The spouse’s Chevy S-10 has had the service engine light on for months. One of those silly emissions-related things that cost a fortune to fix and seem designed more to support the repair industry artificially than to be necessary to us proles. At least, that’s what my nephew’s device for speaking to car computers said, and that’s usually what it is. $500 for… being able to get a valid inspection sticker for a car that has no other symptoms than conspiring to make you fail an arbitrary regulatory hurdle.
Anyway, the sticker expired at the end of September. Money was tight even to spend $29 on inspection, so you can imagine what the extortive repair would mean. I finally took it today.
I got in the truck, started it up, and… no more engine light!
I couldn’t believe my eyes.
I was worried that it somehow cleared itself, and would be in the same state clearing it electronically would create. If you use a device to clear the error electronically, the computer in the car lacks enough data for the inspection computer to say that it’s working right for emissions. You fail, and have to give it a week or so to accumulate information, then get it retested. Thus if you have a rejection sticker and repair will involve resetting it, you really should get the repair done a week or more before the deadline of the rejection sticker. Otherwise you go over, even if you didn’t want (need) to.
But no… it passed! There were no other problems, and the computers had a friendly chat that resulted in much happiness on my part. Even if there is something wrong, at least we buy time.
Recently I got an ear infection. Not shocking, given my childhood propensity for them and the fact that I’ve been almost continuously sick since Sadie started kindergarten in September, culminating with and resuming after a quick bout of flu and about two days of feeling better than I can remember feeling since… I don’t know. Possibly as far back as 1977. Yet shocking in that I’ve tended not to have ear infections as an adult, or even as an older child. I used to have respiratory infections every couple winters, but my ears have never behaved like this.
I’d had the normal sniffles and stuffiness. In a meeting before work in the wee hours, I was especially stuffy. Near the end of it, fluid started dribbling out of one of my ears. Freaky! It kept doing so during the shift, then I went home and searched online for the symptom and what the properties of the fluid meant. Clearly it was not cerebrospinal fluid and I didn’t have meningitis. I didn’t even have a fever.
That was Saturday. I ended up going to emergency care at my doctor’s practice on Sunday, seeing an excellent doctor and getting diagnosed officially with a middle ear infection. That meant antibiotics, which were a bit slow but did clear it up. It stopped briefly right after I started those, but then the leaking ear went on leaking for a few days.
More importantly, this was the first time I had been to a doctor since last May. I’d been shirking, since they like to monitor my blood pressure regularly. Because I simply couldn’t afford to go! We got kicked off of MassHealth as of the end of 2009 for having the audacity to have low enough income to qualify, but an employer who offered insurance we couldn’t afford to buy or use. That’s just the two of us, not the kids, who remained fully covered, because we had low enough income to qualify, but…. what? Insurance from the employer that would have cost too much wasn’t good enough for them, just for the adults? In reality, looking at the rejection, there was some level of care they covered even for us, but it was unclear how to use it. Apparently it was a safety net thing where the doctors and hospitals were supposed to figure out what not to charge us for or something. Also, other people who were required to buy insurance got part of their insurance cost reimbursed at borderline levels of income, but if we were supposed to once we obtained it, I was never aware of that. Perhaps this year, if they ever get back to me, they’ll be clearer. That’s a whole other story, the kids being thrown off and our having to reapply from scratch. They’re seriously taking their time, and we’re overdue for checkups for two kids. Ugh.
Anyway, our insurance meant the first 12 visits to the doctor, or a lower number and some testing, since that’s not unusual, would have cost me entirely out of pocket. I can totally afford 10% of my income before insurance starts to pay 80% of the cost. Yup.
Plus I’d been off and on, mostly off, the three blood pressure meds since early 2009. When I saw the doctor the last time in 2009, I took the drugs for a couple weeks ahead of time, enough to have a passable blood pressure but have him mildly concerned about edema. See, the meds made me feel like crap, and left me almost unable to work. I’d take them, and after a fairly short time the managers would wonder why I was so darn slow. I’d wonder why I was so darn slow, and my brain didn’t work right. Not that this should have surprised me, since one of the meds was a beta blocker. The second doctor to treat me for hypertension avoided giving me beta blockers because they affected me so badly the first time. Arguably I lost my very first tech support job because I was on one. I couldn’t remember anything, couldn’t think as clearly as I ought to be able to, and had a total lack of ambition that went beyond ordinary levels of lazy or disinterested. Took me a long time to blame it on the pills, and I seem to recall that was only when I stopped taking them and transformed back. The second doctor to treat me was happy if he could keep me from going much about 150/95. The next time I went to that practice , seeing a different doctor because mine had left, after being off meds a while my pressure was 185 or something and they flipped. I sat in the waiting room for hours, waiting for meds they gave me on the spot to kick in and lower my BP enough that they’d let me leave. I don’t remember what that doctor gave me, but he specialized in hypertension and set out to determine a root cause.
I don’t generally consume inordinate salt, don’t seem to be affected by it, and am aware that they’ve found minimal correlation, even though doctors still ask. I believe they have figured out 1/3 of people can go higher on account of salt, 1/3 are not affected, and… 1/3 go down! I did 24 hour urine samples for levels of catecholamines. I got an MRI of my kidneys, looking for pheochromocytoma. Nothing. My current doctor, technically the fourth to treat this, also found nothing, in part taking my word for the prior guy’s findings, since the other practice never passed along my records when asked.
Nor did anyone find damage as a result of the high blood pressure, in the past anyway. I was already about to the point of going back to treatment, sure I was being affected by it. I started losing my eyesight when we switched to compact fluorescent bulbs, but I’m not convinced BP hasn’t been a factor. On the emergency visit for the ear infection, my blood pressure was 210 over… now I forget, but not as high as my record 220/140. 120 or 110, this time. Naturally this got me an EKG, and skepticism about my chest congestion pain when taking deep breaths being normal congestion. Heck, that’s an old familiar pain to me, the breathing pain. Without being congested at all I’d get it when I was a kid, if I tried to run any distance in elementary school. Singing, bike riding (I miss my bike!) and expanding my lung capacity mitigated it, but it come back now and then.
I was lucky that the doctor I went to on the Sunday let me go with instructions to resume taking lisinopril, the least likely to cause a problem, in an effort to start controlling it some, and to go to my regular doctor in a week to followup on that and the ear. The EKG showed very minimal signs of uncontrolled blood pressure but was basically fine.
On another note, nobody ever finds I have high blood sugar or cholesterol, despite my mother being convinced from the time I was young that I was fat and was going to get diabetes, have a heart attack and die. Knock on wood.
Backing up a little, the very last time I took the combo of lisinopril, atenolol and hydrochlorothiazide was in the fall for a week. After a week it turned my brain to mush and provoked depression like flicking a switch. It was remarkable to observe! Since it had been months since I’d touched the stuff, and it was completely out of my system, it was a clear test. I’d previously observed that, at least at times I tended to get dehydrated from work and weather, hydrochlorothiazide may have been provoking gout attacks. The emergency doctor thought that made sense, and that the actions I ascribed to the beta blocker made even more sense.
About nine days later I saw my own doctor, getting an extremely prompt appointment once I finally called. You’d think they were concerned or something.
My blood pressure was dramatically lower, like 165/100. My doctor was ready to give me an EKG until I noted I’d had one several days before.
I kept me on lisinopril and added back hydrochlorothiazide, but switched me to amlodipine instead of atenolol. To be honest, I thought I’d made my feelings about beta blockers clear when I first saw him and already thought they messed me up, and I thought – and maybe it was true initially – he was not giving me one of them. Eventually I learned that one of them was, and perhaps that was true all along.
Looking up amlodipine after I got home, I was amused to see it is prescribed for angina as well.
A week went by and…. No wait! Two days went by and it was as if I’d become a new person. It improved more from there. The combo, presumably to be pinned on the amlodipine, almost seems the opposite of a depressant. Since it worked that fast and with no side-effects, I suppose I shouldn’t be surprised that the one day I forgot to take the pills caused a bit of a mood crash. There’s incentive! Skip a day, go all gloomy for two days before returning to normal? Naw, I think I’ll just keep to the regimen, thank you. My vision hasn’t improved. If anything, it’s worse. However, something else I suspected was affected by blood pressure went away, and the ear problem stopped dragging on, as it seemed to be. Google seemed to suggest that the ear symptoms could be tied in with blood pressure, apart from the fact of a very real infection.
It’s hardly perfect, since how glowingly happy can you be when you’ve gotten in a life hole with canyonesque sides, but I’m optimistic and energetic and alert and awake in a way I haven’t been for the most part in years. Not sure it was this good in the parts of 2003 and 2004 when I wrote about being on Lexapro. Who knew I needed it to counter the blood pressure drugs! Could have avoided the whole thing. I’ve also had some insight that goes deep and may help explain the blood pressure problem’s roots, while also helping me move on, but that’s another story. Time to make supper!
One problem we’ve had lately is exactly this dead zone, which you can see as a sharp drop in the 30s before the steadier line upward. You have to click the chart to see a bigger version.
And basically if I do anything other than what I am now and/or work at home/online work as allowed, we then run into daycare issues. If I were on my own, I’d keep what I have for security and bootstrap from it. A part time other job even if I could get nothing full time. Return to being available for unpredictable side computer/support or other gigs. Use any spare time for building more passive but by no means self-constructing income streams. Six months and I could probably be back to “real money” without even relying on a single “full time” thing.
Right now our net effective income is actually down because our income went up, but not enough. A full time job roughly opposite the other full time job would net less than I do now up to hourly rates that start to approach those of a “real job.” It’s a conundrum.
The good thing is the kids are becoming more self-contained, so I’m starting to see clear to being able to do some of the passive side stream and work from home stuff without having to leave for on-site/emergency work of the sort I used to do. Just trying to work out a system where that is organized and balanced against housework…
This is the source and has more, and a second, more impressive chart of how implicit marginal tax rates fluctuate.
Healthcare Financial, Inc.
Thomas G. Gennis
The voice “talent” of Signature Healthcare’s phone system
The designer of Signature Healthcare’s phone system
Heck, the designer of MassHealth’s phone system
Anyone who calls us after 10 PM tops when there’s no deaths in the family or such
Probably a bunch of others not as close to the top of my mind.
I have decided to call the communist state health plan by the evil Mitt Romney and gleeful Democratic legislature, commonly known as RomneyCare, ComneyCare for short, so I don’t have to write out the communist description. But I pregress…
A while back, we were arm-twisted into applying for MassHealth (the official name for ComneyCare) by HFI, Healthcare Financial, at the behest of Morton Hospital, apparently because we could be covered retroactively and they would then collect for the emergency visit with allergy boy early this year. HFI is, as far as I can tell, little more than a law firm/collection agency that specializes in just this kind of thing.
We thought it would be nice to be able to get him medical attention if needed, at least take him for a one year checkup and shots. That appointment is set for Thursday, a month late because of doctor vacation pushing things back.
Anyway, I did the applying through the agent, including affidavits and limited power of attorney and so forth, and sent them a pile of birth certificate copies and such. I thought that included the relevant pay stubs as evidence of income, which I did scan at that time and presumably printed and sent.
I’ve never heard from HFI again.
We received notice of provisional coverage of the kids pretty promptly. Apparently they do this because it take forever to process the applications.
That was the last thing we heard.
On the 12th we received notice from a Taunton office, first we’d ever had anything come from there, indicating we were rejected due to lack of proof of income, if they didn’t hear from us by the 8th.
So this is apparently how they are handling the insane budgetary overrun ComneyCare is creating, by arbitrarily making people unable to obtain the coverage they are legally required to obtain or be fined for not having. Go Massachusetts!
Friday afternoon I faxed that Taunton office the entire original 20 pages of application, affidavits, ID, and pay stubs, a WTF letter, and two subsequent pages of paystubs, supplying phone and e-mail for them to contact me. One secret of being sufficiently broke is that it’s a surprising time sink, where people like to make it hard for you to do anything but deal with crap like this, or where you spend time instead of money because time is what you have.
No word yet. Oh, forgot to mention why I faxed. Besides to get the actual paperwork back in someone’s face ASAP.
The number they supply on the notice is not for the local office, where the fax is. The number they supply lands you in a full voice mailbox – can’t even leave a message – and tells you try again later. Convenient, if they don’t want people to actually get the coverage.
Today I need to contact the doctor’s office and see what they want to do about the appointment Thursday. It’s at least $95 if paying cash (which may as well be the moon). We already owe over $700 from apparently far more visits on grace than I realized last October/November. To the extent it’s up to the doctor, he’d probably say come in anyway and not to worry, because that’s him, so it may be the case. Apparently the shots are paid by the state, so it might be possible simply to go in, get the shot, and leave. But if we’re there, the doctor won’t be able to resist having a good look, so it amounts to the show up and don’t worry about it option. What we can’t do is be referred to any dermatology or allergy specialists without coverage. So it’s good thing we have his condition in such good control, and he’s doing so well at acclimating and outgrowing it so some degree already.
Loads of fun. If McCain had picked Mitt Romney, it would have shown horrible judgment, as well as lack of political savvy. Ultimately they’re all control freaks and would-be tyrants to some degree, but Romney showed naked ambition and elitism over sense more than most.
The blackened sky out there right now, driving a welcome wind through the windows, reminded me I didn’t write about yesterday’s tornado warning. Yes, warning. Not even a mere watch. Yes, in Massachusetts. If that surprises you, by all means Google Worcester tornado and look at some of the results not about the ball team. One of the only times I ever heard the emergency broadcast system used beyond a test was driving down from north of Boston and hearing a tornado watch.
But this was a warning. With our location relatively in bullseye territory. Wow.
We ended up getting everyone dressed and hanging out in the cellar for several minutes during the projected window for the area, at the risk of feeling silly. Deb grew up in an area that had been hit with a tornado and where such things were serious enough they used air raid sirens for warnings and tested regularly. I grew up aware of the Worcesteer tornado, and enough of a weather nerd to be aware they could and did happen here, if seldom, and even rarer with strength. Plus hellow, Wizard of Oz was an annual television event.
In the end nothin happened beside relatively severe thunderstorms, some hail and heavy rain, more darkness in the sky than justified. It was different, though.
I was disappointed that after going offline for the emergency, my Blackberry, from which I am posting this, was not available to look at weather, post, see e-mail, etc. It was as if the cell service shut down completely, right when I wanted it most. Thrilling.
Raining good now, so I’d better make sure no windows are letting it in…