A Grain of Salt

Does this mean I'm getting old?

I've been trying to stick to a 5-6 day a week workout schedule, and recently decided to give myself a break from laps around the lake (3.2 miles of "I'm bored") by going to a cardio hip hop class. Because that sounds fun, right? As I've noticed previously on this blog -- after the other time I tried this class -- I figured out a very successful strategy for not feeling dumb and uncoordinated in such classes: stand in the back so that you can't see yourself. Then stare at the teacher and pretend that they're you. Result? You look fantastic. In my case, that means that I have suddenly morphed into a black man, but you know what? That image is almost more realistic than me actually perfecting a body roll. So I'm sticking to it.

Anyway, last Friday's class was great and I left energized, so energized, in fact, that I stopped by my friend Josh's house afterwards to show him my "moves." Actually, to be more specific, I tried to play it off like it was Josh who wanted to see me dance -- but he was on to me. When I asked, "Do you want to see the dance?" he responded, "I know you want to show me the dance," and reluctantly agreed to watch. So I went out onto the sidewalk in front of his house and ran through the routine.

Fine and good, if a little embarrassing. But as I walked away from his house into the bright mid-morning sun, I felt a pinch in my shoulder. Like, not a little tweak, but some serious pain -- and it didn't go away. Rather, when I sat down in a nearby cafe to try to get some work done, it began to radiate down my arm and make me feel slightly nauseated. I started to wonder if my hip hop routine were actually pushing me into shock.

The pain didn't go away, so I bought some Aleve, convinced the people at the cafe to give me some ice, and called my med school friend, Jenny, to see what she thought might be going on. Unable to determine simply by phone whether it were a simple muscle pull or something more serious, like a pinched nerve, she suggested that if it didn't feel better, I go to the emergency room.

I didn't do that, which turned out to be lucky because if I had, the cause of injury would have been really really embarrassing. See, because it turned out that what I had wasn't a pulled muscle, or a pinched nerve. It was a hip-hop induced muscle spasm in my rhomboid. I think it happened when I threw my arms above my head at the same time as performing a hip thrust. (Do not try this at home.) Once I'd taken a bunch of ibuprofen and had Peter press his entire body weight, via his elbow, into the offending muscle, the pain went away, for the most part -- but it's still a little sore, and when I went running yesterday, it started cramping up again.

So now I'm left in a quandary: Do I lay off the hip hop? Or can I go back on Friday? Because the thing is, the class is really fun. And a lot of the people in the class are older than I am, and don't appear to be doing any damage to their rhomboids. But still, I question: is it worth the risk?

This is the blog for Salt Magazine.

And also . . .

I love the fact that they refer to the online application as the "most grueling task of this whole process." I have several things that, when added up, are a little more grueling. Such as:

-having a breakdown in the Berkeley insurance office in front of a stone-like man named Jay
-being hung-up on by a customer service representative from Kaiser Permanente who affirmed that "no matter how I much I want to pay, there's no way that I can get a plan that actually covers my needs"
-spending a half hour on the phone trying to figure out what the hell MRMIP was (major risk medical insurance pool, a state-run program for high risk people, like me--you know, 27, non-smoker, non-drug-user, exercises 6 times a week)
-having to go back to the Berkeley insurance office to get documentation that would qualify me for the MRMIP program
-having my MRMIP application sent back to me for improper documentation, losing a month of wait-list time in the process
-going back to the Berkeley insurance office to try to get the correct documentation
-having a doctor at Berkeley call me up to suggest the Blue Cross Conversion Plan
-having extended conversations with three different insurance SALESPEOPLE at Blue Cross, none of whom know the benefits available under this particular conversion plan, and none of whom can give me a comparison between the conversion plan and MR MIP
-setting up an appointment with a social worker at the Berkeley student health center to try to figure out what the differences might be; having her call someone else in the insurance office to try to figure it out; having the person on the other end of the phone suggest that I apply for disability to try to get insurance coverage (please note, I just earned a master's degree, and yet I have social workers trying to prove that I am unable to work, just so that I can get my fucking insulin covered)
-realizing, after that visit, that there's no real point in doing the blue cross conversion plan for three months because there's a freakin' $2500 deductible on prescriptions--so why pay $244 a month?
-thinking I'd solved all my woes wtih a $79/month Tonik plan, only to get back the email mentioned in the post below
-being in my current state, still confused about whether to do the conversion plan and pissed that it looks like I'm going to have to pay $244 a month for basically no coverage (and a $2500 deductible if anything bad does happen)

That, I think, is a little more grueling.

Tonik

You know, I sometimes feel like I'm old before my time--most of my casual conversations recently have had to do with medical insurance. It's like I'm 80 and can't stop talking about my colon. Anyway, I just wanted to say something quickly: I thought I'd figured out my health insurance travails (I'm diabetic and have a horrible four months coming up where I'm not going to be insured). I remembered this piece that Stephen Colbert did a while back on the Daily Show about Tonik, an insurance plan that is so youth-oriented that it's spelled wrong. Yes, I realize that it is not a good sign if you are taking medical advice from the Daily Show. But still, it stuck with me, and I figured I'd do a little catastrophic insurance to cover my ass between my two plans.

So I go to the Tonik site, its hipness indikated not only by misspellings, but by the bright color scheme, and go through a like, 20-step application process in which I confirm that I have had absolutely no medical problems pretty much ever except for bunions and a malfunctioning pancreas. I think I'm all good, especially when I get a final screen (this is AFTER giving them credit card information) that says, and I do quote, "Rejoice! You have just completed the most grueling task of this whole process. Now your buddies at BC Life & Health will take it from here." That sounds friendly, right?

Then, two seconds later, I get an email from my "buddies" at BC Life & Health that says, "Sorry, you are not eligible for any of our medically underwritten plans, however you may have options with a HIPAA plan or enrollment in the California Major Risk Program (MRMIP)." Thanks, buddies--Mr. Mip has a wait-list, which is exactly why I was trying to enroll in your krappy ass katastrophic kare program.

I am annoyed.

Lip Bust

I'm sorry that recent updates to this blog have been devoted entirely to medical travails (it's like the summer of '04 and gene's unfortunate run-ins with urologists!). But I've got one more. Before I write it, though, thanks to Saheli for the nicest comment to this blog ever, and for offering to give me a hug to make up for Kaiser Permanente. That's the kind of feedback I like to hear.

So, the basic deal is that I had a random freckle on my lip that I needed to have removed. Since I'm leaving for South Korea in a week, timing was somewhat tight, and it took about 8 calls to dermatologists to even find someone who'd see me. After going to the University Health Services to get a referral (from an unfriendly doctor who basically looked at my lip, signed a form, and sent me to the insurance office), I eventually got an appointment with a dermatologist in Oakland. Perhaps I should have been alarmed by the fact that she was the only person I could find anywhere in the Bay Area with an opening for this week, but whatever, I thought, I'm sure it'll be fine.

Upon arriving at said dermatologist's office, I'm immediately told that oh, the doctor doesn't take my student health insurance, despite the fact that I've gotten approval for it. Great! Fantastic! They suggest that I leave and I refuse, since my home dermatologist said she wanted me to get this thing taken off, and I'd gone through enough trouble to get the appointment in the first place. Several tense conversations ensue, including a phone call to the university and a moment where the doctor walked up to the receptionist and started talking about me in front of me as if I weren't there (I'm not going to accept her insurance. She can't have anything done, she should just go home, etc). But eventually I get led in anyway.

After telling me that she should have sent me home, she lets me tell her my situation, including the fact that I'd emailed a picture of it to my home dermatologist, who said she wanted me to have it removed. "Oh, you can't tell anything from an emailed photo," said the good doctor. "I normally would want to do several checkups with you before taking something off. I mean, it's going to leave a scar. But if she said we had to take it off then I have to take it off. Otherwise it's a liability."

These, while perhaps honest, are not particularly reassuring words to hear when you're sitting in a doctor's chair, about to have someone cut a piece out of your lip.

"So are you saying I shouldn't have it removed?" I asked.

"I'm not saying anything. I'm just saying that if your other doctor said you need to have it removed, I have to remove it."

"Didn't you just say you can't tell anything from an email picture?"

"She knows you better than I do."

"But should I have it removed?"

"I don't know."

"What's your medical opinion on whether I should have it removed?"

"I'd need to get all your information from your previous doctor. Do a full-body scan, and get your medical history."

She had a point, so I asked what sort of information she might need. Perhaps I could help her, I thought. I'm relatively aware of what's been done to my body. And I love answering questions about my health.

She looked at me skeptically. "Do you know your pathology history?"

What did she mean by that?

"Have you had any dysplastic nevi?"

By this she meant, basically, malignant moles. But who would say that when you could say "dysplastic nevi" to make your patient look and feel stupid? Certainly not this doctor, who stared at me as I, predictably, asked her what she meant.

"So what do you actually think we should do?" I asked her, once we'd cleared that up. She repeated that she didn't know but that she had to do it because my doctor had said so.

Perhaps it was all the insurance stress of this week, or the fact that I was very frustrated, but I felt myself well up--which is very annoying, since, after oh, years of never crying in public, this was the second time in a week that I had started to weep in front of a medical professional.

The doctor was not as sympathetic as she could have been, commenting, as I reached for a tissue, that she had "a patient who was actually very sick" across the street and so she "needed to stay on schedule" with me. I told her I wasn't trying to hold her up; I had just had a frustrating week with insurance. (Doesn't she read this blog?) "Poor Catherine," she said. "But you know what? You have a lot of people trying to help you here, unlike the patient across the street, whom no one wants to help."

I am not kidding. She actually said that. This did not help my mental state, which was now embarrassed about crying, still frustrated and upset, and now apparently supposed to feel guilty about being upset when there was an "actual sick person" across the street, to whom I was denying medical treatment.

"I'm just trying not to choke up when you have a needle in my lip," I said, which prompted her to begin to condescend to me by being obsequiously nice.

"You didn't even flinch!" she said to me after numbing my lip--which was really not that surprising considering a. I stick myself with needles ALL THE FUCKING TIME and b. there was no way in hell I was going to flinch, because now I was no longer upset, but mad.

Then, as she dug out the freckle, she began to small talk. "I have good feelings about you," she said, slicing my lip. "You're going to go far. I can feel it. "

I couldn't ask if she were kidding because she was cutting my face.

"The last time I had this feeling was with [name of immemorable person]. And he ended up being a very successful cabaret performer."

"Maybe I should join the cabaret," I muttered.

"So your dermatologist is from New York?" she continued. "I'm going to a conference there. It's led by some man with the last name Moomba. What ethnicity is that, do you think? People from New York are usually *so* good with that. Do you think it's Persian? It's not Afghani, do you think?"

Not only did I not know what I thought--and not care what the fuck the man's ethnicity was--but I couldn't say anything, since she now had a needle in my lip and was tying a knot in a suture. I remained silent.

"There you go!" she said, suddenly cheery. "I gave you black, because that's stylish in New York, right?"

It didn't really occur to me till a bit later, when I was crying in my car, that it might be a bit odd to give someone a BLACK suture for a wound on their face. Arm wound? Sure. Leg? Go right ahead. But wouldn't you think, maybe, that something, oh, say, CLEAR would be a better bet for something on your goddamn face? As it is now, I look like I have some sort of weird double whisker growing out of my lip.

Then, despite telling me repeatedly at the beginning of the visit that we were dealing with an area particularly prone to infection, she told me I didn't have to do anything for follow-up care.

"You're a fast healer," she said, as we walked out of the office.

"Actually, I don't know if I'm a fast healer," I said. After all, one of the trademarks of diabetes--which she knew I had--was that it makes you heal slower.

"Well, let's just think positive, okay?" she said. "I have a good feeling about you. You're going to go far."

The only thing that's making me feel better about this entire experience--besides, obviously, that she has confidence in my future--is this: a video of the Chinese Backstreet Boys lipsynching a Chinese song called Bu De Bu Ai. Man, I love those guys.

Kaiser-ed

Oh, to not be a self-employed diabetic. Excuse my recent silence--it's been a good, relaxing week overall, but I have developed a somewhat weird habit of breaking down into tears whenever I speak to insurance representatives. I think it has to do with the fact that I'm diabetic and thus no one wants to give me coverage. Case in point Kaiser Permanente, with whom I had a very Cingular-esque conversation with yesterday that went something like this:

Unhelpful representative: Can I get your name, please?
Me: Catherine
UR: What's your last name?
Me: I'd prefer not to give it to you. I'm calling to ask about whether diabetic supplies are covered under your individual plans.
UR: You need to give me your name.
Me: I don't want to give you my last name. I just want to know about benefits.
UR: We document every call, so this is going to go under Catherine if you don't tell me your last name.
Me: That's fine. I don't want to tell you my last name. I want to find out about benefits.
UR: I can't tell you what your benefits are unless you are signed up for a plan.
Me: Well, I'm calling to ask you what benefits you offer, so that I can decide whether or not to sign up for a plan. I'm not going to sign up unless I know what benefits you offer.
UR: I can't tell you that.
Me: You can't tell me that?
UR: Not unless you're signed up for a plan.
Me: Do you cover diabetic supplies?
UR: Whatever information I can give you is on the website.
Me: You don't give information about diabetic supplies on the website.
UR: We cover durable medical expenses.
Me: What's a durable medical expense?
UR: All the information I can give you is on the website.
Me: Is there someone I can speak to who might know a bit more about what kinds of diabetic equipment you do cover?
UR: No.
Me: Do you cover supplies for diabetic pumps?
UR: What?
Me: Supplies for diabetic pumps.
UR: Please hold. (She goes to ask someone who knows more than she does)
UR: We don't cover diabetic pumps.
Me: What about diabetic pump SUPPLIES?
UR: You asked me about diabetic pumps.
Me: I asked you about diabetic pump supplies.
UR: No, you asked me about pumps.

This went on for a while, both of us breeding hate for one another, with her ultimately coming back to tell me that pumps and pump supplies would not be covered by Kaiser's individual plans, and no, there wsa no one else I could speak to and no, I couldn't pay an extra fee to get coverage for diabetic supplies. This got me into what one might call a "mood," which resulted in me saying, "Let me get this straight: if I were to want to buy insurance from your company, there is nothing I could say, do, or pay to get medical coverage from you for what I actually need?" She told me I was correct. Then she hung up on me. Then I cried and hit a desk.

Then today I went to the medical center at school to try to find out about other insurance options, as well as why my request for an insulin pump had been denied, and was told that no one was going to want to cover me for a "pre-existing condition" like diabetes, and that they had no record of a denial for the pump--but no record of a request for one either. So I ended up sitting down with a man who looks vaguely like a large version of Dr. Evil, except much less emotive (and with more posters of kittens), and after listening to him say over and over again that he had no denial on record, I realized that I was about to cry. And then proceeded to totally well up. In Dr. Evil's cubicle. He gave me a tissue and said "It's okay" in a most surprising, un-evil way (this after he refused to make eye contact with me for the first bit of the visit) and I walked quickly out of the office, pressing a tissue to my face, unable to speak because I was all teary. Seeking privacy, I wandered down the hall and sat down on a bench, wept for a second, and then looked up to see that I had inadvertantly sat down outside of the psychological counseling department. Go figure.

Huh? No!

The Fine Doctor just called and asked if I wanted to have the cystoscopy on my birthday. 

There are better ways of celebrating a new year in your life than probing the inside of your bladder with a camera.  Not that I can think of one right now.  But I am sure there are.

Emotional and Medical Belches

GP’s back in the blogger seat

Last week's return of hematuria (blood in the urine) worried this editor and sprung him into action.  I thought I had this one licked, but apparently not.  Back to the doctor! 

For this spate of exams, I switched urologists from the almost ironically named Dr Colon to the aptly named Dr Fine.

Too many details after the jump!

Ah, the Life of a Centerfold

First off, thank you to everyone who came to the launch party last night. It was a great success, as the five people who won all the prizes would probably agree. Thanks again to our performers and sponsors, as well as to our contributing editors (including Heidi's $2,000 pie, Monte and Will's door prize/raffle know-how, and Kyoung, who wrapped all our door prizes in tin foil and paper representations of salt shakers that were freakin' awesome). We're like, totally putting up a slide show next week. I'm sure that editor-extraordinaire GP will have words to add to this, so I will skip directly on to an entry that I hope will serve as a sort of personal catharsis.

Since this blog seems, strangely, to have taken on a life of its own as a catalogue of Gene and my medical travails, I will feel no shame in reporting the following: yesterday, I had naked pictures taken of myself. Full body, totally nude.

This was not, unfortunately, an exercise in self-adulation or an attempt to record for posterity the current shape of my rear. Rather, thanks to a mixture of genetics and excessive exposure to the sun at a young age (thanks, Mom!), I have a lot of moles. I used to be so embarrassed about them that one afternoon when I was nine and my friend Danny said, "You've got a lot of moles" in reference to the abundance of actual mole tunnels on the lawn we were walking on, my response was a defensive, "No I don't. They're beauty marks." I also used to be so embarrassed about a mark on my hand that I refused to show anyone the inside of my palm.

Anyway, approximately one hour before yesterday's launch party was to begin, I found myself in the office of Dr. William Slue, taking off all my clothes and wrapping myself in a paper robe (which seemed rather superfluous since I was going to have to drop it in thirty seconds). I was then led into a room that looked like a combination of a doctor's office and a fashion shoot, due to the juxtaposition of a jar of tongue depressors and a poster about Botox with four huge lights, a reflective screen, and a man with a camera.

"Okay, I need you to drop your robe now," said Dr. Slue, as a female chaperone, provided by his office, stood by the door--her face blocked by a huge light shining into my eyes. I put the robe on the nearby examination table, and climbed up onto a small wooden box. "I need you to turn around, and I'm going to put this sticker with ruler markings on your back." He came up behind me and adhered a small sticker to the side of my back. He then told me to continue facing the wall and stand still, then came up behind me and slowly worked up and down my back with a camera, so close that I could feel the heat of the flash.

"Turn to the side," he said, "and raise your arm." Subesquent examination of the photos show that this is the moment where I should have sucked in, but in the moment I was concentrating too hard on trying not to sweat.

"Now I need your inner thigh. Turn like this," he demonstrated a saucy pose, turning his foot outwards and cocking his hip, "and put your hand next to it so I can get your palm."

Next up, standing straight toward him, lights reflecting off my stomach, as he worked up and down the front of my body. The real trauma of this was that, in order not to stare directly at the man taking pictures of my crotch, I stared behind him--a technique that had worked fine when I was facing the wall, but proved mildly upsetting when I realized that there was a computer right behind him where digital copies of the photos he was taking were appearing. The first upsetting thing was that there were a few pictures of his last patient still on the screen; I imagined his next patient checking out my hips while standing naked on the box. But secondly, it meant that there was a live, play-by-play record of what he was doing. It led to the sucking in realization and also to the epiphany that if ever I am trying to seduce someone with my naked flesh, it should not be under such harsh lighting. Yow!!

When he told me to get off the box I had a flash of fear amounting to the thought: "What if he tells me to bend over??" but luckily, shots of my inner thigh proved sufficient. After a few shots of my neck, I was done.

As promised, the entire procedure took about three minutes--and I'm proud to say that, unlike the pathetic small talk I conjure up at the gynecologist as soon as she puts my feet in the stirrups, my only attempt at conversation was, "Now, I've got to ask you--how'd you get in to this?"

Turns out he didn't have a career as a playboy photographer--rather, 25 years ago his wife was diagnosed with melanoma and he wanted to figure out a way to help her keep track of any other changes on her skin. Mole-y friends, I highly suggest getting this done. You get a photo album of yourself fed-exed three days later, which not only helps prevent skin cancer down the road, but makes an excellent addition to your coffee table.

I'm Back! or Cystoscopy, part I

Hello everyone! Gene is back in the saddle after a couple of tough days. Thursday, as avid Salt readers know, was the day of my most recent medical procedure. Cystoscopy was the name of the game, and what a painful, uncomfortable game it was! Much more bloody than rugby and more invasive than tongue hockey, the cystoscopy lasted only five minutes, but will linger in my mind for months to come.

Warning: nasty details ahead! Christian scientists be warned!

I was filled with dread Thursday morning. My mother had warned me a couple days earlier that her friend had recently had the procedure. He had proclaimed it "very uncomfortable" How right he was!

My mother came with me to the hospital. I find in these sort of circumstances it is best to be with a family member. When we got there, the doctor was busy with another surgery. I would have to wait while ABC news at noon blared in the background of the holding pen. (Oh excuse me, waiting room) Word had it from Suzy, the receptionist, that the procedure would be put off for a week or two. This was not something I wanted to do. Get it over with as soon as possible. I did not want my anxiety prolonged longer than necessary.

None of this mattered in the end I did get to see the doctor, though, just about an hour and half after I was supposed to.

I walked into the office. Dr Colon, a short, blunt doctor who has been my urologist for about a year now asked how I was. "A little anxious about the procedure," I said.

"With good reason," he said, "You'll be all right. Of course, I'm not having it done. It is very uncomfortable."

I smiled weakly. A nurse wheeled in a cart with the accroutrements (sic?) including:

(1) Two two-foot long black cylinders attached to the side in tubes of blue liquid looking something like the barbicide (C) you find at a hairdressers
(2) packets of numbing jelly
(3) Iodine
(4) gauze

I could figure out what most of the stuff was for, but the black cylinders were vexing -- was that for my procedure? They were two-foot long! Where would they go?!?

Dr Colon and the nurse prepared for the procedure -- the doctor even requested more numbing jelly. He asked me to get up on the examination table. I asked the nurse if I should take off my underwear. "If you don't want to soil them, " she replied pithily.

I didn't want to soil them, so I took them off. "I don't have any modesty anyway, " I said as I got on the table, asscheeks akimbo. Dr Colon said something witty, but I was too nervous to hear him. The nurse handed me a hospital gown.

"Lay back," Dr Colon said, and lifted my gown. "This first part is the most painful." He was obscured by the gown, but I think he was putting in the numbing jelly at this point. It was excruciating.

Dr Colon took out one of the long black cylinders. I watched as he somehow connected this to my penis, though the details have become fuzzy. "Oh that's what that's for, " I thought. It was a funny sight: the relatively short Dr Colon on his tiptoes looking through a very long tube that he focused like a kaleidoscope. It seemed anachronistic, something out of a 1664 medical textbook.

At least this is what I thought before the blinding pain of someone trawling through my bladder took hold.

I yelped. Dr Colon explained that this was more painful because I had a tight sphincter. I hope this was the only time in my life I would have to hear that.

"If you wiggle your toes and breathe through it, you will feel better," Dr Colon said, still focusing the lens.

I tried wiggling my toes and breathing, but it was very ineffective. Liquids spurted out of everywhere.

Sometime later, I was finished. The nurse wiped me down with iodine and handed me my underwear. Dr Colon explained everything was fine and as expected - my bladder neck is very high and narrow.

I had to pee really badly now. When I did, it came out in spurts, a bit reddish and punctuated with a big drop of blood. Also I was excited to hear a gurgle as my bladder sputtered looking for more liquid to expel. Then the burning began.

After cleaning off, I went to find Dr Colon and ask if this was normal.

"Yes."

"How long will it last?"

"24 to 48 hours."

"Is there anything I could do to relieve the pain?"

"Not really."

I left the hospital, in quite a bit of pain. I went to my mother's house for the rest of the day. She made me a tuna fish sandwich. Emotionally shattered and physically exhausted, I ate my sandwich. I dreaded going to the bathroom.

One day to go...

As many Saltines know, the editors of Salt are dealing with some minor medical things. Tomorrow is a big day for me (Gene). Tomorrow I get my bladder photographed from the inside! I'll let you use your imagination to figure out what that will entail.

Apparently, the anxiety is getting to me. I had dream the other night that went like this:

Having just completed my procedure involving a camera and my urethra, my urologist, the almost ironically named Dr. Colon, explains I will require another procedure. Dr Colon tells that me that he will have to remove part of my liver by going through through my spine. The liver is broken up with ultrasound and then removed with an instrument that looks something like a toothscraper from a dentist. All of this is demonstrated with the help of a plastic model. I woke up before I had any of my liver taken out. Hopefully this will have no bearing on the future.

by the way, my urologist is really named Dr Colon.