A PSA for all of you males on here

@phendrick There is a cure for old age, but please don’t try it.

@OldCatLady @phendrick reminds me of:
Isn’t it hard to be that old?
Answer: It beats the alternative.

Nah I am embracing age and don’t mind the grey hair increasing. Or whatever else happens. Hopefully mostly good things.

@OldCatLady @phendrick @pmarin I asked my mom when she had her first grey hairs and she said she didn’t know because she always dyed her hair. Mine was at 42.

@werehatrack Thank you!

@lisaviolet @werehatrack Having had 3 major cancers so far, I’d agree that catching them early and then using science based treatment nearly always has better outcomes than making any other choice (this is backed up by research as well with respect to using non-science based so called “treatments”).

@Kyeh

@Kyeh @tinamarie1974 Wow, life. Damn.

@Kyeh @tinamarie1974

@tinamarie1974 @yakkoTDI @pmarin It sounds like maybe they’ve caught it early and he’ll be able to survive it…

@Kyeh @pmarin @yakkoTDI

@pmarin Beware of them trying to put you on statins because they think everybody is prediabetic. That crap messes with your short term memory. My PCP tried to put me on them, until I demonstrated to her that I could get my LDL level down under 90 without drugs. (She also was rather nonplussed when I got my creatinine to plummet from 1.55 to .67 in two weeks by discontinuing a different med that she’d put me on.)

If they recommend going on finasteride to forestall protate hypertrophy and reduce the hazard of cancer, that’s almost always a safe move. It also has half a chance of reducing hair loss and maybe even reviving hair follicles that have gone dormant.

@werehatrack “They” tried to put me on statins for about 30 years. Tried a few times and said, Nah! Also at one point back then, doctors said “don’t eat salmon and avocado and nuts; they have fat and bad for you”

Last year was surprised that a new young cardiologist told me that my overall cholesterol was high but HDL/LDL ratio was very good (probably because of salmon and olive oil, etc) that I shouldn’t worry about LDL number anymore and don’t need statins. Crazy med world out there.

@pmarin @werehatrack

Beware of them trying to put you on statins because they think everybody is prediabetic.

Satins aren’t for prediabetes, they are for heart disease - specifically cholesterol levels to try to prevent plaques in your arteries. It is metformin that is often used first line to treat prediabetes/type 2 diabetes.

I come from a long line of everyone, including females having heart attacks on dad’s side of the family. At 43 he was in the clinical trial for cardiac bypass surgery at the Cleveland Clinic. I remember sitting in second year biology watching the clock wanting school to get out so I could go home and see if I still had a dad. Stokes are on both sides of the family. Hopefully satins can help keep me from the fate of so many on both sides of my family. I’m glad I am taking them.

@Kidsandliz @pmarin While the goal of statins is to reduce LDL, the major cause of elevated LDL is strongly interlinked with metabolic syndrome since many of the chronic metabolic stress issues that cause both are shared between the two syndromes. The tendency is strong to assume that anyone with elevated LDL is at risk for both metabolic syndrome/diabetes and atherosclerosis since the two tend to go hand in hand. In my own case, I’ve pretty much convinced my PCP and cardiologist that when my LDL numbers get out of whack, I can fix it without their intervention once I know there is a problem.

@pmarin @werehatrack If and only if your problem is diet alone (which is NOT the case for many) then fixing your diet can help fix the problem (but it is far less likely to remove the plaque you already have).

If someone already has metabolic syndrome (eg the collection having high blood pressure, high triglycerides, high LDL, and impaired fasting glucose) then they are at higher risk of heart disease and plaque build up (and other issues) but the two way relationship is not interlinked to the extent you are implying. Being obese with metabolic syndrome does increase the risk of heart disease but the reverse isn’t true. These are two separate diseases with only a partial overlap of “causes”.

One well done study where what people ate was controlled found: “Though the declines in low-density lipoprotein cholesterol [LDL] levels with these methods range from 0% to 37%, cardiovascular risk may be more significantly impacted than would be predicted from these changes alone.” (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1312230/) Notice that the max was 37% and the min was no effect at all or hardly any effect. Not everyone is going to find diet “works”, although diet can help some beyond the lowering of LDL.

Again if your problem is diet alone then diet should help. Diet is not going to get rid of plaque build up to any great degree although it can help shrink the size of the plaques a bit. If your problem is beyond that then you will need more help. Satins help stabilize plaque, for example, and that helps reduce the risk of heart attack and stroke independently of diet.

It also could be that your doctors have given up since you refuse to take statins and have stopped arguing with you about this figuring you are an adult and if you are going to make decisions against medical device they have already protected themselves against malpractice suits and so are letting it drop since it is pissing you off. If they are seeing that a healthy diet is reducing your bad cholesterol levels and if you don’t have much plaque build up yet in your arteries in the first place they may also have stopped arguing with you about this because in that case diet can help.

I am not in a position to know why they have accepted your decision. What I do know is the some of the science and diet alone for many is not going to be the total solution (although it may be in your case) although it can contribute to it.

@Kidsandliz The Rosenthal study was inherently not going to find much benefit from diet, because it was designed not to. Study after study has made the erroneous base assumption that serum triglycerides and dietary fat are directly linked. They are not. But it’s next to impossible to dislodge that miswisdom because it has formed the core of so much entrenched policy for a century that the research to demonstrate otherwise is ignored.

@werehatrack Reading a meta analysis of 49 studies those findings were, in a large part supported by other studies. Perhaps you have a url of a science based study explaining why it was not designed correctly? Multiple articles and studies over 45 years support that metabolic syndrome and cardiac plaque build up are two separate diseases. There is some overlap of cause but a number of unrelated issues too. Diet does help some people with both diseases but many times that is not enough and not the entire picture. Correlation is not causation. That you are one of the lucky ones where diet alone helps to the point you don’t need meds is good but that doesn’t mean this will be true in all cases or in most of them. But then again you aren’t obese either and obesity contributes to both too. Count your blessing but don’t assume this will be true for everyone.

@ShotgunX well…

If you’re in the age range they “shouldn’t” cost that much.
https://www.goodrx.com/conditions/prostate-cancer/prostate-psa-test-cost-without-insurance

The general age is 55 to start, but, this was a case of ignoring a first degree relative having it it seems?

https://www.hopkinsmedicine.org/health/conditions-and-diseases/prostate-cancer/prostate-cancer-age-specific-screening-guidelines#:~:text=While the general guidelines recommend,who have had prostate cancer

For most insurance plans today this should fall under preventative care. So… Even with a low cost high deductible plan which should cost way less than 1200 for a month for a single male, and instead of paying them you get to put what you can in an HSA, they should cover it per the aging guidelines.

But yes we still have a major insurance/healthcare problem in the country.

@ShotgunX @unksol Thank you for researching this.

@ShotgunX In a more perfect universe, I wouldn’t have had a prostate to worry about, but I do. At about 50, I started having signs of prostate enlargement, I had no insurance, so lab work was out, and the treatments available were often worse than the wait-and-watch approach, so I found an offshore source for finasteride and started taking it. It’s now 20 years later. A recent ultrasound confirmed that my prostate is much smaller than normal, and the PSA blood test shows no cause for concern. As long as that remains true, I will politely ignore that gland’s presence.

@lisaviolet you would obviously probably know way more since you’re dealing with it.

I just obviously searched some reputable sites. Because I know the recommendations on a full colonoscopy have changed for some strange reason.

I’m also not nearing 40, have totally seen a doctor since 2006. But you know there is that cancer and that genetic test. And that liver thing and. Family history

Eeh… Eehmm… It will be fine…right. Right.

Obviously get tested. Shouldn’t cost too much/be as invasive

I should get tests in general. I’m probably broke

@unksol Not really, because we’ve always had some sort of health insurance. We were hit pretty hard for the treatment of the prostate cancer because, even though the radiation facility was one of those recommended, they were out of network, so…we hit our $12K deductible, though. His mom helped.

Now we’re on Medicare and have an Advantage plan. So, the kidney was only $130 and that was for the first MRI at the emergency room.

@lisaviolet well I meant the tests themselves wouldn’t be that expensive.

I guess I didn’t think that all the way through. What’s the point of knowing you have something if you can’t pay to fix it? That’s a little dark…

@lisaviolet @unksol You can’t even get treated now without having co-signers on any medical debt. Or they’ll basically use new law loopholes to try to force your family to co-sign without them even necessarily knowing about it, let alone agreeing to it.

A decade ago my grandma was in a facility for some time due to dementia, and even though we didn’t have power of attorney or anything like that, they casually sent us a bill for like a million dollars after she passed away.

@lisaviolet @ShotgunX @unksol Totally agree with you on the sad state of universal health care (i.e. none) in this country. or even affordable. The COBRA coverage I mentioned in previous post costs me almost $1000/mo because employer has to keep your plan but not pay anything towards it, so you bear the full amount (also includes dental and vision in my case). But the legally-required 18 month period ends next year and from what I could see, private insurance will be about the same $$ but way higher deductibles and less coverage.

As for your grandma’s bills, facing some of that as my mother recently passed a few months ago and I am sole person responsible, But when you get the medical bills they should say that you are not responsible to pay, but that they at some point may go after the “estate” be it her bank accounts or property. In my case the Oregon health insurance (Medicare + add-on) seems to work well so the amounts are small and I decided to just pay and clear up the record. Also just paid $275 for final ambulance ride (billed at $1500, but $275 was amount to pay; I just decide go ahead and pay it).

Luckily she was mentally and even physically pretty strong until near the end and last thing she would have wanted is to be needing continuous nursing care. Also she knew how much it would cost and that was probably the main thing on her mind. She could never stop thinking about money. Go quickly would have been her thought! So in a way that’s a blessing. She was 95.

@pmarin Honestly, you shouldn’t have paid anything, unless you had power of attorney, or she had a lot of assets to her name that they could’ve gone after.

We didn’t pay a dime because there was no “estate” to speak of. She had nothing but a little bit of money rolling over in her month from SSI, so I don’t think going after a few hundred bucks would’ve been worth it to them because just two hours of filing the paperwork would’ve cost them more in legal fees.

For me, as a younger person, even if I’m making $90k a year (hypothetically), it just doesn’t math out. As a single person, I get to keep about 56% of my income after all the taxes and fees. If rent is like $2,800, that’s exactly two-thirds of my net pay going just toward that alone. So $16.8k would be left for everything else. If insurance is $1,200 a month, that’s $14.4k a year. Now I have $2.4k left for food. A sandwich costs $15. ¯_(ツ)_/¯

@lisaviolet @pmarin @ShotgunX @unksol

She was 95

Yes that generation lived through the depression and that left an indelible mark on many people (as does growing up poor depression era or no depression era).

@ShotgunX Yeah, good point about the assets, and most of the paperwork even says “you are not obligated to pay for this at least not right now.” In this case there were some bank accounts with sufficient money to cover any of these amounts so as long as they stayed relatively small (like $400 out of a $40,000 hospital bill) I was OK just clearing it off the books so things remain simple. Still need to meet with her accountant and an estate lawyer I think. Also there is some real estate involved.

For your situation, yeah, at one point I was in a situation with similar (theoretical) salary and monthly expenses, and it was very stressful. Didn’t seem like much left-over for anything. But my employment covered most of the health insurance (think I had to pay a portion for spouse’s share). Honestly one of the reason many of us stay in sometimes-sucky jobs. And I suppose being able to have any sucky job that includes health care is still a bonus in this country, as we are laughed-at by the civilized world.

@lisaviolet @pmarin @ShotgunX @unksol

If you know you are going to be short of cash it is worth knowing what the practice/hospital system rules are for bills sent to collection. Is care cut off? Are you sued? Around here 90% of all doctors are employed by one of 4 hospital systems. Only one of system doesn’t cut off care for the entire system (except the emergency room) and sue you. That sends you to collection and you get nagged but you don’t have care cut off and aren’t sued.

When I had to buy insurance on the open market (did not make enough for ACA care and no medicaid expansion in this state; lost my job over cancers 2 and 3 in one year) I made sure I used (if I could) the system that didn’t cut off care or go after you until my deductible/out of pocket was paid. However with my first cancer I had student health insurance with no out of pocket limit (20% copay) and racked up quite the bill at MD Anderson Cancer Center on top of what I owed locally. Doing some serious negotiation I got them to freeze my account (eg not send it to collection as that cuts off care; also in TX if you go to a state owned system there is no statue of limitations on medical debt) and made payments when I could. Finally they (I initiated that) negotiated what I owed down to about 1/2 of what it originally was so I could pay it off and get out of medical debt.

At least for my next two cancers initially I had better health insurance with a reasonable out of pocket limit. When COBRA ended though it was very expensive to keep my insurance and I needed to since chemo for #3 had killed most of my bone marrow and I came within a hairs breath of needing a stem cell transplant.

There are times I’d like to be a medical refugee in Canada or the Netherlands or even in the UK (except there there you need to pay a premium for second tier insurance if you want some things paid for). About 1/2 of cancer patients eventually end up with more medical debt than they can handle and declare bankruptcy. If you do that though realize you can’t do that again for 7 years so time it carefully.

@Kidsandliz @lisaviolet @ShotgunX @unksol That’s a serious story, thanks for sharing it though, Yeah some of my mother’s bills came from an “agency” but talked to them and they stressed they are just there for managing outstanding bills (I think they got notified by hospital literally when my mother passed) and said it is routine and not to worry about and there was nothing past-due that was a problem, and they would just help manage processing the estate. I did ask if “Guido was going to come break my legs” and the very nice lady assured me that they don’t do that. (yet?).

Thanks to the Oregon health plan she was on, amazed at how much has been covered. I think it’s true this varies by state which is weirdly disturbing, since how your state votes seems to determine what quality of health care you can get or how much it costs. Craziest F’in system if you ask me.

@Kidsandliz I think that if I ever get anything serious like that, I’m just gonna off myself.

Still mulling over the ethics of taking or not taking some members of congress down with me if I do.

@ShotgunX Well I have a list of whom you can take out I’ll be glad to give you. But on the other hand here I am still alive and kicking and driving my now adult kid crazy (that in and of itself is worth the payback ) so I am not so sure in retrospect it would be worth offing yourself. Of course there is no “retrospect” with an action like that. At times living through that sucked bricks big time though. And financially I never recovered from that mess and never will. You can’t get back years you paid little to nothing into social security (nor retirement if the mess didn’t end with getting a good job back, which in my case it did not). But I’d vote for taking down some of the high functioning sociopathic asshats in congress for sure.

hmmm that was in reply to @blaineg good joke re. Ahrq.gov sign. Makes no sense without it lol