Text 35956, 110 rader
Skriven 2010-03-18 19:32:12 av Sean Dennis (1:18/200)
  Kommentar till text 35938 av MICHAEL LOO (1:123/140)
Ärende: medical 940
===================
Hello, MICHAEL.

Thursday March 18 2010 at 20:56, you wrote to me:

 SD>> A quick check of the interwebz says 160-180 mg/dL (9.9-10
 SD>> mmoL/L).

 ML> Thanks.

On that subject, I got a call from the VA today.  I have an appointment with
the Diabetes Clinic at 9 AM (although I'll be going in at 7 AM, since I'm
fasting, to have a lipid block run at the lab, then I'll eat and go to my
appointment).  I am being assigned to a clinical pharmacist and an
epidemiologist (sp?).  Basically, they are going to fine-tune my meds and try
to make my treatment plan optimal to my needs.

I was assigned a clinical pharmacist in Atlanta and she got me on insulin,
which helps.

(For those who don't know what a clinical pharmacist is, it is a highly-trained
pharmacist who can look at a patient's medication plan and "tweak" the plan,
meaning prescribing more or less of a drug, new drugs or removing a patient off
of a drug.  They don't do anything else concerning the patient's health, but
they generally work in concert with the patient's doctor and occasionally an
epidemiologist, like me, to get things fine-tuned.)

This, of course, is not an excuse for me to slack off and not take care of my
own health.

 ML> It is good to cultivate a relationship with a provider. Having
 ML> a practitioner who actually recognizes your face is a good
 ML> beginning.

My PCP's nurse calls me by my first name.  I keep asking my PCP to call me by
my first name as I feel more comfortable with it than "Mr. Dennis".  I call her
"Mrs. Fisher" (she is a family nurse practioner) because she's not only my
doctor, but she is my elder.

 ML> Though we think, poor veterans, what a raw deal they are getting,
 ML> this just reflects that the VA is just another provider trying to
 ML> cut costs, grafted with an insurance plan trying to cut costs.

The only reason they cut costs is that the VA's funding keeps getting cut short
by Congresspersons who don't know a damn about anything but whose ass they have
to kiss to stay in office (of all parties, my personal views aside).  The VA is
chronically underfunded, understaffed and a shining example of socialized
health care (of which it is).

They prescribe third-tier medication; sometimes they prescribe medication that
has long been superceded by more superior and safer medications (sulfamides
come to mind).  What is worse is that each VA's formulary is different and the
care varies greatly on what VA you go to.  For example, when I moved back here
from Atlanta, I was on Actos, which helped me keep my diabetes in check.  It
was deemed too expensive for here, so they pulled me off of it and everything
went apeshit.

The VA doctors are perplexed because I have been deemed allergic to metformin,
which is the first thing they shove at a diabetic, even though it has been
shown that insulin is more effecting than metformin at first (and without the
terrible side effects either).  The VA also had me on glyburide, an old
sulfaurea that really shouldn't have been used in my case.  My doctors in
Atlanta determined that I was overmedicated (when I moved from here).  I can
honestly say that my health has deteriorated and my respect for the VA also
since I moved back here.

Again, it all comes down to money, really.

(Sorry for the soapbox; I know this isn't really the place for it and if we
want to discuss it, we can do it on my board.)

 ML> I got fancy dancy care partially because my provider didn't have
 ML> to answer to the insurance company.

You know what's ironic?  My parents have absolute top-notch BC/BS insurance
from the VA, which the VA partially subsidizes.  But because of my dad being
100% disabled, /by Federal law/ he had to go on Medicare and he is unable to
use a third of the benefits he's paying $500 a month for!  And on top of it,
the VA is always trying to bill my dad for medications that his health
insurance has already paid for....even though the medications are coming from
an outside doctor, not the VA.

So you can say I've got a bitter taste in my mouth with the government getting
involved in my health care, but I've had no choice.  Perhaps soon, with a job I
have applied for, I will be able to pay for my own doctors and get the health
care I feel I should get.

 ML> So far as I can tell the QWK stuff is working. The only issue is
 ML> the number of keystrokes it takes to get to the right place - and
 ML> the keystrokes not corresponding to what other boards use, so of
 ML> course I periodically hit O for M, or O for Q, or G for !, that
 ML> sort of thing. Tomorrow's upload I think will be to your board.

I just dropped to a shell and I've reconfigured the main menu for you.  You can
now use O (that's letter O) to go to the QWK function and B to go to the Blue
Wave mail door.  The reason why I don't use G is because I prefer to have the
letter commands "free" for my use in the different menus.  Also, ProBoard comes
with those global commands "built-in" and I prefer to use those since as I said
above, it gives me more flexibility with the menuing system.

I'll take a look at the message (mail) menu and see if I can switch things over
there.

Later,
Sean

//sean@nsbbs.info | http://nsbbs.info | ICQ: 19965647

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