27 January 2010

I get to...

The other day at work I heard something that really struck me. In a conversation about New Year's resolutions:

"I've resolved to say 'I get to' instead of 'I have to.'"

Wow. What a simple way to change an attitude. I've been thinking about it ever since.

For example,

I have to get to go to the grocery store. I have the means to buy food for my family, and furthermore, I have the power to make decisions about what food to buy. I can pick up a bag of kettle chips, see what novel citrus fruits are there this week, maybe find a great deal on manager's special organic free-range meat.

I have to get to work out. I am blessed with a young, healthy body that I can control. I have access to safe places to exercise. I get to feel my body work as I push myself. I can make myself become stronger, faster, healthier.

Or even something like this: I have to get to call this patient and tell him he has diabetes. If someone has to call with bad news, I know I can be kind and reassuring while I deliver it.

Think about these...

I get to work. I get to give a speech. I get to go to the doctor. I get to go to a funeral. I get to buy a present for someone. I get to write thank-you notes. I get to stop eating so much sugar. I get to cut back on spending. I get to pay my taxes.

Not that I think people should actually SAY some of these things. After all, it's socially inappropriate to say things like "I get to go to a funeral." But I still like the thought exercise. Even the mundane and unpleasant things can have a silver lining when you change that one word.

18 January 2010

How I feel about drug reps

So the office I work for is visited regularly by pharmaceutical company reps. Before I started working there, and when I first started, I was pretty unilaterally opposed to that. I tended to think that offices that barred drug reps from their doors were providing better patient care because they weren't under the influence of the drug companies' bullshit. Now that I've worked there longer, I have mixed feelings about it. For one thing, the providers I work for have told me that they take everything the reps say with a few giant chunks of salt -- they're not passive listeners. For another thing, some of the drug reps are in the business to help the patient/consumer -- you can really tell the difference between reps who are in it for the money only and reps who do truly want to help get good treatment to patients.

But my mixed feelings are primarily because letting drug reps into the office provides samples, and those samples can sometimes be lifesavers for patients.

For example, we have a patient who is an insulin-dependent diabetic. He has private insurance, but not very good coverage. I don't think insulin comes as a generic, and it is expensive. One brand of insulin pen, for example, costs around $200 out of pocket for about a month's supply. We give him his insulin -- via samples -- on a pretty regular basis. It's a similar situation for a lot of patients on anti-osteoporosis medication, testosterone gel, sleep aids, and several medications for acid reflux.

Another thing is that insurance companies are ridiculous and, as you know, enjoy denying coverage as much as possible. One thing that you may not know about is the "prior authorization." It works like this: You go to the doctor for, say, acid reflux. You have already tried a bunch of OTC medications and they're not working for you. Your doctor prescribes Nexium, AcipHex, Prilosec, etc. or their generic forms (which are not on the $4 list). The pharmacy runs the prescription through your insurance and they receive a message that says "Requires preauthorization."

This means that insurance will not pay for the medication your doctor wants you to have unless the doctor's office calls the insurance company and convinces them to cover it. It is usually the same deal for MRIs and CT scans. This call takes about 20 minutes for most insurance companies and sometimes takes up to 2 weeks for the insurance company to decide (Medicaid and TriCare are the easiest -- they have one-page paper forms and reply in 1-2 days).

During this time, what are you supposed to do? Your chest is burning, you can't sleep, and you're at your wits end. Answer? Get samples from your doctor.

To me, it's clear that the real problem here is our fucked-up private health insurance system. It would be awesome if there were a national healthcare system that did not "come between doctor and patient" as we hear pretty frequently these days. Even if that system did continue to require prior authorizations, the government model works much, much better than the private model as it stands (and Medicaid and TriCare approve most submissions).

However, since over half the country insists that socialized medicine is Satan incarnate, we're going to keep having evil insurance companies that refuse to cover necessary medications, and as long as that's the case I think it's good medicine to provide patients with samples. Remove the insurance industry and the need for samples it generates, and there's no need for drug companies to insert themselves into offices. And then the drug companies take a big hit too. Everyone wins.

10 January 2010

What I love about names

I remember learning to play Bach's "Minuet in G Major" for two reasons. For one, it was one of the first pieces I played that was written by a famous composer, and I liked the piece. The other reason was the note on the piece: "From the Anna Magdalena Bach Notebook." The name Anna Magdalena struck me as absolutely gorgeous.

I have been interested in names since I was 8 years old. My mom was pregnant with my little brother, and while his middle name was decided, my parents were having trouble finding the perfect first name. I suppose those discussions started the wheels turning. Around the same time, I found the baby name book that my parents had used to name my brother Nicholas and me. It solidified my interest -- which over the last 14 years grew from merely what I would name my future babies to memorizing meanings and etymologies and following trends in American baby naming.

However, I don't think most people take names -- and naming -- as seriously as I do. I can't fathom when parents admit to having given total control of their child's name to their spouse. To me, names can be exquisite or atrocious or unremarkable; they convey social demographics, personality characteristics, even values.

People judge others based on names alone -- studies have shown that essays and resumes with common English names on them receive better responses, and how often have you heard someone refer to a name as "a stripper name"?

To me, a name can be appreciated in the same way as anything that's a matter of taste. A good name has a comfortable syllabic flow. Its vowels or consonants don't run together. The relative obscurity of each name (first, middle, last) strikes a balance which keeps it from being boring but also from being too out-there. If these elements are broken, it is a purposeful disruption with a striking result. A good name has substance, history, meaning.

The middle name is not wasted, given no thought -- a middle name is a perfect place to honor a loved one, use a meaningful name, balance out an unusual first name with a common middle name or vice versa. It's a good place to experiment; after all, very few people use their middle names, so if a person hates theirs it's not difficult to hide behind its first letter.

Beyond name appreciation, I also find it interesting to see how the American public's taste in names changes. Right now, the trends are:

For boys:
- Old Testament biblical names (Jacob, Isaiah, Noah)
- Names that are or rhyme with Aidan (Braden, Kaden, Hayden, Jayden, etc.)

For girls:
- "Old-fashioned" names (like Abigail, Sophia, Emma, and Grace -- this trend carries over to boys to some extent with names like Henry and Oliver)
- Names beginning in Mad- or Ad- (Madeline, Madison, Adeline, Addison, and variant spellings)
- Names that end in -aylee or -iley (Kaylee, Jaylee, Kiley, Miley, Riley and variants).

Evidently this interest -- at least this intense of one -- is not one that a lot of people share. Names provide a conversation-starter for me, and people usually are mildly curious about names and their usage. After all, everybody has a name.

01 January 2010

This decade

On January 1, 2000, I...

- was 12 years old and in 7th grade.
- supported candidate John McCain for the 2000 election and would have classified myself as a Republican.
- was 5'2".
- loved The X-Files, the Goo Goo Dolls, and Rent.
- had never so much as held hands with a boy.
- would have had a hard time choosing a favorite subject because I liked all of them except Social Studies.
- wore glasses.
- aspired to be a physician.
- thought my blue Hard Rock Cafe t-shirt was the coolest piece of clothing I owned.
- didn't mind having braces.
- had been out of the country, but only to Mexico.
- hoped that in 10 years I would have graduated from Bethel, gotten married, and be a first-year medical student at KU.

On January 1, 2010, I...
- am 22 years old and work at a doctor's office.
- consider myself to be politically to the left of the U.S. Congress.
- am 5'5".
- enjoy Battlestar Galactica, Glee, and bluegrass and folk music (some things don't change that much).
- am married.
- live in Denver.
- have a bachelor's degree in biology.
- aspire to be a physician.
- think skinny jeans are probably the most fashionable piece of clothing I own, but am too self-conscious to wear them most of the time because I just bought them to wear with boots.
- have traveled to Mexico, Canada, England, France, Spain, Portugal, and Italy.

I think my 12-year-old self would be pretty happy with my current self. 12-year-old Allison would have been disappointed that I didn't get into medical school right after college, as that was part of my life plan then. But hey, I fulfilled most of my 10-year plan!

26 December 2009

Christmas

The whole Christmas experience was pretty good up until mid-afternoon on Christmas Day. Ross's parents and Meredith visited last weekend and most of this week (they were supposed to leave on Wednesday morning but -- surprise! -- bad weather in late December makes it a bad idea to make a 20-hour drive and they didn't leave until Friday). We ate a lot of delicious food, went skiing, exchanged gifts, and spent some quality family time together.

Ross and I enjoyed our first Christmas morning together. We made pancakes and bacon (as well as pot roast for dinner), opened our presents, and played Super Mario Brothers Wii which he gave me, and somehow we managed to spend about 5 hours doing those things. It was a lovely morning/early afternoon.

I always get bored on Christmas afternoon. I wanted to go ice skating, but it turns out that there are hardly any skating rinks less than half an hour away from us, and none of those were open. It worked out that we didn't go skating, though, because I developed a killer sore throat and fever and spent the late afternoon and evening in bed feeling like crap. After sleeping for about 11 hours, I woke up this morning to a much less sore throat but the added bonus of inner ear pain.

08 December 2009

Menu Plan

I didn't do my 5-kilometer run yesterday. But I did make a meal plan! Here's what we're having this week:

MONDAY: brats (we were going to have sweet potato fries and salad too, but we didn't make it to the grocery store until today)
TUESDAY: two-bean tamale pie
WEDNESDAY: curried potatoes
THURSDAY: teriyaki salmon over pasta
FRIDAY: pizza
WEEKEND: leftovers

And as usual, we always eat spinach salad with supper.

Menu Plan Monday is sponsored by the blog I'm An Organizing Junkie:

01 December 2009

Holidays!

For the fourth year, I spent Thanksgiving here:

It's the Schug House Inn, a bed and breakfast in the tiny little Swiss-themed town of Berne, IN. Ross's extended family spends their Thanksgiving weekend there, chatting, playing, doing puzzles, and of course eating lots of wonderful food. As a new member of their family, this tradition has been such a blessing -- it's provided a chance to get to know Ross's aunts, uncles, and cousins in a way I wouldn't otherwise.

These are some of Ross's cousins. Have I mentioned that I love my in-laws?








And now that Thanksgiving is over, it's time for Christmas: