Steve Betts: Health

Lexapro day 10

Wed, 14 Mar 2007 02:43:18 GMT

I wanted to list my symptoms so I don't forget.

Initially, I had dizziness, sleepiness, intestinal upset, unable to sleep at night, waking up at 4:30 am every day, and jaw clenching. None of it was too bad, except when I had a margarita last Tuesday and I got so dizzy I had to sit down.

Most of the symptoms have drastically reduced now. I have almost no dizziness, and my sleepiness is gone. I still wake up early, but now it's at 5:45 am. Hmmmm, time change? :)

As far being happier, I don't have visions of me throwing myself down the stairs every time I pass them anymore. That's a good sign. But I don't feel very different.

Lexapro Update

Tue, 06 Mar 2007 20:06:41 GMT

Well, it's been 4 days. I'm still feeling a little tired all the time, and my eyes are sort of itchy/scratchy, like I haven't slept in a long time. Other than that, I'm not feeling significantly different. I got an email today with some work and was pretty happy about that. More so than usual, I think. Meanwhile, no real side effects.

Lexapro update

Sat, 03 Mar 2007 02:43:43 GMT

End of the first day of Lexapro. Just wanting to say what's going on. I'm not quite feeling myself, in that my brain seems not to be fitting in my head quite right. It's almost a little dizzy. It's the dizzy feeling without the nausea. It's been hard to concentrate, sort of like a hangover.No pain, just a little out of it.

Antidepressants

Fri, 02 Mar 2007 12:12:45 GMT

Just a tiny bit of health news. I started taking Lexapro last night. I am going to track my progress and the effects here.

Get the best foodstuff care you can

Wed, 28 Dec 2005 16:51:26 GMT

Foodstuff Benefits.

Imagine if food were a standard corporate benefit like health care. After all it is a necessity; how can any responsible employer fail to provide it?

Of course each company wonâ€™t be able to offer its own foodstuff benefit so, instead, there will be major third-party payers in the system. When you go to the grocery store, instead of taking out your Visa or American Express, youâ€™ll whip out your United Foodstuff card instead. Then there will be a long pause, consultation with the manager, and a few phone calls to determine what sort of copay you are required to make on the various items in your shopping basket. Youâ€™ll end up having to put the Twinkies back because they are excluded from your foodstuff plan.

Some food stores are off-limits to you because they do not accept your foodstuff provider. Others require that you pay in full and then request reimbursement from the provider. There is a lower copay for some generic store brands than for name brands like Coke and Pepsi.

Shopping on vacation is a real problem since United Foodstuff doesnâ€™t have agreements with any grocery chains south of the Mason-Dixon Line. Out of the country, fuhgetaboutit.

Months after each shopping trip you are still receiving bills for the unreimbursed portion of the expense of the nutrition consultant who vetted your shopping list after the fact to assure that you havenâ€™t bought ingredients either singly or in combination that you might later sue either the grocery store or your employer over. You also receive a letter urgently requiring that you prove that you have not claimed reimbursement for food used to make any meals covered by your childrenâ€™s school lunch program or Meals on Wheels.

When your employer decides to switch foodstuff carriers, you have to change your shopping habits both to be in-network for the new carrier and to minimize your copay since the rules have changed. However, if you live in Vermont, you can count on the fact that the State requires coverage for both tofu and maple syrup in all policies and, in New Jersey, cannoli never require a copay.

You must be very careful not to have a gap in foodstuff coverage between employers; individual foodstuff policies are very expensive â€“ some say prohibitively so. And most food stores are very reluctant to deal with people with no coverage at all. Prices are 50% higher for food not bought under a foodstuff plan. Even when you get a new policy from a new employer, pre-existing cravings are not covered.

The value of the foodstuff coverage you will be given is an important part of the total compensation you receive from an employer. When weighing job offers, you may want to use a consultant to figure out the relative value of the foodstuff portions of these offers. But, unless you are protected by a union or an Enron-type executive contract, your employer is free to change the foodstuff plan at will after you are hired.

â€œOK,â€� you say. â€œEnough. This is plainly absurdâ€�

So is employer-funded healthcare, even though it does have an insurance as well as a bill-paying component.

Third party payers add enormous cost and complexity to the health care system. Health care choices are distorted by labyrinthine plans which often seem to be designed NOT to pay benefits. The health care delivery system is largely incapable of charging for care EXCEPT through these plans. When individuals pay directly, even at the point of care, they are charged more even though the cost of collecting from them is much less.

Employers are motivated to cut the cost of the benefit. Third-party payers are motivated to pay out in benefits as small a portion of the premiums they receive as possible. Participants (us and the health care providers) are motivated to game what we perceive as an unfair system.

Employers are only in the healthcare benefit business because, during World War II wage and price controls, these benefits were a legal alternative to raises (see this post on unintended consequences) and because there is currently a tax benefit to having employers rather than employees pay for healthcare.

It is now past time for two major changes:

Employers should pay people salaries with which people buy whatever food, toys, and health care they want (noted that it is debatable whether people should be allowed to go without coverage but this isnâ€™t an employer issue).

Paying for routine healthcare like checkups, immunizations, drugs at reasonable costs and reasonable quantities, belly-aches, cuts and bruises, etc. etc. should be just like any other predictable expense such as food or transportation (noted that it is debatable â€“ at least as long as there is government backup to health care â€“ whether people should be allowed to go without checkups and immunizations). Absolutely no reason for a third party to be involved and all the reasons in the world for them not to be. Insurance for major unpredictable expenses is entirely different and is a legitimate insurance function which must be separated from paying routine bills and from paychecks.

As you can probably guess, more posts on this to come.

[Fractals of Change]

Day of Reflux

Wed, 12 Oct 2005 19:58:46 GMT

So, what's it like having reflux? It's a pain. Both literally and figuratively. I take 3 pills a day to try and control it, and it doesn't.

My day usually goes like this. Get up, belch, and think about how bad it's going to be today. Throat burns, chest hurts, stomach hurts. ok, not too bad. Go to the bathroom and take a shower. In the shower, think about what to eat for breakfast. Not something too sharp. Too crispy. Soggy raisin bran. That sounds edible. No scratching as it goes down.
Get out of the shower and ponder taking Tums (an antacid). It will make me feel better, but the doctor says I shouldn't mix it with medicine, that might cause the stomach to improperly digest the food. Hmmmph.

Get dressed. I hate putting on my shoes, because it always makes me regurgitate whatever is in my stomach. Blech. Kiss the kids, and go downstairs. Get some raisin bran cereal. Pour on the milk and let it sit while I take my Protonix, multivitamin, and glucosamine tablets. Take the first bite, remembering to chew it carefully to I don't scratch my esophagus while swallowing. Hmmm, stomach hurts when swallowing. Gonna have to remember to tell the doctor about that. A couple more bites and it doesn't hurt so much anymore. Finish breakfast, kiss the kids and wife, and leave for work.

At work, it's 10 am, and my stomach hurts again. I can tell I've been slouching because my throat is sore. Hard to swallow again. Stomach is burning again; wonder if I should eat something so it's not so sore.

Lunch time! Let's eat. Ok, can't have anything with grease, tomatoes, or cheese. Well, that leaves peanut butter and jelly, or a ham sandwich. 5 minutes later, I'm done eating, and all afternoon I'm burping up lunch. How can I possibly have eaten too fast and swallowed all that air? Chest pains are starting up again. Wish I had some good food for lunch to justify the discomfort.

Home for dinner. Need to get a small portion, can’t eat too much or I won’t sleep very well. Can’t sit on the floor to play with the kids, or sit on the comfy couch, makes me slouch, makes my stomach hurt. Lie on the couch, continuously swallowing to try to keep the food down. Doesn’t really work.

8 pm. Time to take my evening pills. Another Protonix, Zantac, Singulair, and glucosamine. Hope this helps.

11 pm. Need to get some sleep tonight. Take a Tums before lying down. Aah, blissful lack of stomach pain for 15 minutes. Horrible taste in my mouth, but I fall asleep quickly.

You know, if I could just sleep through the night. It’s sometime in the middle of the night. Lying on my side, trying not to let my stomach rest on the mattress to reduce the abdominal pressure. Doesn’t really work. If I were really fat, this wouldn’t bother me so much. Right? Think about taking another Tums to ease the heartburn. Can’t keep taking those.

Just another day. Having the surgery on Oct 31st. I sure hope it helps.

GERD update

Wed, 04 May 2005 12:28:03 GMT

More on the recent EGD. Met with my doctor about the results, and he's changed my daily prescription from Prevacid 30 mg and Zantac 150 mg to Protonix 40 mg twice a day.

The biposies showed no malignant growths.

So now we spend the next 8 weeks with the new medication. The doctor still thinks that surgery is a better alternative, but I would much rather try the medicine first, so that's what we are doing.

You want to look in my stomach why?

Tue, 12 Apr 2005 02:32:53 GMT

More health reports. Today I had my third EGD in 3 years, and this was a little more depressing than the last two. The first one, about 3 years ago, showed some reddening from the GERD (reflux), but nothing significant, and no ulcers or bleeding.

The second EGD showed a small hiatal hernia too

This third EGD shows much more damage from the GERD. I went into the doctor's office last July, complaining of sore throat and some difficulty swallowing because of a reduction of my medications (Prevacid went from 30 -> 15 mg). So I was put back on Prevacid (30mg) and Zantac (150), but the symptoms just didn't get any better.

I put off going to the doctor about it, because I was just sick of seeing them. But as the months progresses, I had more and more troubling swallowing, and I have a sore throat every day, and I was having some chest pains.

So the GI doctor says that it sounds like it's time for surgery, and that he'll need to do another EGD to make sure I don't have any tumors or anything.

So the results today were more disturbing, because the GERD symptoms are continuing to increase. I still have the (small) hiatal hernia, but now I also have Schatzki's ring, which is a ring of scar tissue in the esophagus, most likely caused by the acid reflux. The doctor dilated that area, which should break up the ring and reduce the swallowing problems.

Also found was Erythema in the antrum, which is the first step in esophageal damage. Basically, it's just red spots where the acid has started removing the mucosa (lining).

And last, the doctor did biopsies of teh Erythema and some normal mucosa from the duodenum. I'm assuming the second biopsy was for comparison purposes.

Sounds like the medecine's not working. I'm hoping that the doctor will prescribe more Prevacid, but he seems to think I'll need the surgery. I'll be seeing the doctor again on May 2, for more feedback.

Effexor 0, Steve 1

Mon, 29 Nov 2004 20:54:55 GMT

I've stopped taking the Effexor. My last dose was Friday. I just couldn't get any sleep. I'd lie down, close my eyes, and sleep for an hour at a time. I kept thinking it was dawn at 1:30 am. After 3 days of that, I was just too tired to think straight. So I've stopped taking it.

I sleep better now.

New Drug - Effexor

Wed, 24 Nov 2004 11:57:58 GMT

Yesterday I started a new drug called Effexor (Venlafaxine). It's an antidepressant in the family of serotonin reuptake inhibitors (SNRI - serotonin and norepinephrine reuptake inhibitor). It has some interesting side effects I wanted to remember.

Today's Dose: 37.5 mg

The primary effects are to relieve depression and anxiety. It did that. I did not feel so compressed. My fingers felt light while typing (I type all day, being a programmer). I was more relaxed throughout the back and neck areas. I didn't have my typical neck pain.

First, it made me dizzy all day. Not dizzy nauseous, but dizzy like I'm not breathing. And not dizzy enough to fall down, but just to have to make sure about getting out of a chair, or bending down.

Another effect was it made my hip pain much sharper. Maybe this is the 'inappropriate antidiuretic hormone secretion' in the precautions. :)

Another side effect is the sleep interference. I was up at least 6 times last night. Any little noise woke me, and I had difficulty getting back to sleep. I woke up for the last time at 5:06 and waited in bed for sleep or the alarm at 7. The alarm won.

The last side effect may be for some other reason, but I appear to have lost 3-4 pounds yesterday. At the Dr's office, I weighed 206, and this morning, I weighed 200. Give a couple of pounds for clothes and shoes, and that's still significant. We'll see if that continues.