Doc’s recommendation was a “tapebuddy”, or impromptu splint made by taping the ring finger of my right hand (the one I broke) to the middle finger of the same hand. Makes typing kinda tough when I’m forced to hunt and peck with just my right index finger.

Sorry for the crappy photos … taken with the Treo 700w camera of my xray on the LCD monitor at the hospital. This side profile of the finger shows the crack from the underside of the finger. The top-view xray showed the crack extending left-to-right, right across the bone.

As a freelance developer, who writes code for a living, as well as a guy who was supposed to play piano at church for Easter this coming Sunday, this is no small event. It got me wondering whether I should look into additional insurance to cover lost income for stuff like this…

Sting had a great tune out years ago called “If I ever lose my faith in you” (lyrics at http://www.azlyrics.com/lyrics/sting/ifieverlosemyfaithinyou.html). In the song, he basically says he’s not going to lose sleep at night for losing faith in science, progress, the holy church, politicians, etc.

I think he needs to ammend the song to include the American HMO health care system.

Whoa, what’s that you say? Ian’s getting political? Is Ian in support of Gov. Arnold’s “universal health care” proposal for California? Well, I don’t support free health care at the expense of my taxes for people in California who also do not pay California taxes, but this isn’t about politics. Read on …

I’ve had an annoying symptom since I was a teenager, a postnasal drip that refuses to go away. I remember trying various OTC cold remedies trying to clear it up, and relief was always temporary. In college, I started getting bad headaches that never really went away either, they’d be pretty random occurences in terms of environment, whether or not I ate or what I ate, time of day, no pattern that I could discern whatsoever.

Skip ahead a little. A year ago when Elizabeth and I got married we discussed health care and whether it made sense to move our medical records from her Kaiser provider to my Blue Cross provider, or just stick with Kaiser and add me to her health care plan. In the end, it turned out to be a good move to move me to Kaiser since I left PriceGrabber this past spring.

So in November 2005, I called Kaiser and asked if they could please assign me a primary care physician (CPC), which they did. Good timing too ’cause I decided enough with the headaches, it’s time to see somebody about it. At this point, the frequency was up to about 3 headaches per week and one hit me so hard I had to stay home from work.

Except the first doctor I met at Kaiser wasn’t my assigned PCP, it was someone else. Okay, he’s busy, whatever, just help me. That doctor thought my headaches were due to a sinus infection, and gave me a nice strong antibiotic to kill it off. A week later my body decided it was allergic to that medication. I go back, meet *another* new doctor for the allergic reaction. Finish the allergy steroids, book a follow-up appointment, meet *another* new RNP who prescribed a preventative medication that has actually worked very well. It’s not foolproof, but Nortriptyline has been quite handy since I started taking it.

So I book another follow-up to address the sinus issue, meet *another* new doctor (for those keeping score, this is #4 since joining Kaiser, in 4 visits) and this doctor isn’t my PCP either. This one puts me on a nasal spray which choked me up in the middle of the night causing my poor wife to panic and race me to emergency ’cause I couldn’t stop coughing long enough to catch a breath. Emergency puts me on a steroid that claims to lower my immune system for up to a year and now if someone across the room coughs, I catch a cold or sniffles.

Obviously I stop taking the nasal spray, meet doctor #5 (also not my PCP) who puts me on a prescription-strength decongestant which after it ran out wasn’t refillable.

So after 5 doctors, I’ve had a chest x-ray, sinus x-ray, blood work, two urgent care visits, one emergency visit, and told I have sinusitis. No, a sinus infection. No, rhinitis. No, you’re just congested.

I decide enough is enough, I want an appointment with my PCP and log into Kaiser’s web site. The earliest date is 5 *weeks* away. I sit and be patient, I finally get to meet the guy, and he’s a very pleasant guy, but seems more intent on my willingness to drop a few pounds than the fact I’m there to discuss my migraines and sinus issues. He does a quick once-over, ponders whether the postnasal drip is allergy related, refers me to an allergist, walks out the door, and is almost never heard from (by me) again.

Just before leaving, I tell him I haven’t had a physical for over two years, so he tells me (and I quote almost directly), “Call and make an appointment for a full physical with me in early September.” I ask when I should call, since I just waited 5 weeks via the web site. He said he didn’t know when the system opened his September schedule (this was a Wednesday in late August, btw), and that I should call ‘tomorrow’ or ‘Friday’ or maybe the next Monday in case it opened up after the weekend.

So I go see the allergist right away who tells me the migrain preventative will mess up a skin allergy test, so they draw some blood, come back in a *month*, and in the meantime, here’s another sronger nasal spray and some Allegra to take in the meantime.

In the meantime, I call Kaiser 2-3 times every week to try to schedule a physical with my PCP. Every time I called I got the same response:

“Hi, Dr. So-and-So told me to call in and book a physical in early September.”
“His schedule isn’t open yet, you’ll have to call back.”
“When should I call back? Do you know when his schedule opens?”
“No, we don’t know when it opens, only he would know that.”
“But he told me himself he didn’t know when it opened, how am I supposed to book my appointment?”
“Sorry, we don’t know his schedule, all we can see is that you can’t book a physical because his schedule’s not open yet. Maybe try again in a few days.”

Rinse and repeat. Finally I kinda get angry…

“Look, my doctor told me explicitly to book a physical with him, and it’s now getting close to the *end* of September. Do you think his September schedule going to open up before September is actually over?”
“Sir, do you want to just book it with an RNP (Registered Nurse Practitioner)”
“YES, good Lord YES, I’ve been trying to book this appointment for almost a month.”

So I schedule to meet “doctor” #6, and rush in the next day to get blood work done because Kaiser says it takes a week to get the results in the system. I give two small vials of blood, and within 48 hours had all of my test results on their web site. The prognosis: overall, pretty normal, exactly mid-point for most things, my good cholestrol is a little low, my ‘bad’ cholestrol is a little high, but overall, my cholesterol is 208 and they like it under 200, so not so bad. What it *does* show, which they highlighted in purple on the letter they mailed, was that my liver results are kinda crappy, could be having some liver trouble. The footnote at the bottom of the letter is from my PCP says something like “Call in October to book an appointment with me in October to discuss your migraines and liver, and we’ll consider medications.”

Now, I know enough about biology to know my liver filters my blood. Nutrients come outta my food, and go through my liver. Medications I take get filtered through my liver. Etc. So I’ve been on at least 6 different prescription medications this year, plus an occasional Advil if a migraine sneaks past the nortriptyline. No wonder my liver is jacked up, and now my PCP wants to prescribe MORE medication to treat my liver trouble?!

Doctor #6 performs the “turn your head and cough”, and then has me go get more blood to figure out what’s going on with my liver and tells me they want to do an ultrasound (I hope it’s a boy) to see what’s going on.

So a full month has gone by, my the allergist tells me that I have no allergies, and doesn’t believe my migraines are triggered by allergies. Funny, my allergist in Ottawa said in late 1999 that I indeed had allergies to dust mites, mould spores, and feathers. But after this allergist tells me I don’t have allergies, gives me a catalog of products aimed at people with environmental allergies such as matress covers, pillow covers, vent covers, air purifiers, etc.

I’m sitting there, staring at her truly dumbfounded, and finally ask why on earth she’s recommending (pushing) that I spend money to get all this junk if I don’t have any allergies. I tell her about my allergist in Ottawa who said I *did* have allergies — I watched the skin test in Ottawa, my arm reacted to all kinds of stuff including pollen, cat and dog fur, smoke, etc, yet this allergist is telling me my blood scored 0′s on all of that. (and I most certainly DO react around dust and feathers, not to mention smoke)

The allergist’s response was a stammered “Well, um, uh … just because your blood doesn’t show antibodies doesn’t mean it can’t be an *irritant*, which is different than being an *allergen*…” Make up your mind lady.

As an aside, I ask if her test included checking for an allergy to feathers because my wife loves her feather pillow and I felt like a tool ’cause she felt guilty enough to throw it in the trash last weekend. She starts listing off a dozen kinds of feathers they could test me for if I really wanted to go get a skin test done right now. I declined. I couldn’t wait to get out of her office.

So we come full-circle back to doctor #1 – the allergist also thinks I have an infection of some kind causing the postnasal drip, prescribes a nice strong antibiotic, which includes such side effects as headaches, nausea, oh, and LIVER DAMAGE.

Dude, seriously, I’ve lost my faith in American health care. Kaiser keeps talking about how wonderful they are, and I’ve read reports about their networking and IT for client records, yadda yadda, yet in the course of 9 months, I’ve met 7 doctors and 1 quack allergist who can’t agree on what’s wrong with me.

In the end, I have migraines which may or may not be triggered by infections and/or chronic sinusitis/rhinitis and/or allergies.

Other search results on my part show that it does indeed cause cancer in labratory rodents, and is a known neurotoxin in humans. So even if it doesn’t cause cancer, we’d be ingesting a neurotoxin. Even weirder: according to wikipedia, acrylamide is used for making glue, paper, cosmetics, construction of dams and tunnels, permanent-press fabrics, and dyes … Mmm, yummy, biggie size that for me, would ya?

Here are some other articles about the checmical:
http://www.acrylamide-food.org/
http://www.who.int/foodsafety/publications/chem/acrylamide_faqs/en/index.html

Funny enough, the LA Times article has a rebuttal talking about how putting warning labels on french fries should then warrant putting a warning on potatoes too (since cooking a potato in any way can produce acrylamide): “No one buys a potato to eat it raw” … Actually, I quite like the taste and crunch of raw potato, washed and peeled and rinsed and sprinkled with a little salt & pepper. Apparently cooking some of these foods over 120C can produce acrylamide, but then goes on to say to ensure you thoroughly cook the food, so which is it? Cook the food, or don’t cook the food?

Wikipedia says “acrylamide may still be a carcinogen if exposed to it in larger doses” and the LA Times article says that french fries contain up to 125 times the amount that would otherwise require a warning label. Potato chips contain up to 75 times the level warranting a warning label.

And of course there are agencies and people saying that all of this is just causing a panic in the general public, but they’ve been doing research since 2002 when a Swedish group first found acrylamide in food and so far they haven’t found *proof* that it causes cancer in humans, but lean on the argument that what causes cancer in other animals *could* cause cancer in humans as well.

Still, since Elizabeth is determined to break some of my bad habits, I figure giving up on certain fried foods for her sanity as well as this whole acrylamide thing is worth considering. I don’t remember the last time I had KFC anyway, but I eat at Buger King or Wendy’s about once a week.

Oh yeah, and smoking produces Acrylamide too — so stop smoking.

“You don’t qualify,” the blond in HR told me, and I thought she was kidding. “Read it again, it only applies to your kids.”
“But I don’t have any kids,” I blurted. “What about *me*?”
“Well, you can call the insurance company if you want…” – she sounded all non-committal.

Turns out, according to the insurance company, that indeed the orthodontics program was only provided for my dependants under the age of 18.

“But I’m the policyholder,” I argued. “Why don’t *I* get orthodontic coverage?”

“If you need braces that badly, you should have gotten them while you were covered under your *parents* coverage.”

(blink)

Nice assumption on their part: all parents have dental plans and thousands of dollars to spend on cosmetic dental corrective appliances, and my parents were somehow bad parents because they didn’t afford this luxury upon me as a kid.

Great West Benefits, if you read this: you suck.

Skip ahead 6 or 7 years.

Elizabeth and I were discussing self-improvements … the usual: lose weight, go to a gym, eat out less, eat healthier food at home, etc. and I decide I’m gonna get braces. I was working for a hi-tech company here in California that actually covered ME for braces, so I went for a quote. I was told it’d cost like $5,000 and that I’d be wearing them for FOUR YEARS, plus a retainer probably for the rest of my life.

I accepted this news the same way I deal with earth-shattering discouraging events. I lost interest, lost the quote and binder of info in the shuffle of paper in my office, and promptly forgot about it.

But I was starting to have problems at that job, my boss/manager/whatever was a pain in the butt to work with — away from the office he’s a terrific guy to get along with, I actually miss chatting with him sometimes, but he wasn’t a very good boss. The CEO, on the other hand, I’ve always gotten along with splendedly. Anyhow, since the foreseeable future was to leave this job, I figured I better get braces while I still had the coverage.

I went for a second quote a few months later and was told I’d only be wearing the braces for 20-24 months and a retainer for a few years, and then off and on if I wanted to keep wearing it. WOW – half the time! Murphy’s Law of course said that the price would be double, but it wasn’t. I scraped up the $1000 deposit, Blue Cross kicked in $1500, and I was well on my way. $700 later to an oral surgeon to surgically extract three VERY permanent teeth, I was ready for my brackets. I went with white ceramic brackets and white wires (“Mystique”), so many people had to be WELL within my personal space to tell I had braces. I’d have loved to have gotten Invisalign, but my tooth crowding and three fresh gaping holes ruled that out. That was December 2003.

19 gruelling months later, through cut gums and lips and cheeks and whining to Elizabeth about having to eat soup for every meal for three days after every ortho appointment, I’ve come to realize a few things:

1. I miss flossing.
No, seriously, I miss flossing. It takes me a good 20 minutes to floss now, so I’m lucky to floss every day where before the era of my “metal mouth”, it would take mere seconds to floss and I’d floss 4 or 5 times a day, usually while code compiled.

2. I miss eating some of my favorite foods.
Elizabeth and I were at Ed & Ryan’s place a few weekends ago for a BBQ (dang, I’ve got NO skills compared to Ed’s cooking!) and he BBQ’d some corn on the cob. Elizabeth offered to shave kernels off the cob for me. I felt like I was 4 years old again — my mom used to have to do that for me as a little kid ’cause my teeth were so jacked up. A bad overbite makes corn on the cob almost impossible to eat. I’ve also had to cut out sunflower seeds, popcorn and any meat on a bone.

3. I’ll never look at elastic bands the same way.
When I started, they needed to pull my two front teeth towards the right side of my head a little, so I wore two elastics that covered the front of my mouth, and two elastics on each side of my molars to pull a few other teeth down towards each other. When they treated me like a 2-year old for not wearing my elastics as often as I should have, they told me that I needed to wear them to eat, essentially wearing them 24 hours a day. I sat dumbfounded about how the heck I was supposed to eat anything that wasn’t prepared in a blender with two freakin’ elastic bands across the front teeth!! Anyhow, that only lasted a few months. Now I just wear three elastics to pull some molars together. But I still hate em.

4. I’m a whiner.
Sorry sweetie. It’ll be over soon. Or at least the *braces* will be over soon, I’m sure there will be plenty of other things to whine about like my gray hair

Anyhow, I had an orthodontist appointment this morning. I told them that I was frustrated that some of the gaps haven’t really closed up and admitted that at night I try to remember to double up on the elastics to move things along quicker. I asked if they had any stronger elastics and he looked at me. And blinked. And questions filled his awkward stare as if to say “You *double up* on those elastics?!?” Turns out these ARE the strongest elastics they make. Before leaving, I confirmed that my monthly payments are over, which means an extra $139/month to put towards other things. I reminded them that I’d need to be in the week of the wedding to have the wires taken off. At my last appointment they told me that my braces would come off in November – YAY.

Elizabeth has promised me corn on the cob and ribs when the braces come off.

It’s past my lunch time. I gotta go make some soup. Thankfully the workplace has an endless supply of cup-o-noodles. Just wish they’d vary the selection a little from beef and chicken.