UHC is a righteous pain in the dick:
UHC, like more and more health insurance companies, has their own, mail-order pharmacy service. In the yearly open enrollment, we're issued a warning about coverage of maintenance-medications: "UHC may choose not to cover maintenance-medications that are not procured through their mail-order service". Like a good little boy, at my last yearly checkup, I had my doctor write all my scripts as one-year, mail-order scripts so I could have UHC's mail-order service take care of them. That was January of 2019.
Fast-forward to yesterday. I get an email from the prescription mail-order service telling me that my next order is being cancelled: my script had expired and they couldn't contact the prescriber to get my script extended.
Couple things, here: 1) my current script, written in the second half of January 2019, is actually good through February of 2020; 2) my doctor will write early script, but charges a fee to do so; 3) because my insurer's pharmacy won't pay that fee, the doctor won't extend my prescription; 4) all of this is only a problem because there's a 1-2 month gap between when my on-file script ends and the period that my insurer's pharmacy is filling for.
So, now, I'm probably going to have to pay a non-office prescribing fee because my UHC's in house pharmacy is full of idiots (causing a 12-month set of prescriptions to effectively be a 9-month set of prescriptions) ...meaning I potentially end up with a medication gap for epilepsy medications as well as leaving me on the hook for to cover an early prescribing fee.
UHC: This is why people hate you and the rest of your cabal.
Wednesday, December 11, 2019
Wednesday, December 4, 2019
Diminishing Returns
Seems like, every time a zero-year birthday is imminent, I go into sort of a funk. And, with each looming zero-year birthday, the time between the actual birthday and the onset of that funk increases. I was a late-term baby: maybe I was late to my very first zero-year birthday because I didn't want to face it and was sulking in my mom's womb? Dunno.
Weird thing for me is that I don't really have a sense of time. My memory makes it so that pretty much everything that's happened seems "recent". The only real way that I have any time-sense is that I'm able to recognize that my memories have order and I know that a longer line of memory-dominoes indicates that something happened further in the past ...but that's about the only semi-tangible clue about the scale of the amount of time that's past. Yet, as nebulous an indicator as that clue is, it still seems to be enough to cause the whole "looming zero-year funk" to start earlier and earlier.
That this past Thanksgiving marked the tenth without my father probably didn't help. Similarly, not being able to have Thanksgiving with my mom due to illness probably exacerbated things. Thus, this time's zero-year dread seems to have started a full two months before my actual birthday. It probably started even before that – though less in the form of dread than small things like starting to answer people's "how old are you" question with, "nearly fifty" ...at least as far back as May.
The universe also seems to be prompting it. For starters, this summer, a month before she was to turn nine, by doggo was diagnosed with cancer. While it seems like like the surgery, recovery and three months of chemo successfully prosecuted the cancer, the event/process still turned my mind to aging and death. Then came the Thanksgiving-time reminder of things. And, as a coda to that, one of the streaming TV services decided that November would be a great time to run a Marathon of Dead Like Me. Don't get me wrong: it's a great series – even if it's been 15 years since I've watched it – but its timing was especially resonant this year.
As fun as going to EDM shows and festivals tends to be, it probably doesn't help the "I feel old thing". Not so much the aching joints an muscles the next day as being surrounded by people that are literally less than half my age (started this birth-year by going to see Herobust at Echostage, for my birthday, where I ran into another guy celebrating his birthday ...but it was his 24th). And, while I'm not the oldest person at festivals I'm usually the oldest at one-night events (including performers, staff and probably even the ownership). And, while the twenty- and thirty-somethings we run into are usually very welcoming and like to point to my wife and me and say "life goals", it's still a compliment that drives home the gulf in ages.
Plus, this zero-year, I'm almost certainly in that part of ones life where there's more years behind than ahead. The only way that's not true is if I manage to top the century-mark. And, while family-longevity says that's a possibility I've enough in the way of chronic health conditions – and semi-toxic treatments for same – that even if I otherwise could reasonably expect to top the century-mark, those conditions and their treatment means the safe money is on not topping it.
Oh well...
Weird thing for me is that I don't really have a sense of time. My memory makes it so that pretty much everything that's happened seems "recent". The only real way that I have any time-sense is that I'm able to recognize that my memories have order and I know that a longer line of memory-dominoes indicates that something happened further in the past ...but that's about the only semi-tangible clue about the scale of the amount of time that's past. Yet, as nebulous an indicator as that clue is, it still seems to be enough to cause the whole "looming zero-year funk" to start earlier and earlier.
That this past Thanksgiving marked the tenth without my father probably didn't help. Similarly, not being able to have Thanksgiving with my mom due to illness probably exacerbated things. Thus, this time's zero-year dread seems to have started a full two months before my actual birthday. It probably started even before that – though less in the form of dread than small things like starting to answer people's "how old are you" question with, "nearly fifty" ...at least as far back as May.
The universe also seems to be prompting it. For starters, this summer, a month before she was to turn nine, by doggo was diagnosed with cancer. While it seems like like the surgery, recovery and three months of chemo successfully prosecuted the cancer, the event/process still turned my mind to aging and death. Then came the Thanksgiving-time reminder of things. And, as a coda to that, one of the streaming TV services decided that November would be a great time to run a Marathon of Dead Like Me. Don't get me wrong: it's a great series – even if it's been 15 years since I've watched it – but its timing was especially resonant this year.
As fun as going to EDM shows and festivals tends to be, it probably doesn't help the "I feel old thing". Not so much the aching joints an muscles the next day as being surrounded by people that are literally less than half my age (started this birth-year by going to see Herobust at Echostage, for my birthday, where I ran into another guy celebrating his birthday ...but it was his 24th). And, while I'm not the oldest person at festivals I'm usually the oldest at one-night events (including performers, staff and probably even the ownership). And, while the twenty- and thirty-somethings we run into are usually very welcoming and like to point to my wife and me and say "life goals", it's still a compliment that drives home the gulf in ages.
Plus, this zero-year, I'm almost certainly in that part of ones life where there's more years behind than ahead. The only way that's not true is if I manage to top the century-mark. And, while family-longevity says that's a possibility I've enough in the way of chronic health conditions – and semi-toxic treatments for same – that even if I otherwise could reasonably expect to top the century-mark, those conditions and their treatment means the safe money is on not topping it.
Oh well...
Sunday, December 1, 2019
Ruminations
I dunno whether it's that had to spend Thanksgiving not with family.
I dunno whether it's the fact that it's just after the tenth anniversary of my dad's death.
I dunno whether it's the realization that I'm on my a bit more than twelve years younger than when my dad died.
I dunno whether it's that my 50th birthday Loom's less than two months away.
All I really know is that death, dying and whether or what might come after has been filtering through my mind a lot lately.
I dunno whether it's the fact that it's just after the tenth anniversary of my dad's death.
I dunno whether it's the realization that I'm on my a bit more than twelve years younger than when my dad died.
I dunno whether it's that my 50th birthday Loom's less than two months away.
All I really know is that death, dying and whether or what might come after has been filtering through my mind a lot lately.
Wednesday, October 2, 2019
Why I Don't Respect Our Corporate Security or Training Teams
So, I get to work today, and find an email from the computer-based training system saying that I'm nearly a month past due on some of my annual training-requirements. This struck me odd, because I generally make sure to knock out training either the day it's due or the last day I know I'll be in the office immediately before it's due.
I login to the portal to look at the training schedule. I find the "overdue" training. I look in my home directory's training certificates folder and notice that there's a matching ID in there from the second half of January of this year ...meaning that its renewal _should_ have been due in the second half of this coming January.
Go back to the training portal and see, "oh: this is a new revision of the training ...released a few days ago, but with an author-date of a few weeks ago. I guess this update obsoleted my existing training. And it looks like the 'overdue' notice was sent out on the day that the training was mad available on the training-portal but back-dated to the day it was authored." All of which is great because our managers get "overdue reports" about each of our training and anything beyond one week overdue is considered unacceptable and might result in our accesses being revoked. So, uh, yeah.
At any rate, I open the new training in my browser ...and quickly discover I have to use a different browser because the _brand new training_ is delivered via Flash and my day-to-day browser disables flash for security reasons. Irony: the training is security training.
As usual, at the end of the training is a "knowledge check" quiz. As I go through the quiz, there's a few questions whose multiple-choice answers are either "not quite right", have answers whose correctness varies on how you read the question (and the question's wording is awkward/muddy/etc.) ...or straight up wrong.
I answer the questions – including choosing "next best" answer on one where the one that turned out to be the "correct" answer _rhymed_ with what's correct but was, itself, _not_ correct (unless my ability to rent a car is an example of a best practice around providing minimized privilege set: apparently, whoever wrote the quiz and whoever did an editorial reading of the test thought "lease privilege" is a real thing in the context of IT security best practices). I hit the done/score button and fail the quiz ...by exactly the number of poorly-written/incorrect questions/answers.
Fortunately, there's a re-try button. So, I go back and provide the right incorrect answers and get a passing grade.
After printing out and saving the certificate of completion, I'm presented with a survey link. "Great," I think to myself, "I'm going to fucking roast them." I was, at minimum, planning to leave a one-word comment, "theiy're," in any available free-form response section. Naturally, the link to the survey doesn't actually work.
WTF.
I login to the portal to look at the training schedule. I find the "overdue" training. I look in my home directory's training certificates folder and notice that there's a matching ID in there from the second half of January of this year ...meaning that its renewal _should_ have been due in the second half of this coming January.
Go back to the training portal and see, "oh: this is a new revision of the training ...released a few days ago, but with an author-date of a few weeks ago. I guess this update obsoleted my existing training. And it looks like the 'overdue' notice was sent out on the day that the training was mad available on the training-portal but back-dated to the day it was authored." All of which is great because our managers get "overdue reports" about each of our training and anything beyond one week overdue is considered unacceptable and might result in our accesses being revoked. So, uh, yeah.
At any rate, I open the new training in my browser ...and quickly discover I have to use a different browser because the _brand new training_ is delivered via Flash and my day-to-day browser disables flash for security reasons. Irony: the training is security training.
As usual, at the end of the training is a "knowledge check" quiz. As I go through the quiz, there's a few questions whose multiple-choice answers are either "not quite right", have answers whose correctness varies on how you read the question (and the question's wording is awkward/muddy/etc.) ...or straight up wrong.
I answer the questions – including choosing "next best" answer on one where the one that turned out to be the "correct" answer _rhymed_ with what's correct but was, itself, _not_ correct (unless my ability to rent a car is an example of a best practice around providing minimized privilege set: apparently, whoever wrote the quiz and whoever did an editorial reading of the test thought "lease privilege" is a real thing in the context of IT security best practices). I hit the done/score button and fail the quiz ...by exactly the number of poorly-written/incorrect questions/answers.
Fortunately, there's a re-try button. So, I go back and provide the right incorrect answers and get a passing grade.
After printing out and saving the certificate of completion, I'm presented with a survey link. "Great," I think to myself, "I'm going to fucking roast them." I was, at minimum, planning to leave a one-word comment, "theiy're," in any available free-form response section. Naturally, the link to the survey doesn't actually work.
WTF.
Wednesday, July 24, 2019
Taking the Long View
In general, I'm not one of those "shiny, happy people". English is only my second language: sarcasm is my first. I'm generally a contrarian ...but I'm consistent with it: not only do I find the clouds to other people's silver-linings, I'll find the silver linings to other people's clouds.
Recently, one of my dogs was afflicted with abdominal cancer. Originally, her primary veterinary-practice vet presumed insulinoma. Subsequent imaging – first a sonogram then a computerized axial tomography (I'd use the more common "CAT" but seems odd to do so in the context of a dog) scan – combined with a non-indicative test-result for overabundance of insulin seemed to indicate that it was probably a liver tumor. Today, she had surgery …and the tumor turned out not to be associated with her liver at all: was a tumor growing off her stomach that had butted up so snug against her liver that the imaging made it look like a liver tumor. Have to wait for histology results to come back to find out just what kind of beastie it is.
At any rate, the afflicted dog was the fourth rescue we adopted ...and the third to be afflicted with cancer. The first two were euthanized because of their (untreatable) cancers. The third dog died of sudden renal failure. In short, I've plenty to be "cloudy" about – particularly when it comes to my pup-luck.
That said, all five of the dogs we've adopted have been absolutely wonderful companions. So, my pup-luck isn't completely shitty. And, taking the long view of things, I've actually got plenty to be thankful for:
Recently, one of my dogs was afflicted with abdominal cancer. Originally, her primary veterinary-practice vet presumed insulinoma. Subsequent imaging – first a sonogram then a computerized axial tomography (I'd use the more common "CAT" but seems odd to do so in the context of a dog) scan – combined with a non-indicative test-result for overabundance of insulin seemed to indicate that it was probably a liver tumor. Today, she had surgery …and the tumor turned out not to be associated with her liver at all: was a tumor growing off her stomach that had butted up so snug against her liver that the imaging made it look like a liver tumor. Have to wait for histology results to come back to find out just what kind of beastie it is.
At any rate, the afflicted dog was the fourth rescue we adopted ...and the third to be afflicted with cancer. The first two were euthanized because of their (untreatable) cancers. The third dog died of sudden renal failure. In short, I've plenty to be "cloudy" about – particularly when it comes to my pup-luck.
That said, all five of the dogs we've adopted have been absolutely wonderful companions. So, my pup-luck isn't completely shitty. And, taking the long view of things, I've actually got plenty to be thankful for:
- I've been employed at a sufficient-enough pay-scale that I've been able to save aggressively not only for retirement but for "rainy days".
- Due to the previous point, my care-decisions for the current dog's treatment have, thus far, only needed to be driven by probable outcomes rather than financial considerations.
- I have a wonderful set of friends and acquaintances who've been wishing us well with our current canine-health straits
- I live someplace where I have access to a number of both day-to-day and specialty veterinary practitioners
- I live close to said practitioners
- Those practitioners have flexible enough schedules that:
- I was able to have my dog be seen by an emergency veterinarian within an hour of the episode that ultimately uncovered the tumor
- Prior to the oncology-referral, the emergency vet asked to do some additional diagnostics that could have included ICU charges, but for which I was only charged the actual lab fees.
- I was able to have very frank discussions with the emergency vet about likely diagnoses and prognostics
- I was able to have my dog be seen by a veterinary oncologist within a day of the emergency vet's lab results coming back.
- I was able to have a CT scan performed the first business day after the oncology consult.
- I was able to have very frank discussions with the oncology vets about likely diagnoses and prognostics resultant of all the preceding diagnostics
- I was able to have a surgical-consult the day after the final imaging results came back
- I was able to have surgery performed the same day as the consult.
- I have a very understanding employer who's been able to accommodate me suddenly needing to take time away from the office so I could take advantage of all of the above scheduling flexibility
- I have an employer who's trying to work within their legal frameworks to help me with the financial aspects of things
- As noted previously, I have enough in the way of savings that I don't need my employer to come up with a financial hail-mary for me.
- Because of my financial standing, even if I didn't have the liquid or semi-liquid savings as an immediate backstop, I could probably fairly trivially pick up a 0/0 credit card to help me bridge any savings-gaps I might have had.
Now, to hope that:
- The pathology report comes back with results that allow me to be thankful to have my doggo for another few years.
- All of the dog-related concerns can ebb soon enough that (what appear to be) incipient health-problems for my wife can be addressed free of worry about doggo. Basically, if wife does end up hospitalized, again (fuck you, Chron's), hopefully doggo will be sufficiently on the mend that I'll be able to visit wife during her hospitalization.
Lastly, as crap as 2019 has been from a medical and veterinary standpoint, there've been enough other positives – both those listed above and those that I've not explicitly stated – that I can easily see that things could be so much worse. And, no, I'm not asking the Universe for a demonstration of how much worse things could be. I would prefer to be able to remain thankful for the luck-detour being manageable.
Monday, July 8, 2019
Stating the Blindingly-Obvious
I was gonna title this "cancer sucks", but changed my mind for two reasons:
- This is may not be the only post in the coming weeks/months that would want that title.
- It's a statement of the blindingly-obvious (and, thusly, not terribly original)
Vet contacted me, today, about Lady. The initial test-results were not confirmative of insulinoma. He said this wasn't surprising because, while her blood sugar levels were quite low, they weren't in the range typically necessary for a blood-draw to be definitive for insulinoma. Worse, just because the sonogram showed a obvious, consolidated tumor in her liver, that no tumors were visible in her pancreas isn't definitive of primary hepatic cancer. It's notionally possible that she could have pancreatic tumors that are too small to see on sonogram - even if they were the primary source of the cancer in her liver. It's a concern because primary hepatic cancer is rare in dogs. So, while she could be lucky - inasmuch as having life-threatening cancer in the liver can be - and have primary cancer of the liver, the odds are against that.
This left me with a couple options:
- Do the oncology consult (scheduled for the morning of July 15th) without doing more to eliminate the likelihood of insulinoma
- Drop her off at the vet, tomorrow, for some additional testing
Since it would be horrible to subject her to liver surgery if one could know that it was both unnecessary and make her spend her remaining weeks recovering from major abdominal surgery, I'm opting for the additional testing. Unfortunately, those tests can still produce a non-definitive diagnosis: like many tests, they're ok for confirming a positive diagnosis (that she has insulinoma) but not for confirming a negative diagnosis (that she absolutely doesn't have insulinoma). For potential longevity sake, I obviously hope for lack of a positive diagnosis from the tests.
Unfortunately, the tests aren't without risk. They have to fast her to see if her blood sugar drops enough to get a definitive positive test result. Fasting her to that point puts her at risk for seizures and worse. Primary thing going for her is that she'll notionally be being closely-enough observed during the fasting that (if she does have insulinoma) that she would be caught low enough to test yet not so low that she suffers neurological impairment (that would necessitate an even earlier departure than pancreatic cancer, by itself, would have caused).
Still even if the fasting-blood-tests don't prove confirmative of pancreatic cancer, proceeding with surgery isn't a slam-dunk. They could open her up, do the liver resection, send off the excised tissue for biopsy and still find that it wasn't primary hepatic cancer. Meaning, that I potentially put her through abdominal surgery for nothing and put her in pain for a non-trivial chunk of her remaining time with us.
I imagine, if tomorrow's tests are non-confirmative, one of the things that we'll discuss at the oncology consultation is further pre-surgical testing. And whether they could be conducted as part of a larger, contingent procedure. That might be something like, "do an MRI (or something) and, if that comes back clean, only then move on to the resection."
Problem is, dogs, unlike humans, can't really be given an MRI without general anaesthetic. That means either doing one, long sedation for the MRI and then surgery (if the MRI were clean). The longer anything is under general anaesthetic, the riskier things become. Notionally, could do separate procedures, but that has its own risks: 1) two applications of anaesthetic in a short period of time is risky; 2) liver cancer is aggressive enough that the delay between discreet procedures likely results in the growth of the existing tumor and/or possibly allow time for it to metastasize even if it has yet to do so. And, risks to Lady aside, there's also the financial impact: doing the additional testing also markedly increases the costs of an already expensive procedure.
My primary concern is that I do the most good for the least amount of harm. And, if I can't do her any good, I'd like to at least not do her any further harm than whatever bomb ticking in her abdomen is want to do.
There's just not a lot of good choices, here.
Wednesday, July 3, 2019
Unwanted Curveballs
To open, I'm not going to say anything like "God is a bastard". I'm, at best, agnostic. Which is to say, while I suspect that the life we have is all there is and that there's no father-like figure out there overseeing my existence, I don't have what I'd consider sufficient proof to make the leap to full-on atheism. Atheism requires a degree of certitude I don't possess. Not really sure how anyone has that much. …But I digress: it's the long-winded way of saying "I don't think there's anyone to call a bastard" and I doubt that, if there is, I don't think he's out there trying to make my life hard. If there's a God, he's got far bigger fish to fry than singling me out for torment. And, really, my torment is small potatoes compared to millions – maybe billions – of others'.
What I do know is that, no matter how Right™ you try to live, no matter how hard you try to properly see to those in your care, no matter how much control you try to exert on existence, it doesn't seem to matter. Sometimes, it feels like the more you try, the more it blows back on you.
I'm one of those people that ascribes to the whole "live within your means" thing and "save for a rainy day" and "save for retirement" ethos. For the most part, I've been able to meet those aspirations. That said, watching how others live frequently makes me feel like people who don't are often rewarded for flauting the fable of the ant and the grasshopper …or, at least, aren't as penalized for spendthrift behavior in a way that's adequately proportionate (which can feel the same as being rewarded).
At any rate, while I don't lack for things I truly need – and it viscerally rankles me when people ascribe the term "need" to things that are, at best, "wants" – and I do indulge in occasional luxuries or self-pampering, I don't do so with the frequency that it seems many people I know do. I shepherd my money.
What I do tend to spend on are things like healthy diet for myself, my wife and my pets. Similarly, I spend for regular/prophylactic medical care for myself , my wife and my pets. Unfortunately, there's years like this one – and felt most acutely on days like today – where it all feels like wasted effort. It's like tilting at windmills. My autoimmune arthritis continues to progress – if more slowly than it otherwise might. My wife's been in the middle of a months-long Chron's flare that looks to have her on a trajectory to another hospitalization. And today?
Today I found out that my dog (we have two – one that's notionally my wife's and one that's notionally mine), Lady, has a large tumor in her liver. I found this out because, as I was working from home, writing automation for a customer's cloud environment, Lady started an episode of repeated pancaking.
In the span of a little less than 30 minutes (from a hair before 11:00 to around 11:25 or so), she was falling flat for no apparent reason. First, I'd seen her get up from her one pillow to go get a drink. On the way, I saw her pancake out of the corner of my eye. It didn't look normal, but, I told myself, "maybe she just stumbled and it looked wrong because you saw it from the corner of your eye. Best to keep an eye on her." Self-delusion is grand. Unfortunately, as I feared, it wasn't normal. After getting her drink and starting to walk back from the dish, she shuddered, briefly, then pancaked again. She got right back up, though, so I didn't immediately panic. But then she went to go lay with our other dog, and pancaked again while taking a step up onto the main stairs. At this point, the sinking feeling really set in: barely controlled panic. I SMSed my wife to tell her to hurry home with the car before calling the vet to arrange an emergency visit. Between the SMS and call to the vet, Lady pancaked one more time before I brought her up on the couch. She had a worried look and I wanted to be able to soothe her. Donna eventually got home and sat on the arm of the couch next to Lady. Lady sat up to say hello ...then toppled back over against me.
Wife home, I went upstairs to get dressed so we could gather up the dog and head to the vet. The on-couch toppling was the last such event before heading to the vet.
We were able to run Lady and Kaiya (our other dog) outside to go to the bathroom without further pancaking from Lady. We were able to get them leashed and harnessed up for the trip (they actually had a scheduled appointment for booster shots, this afternoon) with no pancaking. Lady strode enthusiastically out to the car and hopped up into the back seat without any sign of lack of sure-footedness. Similarly, when we got to the vet, she hopped right down out of the car and did her boxery walk into the vet's office – all with no sign of problems.
The vet-tech took care of Kaiya's booster shot while we waited with Lady for the vet. Kaiya was in an irritable mood – she tends to be leash-reactive, especially at the vet's – so I had Donna run her home while I stayed with Lady. The office staff took us to a room to wait for an available vet.
Eventually he came into the examining room. We discussed what had prompted the change in plans for the day. He decided that some initial diagnostics were in order, but that it would take an hour or so to do them. So he offered the opportunity for us to leave rather than wait in the veterinary facility. Given that the pancaking happened a skosh before lunchtime and it was now 12:45 (and some of my panic had either semi-subsided or I'd been able to compartment it off), I was beginning to feel hangry. So, we took the opportunity to go home so I could get lunch.
Vet called a hair before 15:00 to come talk about Lady. We rushed back down. He indicated that there were some troubling indications in her initial bloodwork. Specifically, here blood sugar levels were critically low – and they'd tested twice to verify that there wasn't a labwork error. That had caused him to do some preliminary imaging. He indicated he wasn't an imaging specialist, but that it had looked like there might be a mass near her liver.
We discussed what this could mean – especially combined with the pancaking and blood sugar levels – and appropriate next steps. We opted to have their sonographer do a more-detailed imaging and analysis. This would take about an hour. Eventually, the results came back: a large, consolidated mass in her liver.
Obviously, my heart sunk through the floor and my voice wanted to betray me. But, I gritted through discussing prognosis and next steps. Because the mass seems to be consolidate/confined, he recommended an oncology consult and offered a referral. There's a chance that, given early enough surgery and that the tumor is as confined as it looks, she could potentially recover in a way where she'd have decent quality of life and not suffer from a premature-for-her-breed death ...but that the oncologist would likely be able to give a better idea.
We started talking numbers, both for today's vet visit, plus likely fees for consult, surgery, etc. Nice thing about numbers is it gives me something non-emotional to focus on. I was doing a running-tally of the current and projected numbers in my head versus how much I knew to be in our "rainy day"/vacation fund. The numbers were close but notionally wouldn't require making a life/death decision based solely on financial capability, and might not even require having to resort to credit cards or tapping into the investment-account (or, as I sometimes refer to it, "the really rainy-day account"). We agreed to a plan of action: he'd provide an oncology referral and steroids to help encourage her liver to release more sugar into her blood; we'd alter her diet to reduce simple carbs and increase protein and fibre intake (irony is that, with a hypoglycemia-inducing liver tumor, the diet change isn't "give her more sweets" but "feed her like she has diabetes") while simultaneously changing from twice-a-day feeding to an every-four-hours schedule (though same basic daily caloric intake) to help smooth out the glycemic peaks-and-valleys; we'd schedule an appointment with a canine oncologist and proceed based on the outcome of that meeting.
Given that we didn't get home till after 17:30 and tomorrow being a national holiday, won't even be able to call to schedule the consult till Friday. I've asked for multiple referrals so that I can take her to whoever's able to see her first. Fortunately, there's enough in the "rainy day"/vacation fund that I'm able to accommodate a "speed trump costs" strategy. In the face of (personal) tragedy, it's always good to look for things to be thankful for where you can find them.
Obviously, as of this writing, haven't had the oncology consult: everything could turn out to be moot.
Regardless of this particular incident, this will make three dogs to have been afflicted with cancer:
In short, dog-owning life has had a way of really making us feel like the Universe is, at best, indifferent, many times cruelly-so.
What I do know is that, no matter how Right™ you try to live, no matter how hard you try to properly see to those in your care, no matter how much control you try to exert on existence, it doesn't seem to matter. Sometimes, it feels like the more you try, the more it blows back on you.
I'm one of those people that ascribes to the whole "live within your means" thing and "save for a rainy day" and "save for retirement" ethos. For the most part, I've been able to meet those aspirations. That said, watching how others live frequently makes me feel like people who don't are often rewarded for flauting the fable of the ant and the grasshopper …or, at least, aren't as penalized for spendthrift behavior in a way that's adequately proportionate (which can feel the same as being rewarded).
At any rate, while I don't lack for things I truly need – and it viscerally rankles me when people ascribe the term "need" to things that are, at best, "wants" – and I do indulge in occasional luxuries or self-pampering, I don't do so with the frequency that it seems many people I know do. I shepherd my money.
What I do tend to spend on are things like healthy diet for myself, my wife and my pets. Similarly, I spend for regular/prophylactic medical care for myself , my wife and my pets. Unfortunately, there's years like this one – and felt most acutely on days like today – where it all feels like wasted effort. It's like tilting at windmills. My autoimmune arthritis continues to progress – if more slowly than it otherwise might. My wife's been in the middle of a months-long Chron's flare that looks to have her on a trajectory to another hospitalization. And today?
Today I found out that my dog (we have two – one that's notionally my wife's and one that's notionally mine), Lady, has a large tumor in her liver. I found this out because, as I was working from home, writing automation for a customer's cloud environment, Lady started an episode of repeated pancaking.
In the span of a little less than 30 minutes (from a hair before 11:00 to around 11:25 or so), she was falling flat for no apparent reason. First, I'd seen her get up from her one pillow to go get a drink. On the way, I saw her pancake out of the corner of my eye. It didn't look normal, but, I told myself, "maybe she just stumbled and it looked wrong because you saw it from the corner of your eye. Best to keep an eye on her." Self-delusion is grand. Unfortunately, as I feared, it wasn't normal. After getting her drink and starting to walk back from the dish, she shuddered, briefly, then pancaked again. She got right back up, though, so I didn't immediately panic. But then she went to go lay with our other dog, and pancaked again while taking a step up onto the main stairs. At this point, the sinking feeling really set in: barely controlled panic. I SMSed my wife to tell her to hurry home with the car before calling the vet to arrange an emergency visit. Between the SMS and call to the vet, Lady pancaked one more time before I brought her up on the couch. She had a worried look and I wanted to be able to soothe her. Donna eventually got home and sat on the arm of the couch next to Lady. Lady sat up to say hello ...then toppled back over against me.
Wife home, I went upstairs to get dressed so we could gather up the dog and head to the vet. The on-couch toppling was the last such event before heading to the vet.
We were able to run Lady and Kaiya (our other dog) outside to go to the bathroom without further pancaking from Lady. We were able to get them leashed and harnessed up for the trip (they actually had a scheduled appointment for booster shots, this afternoon) with no pancaking. Lady strode enthusiastically out to the car and hopped up into the back seat without any sign of lack of sure-footedness. Similarly, when we got to the vet, she hopped right down out of the car and did her boxery walk into the vet's office – all with no sign of problems.
The vet-tech took care of Kaiya's booster shot while we waited with Lady for the vet. Kaiya was in an irritable mood – she tends to be leash-reactive, especially at the vet's – so I had Donna run her home while I stayed with Lady. The office staff took us to a room to wait for an available vet.
Eventually he came into the examining room. We discussed what had prompted the change in plans for the day. He decided that some initial diagnostics were in order, but that it would take an hour or so to do them. So he offered the opportunity for us to leave rather than wait in the veterinary facility. Given that the pancaking happened a skosh before lunchtime and it was now 12:45 (and some of my panic had either semi-subsided or I'd been able to compartment it off), I was beginning to feel hangry. So, we took the opportunity to go home so I could get lunch.
Vet called a hair before 15:00 to come talk about Lady. We rushed back down. He indicated that there were some troubling indications in her initial bloodwork. Specifically, here blood sugar levels were critically low – and they'd tested twice to verify that there wasn't a labwork error. That had caused him to do some preliminary imaging. He indicated he wasn't an imaging specialist, but that it had looked like there might be a mass near her liver.
We discussed what this could mean – especially combined with the pancaking and blood sugar levels – and appropriate next steps. We opted to have their sonographer do a more-detailed imaging and analysis. This would take about an hour. Eventually, the results came back: a large, consolidated mass in her liver.
Obviously, my heart sunk through the floor and my voice wanted to betray me. But, I gritted through discussing prognosis and next steps. Because the mass seems to be consolidate/confined, he recommended an oncology consult and offered a referral. There's a chance that, given early enough surgery and that the tumor is as confined as it looks, she could potentially recover in a way where she'd have decent quality of life and not suffer from a premature-for-her-breed death ...but that the oncologist would likely be able to give a better idea.
We started talking numbers, both for today's vet visit, plus likely fees for consult, surgery, etc. Nice thing about numbers is it gives me something non-emotional to focus on. I was doing a running-tally of the current and projected numbers in my head versus how much I knew to be in our "rainy day"/vacation fund. The numbers were close but notionally wouldn't require making a life/death decision based solely on financial capability, and might not even require having to resort to credit cards or tapping into the investment-account (or, as I sometimes refer to it, "the really rainy-day account"). We agreed to a plan of action: he'd provide an oncology referral and steroids to help encourage her liver to release more sugar into her blood; we'd alter her diet to reduce simple carbs and increase protein and fibre intake (irony is that, with a hypoglycemia-inducing liver tumor, the diet change isn't "give her more sweets" but "feed her like she has diabetes") while simultaneously changing from twice-a-day feeding to an every-four-hours schedule (though same basic daily caloric intake) to help smooth out the glycemic peaks-and-valleys; we'd schedule an appointment with a canine oncologist and proceed based on the outcome of that meeting.
Given that we didn't get home till after 17:30 and tomorrow being a national holiday, won't even be able to call to schedule the consult till Friday. I've asked for multiple referrals so that I can take her to whoever's able to see her first. Fortunately, there's enough in the "rainy day"/vacation fund that I'm able to accommodate a "speed trump costs" strategy. In the face of (personal) tragedy, it's always good to look for things to be thankful for where you can find them.
Obviously, as of this writing, haven't had the oncology consult: everything could turn out to be moot.
Regardless of this particular incident, this will make three dogs to have been afflicted with cancer:
- Our first rescue-bullie, Lana, contracted a treatable cancer, but, it was discovered coincident to discovering she had advanced stenosis. Given her age, the stenosis and the toll treatment would take on her absent those other considerations, we opted to schedule a euthanization (so we could take her home for a few weeks of pampering).
- A month later, our second rescue-bullie, Puckett, had manifested skin lesions. A vet visit revealed them to be from cutaneous lymphoma: an aggressive, untreatable (in dogs, at least) form of cancer. Vet predicted a possible remaining lifespan of six months. We got half that when the cancer spread to his lungs.
- With Lady, our fourth rescue-bullie, I don't yet know the outcome. I suspect the worst, however. That seems to be the way of things.
By a small miracle (at least, it seems that way, at this point) our third rescue-bullie, Cira, was not afflicted with cancer. No... At just shy of nine years old (a skosh longer than six years after joining our household), she died of a sudden-onset, complete renal failure.
So, yeah, our pup-luck has been "not great". I mean, to date, we've been blessed with five really wonderful dogs, but three – and likely a fourth – we'll have only been able to share our home with for far shorter times than is normal for their main breeds' life-expectancies. And that's in spite of the previously mentioned attentive care.
In short, dog-owning life has had a way of really making us feel like the Universe is, at best, indifferent, many times cruelly-so.
Thursday, February 7, 2019
News flash: Virginia is an "Old South" state.
It's nickname is "Old Dominion" for a reason. Several of its most famous historical figures owned slaves and led Confederate forces. Hell, it was the seat of the Confederacy for a while.
I've lived here for a quarter century, now. "Northern Virginia" was a near pejorative for "real" Virginians when I first moved here.
I still remember how stark the difference between the 703 area code was from the rest of the state. It defined not just your dialing rates/locality but a noticable mind-set difference. Just beyond the 703, where you now find tech companies and huge tractsA-friendly neighborhoods McMansions, you used to see farms and rustic stores Hawking souvenirs from "the War of Northern Aggression".
My point is, discovering that a politician that was born, raised and attended college in "Old South" Virginia before the 90s ever participated in black-face is utterly unsurprising. Not excusing it. Just pointing out some unfortunate reality. There's likely a lot of skeletons in the closets of a significant chunk of the Virginia state government's office-holders. It's likely to be another 15-20 years before that's no longer the case.
It's not just a Virginia thing, either. Hell, it's not even just a "South" problem. I grew up in what, as an adult, I refer to as Pennsyltucky. The vast majority of the state is/was rural ...and its main cities were never (on average) something you'd have confused for "cosmopolitan", "sophisticated" or particularly "progressive". I knew plenty of people my age that, even 20 years ago, would say things that might leave you gawping or scratching your head and wondering, "did you really just say that?" And if you were talking people a generation or two older than me? Fuuuuuck. I loved my grandmother dearly, but I don't have enough fingers to count the number of times she would use "the coloreds" or similar terminology in her speech. It wasn't meant in a particularly-racist way - it was normal for her generation and class - but would still leave me sometimes speechless.
I used to travel extensively, for work. I can tell you that Pennsylvania is not alone in this respect among Northern states.
So, yeah, the current news cycle about what's going on in Richmond is pretty fucking gross. However, as alluded to above, given the current composition of the elected body, summarily cashiering people who've had skeletons might not be the smartest thing. The replacements could easily be worse people. It's even likely that the people that dug those skeletons up have the same damned skeletons (that they think are burried a bit better than those of the recently-exposed) but also have something to gain by digging others' up.
I dunno. It sucks. Doesn't feel like there's a lot of good options inside the next decade or so. That said, I'd still probably prefer someone that claims repentance over someone still wearing a MAGA hat.
I've lived here for a quarter century, now. "Northern Virginia" was a near pejorative for "real" Virginians when I first moved here.
I still remember how stark the difference between the 703 area code was from the rest of the state. It defined not just your dialing rates/locality but a noticable mind-set difference. Just beyond the 703, where you now find tech companies and huge tractsA-friendly neighborhoods McMansions, you used to see farms and rustic stores Hawking souvenirs from "the War of Northern Aggression".
My point is, discovering that a politician that was born, raised and attended college in "Old South" Virginia before the 90s ever participated in black-face is utterly unsurprising. Not excusing it. Just pointing out some unfortunate reality. There's likely a lot of skeletons in the closets of a significant chunk of the Virginia state government's office-holders. It's likely to be another 15-20 years before that's no longer the case.
It's not just a Virginia thing, either. Hell, it's not even just a "South" problem. I grew up in what, as an adult, I refer to as Pennsyltucky. The vast majority of the state is/was rural ...and its main cities were never (on average) something you'd have confused for "cosmopolitan", "sophisticated" or particularly "progressive". I knew plenty of people my age that, even 20 years ago, would say things that might leave you gawping or scratching your head and wondering, "did you really just say that?" And if you were talking people a generation or two older than me? Fuuuuuck. I loved my grandmother dearly, but I don't have enough fingers to count the number of times she would use "the coloreds" or similar terminology in her speech. It wasn't meant in a particularly-racist way - it was normal for her generation and class - but would still leave me sometimes speechless.
I used to travel extensively, for work. I can tell you that Pennsylvania is not alone in this respect among Northern states.
So, yeah, the current news cycle about what's going on in Richmond is pretty fucking gross. However, as alluded to above, given the current composition of the elected body, summarily cashiering people who've had skeletons might not be the smartest thing. The replacements could easily be worse people. It's even likely that the people that dug those skeletons up have the same damned skeletons (that they think are burried a bit better than those of the recently-exposed) but also have something to gain by digging others' up.
I dunno. It sucks. Doesn't feel like there's a lot of good options inside the next decade or so. That said, I'd still probably prefer someone that claims repentance over someone still wearing a MAGA hat.
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