable. She gives the biddy far too much power.

3339. JudithAtHome - 6/8/2001 8:32:07 PM

Jen, with all that has been going on with the Dallas police in the last few weeks, I'm not so sure calling them would be such a good idea...although given their response time, you'd probably have between one and two hours to resolve it before they arrived...

3340. CalGal - 6/8/2001 8:33:16 PM

I have a friend from TT who says, "Never call a cop unless you're willing to live with a cop's solution." But in this case, I think a cop's solution would solve a lot of Jen's problems.

3341. arkymalarky - 6/8/2001 8:34:41 PM

You could also just call 911 and I imagine an EMT might come out and administer an emergency sedative, but I don't know. All my grandmother's physical hostility took place in the nursing home under the delusion she was at her house with intruders.

3342. msgreer - 6/8/2001 8:46:01 PM

Jen

I took care of my father, his sister and brother..all who have Alzheimers. Dementia is the same thing. You asked what you should do because you feel there maybe a confrontation coming up. Jen, one of the many things I learned while taking care of dad is you do not argue with someone with dementia. I think if you just say sure, okay, and go along with whatever she says. That is a way to diffuse all these impossible situations. This is not a win-win situation. And if you can give up trying to rationalize with someone who no longer deals with rationality things will calm down. Now it is your husbands turn to take over..for you and for his grandmother. Jen, please, don't try to make sense with her. You will be spinning your wheels and raising your blood pressure at the same time. Do not take what she says personally. Nothing. Regardless of the hurt you may feel. You are in my prayers, Jen. If you want to talk I would be happy to give you a call. I have been where you are. I also have alot of background with nursing homes...your rights, what to look for, the whole nine yards. I'll be home later and will look for any post from you.

3343. msgreer - 6/8/2001 10:36:20 PM

Jen

I wanted to add when I just said fine to my dad he often forgot what he was saying so the entire issue dropped. I was able to redirect him too. It is such a difficult situation. One thing I do know is caregivers have to take care of themselves. I learned the hard way.

3344. Jenerator - 6/10/2001 3:28:58 AM

MsGreer,

I appreciate that. You're right. All of you have been right, I can't rationalize with this woman.

Again, what I struggle with is knowing that she knows what she's doing most of the time. She *does* know the difference between right and wrong, and her nasty streak is the same nasty streak she's always had but more magnified.

Yesterday though was, IMO, a turning point of sorts.

After Britt and I left, Nen continued to stew ALL day. She hid the dry-erase board (you're right Arky, I won't get upset about that, even though it's hard not to) and didn't eat a thing or take her medicine.

Part of our day was going to a neighbor's son's 9th birthday party, so Britt was able to play with peers and have fun. D, I, and the rest of the adults were able to talk and eat some great food. Although we were gone all day. D brought Nen home some barbecue, salad and rolls, at around 6 pm. He said that she was still being fussy.

3345. Jenerator - 6/10/2001 3:30:06 AM

Anyway, I called it an evening at midnight. D stayed with there with Britt --they live one street away. When I came into the living room, I saw Nen slumped over on the floor (with a pillow), the lights were off, the tv on, and the blinds open.
At first I thought she had fallen, but after closer inspection I noticed that she had gone to bed by the back door. I turned on the main light and asked her if she was okay and what she was doing. She replied hostily, "I'm sleeping, JENNIFER!"

I asked her if she wanted to go to her bed where it was more comfortable and she told me she was in her bed. I called D and he came home immediately.

When he physically picked her up, she started shrieking that she didn't want to go back into the living room. He reassured her that she was going to her room and it was painfully obvious for him that she was *out* of it!

He tucked her in, we both said goodnight, and she slept till 11:45 am this morning.

When he woke her up, she had pooped in her bed.

The three biggest warning signs that I had mentioned a year ago had happened:

1) inability to eat/feed herself
2) inability to walk
3) incontinence


D's very stressed and taking this to heart.


CalGal,

I think that if I were to call the cops on Nen for scratching me, it would be a traumatic experience for all of us. I have a feeling that a social worker would come out and then the whole can of worms regarding competency, guardianship, and so on would be opened. Not to mention the resentment my husband would have for me having his 85 year old grandmother arrested.


msgreer,

My e-mail is:

bratdogsadie@yahoo.com

3346. Jenerator - 6/10/2001 3:42:22 AM

Oh, and on a practical note, does anyone know how to treat hives? I've broken out in a severe case of them all over both fore arms and biceps.

I took a Benadryl last night and nothing's happened.

3347. CalGal - 6/10/2001 4:29:48 AM

I have a feeling that a social worker would come out and then the whole can of worms regarding competency, guardianship, and so on would be opened.

Precisely. But then, that's not necessarily a bad thing.

Hives: a paste of baking soda and water. It will sting, but works very well.

3348. Jenerator - 6/10/2001 4:39:57 AM

Thanks for the recipe, I'm off to mix it now.

Regarding Nen, just remember that one needs to have some level of compassion in this situation. I know you'd like to think that if it were happening to you you'd quickly deal with and wipe your hands of it, but it's never that easy.

3349. msgreer - 6/10/2001 5:05:22 AM

Jen

It certainly isn't that easy. I know that first hand. I have to disagree with calling the police. There is never a good time to place a loved one in a nursing facility, Jen, never. Every person involved has some reason why it is not the right time. If you are talking incontinence, inability to nourish herself and walking issues, you are talking serious medical conditions which require medical professionals. There comes a time when everything you and your husband have to give is not enough..meaning she needs more than you can humanly give her. And think about this, what if she falls because her gait is unsteady? You don't want to put her through a hospitalization and rehab. I know Jen. Certainly under different circumstances but with the general idea of knowing when one can no longer offer someone who they love what they need, I took my daughter to a hospital to get her seizures under control. She was there for five years. Now everyone around me knew she needed to go but I was the last to say yes, you are right, I have done everything I could but she needs more. And the same with her private school as well as her present living conditions. It is never easy. It is painful and rips everyone's heart out, but you need to do it. And it's okay, Jen.It doesn't make you a bad person and it doesn't say you can't handle family
traumas...this is way out of your league, Jen. Do you know a geriatric psychiatrist you could go to for help? Listen, it is late. I need to go to bed.
I will email you tomorrow. Hang in there. You have
all of us and we will see you through this.

And, Jen, what I did for my daughter gave her a quality of life she never would have gotten if she stayed home. Now I realize we are talking apples and oranges when it comes to quality of life, but knowing when to say no more, well, let's just say I understand.

3350. msgreer - 6/10/2001 5:08:09 AM

cont. When my mother and I were taking care of dad we made a deal. If one of us could no longer take care of dad we would place him in a facility. All it took was one of us saying no, I can't do it anymore. I think that needs to apply in your situation. And your husband has to honor your feelings. I'll be in touch.

3351. msgreer - 6/10/2001 5:10:59 AM

Jen

Hives. Baking soda paste is a good remedy, so it topical Caladryl. Are you sure it's hives? I ask because my mother broke out with what she thought was hives and it turned out to be shingles. I am not trying to frighten you. If you don't get relief from Benadryl, Caladryl or the baking soda and water paste, please, be checked out.

3352. HollyW - 6/10/2001 5:20:22 AM

I don't really know what the cops would do in this situation, anyway--take her to the hospital, I suppose. Either that, or nothing.

I worked in an Alzheimer's unit for a few years. It is very tough dealing with demented people who are that hostile. I can't imagine how much it must hurt those who are family and are the brunt of such nastiness.

I haven't read all the way back, so I don't know the entire story here, but she needs meds, first of all. Is she on any antipsychotics yet? I realize that she's not taking her pills anyway.

I'm very surprised at the doctor. It is fairly easy to get somebody into the hospital when the family can't cope anymore. Just about every elderly person has a sodium level on the low side--it is nothing to call it "dehydration" and get them admitted, put them on an IV, and get social work on board looking for appropriate placement. We call it a "social admit". (Don't tell the HMOs, ha.) Her behavior also makes her a candidate for a psychiatric unit--where I used to live, the hospital had a special Geriatric Psych unit (and this was rural CT, not inner city). She is clearly not safe, and clearly needs help.

Everything Msgreer said I second. Don't argue, go along with the delusion. If she says, what do you mean, I am in my bed!! and she is lying on the floor, you can say, "I know, dear, but I have fixed up a more comfortable one for you over here, if you don't like it you can go back to this bed," sort of thing, very very very low-key. And just get used to the weirdness.

Hang in there, Jen.

3353. Frankster - 6/10/2001 5:23:30 AM

Jen,

Let me guess what your hives might be the result of ? Follow through on what msgreer said.

Calling the cops might -- I say might-- temporarily play with her head and thus work in the short term in mitigating some of the crap you have been enduring from Nen, but it would undoubtedly leave a indelible mark on your marriage which will more than likely yield negative returns in the long run. It's something you should consider only as a last resort because of all the added baggage it will likely create.
I can't imagine what you are going through as I assume that you are posting but a fraction of what you have to endure on a daily basis. You're on the ropes tiptoeing on some serious eggshells there, young lady. I can't pray for you as you know, but I hope my daily thoughts and concerns of your current problem(s) send some positive vibes in your direction and help mitigate them somewhat.

...Calling the cops worked for me when I was dealing with my former next door neighbor, but I wasn't related to her, nor did I have to live with her. This wacko tested thresholds I didn't know I possessed, but after two years of constant BS from her, she finally went too far one day and I just had to do it. It worked. She moved out two months later. How I wish your problem was this easy to resolve.

3354. HollyW - 6/10/2001 5:24:15 AM

Shingles run along nerve tracks, they have a definate linear pattern. If you are just all blotchy and rashy, it wouldn't be shingles (just trying to head off some possibly unneeded panic!).

3355. Jenerator - 6/10/2001 5:48:38 AM

I love y'all.

Really.



Thanks for being there for me, I haven't been myself lately. Nor have I had the time to do much of anything outside of dealing with Nen for the last few months.

3356. HollyW - 6/10/2001 5:54:58 AM

Just print out msgreer's posts and tape them on the bathroom mirror, Jen. Really.

And take good care. God bless.

3357. msgreer - 6/10/2001 4:29:43 PM

Jen

Holly is right re shingles. They don't usually show up on the forearm. But it is a reflection of the turmoil that is going on in your body. And we all want you to take care of you.
Re hospitalization. First you need a doctor you can work with and will work with you. I don't know the law in Texas but in Florida if someone shows they can no longer live on their own and there is no viable alternative they go to a nursing home. Now I would think you would want to find a facility you and your husband are close to. This is my daughter's last day here, Jen, so I am busy with her. I have your email and I will write. If I knew which county you lived in I could help you with names of facilities as well as nurse advocates. I will email you when I get my daughter after my daughter leaves.

Let me say one more thing. If you serve her eggs and toast and she says I don't want this cereal, say okay, that's fine. Take the eggs and toast away, out of her sight. In ten seconds she will forget the entire thing. Do not argue. Just say sure, yes, I understand, that's fine. As I have told you I took care of my dad, his sister and brother but I have also helped over 50 families who had a loved one afflicted with dementia/Alzheimer's. It takes time to learn out to talk to someone with dementia. Okay, Jen, I need to go.

3358. msgreer - 6/10/2001 4:32:06 PM

Oh, Jen, one more thing. You mentioned how nasty she was. I have found, in many cases, the personality the person had when they were well often comes out in full force with dementia. Of course I can't stage her over this forum. Okay, Jen, I will be in touch in the next day or two.

3359. msgreer - 6/10/2001 4:34:20 PM

re 3357..delete after my daughter leaves, it reads better.

3360. Jenerator - 6/10/2001 7:53:07 PM

My husband and I had "the talk" last night (sort of). I was speaking calmly and in a gentle voice and told him that Nen was getting worse and that he wasn't seeing the full side of it as much as Britt and I have been. Also, that unfortunately the time was coming very soon that she would need more help than we were capable of giving her. He readily agreed.

But what broke my heart was when his eyes welled up and he looked away and said, "I'm not ready to throw in the towel. She always gets better."

I just held his hand and said, "I hope she does get better, but we need to be prepared if she doesn't."

At 3 am this morning, he rolled over, caressed my hair, kissed me on the cheek, and said softly, "I really appreciate you."

He thought I was asleep, but I laid there and secretly watched him fall back asleep.


I smeared baking soda paste all over my arms last night. Unfortunately it did nothing to relieve the hives/shingles.

3361. thoughtful - 6/10/2001 8:43:44 PM

Oh, Jen. I'm so sorry that you are going through this. I just checked in now and am glad that you got such good advice from others. Seems like everytime you post, the stories get worse and worse. I can't tell if she's deteriorating rapidly or if you are just telling us more of what you are going through.

If D is hopeful that she'll get better then there's no reason why she can't get better in a nursing home with the hope that it's a temporary situation. We hated putting my MIL in the home and we told ourselves that it was temporary...and within a matter of a month, it became crystal clear to us that it would be permanent. She would ask us how long she will be here, and we would respond as long as she needs all the care and attention the people here give her. And if she doesn't need that care any more, she could leave. That satisfied her for awhile. Of course, now she doesn't even remember being anywhere else and even talks about her sister and mother being there too -- though both are long-time gone.

I agree with the "don't argue" advice you got, especially if it's about inconsequential things like the board. Things that you may think are helpful may be a failure. Don't take it personally. I can't tell you how many things I tried to help MIL that failed when I thought they'd be perfect...and things I knew would fail that I had to try anyway to keep her happy. I found myself much more successful with my MIL when I asked her rather than told her... giving her as much a sense of control as possible.

3362. thoughtful - 6/10/2001 9:00:57 PM

I'm so glad that you and D talked and that you are clearly getting him to realize that the situation is untenable. While I realize that he's emotionally not ready to have her go, he must realize that you are more than ready. Sounds like you recognize that you are out of patience and that the situation is only getting more dangerous for nen and you. (Heck I woulda hauled off and slugged her a long time ago...Mom told me she used to slug her parents' couch so often that she swore it cringed when she walked by it.)

3363. thoughtful - 6/10/2001 9:29:43 PM

Probably the hardest thing is all the terrible things they say to you that you remember, but they don't...and they will deny every having said it...but that doesn't help you who still feels the pain of those hurtful things. The only defense against that is to remind yourself again and again that the person is simply not rational and doesn't know what she is saying. It is much easier for me now that MIL says really crazy things that have no relation to reality vs. what she used to say when she was being mean to me that sounded a lot more rational.

It must help to know that the first step...for D to see that the situation must change...has been taken and the process will begin in terms of getting the finances/care issues straightened out. That should reassure you that this situation is temporary.

3364. thoughtful - 6/10/2001 9:39:49 PM

calgal's #3338,
Jen should be smooth and unflappable. She gives the biddy far too much power.

I can't help but think you haven't a clue as to what she is living with.

3365. SnowOwl - 6/10/2001 9:53:38 PM

My sympathies are with Granny. She's got a virtual stranger coming into her home and trying to make changes. No wonder she's attempting to assert some control while she's still able.

It does not sound to me as though there has been very much real communication between Jenerator and her husband regarding the situation. If D is not ready "to throw in the towel" he needs to take more responsibility for ensuring that his grandmother has adequate care and that Jenerator has enough caregiver to support to ensure that she has time away from the constant care.

Lest anyone think I don't know what I'm talking about, for the past 2 1/2 months I've been staying with my younger sister who has small cell lung cancer with metastases in the brain. As a result of the brain tumours she's becoming increasingly confused and irritable and has periods of aggression. Recently she's started to believe that I'm trying to poison her and is keeping a dossier on all my supposed wrong-doings. It would be very easy for me to dump her in the hospice and return home (I live at the other end of the country from my sister), but that is simply not a consideration for me. As long as she wants to remain in her own home I'll do everything possible to ensure that she is able to do so.

3366. Jenerator - 6/10/2001 9:57:24 PM

thoughtful,

Thank you for your understanding words (as usual!)

Today has been relatvely painless. I have tried my hardest and succeeded at not arguing. However, the dreaded lunch break just finished and here I am frustrated once more.

As you know, she doesn't like any kind of food except that which is cheap, fatty and salty. So, for lunch, I made some mac-n-cheese and put it in a little ramakin for her (we're talking maybe 1/4 cup) a half of a ham and cheese sandwich and half of a small banana.

She ate three bites of the mac-n-cheese, and half of the half of the sandwich. I was cleaning the kitchen when I saw her feeding the food to the dog. I said nicely that the food was for her not the dog (the chihuahua weighs 25 lbs for a reason!) and she snapped at me. I said in the nicest voice I could muster that I had cooked that food just for her and the dog will get her own meal too when she had finished hers.

Then she put down the plate and the floor and looked at me like what are you going to do about it now!!
As much as I wanted to break the dish over her head, I casually picked it up before the dog ate all of the food and said, "Oh you're finished? Let me get that out of your way."

And maybe it's because Brittani's not my child, but her attitude is getting a little difficult too. I have filled every day of hers with something to do and I have faithfully taken steps to ensure that she has not been left alone here. So, what does she do....she constantly complains about how bored she is.


I feel so completely and totally unappreciated by everyone here. I just try and remember that I'm living with 2 1/2 kids at the moment, and kids by their very nature are unappreciative!;-)

3367. Jenerator - 6/10/2001 10:00:02 PM

Also, the stories I've shared in here have gotten worse. Nen's health has seemingly deteriorated rapidly just in the last week. However, I'm sure that a miraculous recovery will take place next week in the doctor's office.


SnowOwl,

This "relative stranger" has been in her house almost everyday before and after my stay in England as well as during my visits here doing that stay. I can say safely that I have been with her 17 months.

3368. Shannon - 6/10/2001 10:01:30 PM

My kids haven't started with boredom complaints yet, but I have friends who swear by the chore method. "Oh, you're bored. Well, you can wash the dishes, then."

3369. Jenerator - 6/10/2001 10:06:35 PM

I could make a list!


SnowOwl,

I feel like I should tell you this. Some of the changes I've made against Nen's wishes have been:

1) moping up the dust bunnies in the front entrance.
2) helping maintain the yard that she had been fined for having violated code standards
3) cleaning out some of the botulism in her pantry
4) having her dog pee-stained carpet cleaned

And so on.

So please, come over and sympathize with the poor woman.

3370. bubbaette - 6/10/2001 10:08:03 PM

Woah! Trying stuff for a new marriage.

3371. Jenerator - 6/10/2001 10:13:49 PM

I'm ready to be married.

3372. JudithAtHome - 6/10/2001 10:18:23 PM

Honey, you ARE married...this is unfortunately what sometimes comes with marriage. And I hate to say it but you had to have at least some clue that this sort of thing was coming....

3373. christipeters - 6/10/2001 10:24:02 PM

Jen - Kids will complain about being bored. Expect it. Don't let it get to you. I also find the chores solution to work very well.

If LD complains about being bored, I cheerfully list all the chores she could do - both her regular chores and stuff I need help with. This usually has one of two results - she stops complaining about being bored, or, if she's really bored, some chores get done.

I do something similar when she complains about being hungry between meals. I list some healthy snacks she is allowed. If she says none of that sounds good, I reply that in that case she must not really be hungry.

I have a suggestion about Nen and eating. Have you tried, or can you try giving her more frequent small meals? Put stuff in front of her about 6 times a day (pick easy to fix stuff or prepare it in advance and split it up into lots of small portions to make it easier for you). Let her eat as much or as little as she wants and don't stress over it if she doesn't eat. Don't expect her to appreciate you. Don't do it for her, do it for D who loves her.

3374. CalGal - 6/10/2001 10:39:27 PM

Snow,

I'm sorry your sister's not doing well. Keep yourself safe, please.

3375. Jenerator - 6/10/2001 10:40:55 PM

Christi,

She doesn't like to snack. She prefers the idea of eating at meal time. Odd given that she doesn't eat!

I'm glad you said what you did about your daughter, it helps to put it in perspective.

Judith,

I was naive. Nen was a sweetheart up until our wedding day. Seriously.
As I mentioned before, I used to volunteer to help D out by staying with Nen when he was out of town, we used to have fun. Ever since he announced our marriage plans she has gone from approving and supportive to downright nasty.

3376. thoughtful - 6/10/2001 10:45:17 PM

christip, that's a good suggestion about having her eat more often...I know MIL can't remember that she's eaten 5 minutes after leaving the dining room.

3377. JudithAtHome - 6/10/2001 10:56:55 PM

Ever since he announced our marriage plans she has gone from approving and supportive to downright nasty.

Well, then, this must be her illness bringing to the fore her natural personality which is extreme jealously of anything coming between her and D...so see it as an older woman resenting a younger one coming between her and her "son" and not as so evil old woman trying to thwart you at every turn...she feels deposed and is fighting back the only way she knows how, by making things hard on the usurper.

3378. JudithAtHome - 6/10/2001 10:57:37 PM

some evil old...

3379. christipeters - 6/10/2001 10:58:28 PM

Jen - Well, then, if it was me, I would put food in front of her at mealtimes and ignore whether she ate it or not. If she wants to starve herself to death, let her. That's essentially what my father did. He was terminal with the pancreatic cancer. It had spread to his liver and stomach. His stomach hurt and he didn't want to eat. The doctors said he needed ~5000 calories/day. We put tempting food in front of him, all his favorite fatty, high calorie foods, and let him decide if he wanted to eat or not. It broke our hearts to see him literally melting away before our eyes, but there was no sense forcing him when he was terminal anyway. Since Nen is presumably not terminal, if she continues to refuse to eat and that endangers her health, then that would be a reason to get her more help - hospital or nursing home.

3380. christipeters - 6/10/2001 11:01:52 PM

Jen - The only one who needs to approve of your marriage is D. Let her disapprove or approve as she wishes. You are married. That won't change unless you or D decide to change it.

3381. SnowOwl - 6/10/2001 11:08:50 PM

Cal,

Thanks. I'm safe, just absolutely exhausted. This is a horrible time for us all as we are simply waiting for the inevitable to happen. I must admit that in my more stressed moments I've hoped that it would happen soon. Thankfully I'm not the type to be plagued with any guilt for feeling that way. I just wish that things could be easier for my sister who is rational enough at times to know exactly what is happening to her and how insane much of her behaviour is.

I'm now beginning to miss my family very much. My youngest daughter came up for a couple of weeks and it was great having her here, but she returned home this morning so I'm feeling a bit flat and depressed.

3382. arkymalarky - 6/10/2001 11:09:40 PM

Snow,

I've been wondering about you. I'm sorry that the cancer has had such an effect on your sister's mind, and she's fortunate to have someone like you with her. When it's family and you love them you do what you have to do. I only hope I have the strength to handle things as lovingly as you are if I'm ever in that situation and that, like you, I will remember how I really feel and who they really are and not let the last months or years overshadow that, understanding the effects of the disease that's taken over.

You and your sister will continue to be in my thoughts.

3383. CalGal - 6/10/2001 11:15:07 PM

Oh, lord, that's awful for your sister, to be aware of what's happening to her. And you have to take care that you don't get run down, either. Are you doing it all by yourself?

3384. arkymalarky - 6/10/2001 11:15:14 PM

Jen,
Complaints of boredom fall on deaf ears in my house. She probably thinks you're a lot of fun and just wants to continue enjoying herself, since you've gone so far to keep her entertained.

3385. PsychProf - 6/10/2001 11:17:12 PM

Most of the recent posts in this thread are filled with the wisdom of life necessary to sustain long interpersonal commitments. Hopefully, Jen, you will use these to solve both the acute and chronic problems you face.

3386. Jenerator - 6/10/2001 11:20:31 PM

Arky,

You're right, se's 10. Of course she gets "bored".

Thanks PP, I will and I have.

What a blessing you all have been.

3387. christipeters - 6/10/2001 11:24:05 PM

Snow,

I'm sorry about your sister. I will keep you both and your family in my thoughts.

3388. janjon - 6/10/2001 11:26:34 PM

Never been there, never done that, in terms of having to cope with the unique set of circumstances Jenerator is facing (not only an increasingly difficult bitter old woman, a new and not-seeing or coping husband, and a new young stepdaughter - - you could write a novel with those elements at hand).

But, a suggestion notwithstanding. Any possibility that you can somehow arrange to be away for a couple of days, Jenerator? Preferably over a period when your husband would be the logical person to become the caretaker (which is what you've become)? There is always the possibility that granny will somehow hold it together while he's in charge, but that may be getting beyond her capabilities. Maybe, then, he'll somehow see the light.

The doctors don't seem to be very alert.

3389. JudithAtHome - 6/10/2001 11:42:07 PM

Snow...I've been in your situation somewhat...it will take everything you have and then some to get through this intact; you may think y