Monthly Archives: May 2012

The black hole of health insurance

I just got back from the dentist where I had my bi-annual cleaning. Everything’s fine; apparently I do a good job with my “home care.” While I was there, though, I asked about a spot at the top of one of my front teeth that is slightly discolored. I don’t think you’d notice it during normal social interaction, but I do, every time I brush my teeth, or look in the mirror with my lips pulled back, which I do in order to stare at the discolored spot.

I asked the dentist about the spot and he said, “I can fix that.”

He went on to explain that it’s a spot that’s decalcified and isn’t medically problematical, although, if it got worse down the road, it could be. I didn’t need to do anything about it, but if I wanted to, no problem.

I’m not terribly vain, but come on, it’s one of my front teeth. It’s tempting to get it fixed. But wait, I asked, isn’t that cosmetic? Insurance wouldn’t pay for it, would they?

“Oh yes they will,” he said. “It’s all in the insurance code.” Then, with a wink, “It’s a filling.”

And there you have my dilemma. I can have this spot fixed if I knowingly participate in a mini insurance scam. What else can I call it?

I’m astonished and appalled at how little we consumers know about how insurance works. One of our household has been seeing a particular specialist every two weeks for months now. Each time, we write a check for the thirty dollar co-pay. We have never seen a statement from our insurance company about this doctor. When I asked the secretary how much an office visit was, she said it depended on a few factors, but ranged from $195 up. Really? There isn’t a set office visit fee? How much is this costing the insurance company?

In this particular instance, we don’t have a choice. We’ll keep seeing this doctor until they resolve the problem. But invisible charges? I’m much less comfortable with that than I am with the idea that the dentist can code a procedure as a filling so I can have something fixed that I wouldn’t pay for otherwise.

Maybe the insurance industry is rigged to be one big, cosmic, balancing act; my conscience might keep me from taking advantage of my dentist’s offer because I’m angry that the real cost of our health care is hidden from us. If that’s the case, then in the end, I’m the one who loses.

I once called a doctor’s billing office when the paperwork from the insurance company listed several procedures I didn’t recognize. They said, “There aren’t really codes for what you had, so we picked the closest ones.”

Really? So not only does the insurance company not know the truth, but now I have no record of what was done to me because believe me, when they say they picked the “closest” codes, they mean they picked things that look totally unrelated.

I know I can’t change any of the bizarre machinations of the health insurance industry. I do, however, need to make a decision about that little, discolored spot. Would it be wrong to have it done? It is one of my front teeth…

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South Beach or bust

Recently, I wrote about whether or not women who were getting older were letting themselves go, or were victims of menopause. I opted to blame menopause. Now I feel the need to apologize, because even as I posted that piece, I knew I was kidding myself. I’ve been letting myself go. To the casual observer, I still look pretty good, but I know the truth; extra poundage has made itself at home, hanging out around my waist where it interferes with my self-esteem and zipping my jeans.

The last time I was at a crisis point with my weight I was turning forty. I needed a big change so I started at the top and cut my hair. The difference was remarkable. I loved it. And, it gave me incentive to bring the rest of me up to snuff. I’ve illustrated this for you below.

This time, almost thirteen years later, when I got my hair cut, the only person who noticed was my husband. Not the kick-start effect I was hoping for, but I persevered and dug in for my introduction to South Beach, the diet, not the vacation spot. I was a fan of Weight Watchers back in the day, but South Beach purports to help you drop eight to thirteen pounds in the first two weeks – from your stomach! How cool is that? Sadly, it turns out that this is not easy, particularly for someone like me who has frequent bouts of low blood sugar.

As you know, I am woefully under informed about all kinds of things. Remember the time I found out you can’t survive on a diet of jelly beans? In order to work the South Beach Diet I’ve had to learn a lot. For instance, did you know that everything you eat turns into sugar? (Those of us in the know call it glucose.) And your body needs glucose to survive (which may be why I was confused about the jelly bean thing, but let’s not beat a dead horse). I’ve also learned that some foods turn to sugar too quickly for the body to absorb them properly.

So what magic causes the weight loss during the first two weeks of South Beach? You’re not allowed to eat things that turn to sugar too quickly (us educated folk call them simple carbohydrates), like bread, pasta, and fruit. You know what happens when your body takes the time to squeeze glucose out of all those complex carbohydrates, like vegetables and eggs, you’re supposed to be eating? You become weak. You have to do the elliptical at less than half the usual speed. You need to rest three times while mowing the lawn when you normally zip through it without stopping. You lack the energy to move any faster than the zombies on The Walking Dead.

At the end of week one I was exhausted, but I’d lost three pounds and my jeans are easier to zip so I’m not disappointed, exactly, but I’m less optimistic that I can take off five more in week two. I committed to the two weeks though, so I’ll soldier on. If it turns out not to be the miracle diet I was hoping for, I’ll just go back to smaller portions and avoiding ice cream. Then I’ll return the swamp land I bought in Florida.

Uninvited, but very welcome, guests

One day it wasn’t there, the next it was; a bird’s nest resting on the wisteria vine that grows along the top of our farmer’s porch. At first I thought it was yard waste, blown there by the wind. But the next day it had grown larger. I had no idea that birds worked that fast so I wasn’t completely convinced it was a nest until a few days later when I opened the front door and a robin shot out of the mess of twigs in question and flew to a nearby tree.

Andrew and I were beyond excited. We were honored. This robin had chosen our house on which to make a home for her babies. This was personal. We immediately became protective, repeatedly cautioning each other to open the front door carefully so as not to spook her. We’d sit in the living room and crane our necks to look up at the nest. “I can see her! Come look,” we’d take turns telling each other. It didn’t take much urging. We were fascinated.

It took us all a few days to get used to each other. Each time we used the electric garage door opener she’d flee. Walking onto the porch sent her scrambling. But she calmed down after a week or so and now she’ll stay put when we drive home and put up the garage door. Sometimes, if we sneak out the front door quietly enough, she’ll ignore us.

One day, we saw a light blue egg balanced on the wisteria vine below the nest. We panicked. How would we get it back into the nest where it belonged? We figured touching it was out of the question. What if Mom ignored it once it had a human scent on it? Do birds even have a sense of smell?

The bigger problem was logistical. The nest was right above the stairs so getting close enough to reach into it would be tricky. If we were going to attempt a rescue, Andrew needed to see if he could climb up the porch railing. We determined that Mom wasn’t in residence and he hopped onto the railing while I held my breath. I wasn’t thrilled about risking his neck for the baby bird’s, but his inner mountain goat prevailed and he pulled himself up without incident.

“It’s not an egg,” he called down. “It’s just part of a shell. And there are babies in there!” He returned to earth and said, “I could just barely make out two little balls of fuzz.”

I was jealous, but since I have no mountain goat in me I was going to have to wait for the babies to show themselves. It didn’t take long. Mom had started to return from expeditions with worms dangling from her beak. Fortunately, my eyesight isn’t good enough to see all the details of the transaction, but one day I saw Mom on the side of the nest, bending down, and two little beaks pointed up in the air. It was true, I was a grandmother.

The nest and the birds have been wonderful compensation for the fact that this spring’s weather robbed us of our traditional wisteria blossoms. Below is what our vine looks like on a good year. This year, it seems that many of the buds froze and died. Andrew diagnosed that right around the time that the nest appeared. Even if we had all those blooms we might not notice them, transfixed as we are by our little family.

I have no idea how long it takes for baby robins to grow up and move out, nor do I know where Mom goes when she’s officially an empty nester, so I don’t know how long they’ll be in residence. I’m prepared to miss them all terribly when they’re gone, but maybe Mom will spread the word about what a great location it is and next year a new family will settle here. Maybe when they’re gone we’ll leave the nest right where it is and add a little sign that says, “Free Room to Let.”

A weighty matter

There’s a guy at my gym that I know from when our children were in elementary school. We worked on a bunch of fundraisers together over the years. He’s lost a lot of weight and when our paths cross at the gym, he ignores me. I imagine a thought bubble over his head that reads, “I’ve lost a lot of weight so I don’t recognize you anymore.”

Why does his weight loss aggravate my poor self-esteem?

At a party a few years back, a male friend said, “I’m glad to see you’re taking care of yourself. You look good.” I did a quick mental inventory of what I was wearing and tried to remember if I was having a good hair day. I hadn’t discovered the gym at that point, so I was pretty sure I wasn’t taking care of myself.

His comment niggled at me as I began to notice that many women of a certain age are decidedly heavy. However, since I wasn’t particularly taking care of myself, I decided that he had it backwards; they must be actively letting themselves go.

I’ve always been self-conscious about my weight; my sisters are skinny. But when I look at pictures of a younger me I don’t see an overweight girl, or teenager, or adult. I see a regular-sized person. And despite being obsessed with whether or not I was overweight, it wasn’t until after I had my daughter that I was bothered enough to embark on my one, and to-date only, dedicated life-style changing diet. I lost a lot of weight and managed to keep it off for almost ten years. And then it began to creep back.

The weight gain was slow, but steady. I started to worry. Was I finally letting myself go? How could that be? If anything, I had just started to take care of myself! I went to the gym at work an average of four days a week. I ate Weight Watchers meals for lunch. When I was laid off in 2009 the first thing I did was join my local gym. I was not going to let unemployment derail my exercise regime. I kept exercising and the weight kept creeping up.

Then came the hot flashes and I finally understood ─ menopause; the time when women’s bodies begin betraying us by messing with things we hold dear, like our internal thermostat. Without enough estrogen, the hair we’ve cherished gets thinner and hairs we don’t want start sprouting where they do us no good. Our emotions fly all over the place. And worst of all, our metabolism slows down. All of a sudden, we need to eat less and exercise more, just to stay even.

So here’s the news flash: women don’t let themselves go. While we’re happily enjoying midlife, the universe changes the rules. I’m told that many women find the post-menopausal stage of their lives fabulous. I hope that proves to be the case. Meanwhile, next time I see that ex-fatty in the gym and he ignores me, I might just punch him in the nose.

Old friends

My father-in-law once said, “The one thing you can’t make more of is old friends.” This was said in response to my pointing out that he was groaning about an impending visit from one of the same. The implications were that even though you may not have anything in common with a person any more, nor particularly look forward to seeing them, your shared history made them a forever friend. I’m not convinced.

When I complained about a friend who regularly made me sad and couldn’t commit to getting together, another friend said, “I tell my little girl that friends are nice to us and make us happy. Is she really your friend?” According to my father-in-law, the answer is yes.

And what about frenemies? According to Urbandictionary.com, the winning definition is, “An enemy disguised as a friend.” But I prefer this one (copied with all its grammatical warts):

The type of “friend” whose words or actions bring you down. (whether you realize it as intentional or not) The type of friend you ought to cut off but don’t cuz…they’re nice… good …you’ve had good times with them.

I had a very close friend in college; I’ll call her X. She was fiercely loyal to her friends and expected the same in return. The tiniest slight, perceived or otherwise, and she would cut you off and never look back. We remained close after she transferred to finish college in New York and through the years that followed.

During college, X. and I were thoroughly wrapped up in the underground rock and roll scene. It was the late seventies and punk rock ruled. Between The Rat in Kenmore Square in Boston, and CBGB’s in the Bowery in New York, it’s a wonder that either of us managed to graduate. But graduate we did, and then began the laborious process of growing up, building careers, and going to bed before 3am.

She came to visit me after I bought my first house. I was thirty, a responsible grown-up with a job and a mortgage. After admiring my home and catching up, she excused herself to go to the bathroom. When she’d been gone for a while, I tapped on the bathroom door and called, “X? Are you okay?”

She opened the door and I saw works on the bathroom sink. She had just finished shooting up in my bathroom.

I don’t remember the rest of that day, but sometime later X. sent me a card asking why she hadn’t heard from me in a while. I responded honestly with a letter about how sad I was that she was indulging in self-destructive behaviors, and how I thought she needed help. I told her I missed her, and would welcome her back whenever she was ready. She must have considered that disloyal because I never heard from her again.

I think about X from time to time. Sometimes I miss her. She was nice to me and made me happy. By one of the definitions above, that made her my friend, but was she also a frenemy? Her behavior wasn’t hurting me, although it did bring me down. At my age, someone I met in college constitutes an old friend, but if they stopped speaking to me along the way they probably don’t qualify.

I’m going to work on a word for someone you’re fond of that probably doesn’t care if you’re still alive. Suggestions welcome.