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Huntn

macrumors Core
Original poster
May 5, 2008
23,487
26,603
The Misty Mountains
Thanks and excelleng advice! Yes, variety and balanced exercise is critical. Though much less than before, bicycling is still on my agenda. Also hiking long distances. You also make a very good point about weight bearing workouts and bone health.

At my age, I see heart health as especially key and for me swimming has the most benefit in that area, more so than the other forms mentioned. I used to have high blood pressure (work stress related), and since doing an hour or more of 5-day/week lap swimming, no longer need meds for that. Retiring also helped.

But again, your points are well taken.
For a while I was exclusively swimming, but doing about 2500 yards I was getting some shoulder issues. I elected to mix in some weights in the gym, mostly lightweights 30- 60, but up to 100 pounds for core exercises. on Mondays and Fridays I swim and on Wednesdays I do the weights and Iā€™m finding that my shoulder issues are less in the pool and I believe thatā€™s because of the variety that weightlifting offers versus just pulling yourself through the water
 

Richard8655

macrumors 68000
Mar 11, 2009
1,878
1,330
Chicago suburbs
For a while I was exclusively swimming, but doing about 2500 yards I was getting some shoulder issues. I elected to mix in some weights in the gym, mostly lightweights 30- 60, but up to 100 pounds for core exercises. on Mondays and Fridays I swim and on Wednesdays I do the weights and Iā€™m finding that my shoulder issues are less in the pool and I believe thatā€™s because of the variety that weightlifting offers versus just pulling yourself through the water
That sounds like a really good set of balanced exercises with plenty of variety you're doing. Something I should do too. I average 100-120 lengths (25 yard pool) every time I go, and so far no muscle strain or injury issues for a couple years now. But still, as you and OC have mentioned, adding weight bearing would be good.

But I feel fine with mostly swimming laps, as it's really a whole body workout. It's rated as the best exercise for overall health. I'm just glad to be doing something regularly.
 
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HDFan

Contributor
Jun 30, 2007
6,607
2,854
My understanding this is because medicare pays up to $5k, then you hit the ā€œdonut holeā€ approx $2k. gap in coverage, before Medicare catastrophic coverage begins and at that point, if I understand it correctly, I have to pay 5% of the $4500, which is $225.

Medicare Coverage Gap.png
Although the $3K cost during the coverage gap and the $8K out-of-pocket cost to get to catastrophic is alarming it may not be as bad as it looks. Out-of-pocket costs include your payments and any payments by any medicare supplement policy you might have. This can reduce your cost to just a few thousand, much less but still a lot of money.
 
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Huntn

macrumors Core
Original poster
May 5, 2008
23,487
26,603
The Misty Mountains
View attachment 2353441
Although the $3K cost during the coverage gap and the $8K out-of-pocket cost to get to catastrophic is alarming it may not be as bad as it looks. Out-of-pocket costs include your payments and any payments by any medicare supplement policy you might have. This can reduce your cost to just a few thousand, much less but still a lot of money.
According to the insurance, one Actemra RX to the tune of $4400 put me in the donut hole. I paid $1200. Note, the original price requested from the drug company was $9800. It was negotiated down by Medicare or by my Secondary coverage, not sure. The second RX got me into Catastrophic coverage , but there I paid $800, so by my reckoning I only paid $2000, not the $3k gap. There may have been subsidies involved. Next month, in catastrophic coverage, I was told this medicine will be $100 A month.
 

Huntn

macrumors Core
Original poster
May 5, 2008
23,487
26,603
The Misty Mountains
That sounds like a really good set of balanced exercises with plenty of variety you're doing. Something I should do too. I average 100-120 lengths (25 yard pool) every time I go, and so far no muscle strain or injury issues for a couple years now. But still, as you and OC have mentioned, adding weight bearing would be good.

But I feel fine with mostly swimming laps, as it's really a whole body workout. It's rated as the best exercise for overall health. I'm just glad to be doing something regularly.
Whatever works. :D
 

VulchR

macrumors 68040
Jun 8, 2009
3,383
14,255
Scotland
According to the insurance, one Actemra RX to the tune of $4400 put me in the donut hole. I paid $1200. Note, the original price requested from the drug company was $9800. It was negotiated down by Medicare or by my Secondary coverage, not sure. The second RX got me into Catastrophic coverage , but there I paid $800, so by my reckoning I only paid $2000, not the $3k gap. There may have been subsidies involved. Next month, in catastrophic coverage, I was told this medicine will be $100 A month.
So glad I don't have to deal with health insurance paperwork for me and my family any more. I feel for the people who have to navigate this 'system'. I know it usually gets the job done, but it's inefficient. When my father was ill and dying in the US, each treatment generated on average 5 letters, some of which were found to be fraudulent in a court of law, despite my father having really good health insurance...
 
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HDFan

Contributor
Jun 30, 2007
6,607
2,854
When my father was ill and dying in the US, each treatment generated on average 5 letters, some of which were found to be fraudulent in a court of law, despite my father having really good health insurance...

Can you elaborate?
 

VulchR

macrumors 68040
Jun 8, 2009
3,383
14,255
Scotland
Can you elaborate?
So every time my father had a treatment, it would generate the following letters:
  1. The physician would send my father a letter stating how much they were going to charge insurance and how much they expected him to pay.
  2. The insurance company would send my father a letter stating that they had received a bill for $X amount from the physician.
  3. The insurance company would send a second letter stating the amount they would pay and the amount they would decline (they always declined something).
  4. The physician would send my father a final bill - deductibles, co-pays plus the amount the insurance company denied from the claim.
  5. My father would send a check via the mail, provided he agreed.
Multiply this by the number of phsyicans, treatments etc. and the paperwork got massive. Moreover the process got longer if there was a dispute. In one case a hospital claimed to have used a piece of equipment (a pulse oximeter - one of those machines that clips to a finger and takes optical measurements of the state of the blood) to perform a medical test (monitoring blood oxygenation levels). Over the course of his stay, this amounted to nearly $1000 claimed by the hospital from insurance. The insurance company laughed their assess off at this ridiculous claim (which was as nearly as much as one of those machines cost) and denied it as 'frivolous'. My father got stuck in the middle. Eventually, after being harassed by the hospital, and then a medical bill collection agency the hospital turned over the case to, my father took the lot of them to civil court for fraud and won. Why? Because we had multiple pictures of him by the machine on different dates in which the machine was clearly tagged as 'damaged' and not to be used. Also, the hospital could produce no pulse-ox readings taken from the machine, or indeed any pulse-ox readings for his entire stay. Instead, there were nurses' notes on the coloration of his skin. Despite turning over all of our evidence to law enforcement (mailing a false bill is mail fraud, and a federal crime), nobody was prosecuted for the fraud because 'this kind of standard charge is typical'. Imagine the response had one of my family tried to steal $1000 from a store or bank....
 

DeepWebinar

macrumors 6502
Aug 9, 2020
327
767
pharyngeal dysphagia. i canā€™t burp or throw up and eating is uncomfortable a lot of the time. it can be pretty awful. iā€™ve had times where iā€™ve felt weak from how hungry i was but trying to swallow was impossible. when itā€™s particularly bad iā€™ll have days or weeks where even a small amount of food can make me feel like iā€™m about to choke. iā€™ve also been sick to the point that i knew i needed to throw up, but i just canā€™t.

the good news is, i was able to get diagnosed recently after living like this since i was a teenager. apparently there was little to no research into it until recently. i had looked online and mentioned it to multiple doctors, but no one knew what to do so eventually i stopped looking into it. partially from shame because everyone i would mention it to believed it was psychosomatic, but also i figured out some tricks that work. like if i drink water constantly throughout the day it makes eating work more consistently. so i got a big water jug and i carry it around with me everywhere.

a few months ago i came across a twitter thread where someone made a joke about how they couldnā€™t burp until they got botox. it felt oddly specific so i followed up with them. they pointed me to a reddit group of people with the same issue and it just so happens i live in a city with one of the few specialists who treat it and a few weeks later i was in his office getting tested and diagnosed. turns out i just need the doctor to stick a long needle through my throat and hit this one muscle with botox and i should be totally fine about 2 weeks later.

the bummer is that itā€™s so easy to fix and iā€™ve been waiting for months on insurance bs, but iā€™ve been dealing with this for most of my life so whatā€™s a few more months. itā€™s just nice to know thereā€™s a relatively simple solution. lately iā€™ve been daydreaming about running into someone who thought i was nuts at a restaurant, confidently eating a fry off their plate, and loudly burping as i walk away šŸ˜œ
 

Richard8655

macrumors 68000
Mar 11, 2009
1,878
1,330
Chicago suburbs
So every time my father had a treatment, it would generate the following letters:
  1. The physician would send my father a letter stating how much they were going to charge insurance and how much they expected him to pay.
  2. The insurance company would send my father a letter stating that they had received a bill for $X amount from the physician.
  3. The insurance company would send a second letter stating the amount they would pay and the amount they would decline (they always declined something).
  4. The physician would send my father a final bill - deductibles, co-pays plus the amount the insurance company denied from the claim.
  5. My father would send a check via the mail, provided he agreed.
Multiply this by the number of phsyicans, treatments etc. and the paperwork got massive. Moreover the process got longer if there was a dispute. In one case a hospital claimed to have used a piece of equipment (a pulse oximeter - one of those machines that clips to a finger and takes optical measurements of the state of the blood) to perform a medical test (monitoring blood oxygenation levels). Over the course of his stay, this amounted to nearly $1000 claimed by the hospital from insurance. The insurance company laughed their assess off at this ridiculous claim (which was as nearly as much as one of those machines cost) and denied it as 'frivolous'. My father got stuck in the middle. Eventually, after being harassed by the hospital, and then a medical bill collection agency the hospital turned over the case to, my father took the lot of them to civil court for fraud and won. Why? Because we had multiple pictures of him by the machine on different dates in which the machine was clearly tagged as 'damaged' and not to be used. Also, the hospital could produce no pulse-ox readings taken from the machine, or indeed any pulse-ox readings for his entire stay. Instead, there were nurses' notes on the coloration of his skin. Despite turning over all of our evidence to law enforcement (mailing a false bill is mail fraud, and a federal crime), nobody was prosecuted for the fraud because 'this kind of standard charge is typical'. Imagine the response had one of my family tried to steal $1000 from a store or bank....
I really dislike the system we have here.
 
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VulchR

macrumors 68040
Jun 8, 2009
3,383
14,255
Scotland
I really dislike the system we have here.
The irony is that in the US the public spending per capita is about the same as the public spending for the UK NHS, but in the US private spending on healthcare is about the same again, effectively doubling the cost per capita in the US. There are some upsides to the US system - more privacy (no mixed-gender Florence Nightingale wards), generally a speedy response (I am now in year two of waiting for surgery on the UK NHS for removal of a kidney stone), and a high quality of care. Still, I believe these features could be achieved without the millstone of the private insurance bureaucracy around the US system's neck. Just my 2 cents....
 

VulchR

macrumors 68040
Jun 8, 2009
3,383
14,255
Scotland
pharyngeal dysphagia. i canā€™t burp or throw up and eating is uncomfortable a lot of the time. it can be pretty awful. iā€™ve had times where iā€™ve felt weak from how hungry i was but trying to swallow was impossible. when itā€™s particularly bad iā€™ll have days or weeks where even a small amount of food can make me feel like iā€™m about to choke. iā€™ve also been sick to the point that i knew i needed to throw up, but i just canā€™t.

the good news is, i was able to get diagnosed recently after living like this since i was a teenager. apparently there was little to no research into it until recently. i had looked online and mentioned it to multiple doctors, but no one knew what to do so eventually i stopped looking into it. partially from shame because everyone i would mention it to believed it was psychosomatic, but also i figured out some tricks that work. like if i drink water constantly throughout the day it makes eating work more consistently. so i got a big water jug and i carry it around with me everywhere.

a few months ago i came across a twitter thread where someone made a joke about how they couldnā€™t burp until they got botox. it felt oddly specific so i followed up with them. they pointed me to a reddit group of people with the same issue and it just so happens i live in a city with one of the few specialists who treat it and a few weeks later i was in his office getting tested and diagnosed. turns out i just need the doctor to stick a long needle through my throat and hit this one muscle with botox and i should be totally fine about 2 weeks later.

the bummer is that itā€™s so easy to fix and iā€™ve been waiting for months on insurance bs, but iā€™ve been dealing with this for most of my life so whatā€™s a few more months. itā€™s just nice to know thereā€™s a relatively simple solution. lately iā€™ve been daydreaming about running into someone who thought i was nuts at a restaurant, confidently eating a fry off their plate, and loudly burping as i walk away šŸ˜œ
Ouch. I know two people who had issues with swallowing - it is a hard road to trod. Good luck with the treatment!
 
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DeepWebinar

macrumors 6502
Aug 9, 2020
327
767
Ouch. I know two people who had issues with swallowing - it is a hard road to trod. Good luck with the treatment!
thanks bud, i donā€™t let it get me down too much for the most part. i came to terms with it a few years back and was ready for this to just be how it was, but now that thereā€™s something i can actually do about it, iā€™m feeling so relieved.
 
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Richard8655

macrumors 68000
Mar 11, 2009
1,878
1,330
Chicago suburbs
The irony is that in the US the public spending per capita is about the same as the public spending for the UK NHS, but in the US private spending on healthcare is about the same again, effectively doubling the cost per capita in the US. There are some upsides to the US system - more privacy (no mixed-gender Florence Nightingale wards), generally a speedy response (I am now in year two of waiting for surgery on the UK NHS for removal of a kidney stone), and a high quality of care. Still, I believe these features could be achieved without the millstone of the private insurance bureaucracy around the US system's neck. Just my 2 cents....
Exactly. Yes it's usually good quality care, but only if you have enough money to afford it or adequate insurance. What bothers me the most about it is the inequality of it all as profit-based. And then there's the bureaucracy as you've described.
 
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dmr727

macrumors G4
Dec 29, 2007
10,420
5,161
NYC
I thought I'd give a little public service announcement to MR, and figured this thread would be the best place. Sorry for the TMI, but it's important:

If you're in your 40s or older, get your colonoscopy done! Stop putting it off!

The story - I'm 45 and had my first colonoscopy two weeks ago. I was perfectly healthy with no symptoms, but my doctor wife mentioned that the guidance is to no longer wait until 50. So in I went, and they found a 'concerning' 5cm mass. Fortunately the mass was situated such that it could be removed endoscopically by a procedure called EMR, which is minimally invasive. Anyway, they just cut it out today. Apparently the large size and shape indicate that it's likely to have been in the early stages of cancer, but not yet malignant. It's been sent off to be biopsied, so I'll get some real answers on that front in about a week. The good news is the doc says everything went well and he got it all out, but I'll have to go back in 6 months to make sure I'm still clean. But he also said that I was *very* fortunate that I didn't wait until 50 to get my colonoscopy.

So take it from me, don't wait! If you've never had one, it's actually not nearly as bad as I thought it might be. :D

:: off soap box::
 

OldCorpse

macrumors 68000
Dec 7, 2005
1,758
347
compost heap
Yeah, dmr727 is right. Colonoscopies save lives. I had my first one relatively late, when I was 60. They found one polyp, small, but still precancerous. They cut it out right then and there. Because of that I had to have my next one 5 years later rather than 10. So I had it last year again, and this time they found nothing which means my next one will be in 10 years, when I'm 75. I intend to have it.

Colon cancer is occuring in ever younger people, so just because you're under 40, doesn't mean you can't get it. Regardless of age, if you have any symptoms, or family history, or a terrible diet, drink alcohol etc., get one - it might save your life.

And dmr727, good job that you went ahead and had one instead of avoiding it like so many people. Hopefully since they got it all out you now have a clean bill of health. Still, in view of your history you should probably have them more frequently than the average person.
 

boswald

macrumors 65816
Jul 21, 2016
1,308
2,179
Florida
I have "major depression," and a back fusion (another coming soon). Not the end of the world, but that's what I'm dealing with on a daily basis.
 
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dmr727

macrumors G4
Dec 29, 2007
10,420
5,161
NYC
Colon cancer is occuring in ever younger people, so just because you're under 40, doesn't mean you can't get it. Regardless of age, if you have any symptoms, or family history, or a terrible diet, drink alcohol etc., get one - it might save your life.

And dmr727, good job that you went ahead and had one instead of avoiding it like so many people. Hopefully since they got it all out you now have a clean bill of health. Still, in view of your history you should probably have them more frequently than the average person.

Thanks man. I give a lot of credit to my wife - had it not been for her I'm sure I would have waited until at least 50. The pathology came back today and fortunately it wasn't cancer (they called it a tubulovillous adenoma), but I'm told it would have become cancer had I waited. As you noted I'll be getting a colonoscopy more frequently - every three years from here on out is what I'm told.
 
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The-Real-Deal82

macrumors P6
Jan 17, 2013
16,389
24,134
Wales, United Kingdom
My only ailment is i have NAFLD (Non-Alcoholic Fatty Liver Disease). It sounds more serious than it is but it is easily managed via a healthy diet and exercise which I do follow. I also have to limit alcohol consumption, but I am not a heavy drinker anyway, so not so hard to do. In fact I drink probably 1 to 2 units every couple of weeks.
 
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CMoore515

macrumors 6502a
Sep 27, 2015
679
787
Des Moines, IA
Was born with Cerebral Palsy. The spastic-quadriplegia variant.

All things considered, it's moderate as the only things affected were my limbs and ability to walk.. But with that comes things that what I call are CP-adjacent, like bowel and bladder urgency issues that prevent me from ever being able to work at this point.

Also have depression/anxiety, which is treated with Bupropion and clonazepam.

The major downside for me is that while I'm mostly physically impaired, I'm smart enough to tell when people look at me differently and don't include me in stuff because of it, even while I was a young kid. (I'm 35 now) A large part of the depression comes from understanding that fact and realizing that I'm "different" from all my friends, etc.

Oh and IBS, which the CP also complicates.

It's been an interesting life, to say the least.
 
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fanboy-ish

macrumors 6502
Apr 1, 2022
273
287
My mood disorder (Interictal Dysphoric Disorder) is at it again.

What does it look like? I'm always alternating periods when I'm normal - there's no euphoria there, I'm simply fine - with periods when I feel its effects. There's no apparent trigger, sometimes it starts days before a seizure, sometimes it doesn't; if it started before a seizure, then the symptoms will be relieved after the seizure, not immediately, but maybe after a day or two, during which I feel like I've taken a heavy dose of sedative medicine, otherwise they'll go away on their own, for no apparent reason. Usually, these "bad periods" are shorter than the ones when I'm free of symptoms.

The latter ones start slowly and progress in intensity over the course of a few days, I'd say it takes 3 or 4 days to peak.

When I'm not feeling its effects, I may sign up for a lot of activities or groups, I buy books, I plan to watch something, then, once the mood effects start, I lose interest in everything.
What I used to enjoy becomes void, for example, music, tv shows, movies, people stop eliciting any kind of emotional response, when I read books - I read non-fiction mostly - I stop retaining concepts from the books, I just read them passively.
I'd have problems sleeping, or if I sleep, I'd never feel rested and have lack of appetite. Simple tasks, like showering, brushing my teeth, shaving, riding in the passenger seat of a car, preparing meals - even the simplest ones, like breakfast -, feel like chores and I have physical pains - mostly back pains - afterwards.
I lose interest in personal relationships, both friends and even just sex, most people feel like a nuisance. I start being irritable, even to the most innocent stimuli, like conversations, TV, and sometimes I'm confused to the point that it's difficult to sustain a basic conversation, as basic as "What would you like to eat?".
And I'm perfectly conscious of what's going on, I know how I feel, I just can't say why.

When I'm feeling the effects of this mood disorder, I feel like I'm in a loop. I'd love to meet new people and to partake in activities, because, subconsciously, I think that it might help me to "snap out of it", but I just feel so tired, so devoid of emotions, interest, energy, both physical and mental, that I just avoid as much human contact as possible, and the most I can do - besides going to work, because, I never know how long it's going to last, so I just have to go - is just some passive binge watching YouTube videos or passive music listening.

To add insult to injury, these, let's call them "mood swings", worsen my scalp psoriasis and atopic dermatitis.
 
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rm5

macrumors 68020
Mar 4, 2022
2,284
2,610
United States
A large part of the depression comes from understanding that fact and realizing that I'm "different" from all my friends, etc.
Ugh, I'm really sorry... :(

Just know that I will respect you, and I won't look at you weirdly. And I absolutely know how that feels, too.
 
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Huntn

macrumors Core
Original poster
May 5, 2008
23,487
26,603
The Misty Mountains
My mood disorder (Interictal Dysphoric Disorder) is at it again.

What does it look like? I'm always alternating periods when I'm normal - there's no euphoria there, I'm simply fine - with periods when I feel its effects. There's no apparent trigger, sometimes it starts days before a seizure, sometimes it doesn't; if it started before a seizure, then the symptoms will be relieved after the seizure, not immediately, but maybe after a day or two, during which I feel like I've taken a heavy dose of sedative medicine, otherwise they'll go away on their own, for no apparent reason. Usually, these "bad periods" are shorter than the ones when I'm free of symptoms.

The latter ones start slowly and progress in intensity over the course of a few days, I'd say it takes 3 or 4 days to peak.

When I'm not feeling its effects, I may sign up for a lot of activities or groups, I buy books, I plan to watch something, then, once the mood effects start, I lose interest in everything.
What I used to enjoy becomes void, for example, music, tv shows, movies, people stop eliciting any kind of emotional response, when I read books - I read non-fiction mostly - I stop retaining concepts from the books, I just read them passively.
I'd have problems sleeping, or if I sleep, I'd never feel rested and have lack of appetite. Simple tasks, like showering, brushing my teeth, shaving, riding in the passenger seat of a car, preparing meals - even the simplest ones, like breakfast -, feel like chores and I have physical pains - mostly back pains - afterwards.
I lose interest in personal relationships, both friends and even just sex, most people feel like a nuisance. I start being irritable, even to the most innocent stimuli, like conversations, TV, and sometimes I'm confused to the point that it's difficult to sustain a basic conversation, as basic as "What would you like to eat?".
And I'm perfectly conscious of what's going on, I know how I feel, I just can't say why.

When I'm feeling the effects of this mood disorder, I feel like I'm in a loop. I'd love to meet new people and to partake in activities, because, subconsciously, I think that it might help me to "snap out of it", but I just feel so tired, so devoid of emotions, interest, energy, both physical and mental, that I just avoid as much human contact as possible, and the most I can do - besides going to work, because, I never know how long it's going to last, so I just have to go - is just some passive binge watching YouTube videos or passive music listening.

To add insult to injury, these, let's call them "mood swings", worsen my scalp psoriasis and atopic dermatitis.
Iā€™m sorry you have to deal with thisā€¦šŸ˜”
 
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