Dealing With Insurance Companies

I've been told more than once that if you stay with an insurance company for a few years, then even if you haven't submitted any claims, eventually they'll increase your premiums significantly, assuming that you'd rather just pay the difference than go to the trouble of shopping around. Apparently that's true, because when I opened the new quotes for my car, condo, and umbrella policies (which are bundled) for the coming year, I discovered my car insurance premium has gone up by a whopping 44%. I spent the next 20 minutes entering specifics about my driving habits and coverage and shopping around online to see what other companies would charge me if I were to switch, all of which convinced me I should contact my current company to protest this unwarranted increase. 

I also spent some time looking up things that can affect your insurance rate other than accidents or tickets, including age, number of miles driven per year, and credit rating. Today, with all my ducks in a row, I called my agent and reported:

·      I drive under 4,000 miles per year, which can be confirmed by checking the   odometer readings on my annual inspection reports

·      I've never submitted a single claim to this company on any of my policies

·      No moving violations EVER and not so much as a parking ticket

·      My credit score is 824

·      I’m 73, so 2 years younger than the age of 75, at which age I’m aware some companies increase the premiums

I also said I’m not paying the 44% increase on my policy, because I’ve already checked around online and know I can get the same coverage that I have right now for the same price I’m currently paying. It’s been assigned to someone named Mike who will provide a requote. Fingers crossed.

 

Old Age is Not for Sissies...

Shortly after Christmas, sitting in my living room late one night, I reached over the back of the couch trying to find the switch to turn off the tree lights. The switch was just out of my reach, so I stretched a little further, with my ribcage pressed against the hard frame of the back of the couch, and just as my fingers made contact with the light switch, I heard a loud "pop" and had the unsettling sensation of what felt to me like massive movement inside my body. There was no pain, just this noise and this distinct sensation of movement where there shouldn't be movement. I sat down on the couch and everything seemed fine. I stood up, and everything continued to seem fine. But WTH had just happened? 

I Googled "popping sound and feeling of movement in ribs" and after reading this description: "a popped rib happens when the cartilage attached to any or your 'false ribs' breaks, resulting in abnormal movement. It's this slipping out of normal position that causes pain" I decided that even though I wasn't feeling pain, in all likelihood I'd probably popped a rib. Years ago, in my old house, bending over the back of that same couch and resting my ribcage against the hard top of the frame to pick  something up from the floor, I'd done the same thing. There'd been no apparent consequences then, so I wasn't too worried about it now. The last time it happened was pre-internet, so I didn't know what I'd done that time, but reading about popped ribs this time convinced me that's what I'd done both times. 

The thing is, I'm 72 now, so if I had any sense, I'd have taken it easy after doing this. But since I hadn't had any problems the last time, I assumed this time would be the same, and so the day after popping the rib, I took down and packed away my 9' artificial tree by myself, and then for good measure I went to Lowe's and bought six more 30-pound bags of rocks for my patio, which I loaded onto a cart and then into my car at Lowe's, and which I unloaded and carried from my car to my patio once I got home, where I opened the bags and finished laying the rocks where I wanted them, all without giving my rib a second thought. Big mistake.

That night the pain began. Not a lot of pain but constant pain: sort of a dull ache that starts directly beneath my right breast and then runs around to the side, toward my back. It hurts when I laugh and it hurts when I breathe. Lying on my back, or even reclining is impossible. It hurts enough when I lie down that the first night I finally gave up and tried to sleep on my chaise lounge, but that didn't work because even sitting up, leaning back leaves me in pain.

I have not called my doctor about this because my doctor is very much of the "Well, you're old, what do you expect?" camp, and there's no treatment other than time to heal the cartilage anyway. Re the pain, I can't take NSAIDs, so I'm pretty much stuck with it. I discovered I can get some sleep if I sleep on the offending couch though. If I remove the back cushions, the couch is quite deep, and if I prop pillows of various sizes against the back of the couch I have enough support to be able to actually lie on my side. 2 days into this, I began to feel as if my lower back might go out. I'd guess that was due to strain from trying to compensate for the rib pain. 

So I went to the drug store and picked up some large heating patches. I applied one of those to my ribcage in an attempt to get some relief. It didn't really help with the pain, and somehow the patch managed to rub raw a spot about the size of my thumbnail on the side of my body. I was going in for my annual skin check, and didn't want to get into a conversation about my popped rib with the dermatologist, so I just put a bandaid over the raw patch. When she saw it, the dermatologist asked, "Anything there I need to know about?" I said no and she moved on with the rest of the exam, at the end of which, 4 AKs (actinic keratoses) on my face and 4 more on my shoulders were removed by freezing, and one suspicious mole on the back of my neck was biopsied. All well and good, but that night, after I stepped out the shower, I caught a glimpse of myself in the bathroom mirror and saw a red bandaid on my side, around the raw patch. Except that I'd removed the bandaid as soon as I came home: it only looked like a red bandaid in the mirror, because the bandaid itself had caused a raised red rash everywhere it came into contact with my skin. Damn!

What's next? Will I start growing a second head inside my nose? A few years ago I would have said, "Don't be ridiculous!" but these days, I'm thinking, "I dunno, seems possible, maybe..."

I Can See Clearly Now...

 8 years ago, due to a congenital defect, I had surgery on the retina of my left eye. I had an excellent surgeon, and I'm confident that he did nothing wrong. Nevertheless, as he had cautioned me might happen following such an invasive procedure, shortly after the surgery I developed a fast-growing cataract on my left eye. Within just a few months of having the surgery, which was otherwise successful, the vision in my left eye had deteriorated to the point that I was unable to read the letter "E" on the eye chart.

Accordingly, 10 months to the day after the first surgery, I had a second procedure, performed by a different surgeon, to remove the cataract and implant an IOL (intra-ocular lens). For several years after that second surgery, I had enviable distance vision in my left eye, but eventually, I developed something called PCO, or Posterior Capsular Opacification.  As a result, the vision in my left eye deteriorated. I had difficulty focusing, and in the past couple of years I'd developed something called "ghosting", which occurs when you eyes see two slightly different images transposed next to each other. This meant that if I was looking at someone seated 8 to 10 feet away, instead of seeing their face I'd see 2 faces, one in front of the other, which was annoying to say the least, but also, due to this I was now finding it impossible to read road signs. 

PCO is the most common complication of cataract surgery, occuring in approximately 20% of patients. It's caused by a cloudy layer of scar tissue growing behind the implanted lens. This happens because when a cataract is removed, a small amount of tissue covering the lens, or capsule, is left behind to help hold the IOL in place. A PCO forms when the eye attempts to make a new lens using the material left behind. Different types of cells can cause the opacification, including migrating epithelial cells and residual lens cortex cells, but no matter what type of cell is causing it, when PCO occurs, although it's a natural part of wound-healing in the eyes,  it causes problems with vision.

In addition to everything else, I also have glaucoma in both eyes, so I see my ophthalmologist every 6 months for a thorough eye exam. He had noticed the increasing PCO over the new lens, and asked me about my vision. When I told him about the ghosting (by far the worst effect for me) he encouraged me to schedule a procedure to restore the vision in my left eye. This procedure is called YAG laser capsulotomy. YAG is short for yttrium aluminum garnet, which is the type of crystal located within the laser used for the capsulotomy. It dates back to 1982, and it's considered very safe and low risk for complications.

I considered going back to the surgeon who had removed the cataract and implanted the IOL, but when I learned that my ophthalmologist was one of the first doctors trained to do YAG laser in Texas, and has been doing this procedure weekly for almost 40 years, I decided to have him do it. 

From a patient standpoint, YAG laser capsulotomy is a simple, outpatient procedure. I went to my doctor's regular office. When I arrived, drops were instilled in my left eye to lower the pressure, and also to dilate my eye. It took about 10 or 15 minutes for the drops to take effect. I then walked down the hall to a different suite, where the laser was located. It's important to remain still during this procedure, so to help immobilize my head, after being seated, my head was positioned in the chinrest of a slit lamp microscope to which the laser was attached. A slit-lamp microscope is the thing where you sit in a special chair and then lean forward to rest your chin and your forehead on the device to position your eyes so they can be examined. When you go for your annual eye exam, your optometrist almost certainly uses a slit lamp microscope to examine the back of your eyes.

An assistant instilled numbing drops in my eye. She then placed a special contact lens filled with a gel-like substance on the front of my eye. Due to the numbing drops, I didn't feel anything. My ophthalmologist then performed the capsulotomy. Focusing on the posterior capsule, he "zapped" the PCO formation with the laser, which uses a wavelength to break up the tissue, first forming a hole in the central area of the lens and then moving in a circular manner around it. The zapped tissue falls off the posterior capsule and into the vitreous. The entire procedure lasted for just a few minutes, and there was no pain involved. 

Most patients experience increased intraocular pressure (IOP) as a result of this procedure, so afterward, another pressure-lowering eyedrop was instilled as a preventative. I then walked back to the inner office waiting room, where I sat for about 20 minutes before my IOP was again checked. It was at a healthy 18, so I was discharged.

Immediately after the procedure, my vision was blurred and I had some horrendous floaters, both of which are normal. It’s not unusual to see floaters for up to 3 weeks after this procedure. However, just 9 hours later, at 10 PM, although I still have some floaters, my vision is crystal clear.

General Info

You shouldn’t drive for the first 24 hours after having this done, so you need to arrange for transportation to and from the facility.

 

Financial Considerations

Medicare Part B covers YAG laser capsulotomy if it’s deemed medically necessary due to complications from cataracts and cataract surgery, but you’ll generally need a diagnosis of posterior capsular opacification for it to be covered.

Also, if you’re having YAG done, be sure to ask ahead of time if your surgeon charges a facility fee. Facility fees can range from modest to exorbitant, and you’re responsible for 20% of the facility fee even if Medicare covers the procedure, so be sure to ask about this ahead of time. My ophthalmologist didn’t charge a separate facility fee because he has a laser on site, but if I used the surgeon who removed the original cataract and implanted the lens, I would have had to pay a separate facility fee.

Old Friends...

 

Old friends, old friends

Sat on their park bench like bookends
A newspaper blown through the grass
Falls on the round toes
Of the high shoes of the old friends

Old friends, winter companions, the old men
Lost in their overcoats, waiting for the sunset
The sounds of the city sifting through trees
Settle like dust on the shoulders of the old friends

Can you imagine us years from today
Sharing a park bench quietly?
How terribly strange to be seventy

Old friends, memory brushes the same years
Silently sharing the same fears

Time it was, and what a time it was, it was
A time of innocence, 

A time of confidences
Long ago, it must be, 

I have a photograph
Preserve your memories; 

They're all that's left you

Paul Simon

I'd been thinking of a friend of mine, whom I hadn't heard from since BC (before Covid). I was feeling a little irritated at his not staying in touch, and thinking of calling him, but for some reason I decided to Google him first and when I did, my heart sank, because there it was: his obituary. He died, apparently peacefully and at home, perhaps in his sleep, late this past February. Not from Covid. This makes 4 friends who've died in the space of 16 months: none of them from Covid, but dead nevertheless. They ranged in age from 66 to 72. My 72-year-old friend had been sick, with Parkinson's and Lewy Body Dementia, but the other 3 deaths were totally unexpected, happening as they did to people who were relatively fit, with no known health issues. I remember my father (who lived to be 91) telling me it was so hard to outlive all friends and many family members. It's a weird feeling, to know these friends are gone. I miss each of them, and life suddenly seems much more precarious than it did 2 years ago, before this started happening.

Can You Hear Me Now?

I loathe and despise corporate America, and especially Big Banks, so after a recent fiasco with Bank of America, where I've banked for more than 30 years, I decided enough is enough and began the arduous process of switching to a smaller, friendlier, less expensive institution. If you live in a house, where you have a unique street number address, congratulations, because you've automatically saved yourself hours of work. But if, like me, you live in a condo (or an apartment or a co-op), where although your apartment or unit number is unique, you share the actual street address with many other people, plan to spend a couple of weeks downloading paper application forms which you'll have to complete the old-fashioned way and submit via snail mail before you're allowed to open an online account. When I asked why there's no provision to apply online unless you live in a house, I was repeatedly told this is a provision of The Patriot Act, "to prevent terrorism". I didn't realize terrorists only operate out of apartments or condos, but hey, what do I know? 

So today, approximately a month after I submitted the initial paperwork via snail mail, having jumped through all the initial hoops, I went online to activate my new checking and savings accounts. I'm retired and my only income is my Social Security check, so the first thing I did was go online to change that deposit from Bank of America to the new place. Today is June 8th; that change will go into effect in late August (!!!). I spent several hours online, attempting to update auto-pay sources. I use AT&T for my cellphone, and Spectrum for internet, and I was unable to change the info at either of those websites due to problems with the websites. Neither website provided any information that they were having problems. Instead, both websites allowed me to enter all of my information, including account and routing numbers, but after I hit submit a pop-up appeared with a message saying they were "unable to complete your request at this time, but please do try again later". Eventually, I was successful with AT&T but not with Spectrum. Tomorrow I'll try once more and if Spectrum still can't process my request, I'll phone customer service and try to get help that way. I find it ironic that the website that gave me the most trouble is my internet provider website. First world problems, I know, but I do have to solve this.

These Foolish Things...

Last night I went on my walk, but late. The day had been stiflingly sticky and hot, but once the sun went down, the air was pleasant, almost cool, so I decided to go further than I had planned. I followed one of my regular routes, which takes me through residential streets in my neighborhood, far removed from heavy traffic. 

Eventually, this route took me to one of my favorite streets, Glen Heather. This is a street with huge (for Texas) well-established trees, many of which reach from either side of the street to almost meet overhead, forming a beautiful green bower. I'd guess the houses on this street were built in the late 70s or early 80s. Every house is MCM (mid-century modern), with lots of wonderful sharp angles and big, floor to ceiling windows. Most of these houses are just one story tall, with a few exceptions, but whether one-story or two, every house on either side of the street is a duplex. I don't know what possessed the builders to construct an entire street of nothing but duplexes here in Dallas, where the soil is so abysmally bad that sooner or later, every house ends up with foundation problems, which I'd think would be horrendously complicated, legally, if you're sharing a slab with a neighbor. But foundation problems aside, the other unusual feature of this street of houses is that without exception, every one has a lovely enclosed patio. 

All of the patios are huge. Some run across the front of each house and then turn to go run along the sides as well. Each patio is enclosed by a brick wall of varying heights: some are just 3 or 4 feet tall, so that from the street one gets a glimpse of who or what's inside, but others are 5 or even 6 feet tall, providing complete privacy. I am so intrigued by these wonderful patios, that every time I walk down this street, I imagine different scenarios: I imagine having breakfast on these patios on beautiful days, sitting in a comfortable chair at a tempered glass table set with eggs and bacon and toast; a tray with croissants and jam and butter; glasses of freshly squeezed orange juice; cups of hot coffee with cream, hearing the softly rustling pages of a newspaper as it's held to be read, back in the days when newspapers were actually made of paper and delivered to one's door. I imagine lively cocktail parties, back when people still had cocktail parties, in the 50s and 60s. That was before these houses were even built, of course, and yet these enclosed patios beg for the presence of cocktail parties. If I close my eyes I can almost hear the laughter and soft tinkle of ice in glasses that need regular refills. I imagine having dinner parties on these patios. When I was a bride, in the early 70s, we and all of our friends had regular dinner parties for 6 or 8. I can imagine hosting dinner parties on these beautiful patios, drifting in and out of the house to bring more food and refresh drinks, the night air perfumed with the scents of the jasmine and honeysuckle and gardenias that grow freely along the patio walls. 

But in the entire 3 years I've been walking down this street, I've never seen a single soul out on any of the patios. Not in the daytime, and not at night. A handful of houses have strung lights which make the patios look festive at night, but despite the lights, the patios are empty. Instead, the windows of the houses occasionally flash blue, evidence of someone deep inside the house, watching television instead of hosting a cocktail party or dinner party on their lovely patio. 

The times we live in.

Happy Endings

On Sunday night, as I was cleaning up downstairs, I decided to clean the filter pump on my LG washer. My washer and dryer are located in a small laundry closet in my kitchen, and I try to clean the washer pump filter out as recommended, about once a month. I got a small basin and sat down on the floor and first drained the hose, then replaced that and removed the filter, which, as usual, needed cleaning, mostly because Chili has a heavy coat and sheds a lot. I removed what I could by hand, then rinsed the filter out in the sink until it was perfectly clean. Then, rather than sitting down on the floor again to carefully screw it back into place, I just reached down and put it into the slot and turned it a few times, to secure it.

 

Late Monday morning, I did a load of wash. An hour or so later, when I walked into my kitchen, I discovered the kitchen floor was completely flooded. I have 5' x 7' woolen area rugs with heavy felt pads in both the kitchen and the breakfast nook, and the rugs and pads were soaked, as were the wooden floors beneath. The rugs and pads weighed a ton soaking wet, so I dragged them one at a time out onto my patio, where it was raining heavily, but not having a garage, that was my only option. Inside, I first put towels all over the floor to soak up the water, and then spent some time figuring out what had happened. Once I was sitting on the floor directly in front of the pump filter slot, I could see that it wasn't all the way in, so most of the water used when the machine was on had ended up being pumped out onto the floor. On the plus side, front load machines use considerably less water than top loaders, but it was still a lot of water on wooden floors. I removed and re-inserted and secured the pump filter, then spent the rest of the afternoon moving everything I could out of the kitchen so the floor could dry thoroughly.

 

I don't think the rug pads can be saved, so I ordered new ones. The rugs are both inexpensive. The one in the pic is from IKEA. But I like them and wasn't sure I could easily replace them, so I decided to take both rugs to a laundromat with commercial sized machines. I was worried the rugs would be too big and heavy for those machines, but I needn't have worried: those machines are so big it was almost like washing potholders in a regular machine. I washed each rug separately, in hot water, and then dried each rug separately, which took forever. When I brought them home they were both still a bit damp, so I laid them out on my seagrass rugs in the living room to finish drying.

 

Both rugs were several inches too big for the areas where I was using them, which was a real pain because it meant I had to fold the edges under to the size they should be. So this morning I decided that since both rugs were now as clean as when they were new, I might as well take them to get them cut down to the right size. But when I laid them out on the floor to see how much needed to be trimmed, I discovered to my delight that both rugs had shrunk to the point that I no longer need to have them cut down. So there really was a silver lining to this mishap.

I Might Need A Victorian Fainting Couch (and maybe a new doctor, too)

About a month ago, as I was brushing my teeth and getting ready for bed, I noticed a rather large lump on the left side of my neck. Note: I know in the pic I've posted, it looks like it's on my right side, but that pic was taken in the mirror, so everything is reversed. I was going in for my regular 3-month diabetes check-up in a few days, and as I looked at the lump in the mirror, I thought I really should have my doctor check that out, but then I reconsidered. I currently have a doctor who, although he's a GP, prefers no physical contact. 

I'm old enough to remember when at the very least, every doctor visit included palpating your throat and jaw line for tumors, and once a year, there'd be a breast and pelvic exam, but those days are long gone. Several years ago, when I was still working, the health program at work was sending me regular emails reminding me I was overdue for a pelvic exam, so when I called to schedule my annual check-up I specifically requested a pelvic exam be included. But when it came time for the annual exam, my GP refused to do the pelvic. You would have thought I was asking him for a date. He told me I'd have to make a separate visit to an OB-GYN for that. So when I went in for the 3-month check-up, I didn't mention the lump on the side of my neck, and he didn't notice it. 

Fast forward 3 weeks to Mother's Day, when my son Chris, who happens to be a paramedic, came over to have lunch with me. After lunch he said, "Hey Mom, what the heck is that thing on the left side of your neck?" I said, "Oh, so it IS visible!" He replied, "Hell yes it is, and you need to get it checked out, right away." I told him I would, and that night, standing in front of the mirror before I brushed my teeth, I used my phone to take a picture of it. 

Two days later, I was back in my doctor's office, waiting for him to examine me. "What are you in for again?" he asked, even though I'd been very specific on the phone with the reason for my visit, and I'm sure it was written on my chart in front of him. I told him I'd found a lump on the side of my neck and wanted him to check it out. He looked at me and said, "I have to tell you, I can't see a thing!". I told him it was on the left side of my neck, and showed him where. Standing in front of me, he poked around a bit and said, "I can't feel a thing either! Do you think this is something that has just disappeared?" At which point I pulled out my phone and showed him the photo. His eyes got big and he said, "Holy cow! I can see why you called me! If you'd just sent me this picture, looking at this and considering your age I'd say oh yeah, that's probably CANCER! I can't see or feel it, but based on the pic, I'm gonna send you for an ultrasound, to rule out anything serious." 

After mentally giving him an "F" in bedside manner, I felt relieved that at least I was getting referred to someone who might be more interested in determining what this thing was. He specified on the order that he wanted an ultrasound for "lymphatics/venous/artery/jugular" and told me to be sure to show the tech the photo. The Imaging Center was able to schedule me for late in the afternoon the same day. To my relief, the technician had no trouble seeing the lump, and she spent a good 10 to 15 minutes mapping it with ultrasound. When she finished, she told me the results would be sent to a "neck specialist" who would write a report and send it to my doctor within 24 hours. I went home and against my better judgment, I Googled "ultrasound for lymphatics/venous/artery/jugular". Uh, yeah, not a good idea to do that. 

This morning I got a phone call from my doctor's nurse, reporting the results. It seems the lump is something called "A Prominence of the Jugular" (capitalization by me). Hahahahah! Does that sound Victorian or what? Thus my thought that I might need a Fainting Couch. If this was on the right side of my neck, a good doctor would be looking for signs of congestive heart failure, but apparently the prognosis is not nearly so grim when it occurs on the left side. I asked the nurse to send me the report, so I can read it myself and decide whether I want follow up. In the meantime, I'm thinking it may be time for me to find a doctor who's a little more interested in me as a patient.

You Gotta Love Frozen Peas

Yay! The bandage is off, and to my great relief, my eye is not stitched shut, so I can see out of both eyes again. Depth perception is BACK!

 

The dark long line beneath my eye in the pic is surgical thread, which appears to be anchoring the tiny stitches in the graft, which was taken from the outside edge of my eye. I feel much better now, but at about 3 AM this morning, with my face hurting quite a bit, I decided to open the Swiss Eye Masks and attempt to get some relief by cooling my eye through the bandage. First of all, I've gotta say, whoever thought that printing the instructions for a mask to be used after eye surgery in pale grey ink in a tiny font on a shiny white background should be fired. When I finally got one of the mask packets open and picked it up to put it on over the bandage, I realized why I was told I could "just use a bag of frozen peas" instead. The masks are SLIMY and totally disgusting, to the point that I'll pass on using them.

 

I like peas, but in a lifetime of eating peas, I've never been so happy to see a bag of frozen peas in my freezer at 3 AM as I was last night. The bag of frozen peas inside a clean wash cloth provided some instant relief from the pain, even through the bandage, so that's what I'll be using to ice my eye for the next two weeks.
 

I Survived!

I was at the facility from 11 AM until 4 PM. The two surgeries (removal of the BCC and then reconstruction of my eyelid) took just over 2 hours. I had a general anesthesia during this time, which included insertion of a breathing tube. They told me to expect a sore throat. The recovery room nurse asked me if I've ever been diagnosed with asthma. Yes, when I was in my early 50s, and for about a year I took Singulair, but I’ve never had a severe asthma attack, so I discontinued that and just keep rescue inhalers on hand, which I occasionally use. Apparently, I had some problems tolerating the breathing tube, and she appeared to be a bit alarmed with my perfectly normal (for me) post-op cough, so she sent me home with an inhaler. I was told I have deep stitches, which will dissolve on their own, and surface stitches, which the surgeon will remove in a couple of weeks. Dunno what they look like though, because I have what appears to be a MaxiPad covering my right eye. I’ll remove that tomorrow. Some people who've had this surgery said they had no pain, but I’m not gonna lie, my eyelid and the area below it HURTS…really hurts. I was told to take Tylenol for pain, and I took 2, which haven’t have any effect whatsoever. They also sent me home with something called "Swiss Eye masks", which are currently cooling in the refrigerator and which I've been instructed to use for treatment of pain and swelling, or, if I don't like those, I've been told I can use a bag of frozen peas. I also received an antibiotic ointment which I'll start using tomorrow, once I have access to my eye.

 

I’d fasted before the surgery, of course, but I wasn’t really hungry afterward. Nevertheless, I was instructed to eat something, so when I got home I heated up some Trader Joe’s tomato soup, and had that and some ginger ale, after which I brushed my teeth, inserted a new set of Invisaligners, and went to bed, where I slept soundly for a couple of hours. I'm so relieved the actual surgery is OVER.

 

Oh, and one other thing. I'm not driving (of course). I'm writing this using my left eye, in which I have an IOL (intraocular lens) for distance only. So I must wear eyeglasses to be able to see anything up close, like my laptop screen. But another effect of having just one eye to use is that my sense of depth perception, which has been on shaky ground since the 2 surgeries on my left eye anyway, is just pretty much gone for now. Attempting to put toothpaste on my toothbrush really illustrated this for me, because when I tried to load my toothbrush, I discovered I was nowhere near it. I actually laughed out loud when I realized the toothpaste was going all over the sink. Sheesh.

 

 

 

Results: Basal Cell Carcinoma

This afternoon the surgeon called and told me that the results of the biopsy showed that I have BCC, or Basal Cell Carcinoma of the eyelid. BCC is the most common form of skin cancer, and although a cancer diagnosis is never good, if one has to have some form of cancer, this is one of the best forms to have, because it's rarely life-threatening and is generally quite treatable. BCCs can become locally invasive and can cause disfigurement and permanent skin damage if left untreated, though, so prompt treatment is important. The only tricky thing about this BCC is the location: it's on my eyelid. That sounds so innocuous, doesn't it? When the PA at my dermatologist's finally agreed with the self-diagnosis that I'd made almost a year ago, I didn't understand why she immediately referred me to an oculoplastic surgeon. So when I got home, I Googled "lower eyelid cancer surgery" Images. Oh. Well then. OK. I see the need for the referral to an oculoplastic surgeon, because basically, the oculoplastic surgeon has to reconstruct the eyelid after the tumor is removed. 

I'm trying to balance out the positive and negative aspects of this. One of the negative things is that I've had this growth for well over a year, but one of the positives it that it seems to be nodular rather than flat and diffuse, and I think that's a big plus in terms of removal. Because I've had this so long, apparently it's more likely to recur, however, now I know what to look for. I'm grateful that I live in a place where I have access to excellent doctors who have experience doing this type of procedure.

I've been going to a dermatologist's office for annual skin cancer checks for over 20 years. I've just learned that eyelids are one of the most common sites for skin cancers to occur in fair skinned people, but not once in the 20+ years I've been going for skin checks has anyone thought to examine my eyelids. You've seen the pics of my eyelid. This BCC is just a tiny, pearly lump on the surface of my lower eyelid. It never bled or crusted over. It didn't hurt. The 2 main symptoms for me were loss of eyelashes where the tumor was growing, and a noticeable blood vessel going to the center of the tumor. It looked so innocuous that even when I made a special appointment 2 months after my annual visit and said the reason for my visit was that I'd been a bad patient and spent time on the net and was pretty sure this was a skin cancer, no one took me seriously, and it took 7 more months for anyone to believe me and biopsy it and confirm that it was indeed a BCC that must be removed, and the sooner the better. So, please, monitor yourselves.

Biopsy

15 September 2020 - So today I had the biopsy. I was told they'll have the results in approximately one week, at which time if it’s benign, I can decide whether I want it removed (YES) and if it’s malignant, there's no choice, I’ll be scheduled to have it removed.

 

I drove myself to and from the biopsy with no problem. For the biopsy, I did not wear the contact lens which I normally wear in that eye for reading. I was given an ice pack to hold against my eyelid for about 5 minutes before I went into the room where the procedure was done. Both eyes were then numbed with an anesthetic eye drop, after which the surgeon administered an anesthetic injection into my lower right eyelid. That stung a bit, but the eyelid became numb almost instantly. Then, keeping my eyes wide open, I had to stare up and to the left the entire time the biopsy was being done. That was actually rather difficult to do, because it meant that the very bright light which the surgeon wears on his forehead to do the procedure shone directly into my eyes the entire time. He had to go in twice to remove enough tissue for the biopsy. There was a slight stinging and tugging sensation as the tissue was removed, but really the most unpleasant part of the procedure was after the biopsy was over, when he cauterized the incision, because I could feel the heat and smell my flesh burning as that was done. Ugh. But the whole thing was over very quickly: 30 minutes from start to finish. Immediately afterward, my eye felt dry and my eyelid was so sore that I didn't even think about putting my contact lens in for the rest of the day. I turned down an eye patch, preferring the incision to be exposed to the air to heal. After I got home, I instilled Systane preservative-free dry eye drops in both eyes whenever they felt dry. Fingers crossed for the results.

Oculoplastic Surgeon Visit 1 2020.09.09

 

I like the oculoplastic surgeon. I met him on September 9, 2020. He asked me to state in my own words why I was there. He then carefully examined the lump on my eyelid and gave me some good news: he said it may not be BCC after all. He said it’s right on the borderline, in terms of characteristics. He said, “If this isn’t malignant, I won’t be surprised. But if it IS malignant, I also won’t be surprised. That’s why it’s got to be biopsied." I was momentarily surprised to hear this, because the Physician's Assistant at the dermotologist's office had FINALLY diagnosed it as Basal Cell Carcinoma. But then I thought back to when I'd worked as a clinician in pediatric psychiatry, about all the patients sent to us by other psychiatrists who had diagnosed them as Bi-polar, but whom we determined, after we'd examined them, had been misdiagnosed, and I realized that until a biopsy is done, diagnosing skin cancer by simply looking at the physical characteristics of the growth isn't really any different from that. So I’m going back on September 15th for the biopsy, but in the meantime I’m feeling optimistic.

 

Beware of bumpy eyelids

 

Sometime last year, I developed a small bump almost in the center of my lower right eyelid (see selfie above). At the time I thought, "Damn. I'm getting a stye, and I HATE styes!" I was so sure it was going to turn into a stye that I checked my medicine cabinet to be sure I had some ointment specifically for treating styes, which I did. 

 

But it never turned into a stye. It didn't get red, or sore. It was just this tiny pearly bump, right on the surface of the eyelid, almost at the center. When it didn't turn into a stye, I thought maybe it was a blocked Meibomian gland. Can you tell I worked with a bunch of ophthalmologists at an eyecare company for 10 years?

Being fair skinned and living in Texas, I have a standing annual appointment for a full body check for skin cancer every December. It's supposedly a "thorough" skin check. The PA even goes through the hair on my head, to examine my scalp. But she's never examined my eyelids and I didn't call her attention to the bump at that visit, so she didn't notice it. I've since read that a thorough skin cancer check should always include careful examination of the eyelids, which are a common site for skin cancers. 

 

In early February, two months after my annual visit, when the bump still hadn't gone away, like all bad patients I looked it up on the internet and learned it could be skin cancer. "Nah", I thought, "no way!" But to be on the safe side, I called the dermatologist's office and made another appointment. At that visit, on February 26th, I mentioned that I was worried it might be skin cancer. The PA scraped the bump. She did not take tissue for a biopsy, but said she didn't believe it was skin cancer, but thought it was some sort of milia cyst. She sent me home with instructions to treat it with warm compresses, assuring me it would go away.

I did as instructed. But it didn't go away. And my eyelashes stopped growing in that area. And if you looked at it closely, in a 10x magnifying mirror, like I did at least once every day, you could see a rather fierce looking, spidery red blood vessel, like a flower stalk, going to the center of it. 

 

So in early July I called to make another appointment. Asked for the reason for the appointment, I told the receptionist that a bump on my eyelid for which I'd been seen in February hadn't gone away, had in fact grown, and that I believed it might be skin cancer. None of which impressed the receptionist. Mid-August was the first available, she said. I took it. 

 

At the August appointment, which was on a Monday, the PA examined the bump again. This time, she noticed the missing eyelashes and the blood vessel, two tell-tale signs of BCC. She measured the bump and said it's 3 mm across (tiny, right?). But she looked rather somber when she said, "This appears to be a BCC (basal cell carcinoma)". She referred me to an oculoplastic surgeon, and then, brightening up, she said cheerfully, "He'll remove it and put in a couple of stitches", leading me to believe this was no big deal. She did say if I hadn't heard from the oculoplastic surgeon's office by Friday, I should call them. She also said if they couldn't see me right away, I should come back to the dermatologist to have it removed.

Uh huh.

On Friday, not having heard from the oculoplastic surgeon's office, I called them. They told me the reason they hadn't contacted me was simple: they hadn't received the referral. In fact, they hadn't received any referrals at all that week from my dermatologist's office. The woman who took my info was very nice. She said, "The way it works is your dermatologist will remove the BCC, and then you'll see the surgeon for reconstruction of your eyelid." That was the first time I'd heard the word "reconstruction" regarding any of this. It sounded rather ominous, but also, that was not what I'd been told, and I said so. I told her that the PA had told me that the oculoplastic surgeon would remove the BCC and repair the eyelid. She paused for a moment and then said, "OK. Well, that means it's either too big, or in too critical a location for the dermatologist to remove it. But don't worry. Dr. A does this all the time. You're in good hands here." First available appointment was second week in September. Needless to say, I took it.

 

To be continued.

Orthodontia for Boomers!

I'm 69 years old. When I was a kid, my family was poor, and by poor, I mean no car, no indoor plumbing, bread-and-dark-Karo-syrup-for-dinner poor. So of course, no doctor visits unless you were dying, and nothing so luxurious as a dentist. My dad had almost no teeth, and my mother had false upper teeth, due a car accident in which she lost her upper teeth when she was young. 

When I was a kid, none of my six siblings owned a toothbrush. When I started school and became vaguely aware of dental hygiene and asked for one, I was told, "Go eat an apple; it does the same thing." 

When I was 8, we moved to town. For the first time, we had indoor plumbing, and I was enrolled at an elementary school where twice a year the teacher expected to see proof that each of her students had seen a dentist. We didn't have money for fillings (of course), so at my first dentist visit, two permanent molars which needed fillings were pulled from my mouth.

You get the picture. Eventually, I began taking good care of my teeth, but by the time I realized I needed to do this, there was a lot of damage to deal with. So for my entire adult life, although my gums are in great health, I've had a mouth full of fillings. In my 40s, I had all the silver amalgam fillings replaced with white composites, which have lasted well on my back teeth but not so well on my front teeth. Also in my 40s, I switched to a very expensive cosmetic dentist, who recommended a "smile makeover", but I couldn't afford the cost estimate of over $30,000, so I didn't do it. From time to time we did discuss the possibility of just putting veneers on my front teeth, but veneers are also incredibly expensive, specifically, I was advised that "to get a good result" I'd need a minimum of 6 veneers on top, at $1500 per tooth, "but 8 would be better".

20 years later, as a sexagenarian, I'm hardly in my cavity-prone years, but even without hard use, old composite fillings deteriorate, with the result that in the past 10 years I've had the composites on my upper central and lateral incisors redone close to a dozen times, each time losing a bit more tooth structure. Eventually, the very expensive, highly rated cosmetic dentist I'd been seeing retired, so I switched to a highly rated general dentist in my neighborhood.

The first time I went to see Dr. G, she looked in my mouth and said, "What's going on here?" "No dental care as a kid," I responded. "Yes," she said, "I can see that, but why on earth do you have all these composites on your front teeth? Hasn't anyone suggested crowns or veneers?" 

After reviewing my x-rays, she advised me that in her opinion, I had so little intact tooth structure that I'd be better off with crowns than veneers. Then she dropped the bomb, and asked, "Have you ever considered getting braces? Because look how your fillings and even your intact teeth are worn. If you don't correct your bite, you'll continue to have problems with any additional dental work." My teeth LOOK straight, that is, my central and lateral upper incisors are lined up as they ought to be, but after that, things get a little crazy. The permanent molars that my childhood dentist pulled so many years ago left gaps on opposite sides of the top and bottom of my mouth, so when my wisdom teeth came in (and I have all 4 of those), the gaps filled in, permanently changing the alignment, and not for the better. In the bottom of my mouth, my teeth have been moving sideways ever since, with the result that my lower teeth have not been remotely aligned with my upper teeth for years. In my upper teeth, one pre-molar is totally turned sideways and in addition to the cosmetic aspects of this, my entire adult life I've had an open bite on the left side of my mouth: my top and bottom teeth on that side don't meet by close to half an inch. I haven't had the headaches that plague some people when their bite is off like this, but for years I've periodically bitten the inside of my mouth due to this malocclusion, and more recently, as my teeth have continued to shift, I've worn down the enamel on my upper teeth, to the point that the bottom of my left lateral incisor is now crescent shaped. So rather than be put off at the suggestion of braces, the thought that all of this could potentially be corrected, even at my advanced age, THRILLED me.

Dr. G recommended Invisalign, a system of clear, plastic aligners that you wear 22 hours a day: you take them out and clean them while you eat, but the rest of the time, including when you sleep, you're wearing them. They're then changed each week until your bite is corrected. I could have gotten Invisalign through Dr. G, but after doing some research on the internet, I decided I wanted an orthodontist, and specifically, someone who had Invisalign's Top Provider rating and who could plan my treatment after scanning my mouth digitally with Invisalign's iTero 3 D Scanner.

Three of my four children had braces, but the thought of spending thousands of dollars out of pocket on straightening my own teeth at age 69 seemed incredibly self-indulgent to me. Also, when I'd mentioned that I was considering this option to 2 of my kids, although I know they love me, their reaction was "Really Mom, at your age?" But I kept thinking about the fact that if I didn't do it, I would just be setting myself up for more problems with whatever future work I had done on my teeth. I'd learned there was no charge (and no obligation) for the initial consultation with the orthodontist, so one Tuesday in May I called the office of the local orthodontist whom I'd decided I'd want to do the work, and 2 days later I was in his office for my free evaluation. "I guess I'd probably be your oldest patient", I said nervously, but he just smiled and said his current oldest patient is in his late 80s. He said he was intrigued by my open bite, which would be something of a challenge to correct. Nevertheless, there was no pressure to sign up for the treatment. One of his assistants provided detailed information on the interest-free payment plan, which required $500 down and then monthly payments of a little over $300 a month (no interest) for the next 15 months. That was doable financially, so I handed over my credit card and signed on, after which my mouth was scanned and a follow up appointment was made for one month later, at which time my first sets of aligners would be ready for me.

At the follow up appointment, I was excited but also nervous about putting in the aligners. I was worried they would hurt, but (so far at least) they don't hurt at all. I was nervous about being able to put them in and remove them, but that's easy to do. I was worried I wouldn't like the way they feel in my mouth, but they feel fine. My treatment plan is for 26 aligners, to be worn for 1 week each, or 6 months of treatment. The orthodontist explained that because of my open bite, it's possible that at the end of 26 weeks, I may need additional treatment to close that bite, but there are several options if that happens, and of course it may not happen at all.

So I picked up 13 of the 26 aligners and 2 orthodontic retainer boxes and made a follow up appointment for September, when I'll be halfway through treatment, and headed home. So far, so good!

Rich Man, Poor Man

There was a screw up at the closing of my house. The final numbers were wrong, so I was notified by the Title Company that I owed the buyers an additional $4K which I'd need to provide in the form of a cashier's check. According to my bank's website, the bank charges a $10 fee to issue a cashier's check, but when I went to the bank to get the cashier's check, I was told "Oh no, we won't charge you for that! There's no fee for you!" The reason for this is that for now, the proceeds of the sale of my house are in a savings account at the bank, and so they've increased the measly percentage of interest that I earn on my money and waved all sorts of fees that I previously had to pay when I had considerably less money in my accounts. I appreciate the temporary savings, but I can't help but think this policy, of charging all sorts of fees to the customers who can least afford them, is just cold and cruel. It's yet another way that America punishes people for being poor.

SMDH

So last month, I placed a bid on a place that I really loved. The couple who owned it had already bought another place in the western US, and they had a number of stringent conditions regarding the sale of their place here in Dallas: the closing had to take place in early June at the latest; they had to be able to then rent it for another couple of weeks while they moved out, yada yada yada. I thought the list price was too high and my agent, who is also a broker who normally does tax appraisals, agreed, so after researching the price per square foot for comparable homes in the neighborhood, I made an offer. It was slightly under the list price, but I could pay cash, and I had no problem agreeing to all of their other terms. I had to provide proof of my ability to pay cash, which I did, and in addition, the sellers wanted to know about me personally, because they didn't want to sell their home to a developer. My agent said there was one other offer, from a couple who had cash for the standard 20% down, but who would require financing for the rest of it. She predicted the house would not appraise for the list price (and she should know), in which case, in addition to the 20% down, the buyers would have to pay the difference in cash. She told me there was no way anyone could close in the desired short time frame if financing were required, so she was confident my bid would be accepted. Accordingly, we were both shocked when the sellers accepted the slightly higher offer which was dependent upon financing. The sellers suggested I put in a back up offer, which would require my depositing several thousand dollars into an escrow account, and that money would be tied up until their deal either closed or fell through. I said no thank you. I was disappointed, but I decided then and there that I'd wait until the market cools a bit before bidding on anything else.

This afternoon I got a call from my agent, who said she had received a call from the sellers' agent who said it appeared the buyers' financing had fallen through so they wanted to know if I was still interested in the place. Three weeks ago I very nearly bought the place, and if my bid had been accepted, I'm confident I'd have had no regrets, and yet this afternoon I told my agent I'd have to think about it. Getting turned down forced me to give a lot of thought to what I want, and for that matter to how much I'm willing to spend. I didn't have a big budget to begin with, but because I'm retired and have a fixed income, I've begun to think perhaps I should plan on spending even less and banking the difference for unanticipated big expenses, e.g., having to replace the AC or furnace. So I didn't jump at the second chance to buy this place. I came home and looked again at every photo of every room. The house is beautiful; there's no question of that, and the location is good, so it will certainly increase in value. And yet I hesitate. It's a traditional home, built in 1971. It's had a fire and has been remodeled, so the interior and exterior are like new, and yet there's a part of me that would love to move into something brand new. So I was trying to decide what to tell my agent when she texted me again. Apparently the buyers haven't officially backed out, and asking me if I'm still willing to buy it was simply a ploy, I'm not sure by whom, to apply leverage, I'm not sure for what. But I am thoroughly disgusted.

Gettin' Old...

Although I've done nothing in particular today, tonight my hands and particularly my fingers, are swollen and aching. The osteoarthritis causes this, and it's just a part of aging, but it is, literally and figuratively, a pain. *sigh*

Blood in the Water

So here's how it works. This morning, I saw a new listing for a small, remodeled house a few blocks from Katharine's. Although it doesn't have everything I want, the remodel is well done, and I like it. List price is $250K, which seems a steal for this 1400 square foot remodeled home. But there's no Open House scheduled, and I'm pretty sure that low price is only listed to generate interest. Starting this afternoon, there will be a bidding war, and the house is likely to sell for up to 30% over list. The rub is that it probably won't appraise for that, in which case the buyers have to come up with the difference in cash, but in this market, it's likely they will.

This is not my idea of how to do business. I know I'm old fashioned, but it's so not my style to wheel and deal, to barter. Frankly, I find it offensive. In this market, that's a losing attitude, and I know that I won't find a place to buy in this market with that attitude. 

So for now, I'm out of it. In the interim, Kath has graciously allowed me to stay with her. I'm paying her rent, of course. I'll resume looking for a new place later this summer, when/if the market begins to return to normal.

House Hunting, or Why I Hate Real Estate

I've always viewed the place where I live as my home, never as an investment. And therein lies the problem, I suppose. So when a young mother from down the street approached me as I set out spring plants and asked if I was getting ready to sell my house, I admitted I was. When she said she and her husband were house hunting and would love to see it before I listed it, I agreed to let them do so. When they made an offer, albeit 10K under what I'd planned to list it for (which my agent had agreed was a fair price) I reluctantly accepted it, thinking it was the decent thing to do because despite the money I'd poured into it in the past year getting it ready to go on market, the house being 41 years old I knew there were still things they'd have to upgrade. But decency has nothing to do with real estate. It's all about the $$$$$$. To my dismay, as soon as I'd accepted their offer, their agent began cut-throat negotiating to try to get me to drop the price considerably lower. I agreed to a couple more concessions, then told my agent I was perfectly happy to walk away and start all over before I would go any lower on the price. The deal went forward and we closed on May 11, but it turns out in this market I would probably have gotten at least $25K more had I listed it, shown it, and ended up with half a dozen couples trying to outbid each other. What's done is done, but this error on my part may end up being an expensive one because in the past week I've submitted bids on several places, all of which have gone for considerably over list after a bidding war amongst potential buyers. I'm paying with cash, so there's no contingent financing involved. The last place, in addition to agreeing to pay 2K of seller's closing costs AND bidding over list AND agreeing to give them 2 days to move out after closing, etc., etc., etc., they still didn't accept my offer. Last night, looking at places online, I saw a small house that I found interesting. At 67, I don't want a house because I don't want to be responsible for all the maintenance, but I liked what they'd done with the interior, so from the website I clicked on a link to send it to myself. The computer auto-populated my agent's name in addition to mine, so it showed up in her inbox early this morning. She assumed I wanted to see it and tried to make an appointment, but by 8AM it was already GONE (i.e., under contract). So it was on Realtor.com less than 24 hours before it went under contract. In the meantime, I'm living on savings. I haven't yet filed for SS, because if I wait until September, when I turn 68, I'll get an additional 8% which, quite frankly, I need. I also haven't started drawing on my 401K, because I don't have a clue what I need to do. Does that sound stupid? Yes, I'm sure it does. If I pay $5,000 to a financial advisor, she'll walk me through all of this. $5,000 isn't a lot if you're working I guess, but my SS will only be about $18,000 per year so $5,000 is significant to me, so I haven't leapt at the opportunity. And the sad thing is, I'm in better shape, financially, than the majority of boomers, or so all the financial people tell me.