medical cw

~ Brin ~ 1 Comment

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rustingbridges:

alarajrogers:

brin-bellway:

rustingbridges:

I have no idea how dental insurance companies make any money, why would you ever sign up if you didn’t know they were going to pay out more than you put in?

I come across so many personal-finance bloggers who think dental/prescription insurance is just obviously a basic necessity, and then you look at the plan they’re on and the payout caps are so low that it’s damn near physically impossible to get out more than you put in no matter *how* bad your health luck is.

(Meanwhile they live in a jurisdiction where the government has high-deductible anti-catastrophe prescription insurance for everyone and they don’t know it.)

They make money because of people like me, who have dental insurance, but never have enough free cash lying around to get my teeth worked on even though I have dental insurance, because what they pay for is pretty limited.

I have to keep it, because any month I might have enough money to afford dental work, and if you give it up, you don’t get it back for the rest of the year. But while it covers a significant fraction of any dental work I do get done, it doesn’t cover enough for me to get that work done, most months.

ideally if you’re paying in more than they’re paying out, you could cancel and self insure and come out with a slight edge

I do get tho that in economically precarious positions people often have somewhat elastic expenses that preclude that kind of thing. been there

(also depending on what procedures are necessary waiting periods might make this more of a calculated gamble than pure bad EV)

@profound-yet-trivial actual catastrophic insurance (for adults) is rare, most of what is called dental insurance has very low payout caps ($1000-2000 on something like $240-700 of premiums) which makes it +EV for me only if I’m likely to be buying a lot of dentistry

my other theory is that dental pricing is opaque enough that insurance is making its money thru some kind of obscure mechanism internal to the industry.

like, I want to buy some dentistry. I did a few hours of research and purchased an insurance plan which is, I believe, going to pay out more than I am paying in premiums. I am reasonably confident I am going to come out ahead having this plan, but I am not confident at all and would likely bet that I have not selected the maximally efficient strategy.

I estimate that confidently determining such a strategy would probably take me ~20 hours. getting this right could save me a lot of money! but maybe not that much money?

so yeah if anyone is familiar with the economics of dentistry in seattle I am willing to pay you for advice! hmu with your cost estimate. alternately I guess I could download tinder and try to match with dentists or something lol

Tags:

#conversational aglets #adventures in human capitalism #medical cw

~ Brin ~ 1 Comment

rustingbridges:

I have no idea how dental insurance companies make any money, why would you ever sign up if you didn’t know they were going to pay out more than you put in?

I come across so many personal-finance bloggers who think dental/prescription insurance is just obviously a basic necessity, and then you look at the plan they’re on and the payout caps are so low that it’s damn near physically impossible to get out more than you put in no matter *how* bad your health luck is.

(Meanwhile they live in a jurisdiction where the government has high-deductible anti-catastrophe prescription insurance for everyone and they don’t know it.)

Tags:

#reply via reblog #medical cw #adventures in human capitalism #(unfortunately there *isn’t* high-deductible anti-catastrophe government dental insurance) #(and my dad sure did have some dental catastrophes this year) #((but a dental plan with a $400 cap wouldn’t have helped a damn))

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~ Brin ~ 1 Comment

virtualyric:

scientia-rex:

asmrican:

boeing747:

i think grossness is a vital aspect of life btw and we all experience it and i think its important to represent in art and i think oversanitization of popular media is 100% our downfall. things are gross and disgusting and yucky and thats life we cannot deny ourselves this

5b8e90736dabd90c0efe627961848560a8da33ad

I keep thinking about this in the context of caring for my ageing patients. No one TELLS them, before they’re old, how things are going to change, or why. No one talks about the loss of elastin, and how that doesn’t just affect your skin looking old, but also how it heals. No one warns them that their skin will become paper-thin if they live long enough, incredibly fragile and easy to tear. Just “hurr dur wrinkly!!!”

No one tells them their bowels are going to lose strength and coordination, so it gets more and more difficult to have bowel movements. No one warns them about obstipation, much less bowel obstructions. I have a saying I repeat often in clinic: “Proper pooping prevents problems!” I say it because it makes people chuckle, because it destigmatizes needing to poop. Everyone poops. And it turns out pooping requires both a complex network of nerves to create peristalsis, and stools soft enough to move through the bowels, and I have watched more than one elderly patient die because their bowels stopped working right.

No one talks about hemorrhoids, so I have patients coming in terrified by blood in their stools–and listen, blood in your poop is definitely a good reason to see a doctor; if you’re over 50 and you haven’t had a colonoscopy, get one. It’s the best health screening we have evidence for, in my opinion. Colon cancer is a bitch. But more commonly, people have bloody stools because they have either hemorrhoids that are bleeding or because they have an anal fissure after straining on a hard bowel movement. Do you know what a hemorrhoid is? I didn’t, until I was well into medical school. Everyone has them. They’re venous columns that surround the rectum and anus. Internal ones can bleed; external ones can itch. Most people will get them eventually. Be kind about them.

Everyone is going to have trouble peeing if they live long enough. Men can’t start, women can’t stop. Because people with prostates will often have benign enlargement of the prostate–it’s not cancer, but it gets bigger–and the urethra, the tube that lets urine leave the bladder, goes through the prostate. Bigger prostate = compressed tube, less flow. Meanwhile, people with uteruses have much shorter urethras, which means that when we lose that beautiful collagen and elastic, we also lose it in the two sphincters that help us keep from leaking urine, and so we leak urine. Especially when something triggers an increase in intra-abdominal pressure, like a sneeze or a cough or a laugh.

All these things people are taught to be ashamed of and embarrassed about–they are so common. They’re normal parts of having a human body and doing the things one does with a human body. Poop trouble? Welcome to the club! People have been writing about their cures for constipation for as long as written language has existed. Listen, you are not alone. You are not alone. You are not alone. And that means that when someone else has a gross problem, you must be kind to them, because that is going to be you. There will be a day when you have diarrhea, because viral gastroenteritis spreads like wildfire every winter. There will be a day when you cough a huge glob of mucus comes out, because mucus is a natural defense mechanism and kind of miraculous but also nasty. Every gross thing a body can do, yours is likely to do, if not now then later.

Be kind.

Most of the responses to this are about how gross bodily stuff shouldn’t be stigmatized, it shouldn’t be viewed as a moral failure, it’s nothing to be ashamed of, and it shouldn’t be covered up or lied about, especially since it can be very important information for health.

Which is indeed the important message here, so I’m glad there are so many responses like that!

But I do want to go back to the initial post saying that “grossness is a vital aspect of life” and “we cannot deny ourselves this”.

Maybe it’s just saying that our lives function a certain way right now and we aren’t currently able to change that. But a phrasing like “vital aspect of life” really sounds like it’s going beyond that. It sounds like it’s saying that if it was possible to live a life free of this gross stuff, that in itself would constitute some sort of impoverishment of experience.

And sure, maybe deep grossness (as opposed to just, like, finding the architectural style of someone’s house to be vaguely yucky according to your personal tastes or whatever) is something that some people would miss having in their lives if they somehow didn’t have it; maybe they actually would feel impoverished and would go seek out gross experiences, and I want them to be able to get what they want!

But not everyone would miss that. If it was possible to live without the gross aspects of life that are currently inescapable, that would be a great thing for some of us. I wouldn’t be losing any important part of who I am, if I had the choice to live without that gross stuff and I took it.

Tags:

#…yeah to me the obvious reading of OP is ”escapist fiction is wrong‚ if you’re not disgusted by what you’re watching you #ought to get a different movie” #(I originally wrote ”reading” and ”book” there‚ but actually this is a much bigger issue with video because it’s harder to skim) #the stuff in the comments about the importance of having forewarning about aging is good‚ but… #…are they *sure* they’re actually agreeing with OP? #I’d be a lot more willing to reblog that comment if it weren’t attached to OP #originally I’d decided against it‚ but with this new addition I’m leaning towards #(I guess the main argument I can see for not reading OP that way is that #there’s a difference between saying *more* media should be gross and saying *all* media should be gross) #(but…what media environment are they living in such that the grossness levels are far too *low*?) #(*I* go upstairs in the afternoon and find Mom watching a movie about people dying horribly of hyper-Nipah‚ you know?) #((and that’s if I’m lucky and she doesn’t try to watch it in the living room over the speakers)) #(and honestly I’m still not 100% over the very visceral food-poisoning scene in Minority Report) #(people in movies are *constantly* yelling in each other’s faces‚ making out‚ getting covered in blood) #((sometimes all in the same scene!)) #(yeah‚ yeah‚ I know‚ something something pathogen-stress hypothesis) #–((it’s a different person‚ but I notice the aging-forewarning commenter casually mentions viral gastroenteritis as ”a day”)) #((which‚ uh))– #(but god‚ please‚ don’t make *me* live at *your* setpoint) #tag rambles #is the blue I see the same as the blue you see #aging cw #unsanitary cw #discourse cw #medical cw

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~ Brin ~ Leave a comment

thcgay:

clodiuspulcher:

bauliya:

bauliya:

everyone’s like wehhhhh why doesn’t doctor house gets suuuueeed! like my man. literally every patient he sees is someone that’s been trying to find a diagnosis for ages. i could live with a little medical malpractice if it were coming from someone ready to break into my home to look for allergens and not simply half heartedly listen to me before suggesting I lose weight and take ages of back and forth arguing to order a single test

“it’s medical malpractice” have u ever been a doctor? most medicine is malpractice. let the man limp around chewing vicodin doing 50 invasive tests please

Once Taub (derogatory) derisively said about a patient with unexplained chronic pain “7 doctors couldn’t find anything wrong with him, what does that mean?” and House replied without even thinking “it means they’re idiots” and proceed to work his ass off to diagnose the patient Taub wanted to write off as a faker or something. If a doctor had said that when that patient was ME, I wouldn’t dream of suing them in a million years

f2595ba210e994c64eeac12ad8e31ebf23b32f70

Tags:

#House #anything that makes me laugh this much deserves a reblog #((this amusement not to be taken as expressing an opinion regarding the statement itself)) #high context jokes #medical cw #this probably deserves some other warning tag but I am not sure what #discourse cw?

~ Brin ~ 1 Comment

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brin-bellway:

paradigm-adrift:

In the last 3 years I got tinnitus, feeling like I’m suffocating, and joint pain added to my moment-to-moment suffering. That’s 1 constant burden added per year. Let alone the several other minor things breaking during that time that I notice daily but not constantly.

At this rate I’ll have about 50 problems as bad as tinnitus weighing on me at any given moment by the end of my expected life span. Actually, rumor has it that new problems accelerate as you get older rather than showing up at a constant rate, so if the last 3 years aren’t a fluke, 50 could be too optimistic.

But that can’t possibly be true, right? Yeah, aging is bad, but if it were that bad people would get almost-universally institutionalized indefinitely in their 40s as the constant torture accumulates, probably, and that clearly isn’t the case. It’s gotta be better than what my gut instinct suggests the future will be like, right?

Right?

I used to wonder about this myself (right down to the annual frequency), and from my experience thus far it seems like at least part of the answer is: not all long-lasting problems are permanent. They sometimes mysteriously *disappear* just as they mysteriously appeared.

I’m not prone to earwax clogs anymore (as I was for roughly a decade). I don’t get waves of stomach pain every night around 12:50 AM anymore (several years). I usually don’t have an itching response to my own sweat anymore (~two years). I tried stopping my use of dandruff shampoo recently to see if the dandruff would come back, and so far it *hasn’t*.

(This isn’t even counting the late-onset dysmenorrhea, the chronic constipation, or the once-frequent rashes on the backs of my hands, for all of which the underlying tendency is still there but very well-controlled.)

I’m not *planning around* the possibility that, say, my ability to breathe unfiltered outdoor non-winter air will someday return, but I acknowledge that it might and I’ll gladly accept the bonus to my expected quality-of-life if it does.

#A good answer! #Thank you. (paradigm-adrift)

Tags:

#conversational aglets #is the blue I see the same as the blue you see #aging cw #medical cw #illness tw? #injury cw? #venting cw?

~ Brin ~ 1 Comment

paradigm-adrift:

In the last 3 years I got tinnitus, feeling like I’m suffocating, and joint pain added to my moment-to-moment suffering. That’s 1 constant burden added per year. Let alone the several other minor things breaking during that time that I notice daily but not constantly.

At this rate I’ll have about 50 problems as bad as tinnitus weighing on me at any given moment by the end of my expected life span. Actually, rumor has it that new problems accelerate as you get older rather than showing up at a constant rate, so if the last 3 years aren’t a fluke, 50 could be too optimistic.

But that can’t possibly be true, right? Yeah, aging is bad, but if it were that bad people would get almost-universally institutionalized indefinitely in their 40s as the constant torture accumulates, probably, and that clearly isn’t the case. It’s gotta be better than what my gut instinct suggests the future will be like, right?

Right?

I used to wonder about this myself (right down to the annual frequency), and from my experience thus far it seems like at least part of the answer is: not all long-lasting problems are permanent. They sometimes mysteriously *disappear* just as they mysteriously appeared.

I’m not prone to earwax clogs anymore (as I was for roughly a decade). I don’t get waves of stomach pain every night around 12:50 AM anymore (several years). I usually don’t have an itching response to my own sweat anymore (~two years). I tried stopping my use of dandruff shampoo recently to see if the dandruff would come back, and so far it *hasn’t*.

(This isn’t even counting the late-onset dysmenorrhea, the chronic constipation, or the once-frequent rashes on the backs of my hands, for all of which the underlying tendency is still there but very well-controlled.)

I’m not *planning around* the possibility that, say, my ability to breathe unfiltered outdoor non-winter air will someday return, but I acknowledge that it might and I’ll gladly accept the bonus to my expected quality-of-life if it does.

Tags:

#reply via reblog #is the blue I see the same as the blue you see #aging cw #medical cw #illness tw? #injury cw? #venting cw?

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~ Brin ~ Leave a comment

the-dao-of-the-zerg:

garmbreak1:

look man, life is hard and the rules of society are complex

but let people off the fuckin train before you try to get on

and don’t play your goddamn music on your phone speakers in public

Genuinely curious: Why is music treated so much worse than conversation? If the norm was to actually be quiet on the bus, that would be one thing, but I see people primarily single out “music” without even mentioning loud conversations and such.

(I’m guilty of this too – I would never dream of playing music out loud, but get me excited and I will lose all awareness of how loud I’m talking)

Because music *is* worse than conversation. More distracting (consumes more mental processing power), and with potentially much deeper valleys of unpleasantness.

I can only assume that mileage must vary on this, though, given that store background radios are not just legal but *encouraged*.

(Even my *dentist* has a background radio. I was afraid to point out the risk of [them getting distracted by the music at a crucial moment and fucking up a procedure] for fear of self-fulfilling-prophecies/centipede’s-dilemmas. Possibly I should have at least pointed out that playing lowest-common-denominator pop music while performing potentially invasive medical procedures on people risks giving them PTSD *with extremely common triggers*: that issue seems incredibly obvious to *me*, but then I have relevant experience and perhaps it’s not obvious otherwise.)

Tags:

#we should fine the shit out of stores with background radios #you can be allowed to turn a profit once you’ve proven you can be trusted with public soundscapes #reply via reblog #music #is the blue I see the same as the blue you see #medical cw #this probably deserves some other warning tag but I am not sure what #infohazards?

Vaccination round two (actually round three)

~ Brin ~ 1 Comment

{{previous post in sequence}}

finestoftheflavors:

Walgreens says they’ll add multiple vaccinations into a single shot! They show a big list of vaccinations! I didn’t know some of these existed yesterday! Gotta admit, I’m a slightly tempted to just get everything even if there’s no practical value to it. Is there any reason why I would not want to do that? I know older people with little impact craters on their arms where they got the smallpox shot back in the day, so a least some vaccines aren’t as simple and painless as the covid19 one is… would they leave it off this list if it was a potentially serious one, like if getting vaccine for yellow fever could harm somebody then maybe they wouldn’t let me just get it all willy nilly when I’m not actually at risk of tropical diseases. I don’t actually know!

  • COVID-19
  • Pneumonia (Pneumococcal)
  • Shingles (Herpes Zoster)
  • Tdap (Whooping Cough)
  • Chickenpox (Varicella)
  • Cholera (Vaxchora)
  • HPV (Human Papillomavirus)
  • Hepatitis A (Hep A)
  • Hepatitis A/Hepatitis B (combination)
  • Hepatitis B (Hep B)
  • Japanese Encephalitis
  • MMR (Measles, Mumps and Rubella)
  • Meningitis (Meningococcal)
  • Polio
  • Rabies
  • Td (Tetanus, Diphtheria)
  • Typhoid
  • Yellow Fever

I know I got whatever was considered standard childhood vaccinations when I was a kid, and I know that included MMR, but I honestly don’t remember if that included anything else on the list. Whooping cough is one of those diseases that kids don’t get anymore, presumably I’ve got that one maybe? Better check on that.

Walgreens apparently will not let me get a booster with a different brand name, those bastards. They say “CDC recommends getting the same brand” and then link to the CDC page that does in fact say getting mix-n-match boosters is okay. Apparently CVS is cool with it? I think I’ll just sign up for the covid19 and flu combo for now.

 

rustingbridges:

what’s this? an opportunity to get myself injected with an unwise medley of juices?

color me intrigued

 

rustingbridges:

alright but I unironically want several of these for Actual Reasons besides The Juice. how much is too much

 

necarion:

Pro-vaccine advice: don’t get all of these vaccines

You really shouldn’t get the cholera vaccine, unless you’re seriously likely to need the cholera vaccine. It lasts about 3 months, and for the first 2 weeks you have to be super careful about washing your hands because you can transmit cholera to other people (because live attenuated).

TD isn’t needed if you’re getting TDaP (same TD there, plus pertussis).

Rabies only lasts about a year, I think, and it sucks to get unless you really need it. A better rabies vaccine would be great but we really don’t have it. I think there’s something similar with Typhoid; the immunity just doesn’t last.

There are 2 pneumonia vaccines, and you only really need one if you’re over 65 or have serious immune or respiratory issues (ask your doctor). Ditto for shingles; you don’t really need it if you are younger than that and/or had chickenpox after the age of 2 or 3.

The one non-standard one you could seriously consider getting is Yellow Fever, and they generally don’t recommend it unless you’re going to need it. It has a low complication rate, of something like 1/50 to 100M, but does have the possibility of giving you the virus. It’s still one of those we could consider expanding, but we really did wipe it out in the US.

 

necarion:

Adding these tags from @brin-bellway

I added mine to my Word doc where I have all the meds I’m currently taking, plus doses, and the contact info for my past doctors.

The nurses are always super grateful when I just hand them a piece of paper when they ask “what are you taking”, and I don’t have to write it down every time.

 

brin-bellway:

I don’t think my situation has gotten *quite* complicated enough yet to need a standard ref sheet, but I’ll bear that in mind as I get older.

I do write down the details every time I have a new concern, and hand them that when they ask about the purpose of the visit. They seem a little weirded out by it, but they’re willing to go along with it, and I think they’ve been adding the sheets to their file on me.

(In related news, it’s amazing how much more seriously people take you when you have things in writing: nothing says Responsible Adult like a clipboard, apparently. This mostly holds even if you’re using it as assistive tech for your shitty autistic speaking ability and/or your shitty immune system (leading to the use of a high-grade-but-pretty-muffling prosthetic immune system) [link]. It’s a good trick to have in my arsenal, given that I look about 13 and often have trouble getting people to take me seriously in meatspace.)

 

necarion:

Yeah, definitely have a list of things you want addressed. Doubly so for you if you need to be taken seriously, but still singly so for others. They might look at you strangely, but it makes their job easier, and you won’t forget something. Also helps to have your own notes and a bunch of past history and contacts.

I would still highly recommend having a “this is my medication” sheet you can print out whenever you have to see someone new.

I’ll take that under advisement, and I will definitely check the medication section on my smartphone’s emergency screen and make sure I included dosages.

My GP is surprisingly good at code-switching into People Who Actually Gave Their Health Problems Some Serious Thought, so I don’t actually tend to think of “people not taking me seriously” as being a primarily *medical* thing. Still good to have a clipboard handy, though.

Tags:

#reply via reblog #medical cw #illness tw #vaccines

Vaccination round two (actually round three)

~ Brin ~ 2 Comments

{{previous post in sequence}}

finestoftheflavors:

Walgreens says they’ll add multiple vaccinations into a single shot! They show a big list of vaccinations! I didn’t know some of these existed yesterday! Gotta admit, I’m a slightly tempted to just get everything even if there’s no practical value to it. Is there any reason why I would not want to do that? I know older people with little impact craters on their arms where they got the smallpox shot back in the day, so a least some vaccines aren’t as simple and painless as the covid19 one is… would they leave it off this list if it was a potentially serious one, like if getting vaccine for yellow fever could harm somebody then maybe they wouldn’t let me just get it all willy nilly when I’m not actually at risk of tropical diseases. I don’t actually know!

  • COVID-19
  • Pneumonia (Pneumococcal)
  • Shingles (Herpes Zoster)
  • Tdap (Whooping Cough)
  • Chickenpox (Varicella)
  • Cholera (Vaxchora)
  • HPV (Human Papillomavirus)
  • Hepatitis A (Hep A)
  • Hepatitis A/Hepatitis B (combination)
  • Hepatitis B (Hep B)
  • Japanese Encephalitis
  • MMR (Measles, Mumps and Rubella)
  • Meningitis (Meningococcal)
  • Polio
  • Rabies
  • Td (Tetanus, Diphtheria)
  • Typhoid
  • Yellow Fever

I know I got whatever was considered standard childhood vaccinations when I was a kid, and I know that included MMR, but I honestly don’t remember if that included anything else on the list. Whooping cough is one of those diseases that kids don’t get anymore, presumably I’ve got that one maybe? Better check on that.

Walgreens apparently will not let me get a booster with a different brand name, those bastards. They say “CDC recommends getting the same brand” and then link to the CDC page that does in fact say getting mix-n-match boosters is okay. Apparently CVS is cool with it? I think I’ll just sign up for the covid19 and flu combo for now.

 

rustingbridges:

what’s this? an opportunity to get myself injected with an unwise medley of juices?

color me intrigued

 

rustingbridges:

alright but I unironically want several of these for Actual Reasons besides The Juice. how much is too much

 

necarion:

Pro-vaccine advice: don’t get all of these vaccines

You really shouldn’t get the cholera vaccine, unless you’re seriously likely to need the cholera vaccine. It lasts about 3 months, and for the first 2 weeks you have to be super careful about washing your hands because you can transmit cholera to other people (because live attenuated).

TD isn’t needed if you’re getting TDaP (same TD there, plus pertussis).

Rabies only lasts about a year, I think, and it sucks to get unless you really need it. A better rabies vaccine would be great but we really don’t have it. I think there’s something similar with Typhoid; the immunity just doesn’t last.

There are 2 pneumonia vaccines, and you only really need one if you’re over 65 or have serious immune or respiratory issues (ask your doctor). Ditto for shingles; you don’t really need it if you are younger than that and/or had chickenpox after the age of 2 or 3.

The one non-standard one you could seriously consider getting is Yellow Fever, and they generally don’t recommend it unless you’re going to need it. It has a low complication rate, of something like 1/50 to 100M, but does have the possibility of giving you the virus. It’s still one of those we could consider expanding, but we really did wipe it out in the US.

 

necarion:

Adding these tags from @brin-bellway

ce2fbde938547981aa3522d157df88e7af3d910a

I added mine to my Word doc where I have all the meds I’m currently taking, plus doses, and the contact info for my past doctors.

The nurses are always super grateful when I just hand them a piece of paper when they ask “what are you taking”, and I don’t have to write it down every time.

I don’t think my situation has gotten *quite* complicated enough yet to need a standard ref sheet, but I’ll bear that in mind as I get older.

I do write down the details every time I have a new concern, and hand them that when they ask about the purpose of the visit. They seem a little weirded out by it, but they’re willing to go along with it, and I think they’ve been adding the sheets to their file on me.

(In related news, it’s amazing how much more seriously people take you when you have things in writing: nothing says Responsible Adult like a clipboard, apparently. This mostly holds even if you’re using it as assistive tech for your shitty autistic speaking ability and/or your shitty immune system (leading to the use of a high-grade-but-pretty-muffling prosthetic immune system) [link]. It’s a good trick to have in my arsenal, given that I look about 13 and often have trouble getting people to take me seriously in meatspace.)

Tags:

#medical cw #vaccines #transhumanism #reply via reblog #illness tw

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