I seek out the wisdom of the old tree on this Yom Kippur evening.  The ghosts who are always with me are crowding in closer as the time of the Jewish Remembrance of the Dead comes just as my own family’s fall season of dying begins.  When is a good time to die?  Most of my family members have chosen the fall months.

The sycamore tree, here since before the Pilgrims landed, hasn’t changed much since my last visit.  The ducks and egrets, plus assorted birds lend truth to this park named as a nature preserve.  The leaves haven’t begun falling off the old tree in earnest yet.  I am pleased I can still hoist myself up into the nook in the tree where I sit.

Tonight I seek out my god, nature.  And I feel connected to it.  I am aware sitting here among my ghosts, that in age and thought, I am closer to the dying.  Not that I’m not very grateful I am alive and basically still healthy enough to do most of what I want to do.  But I feel the heavy burden of maintaining my health since healthy living is the only kind of living I want.

A friend almost my age confided that she doesn’t have anything left on her bucket list.  Nor do I.   Other than some unrealistic regrets like not becoming a dancer, my list has everything checked off.  There is some contentment to having achieved an empty bucket list, but it feels — well — finished.

Then the wisdom of the tree tells me I do have one, or maybe two items, to put on my bucket list.  Is it unrealistic to add “being a successful writer?”  But, of course, the definition of successful is elusive.  Does it mean figuring out how to publish the Chinese translation of my first book, “Memoirs of a Middle-aged Hummingbird?”  Is it finding just the right venue for my new book, not yet published, “Out of Step:  A Diary To My Dead Son.”  Is it something I have yet to write?  Perhaps just writing two books was a success.  But then my bucket list would still be empty.

The old tree whispers to me — “mind-body connection.”  Yes, that’s something I want to put on my bucket list.  I have read about the mind-body connection.  I have felt it.  I believe in it.  And yet there is a depth to it that I know I haven’t reached.  It’s challenging to believe the mind-body connection can heal while health insurance, Medicare, Big Pharma all yell so hard to convince us otherwise.

A little boy visiting his Korean grandparents crawls up and along a branch of the tree.  He whines when his father wants him to come down.  I wave to the little boy bravely standing tall on his branch.  He waves back with a smile.  He’s the same age as my half-Chinese/half-Korean grandson.  Old trees connect to young children like old grandparents connect to their grandchildren.

Thank you old tree.  As it gets dark, I hug the tree, enjoying its strong, grounded feeling.  I leave with the energizing challenge of two new ideas for my bucket list.  I walk home, surrounded by my friendly ghosts.

Comments?? E-mail Suellen at ZimaTravels.com

To seniors in the U.S., December 7th is more than remembering Pearl Harbor.  It is the deadline to sign up for your 2012 Medicare Plan.  Perhaps a few understand (I’m not one of them) why “enrollment” became so complicated and stressful for already deteriorating seniors who must enter this mine field cautiously.  From what I understand, Medicare annually decrees what each plan will offer.  They tweak one plan this way, and one plan that way.  The plan you had last year will definitely change.  Will it still suit you?

There are seminars in retirement communities and senior centers with well-dressed, swift-talking agents telling you the pros and cons of this plan and that plan.   This is their job, and their hefty commissions are their incomes.  Whole forests of trees are felled to provide the paper that is sent out to present members, and possible members to be.  This is NOT light reading.  First, there’s the Notice of Changes.  Then, there are  Summary of Benefits for EACH plan.  Just one of the ones I received is 57 pages written in that strange language called Legalese, ending with a page of Disclaimers.  And then there are other booklets of Providers (Doctors) that go with each plan.  The ones that make me angriest are Formularies that go into excruciating details about co-pays for drugs.  American seniors are the most drugged seniors anywhere in the world, and require pages and pages of what drugs are waiting at your friendly pharmacy.   There, donut holes are scary rather than tasty.

At this time of year, the Post Office gets a shot in the arm with large numbers of advertisements for different Medicare plans.  I must have received at least 40 so far.  They all spell C O M P E T I T I O N for the Medicare billions (trillions?) that some claim are breaking  the American economy.  But it’s hard to compare the plans because they are very localized.  Just a city or county away, the same company will offer very different “benefits.”

I owe my good health mostly to not having had decent medical insurance until I was 65.  I’m serious.  Since turning 65 and finally being on the list of Medicare-insured, I feel like I’ve entered a dangerous physical and economic quagmire.  Because I belong to Medicare, I am now able to get medical care.   But how much of that medical care do I trust and believe in?  I have had some unfortunate substandard medical care since I qualified for Medicare.

And the changes in the plans do matter.  But I didn’t realize that for a few years.  I didn’t know I had to be ever vigilant when a new year came around.  And so I faithfully stayed on the Medicare plan I’d started on after it changed.  Bad mistake.  2010 was the year I ended up in the hospital twice within one week, incurring two hefty hospitalization charges plus various other co-pays.  The total bill for 5 miserable days was $40,000.  I personally shelled out about $1,000 and never found out how much was actually paid out by other parts of Medicare.  I felt I was lucky just to get out alive.

As with any insurance, how do you know exactly what kind of insurance you will actually need in the coming year?  It’s really just a crap shoot.  Sometimes you guess right; sometimes you don’t.  But at least your mistakes only live with you for one year.  Then you get to go through it all over again. Is Medicare medical care or just another name for Big Business?

Comments?? E-mail Suellen at ZimaTravels.com

Mike says:  OMG! This sounds like a nightmare! I can imagine how confusing – and how boring –  having to deal with this must be. Especially knowing that these agents are nothing more than salesmen interested in earning their commissions rather than social workers with your best interest at heart.

November 14, 2011

The donut hole for medication isn’t the only hole in Medicare.  In fact, there are so many holes in the Medicare system, it resembles swiss cheese.  One gaping hole I fell into is how to make quality of care complaints.  I have written before about the problem of disputing hospital bills and reporting poor quality of service.  I couldn’t get anywhere on the co-pay dispute, but I persisted on a very looong winding road to report quality of care issues — first to the hospital, then to Secure Horizons (my Medicare provider), and eventually to a Medicare program called HSAG (Health Services Advisory Group).

After two unhappy hospitalizations, all I had after months of trying to express my quality of care issues to the hospital and Secure Horizons were letters thanking me for letting them know, but a firm end sentence letting me know that,  since it was a personnel issue, and personnel issues were protected by confidentiality, I would hear nothing more from them.  That was not good enough for me, so I persevered and finally heard about HSAG that oversaw Medicare quality of care complaints.

Their system was to have a panel of doctors examine my medical records to see if they felt there were quality of care issues that should be addressed.  That took 6 months.  When this panel determined that there were definite quality of care issues during my hospitalizations, I was offered the chance to either simply get a letter stating that, or have a Mediation session.  It was made clear that I could request anyone I wanted to be part of it except for Secure Horizons, my Health Care Medicare Provider.  However, participation was strictly voluntary.  I asked for representatives of the hospital and Monarch, the provider of the doctors to the hospital to be present.

A trained Mediator who was also a doctor was selected to lead a conference call.  The call was set up for a few months later and took about 2 hours.  I was able to say what I wanted to say, and the hospital and Monarch, the provider of doctors, agreed voluntarily to take certain measures that would deal with the issues so that, hopefully, future patients would benefit.

Even though the Mediation had nothing to do with suing or money,  confidentiality was the shield cloaking everything.  Supposedly there are confidentiality laws, but I kept wondering who was being protected from what and why.  I was apparently also being protected by confidentiality, but felt only hindered by it.

After the hospital and Monarch agreed to take certain measures, they were supposed to report back to HSAG to show that the specific quality of care issues had been addressed, how, and with what results.  That was the end of their part of the bargain.  It took Monarch an extra two months to report back to HSAG.

I wish I could say I was excited or comforted by the attention my grievances received.  But, once again, the wording of what was done was vague and not very informative, with confidentiality once again being the main point emphasized.

I have since been told that the Mediation program for Medicare recipients has been ended.  It was tiresomely long, way too costly, and minimally effective.  Something else is being proposed, but has not yet been implemented, so I can’t really say what option there is in its place to complain about poor quality of care.

What did I learn from this 16 month exercise in futility?  When you are in the hospital and are having ANY problems, ask for a Case Manager!!  They are medically trained and may be the only helpful person you can find during your hospitalization.  If you have quality of care complaints, good luck in finding any procedure for having them aired.  However, there are departments called Quality of Care or Care Improvement in every hospital and provider of doctors to hospitals.  If you can find a way through the barriers to talk or write to them, do so.  If you want to report specific doctors, you can write about them to the state’s Medical Board.  I’ve never sued a doctor.  I’m sure it’s not easy, but suing may at least get you a hearing.

I’m thinking of writing to President Obama, who already knows the Medicare system is a totally bloated, bureaucratic, holey morass, suggesting that some viable means of addressing meaningful quality of care complaints get some priority.  But to do this, confidentiality has to be used meaningfully, and not as a weapon against the patients.  But it’s very clear that complaining requires good health, strength, and tireless persistence.

Comments?? E-mail Suellen at ZimaTravels.com

October 27, 2011

It’s been an unappetizing couple of days.  Experiencing the movie “Forks Over Knives” the day before a Medicare Forum in my retirement community brought into sharper focus my problems with each.  “Forks Over Knives” is a full length movie with gobs of convincing statistics and smiling people about getting healthy by eliminating  meat, fish, and dairy in all its forms from our stomachs.  In fact,  “if it ever moved, slithered, had a face or a mother,” don’t eat it.  For other health reasons, banish oil and sugar too.  What’s left?  A plant-based diet that insures our bodies get what they need and not what will produce obesity and disease, especially cancer.

Going to the opposite extreme, the Medicare merry-go-round promises more doctors, medical tests, and pills than you could ever need.  Medicare is a bloated, unhealthy health care system that has ballooned into a for-huge-profit enterprise that would horrify dear old Dr. Welby and his kind, long dead and forgotten but for a few or us  who actually knew doctors like them.  I feel no security in a system that  hospitalized me a year ago for 4 days and presented me with no apparent diagnosis, but a $40,000 bill.  Or an ambulance service that charged over $1,000 to transport me from my doctor’s office to the hospital next door.

I have so far rejected various for-the-rest-of-my-life medications that doctors encourage me to use, but the pharmaceutical industry is so closely tied to our medical care system, part of Medicare’s function (anyone care for a donut hole?) is to support the expensive, pervasive drug culture it has created.  American seniors take far more drugs than seniors anywhere else in the world.   That can’t  all be attributed to bad eating habits.  And what about all those so-called preventive tests that are urged upon everyone?  Is that for the benefit of patients, or making sure more business is assured?  Plus, those tests often require expensive equipment  to keep that industry in business as well.

A speaker today assured us that Medicare is working hard to stamp out Medicare fraud that amounts to billions of dollars.  (No doubt that involves another department of Medicare we need to pay for.)  But the whole Medicare system made fraud so very easy.   With few checks and balances, Medicare is an ever-growing  out-of-control cash cow that keeps ballooning bigger and bigger.   No political wrangler can wrestle it to the ground.

Looking at all those tables in the big room with cute little gadgets and candy for the taking, and eager people trying to “sell” me this or that Medicare program made me rather anxious and nauseous.   Could a plant-based diet really cure me from the Medicare madness?  With no good answer, I went to work out in the gym, surely the best choice for low-cost, reliable health care.

Comments?? E-mail Suellen at ZimaTravels.com

July 24, 2011

I’m sure there are instances when confidentiality is a good thing. But my recent dealings with Medicare make me question who and how confidentiality protects.  It not only protects, but also hinders.  Those of you who have been following my blog since last July will remember that I had two hospitalizations within three days that, I felt, left much to be desired in the quality of care I received.

I wrote a detailed letter of my complaints to the hospital, and received back a letter informing me that they had referred my concerns to their Director of Medical Staff.  However, and I quote, “unfortunately, the results and conclusions of those findings are, by law, protected and the hospital is unable to disclose those findings outside the committee review process.”  And, that was the last I heard from them.

Since my strongest complaint was the lack of communication from 7 of the 8 doctors assigned to me during my hospitalizations, I was also referred back to my Medicare provider, Secure Horizons.  I will not recount here the many phone calls it took to Customer Service at Secure Horizons to obtain the name and address of their grievance department called Ovations.  Upon sending through a very detailed explanation of my quality of care issues to Ovations, I received a letter that basically said the exact same thing as the letter from the hospital.  I also sent a grievance about the co-pay I was charged, but that went to a different Ovations Department.

Feeling unheard,  I sought out another avenue and found HSAG, Health Services Advisory Group, for Medicare.  Their procedure is for uninvolved doctors to look ONLY at the medical records and determine if there are possible quality of care issues.  That takes about 6 months.  They deal only with quality of care, not co-pay disputes.  In my case, they said they found sufficient quality of care questions to offer me the opportunity to have a Mediation session with a certified Mediator and whichever people or groups I wanted to invite, excluding unfortunately, Secure Horizons or Ovations.  All participation is voluntary from all parties.  The purpose is to try to improve the quality of service in the future.

I selected to invite the hospital and Monarch, which contracts with the doctors at that hospital.  I didn’t give any particular names of people to invite, but was pleasantly surprised to find that there are staff whose titles and duties actually fall under Quality Improvement.  At the hospital’s request, it was a teleconference rather than a face to face meeting.  It lasted 2 1/2 hours and ended with 6 suggestions of what should be looked into and improved by the hospital and Monarch.

Why the severe restrictions of confidentiality?  In my view, confidentiality blocks progress.  For example, it became very clear to me that it is crucial for any in-patient to have an advocate looking after his/her best interests.  Usually this is a family member.  However, I don’t have any family members geographically close enough to visit me in the hospital.  After my ordeal, I asked about setting up a group of advocates for those of us who don’t have family members nearby.  I was told by a social worker at the hospital that there are now strict HIPA rules that prevent doctors from giving  medical details about patients to anyone but family members.  That worked against me.

Confidentiality is also protection for the doctors as personnel.  We have all heard of the huge amounts U.S. doctors must pay for malpractice insurance.  And, the U.S. today is definitely an overly litigious society, ready to sue for just about any reason.  However, we are now given forms to sign that say we will go to arbitration in case of a dispute with a doctor.  So, is there still such a strong threat of malpractice suits?  How can doctors learn what they need to improve if they’re always on the defense?

The whole HSAG process took a lot of preparation on my part, as well as the other participants.  I don’t even want to think of how expensive the whole procedure is as another Medicare expense (the patient doesn’t pay directly for the mediation).  If this will make a difference in the quality of care for future patients, I can feel all the time and energy I expended on it were worth it.

I am supposed to receive further information about the follow-up from the hospital and Monarch.  I would like to tell you more details about the issues we discussed, but, of course, I’m not allowed to because I had to sign a vow of confidentiality of everything in the proceedings!

Comments?? E-mail Suellen at ZimaTravels.com

I can see from the statistics of my blog readers that many people are still finding my blog when they are looking up disputing hospital bills and quality of care issues with Medicare.  And I promised to update you on the latest chapters of my personal sorry saga.  I’m about to enter another attempt to make something positive come from my miserable experience with my hospitalization back in July of 2010.

For a fast recap of what has taken me countless hours and many months — I contacted the hospital about my complaints about both my care and my co-pay for two hospitalizations in July three days apart.  The hospital informed me that the doctors are NOT employees of the hospital and the hospital is responsible ONLY for doing what the doctors tell them to do.  BUT I could send my complaints about the doctors to their department that keeps records on the doctors.  I later found out that my complaints never got into the files of the doctors.

After numerous conversations with uninformed and misinformed customer service representatives of Secure Horizons, my Medicare HMO, I submitted a co-pay dispute claim and a quality of care complaint with Ovations, the Appeals and Grievance Department of Secure Horizons.  I eventually received a form letter from Quality of Care thanking me for contacting them, but let me know that any further action would be confidential because it’s a personnel issue.  End of my quality of care complaints as far as they were concerned.  The co-pay dispute claim was denied — BUT I could appeal their decision, which I did to Maximus, an organization approved by Medicare to handle appeals.  BUT I could appeal their decision through the Office of Medicare Hearings and Appeals — which I did.  There was a telephone conference with a judge and a representative of Pacific Care that somehow oversees Secure Horizons.

The judge upheld the earlier decision of my financial responsibility, BUT I could appeal yet again.  However, by then I had figured out and had it later confirmed that co-pay complaints will never win when they are based on quality of care issues because quality of care and co-pays are totally separate in the complaint process — and never the twain shall meet.

If you’re still with me, I then followed another path to complain about my bad quality of care issues.  The  Health Services Advisory Group (HSAG) is made up of doctors that look ONLY at the medical records and determine if the quality of care complaints from the patient have merit.  That takes about 6 months to review.  They can say absolutely NOTHING  about co-pay disputes.

I have just received a letter from HSAG saying that, after careful scrutiny by uninvolved doctors, they feel my quality of care complaints have merit.  They offer me two options — one option is to receive a letter from them outlining their findings, and the other is the Medicare Alternative Dispute Resolution Option.  There is no cost to the patient for choosing either option.  All parties must agree to meet voluntarily with a qualified mediation counselor.  What can the results be?  I quote, “The mediator encourages everyone to listen to the concerns of the other participants.  This open communication helps all participants to better understand one another and to discuss possible solutions to the issues of concerns.”

So, it won’t change what happened to me.  But it MIGHT help to make changes in the system.  Long having been a cause-oriented person, I decided I’d like to take the Alternative Dispute Resolution option.  And, instead of inviting the individual doctors I had complaints about, I’ve decided to invite representatives from the hospital administration, medical records, and Monarch, which is the agency that actually hires the doctors.  Unfortunately, they cannot invite my HMO, Secure Horizons, to come.

Will they accept the invitation for mediation?  Stay tuned.

Comments??  Please e-mail Suellen@ZimaTravels.com

Do they still slap newborn babies to make them cry and take their first breath?  Did you ever wonder if it’s really necessary for the first sensation a newborn feels to be the pain of being slapped?  Along with movies, tv, and computer games, there’s too much violence in medical care.  I thought about this recently when I went to the doctor for a gastro-intestinal problem that wouldn’t go away after a week.  It didn’t behave like a regular stomach virus.

My doctor said he thought it was bacterial, and prescribed an antibiotic.  Since one reason I chose this doctor is his knowledge of alternative medicines, I asked him if there was one I could take instead of the antibiotic.  He sold me a supplement and said to try it for a few days.

When I took a dose of the alternative medicine, I felt somewhat better, but the problem returned after the dose wore off.  I bought the antibiotic just in case.  Whenever I’ve taken antibiotics, I feel the harshness of the medication as it attacks my body, good bacteria along with the bad.  I also get uncomfortable side effects from antibiotics that require taking something to overcome the side effects.  I don’t doubt that antibiotics are reliable killers of bacteria, but I wanted to believe that gentler, kinder medication could also work effectively.

I tried the gentle medication for two days, then three.  Each time I came close to taking the antibiotic, I talked myself out of it and said, “One more day.”  In my quest of understanding more about the mind-body connection,  I learned “tapping” several years ago.  It is a way of energizing the body’s healing powers that I had found  useful.  So, I found myself once again tapping certain parts of the body while verbally communicating with myself.   At the very least, it could do no harm.

After 5 days, I became aware that I didn’t need to take the alternative medication as often.  I never took the antibiotic, but I got better without it.  It was a good feeling to know that I had helped my immune system fight off the “bad” stuff without putting it through the side effects of antibiotics.

As I age and deteriorate, it’s more and more important to me to believe in the mind-body connection as a way of keeping myself healthy and well through all the bodily blips of aging.  It’s hard to know what to believe in these days, especially when it comes to medical care.  One example is that our medical care system reinforces pharmaceutical drugs by subsidizing them, but not the alternative medications.  The alternative supplement that cured me cost $50, while my co-pay for the antibiotic was only $3.

Besides being expensive, alternative medications can also be strong and sometimes dangerous.  Pharmaceutical drugs are often too powerful and throw off the balance of the body, leading to other problems and complications.  Pursuing the mind-body connection can be a bumpy road paved with grandiose promises and wishful thinking.  There are several theories out there to choose from.  One I have just started to learn about is called Body Talk, a form of energy medicine that derives its power from “increasing the levels of internal communication within the body, (thus) stimulating the body’s own ability to regain and maintain a healthy balance.”

Many years ago my dog was under attack from fleas that caused her to scratch herself constantly until she made sores.  The vet I took her to gave her a shot of cortisone that sent her into a deep depression.  I was desperate to find a different way to help her.  At that time, wheatgrass was talked about as a powerful cure-all for just about every disease.  I bought wheatgrass seeds and planted them in a box.  As the grass grew, I kept cutting off the tops and adding it to my dog’s food.  She no longer appealed to fleas and they left her alone.  I don’t know why or how, but it worked.  And it was gentle, kind, and cheap.  Wheatgrass turned me into a seeker of kind and gentle medication that works.

Comments??  Please e-mail Suellen@ZimaTravels.com

I’ve just received the discouraging words that my third appeal of a co-pay for my hospitalization has been turned down by the judge.   My point in disputing one co-pay was that premature discharge and insufficient treatment during my first hospitalization directly led to my second hospitalization within three days.  I offered proof that can be found in my medical records.   The judge didn’t deny that.  However, in his words, “Appellant has challenged the quality of service.  Unfortunately,  an Administrative Law Judge proceeding is not the proper forum to bring such a challenge.”

And, therein lies a big problem.  Medicare divides co-pay disputes and quality of care disputes into two separate paths, and those paths apparently can never converge.   I have followed the two paths, making formal complaints to the hospital responsible for the inadequate care (which got nowhere), and then filing both a co-pay grievance and a quality of care grievance with Ovations, the section overseeing complaints and grievances for Secure Horizons patients.  The quality of care complaint with Ovations barely merited a letter telling me that complaints against doctors was a personnel matter I would not be privy to (I later found out from Monarch that employs the doctors that nothing about my complaints could be found in any of Monarch’s files).  The co-pay grievance was turned down, sent to Maximus to review, and was turned down there, leading me to the third appeal with an Administrative Law Judge that also resulted in my being turned down.

Prior to the third co-pay appeal, I also sent a formal quality of care complaint to HSAG (Health Services Advisory Group).  They do seem to be interested in my quality of care complaints, which go beyond the problems from my first hospitalization leading to my second hospitalization, but HSAG makes it very clear that they have nothing to say about co-pay disputes.  So, there it is.  An impasse with no visible way out.

I have the choice to appeal the co-pay dispute yet again to the Medicare Appeals Council (MAC), but I wonder what the point would be since quality of care and co-pays cannot influence one another in Medicare law.  Why do I see a connection between them when Medicare doesn’t?  I’m one person that cannot be divided into two paths.  The inadequate quality of care definitely influenced the cost of my co-pay because I was charged for two hospitalizations.  Am I stuck in a dead end?

Comments??  E-mail Suellen@ZimaTravels.com

 

I’m getting ready to go on vacation for three weeks, first to visit a good friend, and then to spend my granddaughter’s winter break with her when I don’t have to share her with school.   It strikes me as strange to take a vacation from retirement.  After all, isn’t retirement a never-ending vacation?  Your time is your own and how to use that time is totally in your control.

But wait!  Retirement isn’t quite all that free.  First of all, there’s 60 to 90 minutes of exercise 6 days a week required for my self-imposed mandatory heart medicine.  Since I no longer drive, that means taking a bus to get to the fitness center for weight training and cardio, to the gym for aerobics, and to the senior center for yoga.  Of course, I have to fit in a shower at some point in the day to wash off the sweat.

So much for the body.  But then there’s the brain.  How many times have I been told that the brains of seniors must be stimulated to keep it from atrophying?  I have friends who love doing  jigsaw puzzles, Sudoku, making up original riddles, doing crossword puzzles, finding the hidden words, and beating themselves on electronic games.  I hate all those things, and always have.  But when I was younger, I didn’t see any need for exercising my brain.  It just happened.  Now, as I regularly forget people’s names and why I walked into a room, I wonder if I shouldn’t force myself to do those brain stimulating games I hate.

They say that learning languages is a good way for an old brain to stay active.  I’ve studied Chinese off and on for years, never progressing past a certain level of survival Chinese.  But a Chinese resident of our retirement community has offered to give a class once a week, so I’m trying again.  Most of what I’ve accomplished so far is just re-learning what I’ve forgotten over the years.

Volunteering has always been a part of my week, so I continue to volunteer for clubs and committees, am the President of a local branch of the National League of American Pen Women, and am entering the tenth year of spending my Sunday afternoons as a docent with seals and sea lions at the Pacific Marine Mammal Center in Laguna Beach.

I noticed a shift as I aged from “doing” to “being.”  So, I make time for “being,” going down to a pretty creek near my home and sitting in a tree, taking solitary night walks, meditating and deep breathing.  I am usually reading a few books at a time, which is another form of “being” because it brings me to different ideas, new places, stationary travels, without “doing.”  I try, but don’t often succeed, in getting through one Saturday and one Sunday newspaper a week.  I used to get magazines, but they were an expense I’ve had to cut out of my dwindling budget.

Socializing is necessary for mental well-being, and mutual enjoyment.  Since I live alone, I need to allot time for being social and nurturing  friendships.  Living in a retirement community helps by offering many activities, club events, and chances to be with other people.  I won’t say there aren’t any isolated people among the 18,000 of us who live here, but there are numerous, convenient, and easy opportunities to be social.

I used to spend a lot of mental energy on planning what comes next, where to live, where to go next, how to find a job.  Although I like to be thinking a few months or a year in advance of travels, my future planning doesn’t extend too far into the future anymore.  It is in proportion to my lower energy level and my severe financial restraints.

Reluctantly, more of my mental energy seems to be going into physical realms.  Blood pressure and cholesterol and keeping down my food intake are daily thoughts.  There seems to be an increasing rate of “little” problems — strange twinges, tweaks, creaks, and pains that weren’t there when I went to bed.  Of course, Medicare reminds me regularly of all those regular preventive tests they think I should be taking.  It’s boring – and scary – as friends succumb to all sorts of ills.  I count my health blessings daily along with wondering, as I did today, if I really should still be climbing up a ladder to clean the outside of the my bedroom windows.  I still do all my own housecleaning, but it’s more tiring than it used to be.

In fact, retirement is a busy time.  No wonder I need a vacation!

Comments??  Please e-mail to Suellen@ZimaTravels.com

December 5, 2010

Have I finally met Dr. Right?  In my continuing effort to be an empowered patient with the encouragement of Elizabeth Cohen’s book, I have scheduled two “meet and greets.”  Such a possibility isn’t widely advertised, but I had no trouble asking two different doctors for an interview before choosing a new primary care physician on my Medicare program.  I had high expectations for the second doctor because I had found out beforehand that he had a different approach to doctoring than other doctors I had encountered.  And, he didn’t disappoint me.

Most of the doctors available to me on my Medicare plan are traditional doctors who see a problem and treat it with drugs, often very expensive ones and usually, if one is a senior,  to be taken for the rest of one’s life.  Unfortunately, that is how our medical system has evolved and remains under the powerful influence of pharmaceutical companies.

I have been very fortunate to have stayed mostly healthy during my lifetime.  The combination of spending my middle-aged years living in faraway countries and the high cost of medical insurance made me very good at self-diagnosis and self-treatment.  But aging, getting old enough for Medicare, and two hospitalizations last July, have shown me it’s definitely time to choose a good, reliable doctor that I feel comfortable talking to.

I have felt drawn toward “integrative medicine” for the past few years because of reading Dr. Andrew Weil. Although I don’t adhere to his excessive use of supplements, I do feel more relaxed with his intelligent analysis of good health.  He doesn’t rule out using popular drugs if he feels they’re necessary, nor does he rush to inflict them upon the body.  And, a believer in the mind-body connection, he looks at patients holistically.

I felt a difference in what I hope will be my Dr. Right from the moment I entered his office.  It was small and tastefully decorated – not as generic as most doctor’s offices.  I had called twice to set up  my appointment and had been surprised both times when the doctor himself answered the phone.  The office staff was small and less official.  I didn’t have to wait long before I was taken to a room to wait for the doctor.   His words were comforting.  He had been trained in India and the U.S., so his vision was broader.  He said things I believe and was longing to hear from a doctor —

“The body wants to be healthy and has great restorative powers.”

“Medications often cause more problems than they cure.”

“I look at the total person to understand his/her medical problems.”

He also emphasized that he welcomes questions from his patients.  In fact, he introduced me to one of his patients and she showed me a folder she brought to her appointment with her questions and his answers.  That was truly music to my ears because the lack of communication from the doctors assigned to me when I was in the hospital had been the most frightening part of the total experience.  Actually, I want to consider my doctor a consultant in my medical care, albeit a highly trained and experienced one.  I want to respect my doctor, and feel respected by him.  I expect to listen to him, and I expect him to listen to me.

How can he spend more time with each patient?  He said he limits the number of patients to about 20 a day, compared to the 35 patients many primary care physicians see daily.  I felt relaxed talking to him instead of sensing a clock ticking that I usually feel with doctors.

So far, so good.  He is now officially my primary care physician.    Time will tell if I have found my Dr. Right.

Comments??  Please e-mail Suellen@ZimaTravels.com

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