Δαφνη Ευτυχια Αρθουρος

Wow. Two nights ago I was wrapping the blankets around myself to stave off chill, and now it's hours past sundown and the bedroom is still three hundred and one %^$#ing Kelvins with the window open and I've been miserably sticky all day. Am I misremembering, or are the temperature swings faster/deeper than most years? (One day last week, I've forgotten which, we had a frost warning overnight and early-summer weather by afternoon. And several times now the weather has warmed enough that I could wash my hands without waiting for the hot water to reach the bathroom faucet, only to be taken off guard by painfully icy water two days later when the temperature outdoors had dropped far enough again to make my pipes and my basement cold.^[1].)

I'm still on this inconvenient sleep pattern where I stay awake-and-groggy far too long then crash at inopportune times and either sleep an hour or two and wake still bleary or stay mostly asleep (with occasional painful interruptions) for ten to fourteen hours (after which I may feel properly alert for a few hours). Missed a couple of phone calls over the weekend that came in at what would have been very reasonable times if my body weren't being so unreasonable.

Have an appointment with the doctor this afternoon. Hope I'm feeling well enough to get to it (aye, the perversity of a world in which one can be feeling too unwell to be able to get to the doctor one especially needs due to feeling unwell). She's quite nearby -- walking distance on a good day -- so I'll probably risk the four minute drive even if I'm a little dizzy (but not if I'm so dizzy that I fear driving over pedestrians). I don't really expect much to come from this visit other than a scolding for having failed to get blood drawn three months ago (On a day when I could deal with the whole fasting thing I came in for the blood tests but the phlebotomist had to leave early, then I started feeling unwell and didn't make it that far from my house again for several weeks and the tests kinda dropped off my mental to-do list from inattention). But I'll explain about these past couple months and maybe make puppy-dog eyes at her and see whether she has any ideas. The main thing I expect to come from the appointment is excruciating fatigue from sitting forever on uncomfortable furniture near a too-loud television and trying to stay alert enough to make sense and remember what I wanted to say when she finally gets to me. At least that and prescriptions are what I usually get out of doctor visits -- by the time I get home I'm usually miserable.

I did not get to the grocery store over the weekend. I wound up feeling worse both days than I had on Friday, so I guess I should have tried to get out Friday after all. Oh well. I did spend a little while playing guitar through headphones -- I get different musical ideas playing amplified and with distortion and other effects, than I do playing unplugged like I usually do.

And now I think it may be time to brush the cat. At least according to the cat.

[1] Severe pain from putting my hands in cold water or grabbing cold things. Didn't used to be a problem, but has been for ... er, a while recentlyish (a year or so?). Don't think it's Reynaud's, 'cause there's no sign of circulation changes, and my fingertips don't go blue or pale, but it does hurt enough to make me jerk my hand back and swear. Water noticably cooler than room temperature is okay, but tap water during wintertime is cold enough to hurt. It's a little thing -- just run the hot water a bit before I stick my hands in -- so it mostly bugs me just because "my body isn't supposed to have that problem" ... and the startling pain when I forget.

[The two most common bits of FUD I hear when the prospect of universal health care in the US is discussed, are "you won't get to choose your own doctor," and "other countries have waiting lists." My experience with HMOs leads me to question how many Americans get to choose their own doctors now; Canadian friends boast (not quite the right word, as they're being sympathetic) of getting to see their doctors more quickly. Today's quote suggests that the disparity between the FUD on the one hand and the relative experiences of myself in the US and my friends in Canada on the other, is not a matter of sampling error on my end.]

(Responding to being asked how the US health care system stands compared to the rest of the world ... ) "There's a controversial ranking that the WHO did, where they looked at the equity of different countries, the technologies that they have, the innovation, and so on. The US came out thirty-seventh, largely because we have so many who are uninsured [...]

"But when you even take away that controversial kind of ranking, you ask questions like, 'If you have a respiratory infection and you want to see your primary care doctor, can you get to your primary care doctor within a week?' You ask people here, and it is far harder for them to see a primary care physician, even when they have insurance, than it is in most of the countries in Europe that have been surveyed, for example. There are waiting lists in other countries for some operations that we get to much faster. The biggest picture though, is that for those of us who have insurance today, we are all running up against the complications and difficulties of being unable to access the care. We have emergency rooms that you wait for hours and hours, many that are on diversion -- not even taking new patients. It's a problem."

-- Dr. Atul Gawande, interviewed by Charlie Rose on the PBS television program, Charlie Rose, 2009-04-01

Saw doctor. When she has my chart in front of her, she calmly writes new prescriptions same as old like it's all reasonable; when she doesn't have my chart (about half the time, her staff fails to get my chart from records on the day I have an appointment), she acts surprised at what I'm taking and says it's all too, too much.

She gave my symptoms a scary-sounding name, which she politely translated ("feeling like you're going to faint"), said there's all sorts of stuff that can cause this, that she doesn't have some of the equipment she'd want to use, and since I don't have insurance that covers specialists (which she'd be sending me to) anyhow, I have to go to the emergency room. She was extremely concerned that I'm living alone and have these symptoms. (I would have mentioned Perrine, but I get the impression that only folks who can call 911 on my behalf count, not cats.) She did do some low-tech tests to rule out stroke as a likely cause, and seemed to consider my already having stopped various drugs for two weeks at a time for troubleshooting purposes, to be convenient for her.

She also gave me a cane. Golly gee, it turns out that having something to lean on when I'm beyond arm's-reach of walls and furniture helps... (Yeah, yeah, point and say "duh", go ahead...) But the big message I took away from this afternoon is that while I've been mostly annoyed and frustrated (and uncomfortable) from all this, she's seriously concerned (er ... and I guess that when the professional is more worried than I am, it's probably a sign that I should be more worried).

So very much dreading the emergency room. It's going to be a long, uncomfortable day, in a loud, glare-y, uncomfortable place, feeling bored and trapped and probably hungry after a while; since I won't be spurting blood or sporting visible bits of bone or turning blue, I'm going to have to wait and wait while folks with much more time-sensitive emergencies (emergencies that I think of as being, well y'know, emergencies) go ahead of me. So very full of dread. And all just so that I can say, "I'm here because I can't afford to go where I should, so I'm going to rack up an even bigger bill that we all know I won't be able to pay -- which maybe shouldn't stress me out as much as it does, since it is The Way The Game Is Played Here, expected and all, but it still feels like doing something wrong.

I want Canadian-style health care. I really don't think Obama will give us that, but I do hope he can bring Congress around to giving us something better -- and more sane -- than what we have now. Anyhow, I can't afford to wait that long, so the ER it'll be. Any locals care to weigh in on which ER I should choose?

But for the moment, I think I need to lie down, with earplugs in, close my eyes, and let my cat curl up against me.

( report of appointment this afternoon, and a sort-of plan )

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