Cancer Scare(ier)

Two years ago when I was getting multiple biopsies to try to ascertain whether or not I had cancer in my neck, I wasn't that fussed about it. Either I did or I didn't, and if I did, then it was a simple matter of removing it surgically and maybe having some targeted iodine radiation if it looked like it had spread.

I was confident in my care team and just didn't think about it too much.

About a year after my surgery, my endocrinologist ordered a follow-up DEXA scan (to make sure my post-surgery efforts were indeed regrowing bone) and a neck ultrasound (to make sure everything was out). I told her that I simply could not afford imaging since we lost our health insurance. She understood.

I spoke with her for the second time since my surgery this week, and she said she was aware that I was unable to get imaging, but that there is also one lab that she's ordered twice and that I have not gotten since my thyroid was removed two years ago.

The reason I haven't had this test done is semi-complicated. She is sending lab requests to Quest but because I don't have insurance and instead pay out of pocket for my labs, I actually have to use a third party company (Ulta Labs). I go to their site, find the tests she wants me to have done, and buy them myself so that by the time I show up for the blood draw (Quest only charges Ulta $12 for this, and I can't see how they stay afloat!), everything's already paid for.

The issue here is two-fold: 1) The tests on the website aren't always called exactly what the doctor calls them. 2) Me. I'm the other problem. I'm not a medical professional so I'm trying to read the description of the tests and match them as closely as possible to what she wants. Stuff like a CBC with differential or a lipid panel is pretty straightforward. But is free T4 different than T4? I... don't know the answer to that and it seems like I should be an expert by now!

So... I haven't had a thyroglobulin test since my surgery. I've had several thyroglobulin antibody tests, and those have been negative (which is great; I shouldn't have Hashimoto's if I don't have a thyroid!). I thought that those tests meant we were in the clear. But no. She said neck ultrasound and thyroglobulin levels are how she makes sure we don't have a recurrence of cancer.

I finally understood and paid for the test she's been wanting all of this time. I had it done yesterday.

I'm pretty sure I'm fine, but the thought that I could have "persistent papillary thyroid cancer" (which happens in 10-30% of papillary thyroid cancer patients) hits different than it did the first time for one single reason: We no longer have health insurance.

James got laid off 5 days before my surgery in May 2024, but our coverage extended into August. It was over $60,000 and we did not pay a penny because we'd already hit our deductible for the year.

If I required further surgery and likely follow-up iodine radiation, I'm not sure what we'd do. It would be even more expensive. It would be a bankrupting-level expense.

Today at our library group, my friend pointed out that of the 48 countries represented at the World Cup, the United States is the only country that does not have universal healthcare. 

For me, the fear associated with finding out "it's back" isn't for my health. It's still a very survivable cancer. But it is how our lives would change when we were personally responsible for such an astronomical sum, especially adding in the nuclear imaging and all of the other pre-surgical stuff I had done before.

Fortunately, my lab results came back today and my thyroglobulin level is .1 which is practically zero; it will likely be 0 in another year or so. This is really good, especially since I'm no longer on a suppressing level of synthetic thyroid hormone (which I was for a year to try to prevent any residual tissue from growing).

Additionally, my surgeon is someone who has done tens of thousands of parathyroid/thyroid surgeries and I trust her completely. She took out a few lymph nodes for testing, and neither they nor my errant parathyroid were cancerous; it was just the thyroid. She said she thinks the inflammation from Hashimoto's almost made a little "wrapper" that kept the cancer isolated.

I've been fortunate. 

But it makes me mad that we're expected to rely on fortune, luck, the grace of any god, or our bootstraps to maintain our health. 

Elon Musk has just become the world's first trillionaire. No one should accumulate that much money. Especially when, if he just paid a fair share in taxes, we could absolutely use some of HIS fortune to improve the lives of hundreds of thousands of estadounidenses (I wish we had an English word for this). 

I guess keep your fingers (and toes) crossed for me that it doesn't come back or that it holds out until I qualify for Medicare in 12 years! And that Medicare is still around. Also Social Security. And please vote for a candidate who aligns with your wellbeing in the next election. I mean you, non-oligarch-level-rich person. Thanks.

Year-later endocrinologist follow-up, with bonus gynecology content!

I met with my endocrinologist today for the first time since my surgery. She told me that I needed to get a neck ultrasound ASAP, as I really should have gotten one pretty soon after the surgery. I wish I'd known because I had insurance until the end of August 2024! Now I'm applying for the Travis County Medical Access Program.

Also, the doctor mentioned that the medication I'm taking is actually lower than my weight would dictate I need, so she's wondering if that means part of my thyroid was left. I definitely hope not, because that would mean another surgery. I know there was a lot of inflammation, and I know guts look a lot alike so I suppose that anything is possible.

This wasn't a lot of fun when I had insurance, but I wasn't worried about the finances at all. If I have to do it again, it's going to suck, but it will suck a lot more than it did when I didn't have to stress over every penny (or tens of thousands of dollars).

To review, here's what I had done: Neck ultrasounds (one in an imaging place, two at my endocrinologist's office, and one in the surgeon's office), two sets of biopsies, a DEXA scan for bone loss, multiple labs measuring PTH and Vitamin D, a 24-hour urine test (the worst part of the experience by a wide margin), a nuclear scan (two+ hour procedure), a pre-op visit with the surgeon, the surgery and overnight in a surgical hospital, post-op with surgeon, more labs, and now prescription forever.  

Also, my regular doctor wants me to see a gynecologist because of some menopause stuff that isn't like "I feel weird" but like "that shouldn't happen and you need to get it looked at." And actually, I feel fine. It's hard to worry much when you don't feel off, but that's how it was with my hyperparathyroidism and Hashimoto's, so I know my body likes to hide dysfunction from my feelers.

I'm hoping if we get approved for the MAP, then I can stop obsessing over find the cheapest care for each specialty.

I hate healthcare being tied to a job.

My friend Adrienne told me that she doesn't care if I have to go into medical debt to take care of myself, so if that happens I'm just putting all of my medical providers on notice that Adrienne in Las Vegas (kind of) assured me it would be JUST FINE. You'll get $200 a month for the rest of my life, so I guess you'd better do a good job to make sure that I'm going to be around to pay it for a long time.

When you see it visualized like this, it seems like it wouldn't be any big deal to get the thyroid out! But also... that she removed the thyroid but kept 3 of my parathyroid glands in there is pretty unbelievable.

A Thing I Learned About My Asthma Treatment and the Rest of My Body

That was a long title! Thank you for staying with me.

This past month has been an education, for sure.

When James got laid off, he got a stipend to pay for COBRA (a continuation of his work-provided healthcare) for three months. That ended on August 31.

We're all pretty healthy, but D and I are on a few prescriptions, including two pretty expensive meds (one each). Mine is my maintenance inhaler.

For many years, I just didn't have access to a maintenance inhaler because of the cost. They're several hundred dollars every month! I would get the albuterol rescue inhalers ($30 per month, except when I and friends/family bought them in Mexico) and had to use them at least once a day, and usually closer to 4 times per day. It sucked, but it was relief and I appreciated it.

Indeed was the first company that offered family insurance at a low enough rate that we felt like we could swing it. Soon after that, I started on a maintenance inhaler and it was an absolute game changer. I kept my albuterol, but only needed it on particularly bad allergy days. 

I was on Flovent for about 3.5 years, then my insurance stopped covering it. I was upset but they offered an alternative in Pulmicort. I switched, but after a few months, I could see that it wasn't as effective for me. I was having to use a rescue inhaler a couple of times per week, much more frequently than I was used to.

Just as I was about to contact our insurance about other alternatives, they reached out to me to say that Pulmicort was being discontinued (and apparently Flovent was also discontinued at the beginning of 2024). 

This time, I was switched to Wixela, which is a generic version of the meds combo in Advair.

This one seemed weird because instead of being an atomized liquid, it is very powdery. I didn't always remember to rinse out my mouth after taking the other inhalers, but I definitely remembered with this one. 

I took it for probably a year before we lost our insurance. The sticker price for the inhaler is over $300 a month. Even with a discount card, it was more than $100. Just not feasible.

Fortunately for me, I had backups of both the Pulmicort and the Flovent because when they refilled, I typically still had some left. I decided to start with the Flovent, which was older, mostly because it actually worked for me. My hope was that by the time I ran out of Flovent, we would have insurance again.

A week or so after I ran out of the Wixela and returned to the Flovent, my daily intense bouts with acid reflux returned. I was on Prilosec for about five years because otherwise I was awakened by painful burning in my throat one or two nights per week. You're only supposed to take Prilosec for 2 weeks because it can cause bone loss and kidney issues, but your girl has to sleep.

However, as I realized that I had bone loss and kidney stress from the hypercalcemia that comes with hyperparathyroidism, I stopped taking Prilosec in the first quarter of this year. I was still having some acid reflux, but never the tear-inducing wake-you-up pain of before, and I was able to treat it with normal antacids (which did not put a dent in my GERD before). Side note: my symptoms improved noticeably after my parathyroid removal.

As my acid reflux became more prevalent and intrusive, I googled "Flovent and acid reflux." It's not common, but some asthma medicines can relax the lower esophageal sphincter, thus allowing acid to travel up the esophagus. 

Desperate to keep my asthma at bay while still being able to do things like sit down and go to sleep without having my chest on fire, I searched and was able to find a way to get the Wixela for $50 a month at a pharmacy more out of the way than the one we typically use.

Would I have been willing to pay $50 at the beginning of this experience? Meh. Probably not. If the Flovent had worked as well as it used to AND I hadn't had acid reflux, it would have been fine. But from here on out, I'm going to pay my 50 bucks and thank my lucky stars that our insurance jerked me around so much with different options so that I found this one!

I took the Wixela yesterday and was able to lie down last night and sleep all night with zero burning. So, yay! Some people try to avoid medicines at all costs, but, man, the quality of life that some of them offer is just an absolute miracle. Big Pharma? Boo!! But I can't quit them because they're truly just so so good at what they do.

Final (maybe? hopefully!) bit about the parathyroid/thyroid drama

Yesterday, I had my follow-up with my surgeon. She took the Steri-strips off of my incision site, and I had been thinking, "Yay! No more neck coverings!"

Well, two things: 1) I cannot let sun get on the scar at all, and I am only to use Aquaphor on it 3-4 times a day for the next two weeks. After that, I am to use silicone tape for 6-12 MONTHS to protect it. Yikes! Scar care is definitely a long game! 2) That area is SO SWOLLEN. As my regular endocrinologist said, "Your tissue is mad!" So for now, I'm wearing false collars and scarves. And it's hot. Let's all feel very sorry for me. Thank you.

And I have one more thing to add regarding the whole "getting diagnosed and surgically healed before I knew there was a problem" angle:

I followed up with my surgeon yesterday, and my endocrinologist today. Of course, everything that was taken out of my neck (one parathyroid, my entire thyroid, and several lymph nodes) was biopsied. The 9 millimeter adenoma on the left lobe of my thyroid was papillary thyroid cancer. Thing is, there was another adenoma, 4 mm, on the right lobe of my thyroid that no one had visualized (I had multiple ultrasounds, the nuclear Sestamibi scan, and an accompanying CAT scan that went all the way around to the back of my neck.

That smaller adenoma also tested positive as cancer.

The parathyroid and the lymph nodes all tested negative for cancer, and the surgeon said she wasn't sure exactly what happened, but that thyroid cancer is very slow-growing, and also maybe the inflammation from the Hashimoto's kind of created a "shell" around my thyroid so nothing spread.

So, there we go. I'm cancer-free before I even knew for sure that I had cancer. Kind of makes me glad my parathyroid started acting up, because otherwise, who knows when we would have found this.

Also, I'm grateful for my surgeon and her confidence that I needed to remove my entire thyroid, even though a support group I am in suggested getting a second opinion. I trusted her and she was right. She saved me another surgery down the road. This hasn't exactly been a nightmare, but it's not something I care to repeat.

I'll test for antibodies again in October. They should all be gone by then, assuming that there is no remaining cancer. If anything ever comes up in the future, I might have to get radioactive iodine treatment to kill any microscopic thyroid material left in my neck... but I'm planning for that not to happen, so I haven't even looked up what that involves. 

My remaining parathyroids appear to have stepped back up and are maintaining my calcium levels. I test that and my thyroid hormone levels in July.

Continue to feel very fortunate and grateful.

The Rich Get Richer

One last thing before we get off of the subject of my glandular heave-homent:

This whole thing started because we had insurance (have, until the end of this month). Since we have insurance that fully pays for annual check-ups, I've gotten bloodwork done every year for the past 5 years. There have been some things, like low whole blood, that required some looking into but were determined to be nothing. 

But in January 2023, I had high parathyroid hormone level as well as high calcium. Those two things both being elevated is an automatic diagnosis of hyperparathyroidism, and the only way to treat it is surgery. 

Getting referred to a good surgeon led to the suspicion and diagnosis of Hashimoto's disease, and all of that resulted in my having my thyroid and one parathyroid removed.

What had already happened was that I have experienced some bone loss (would be characterized as "osteopenia" if I were post-menopausal), and that I was frequently eliminating cloudy liquid as my poor little kidneys tried to flush the excess calcium out of my blood.

What could have happened was hypothyroidism, and any of several more advanced autoimmune disorders like Crohn's, Grave's, or lupus. I also could have had permanent nerve damage at my extremities due to wonky calcium levels. I could have fractured my hip. 

But I didn't.

We knew what was going on because I had access to adequate, thorough health care. Through James's work. Which he doesn't have now.

I went most of D's life without insurance and, consequently, we only went to the doctor's office when there was something overtly wrong. But in this case, if I'd waited until possible symptoms of thyroid disease had presented themselves, my body would have definitely been worse for the wear.

So I'm grateful.

I don't know what's going to happen in terms of our insurance after the COBRA stipend runs out. Tech employment is rough right now. But I do know that everyone deserves preventative care (in addition to acute care, obviously). Why is that a controversial ideal?

Bits and Pieces

Hello, fellow Americans (and any other nationalities, honestly... all are welcome)!

Yesterday was Mother's Day in the US, and my local family came out to my house to visit. We had a nice afternoon hanging out, and I didn't have to do anything because James and Mal picked out snacks, my Dad brought food and plates, and it was just a fun time all around.

Today, I had an early appointment at a radiology office, not realizing that I was getting some nuclear imaging and a CAT scan. Woo hoo. Fun times. Before going into the imaging chamber, I got an IV of radioactive material! About two short hours and I was done. What a psychic workout, though.

First, the radiologist was trying to keep my elbows in place (the camera automatically keeps 1 inch between itself and a body, and she didn't want me moving my arms and making the camera back off). It was kind of like swaddling, and it was comfy enough... until she started lowering the imaging plate to within 2 inches of my nose and my claustrophobia kicked in. I pulled off the sheet and promised that I would keep my elbows tucked under my own power. She offered to try something different and I told her that if I felt restrained, there was no way I could do it. So we kept my arms free and everything was relatively fine after that.

I had 3 different 5-minute scans, during which I could not move. I was kind of restless after those, but THEN it was time for a 25-minute scan! That one did a number on me, as I tried to relax and maybe even nap since I'd gotten less sleep than usual the night before. But my body kept bringing me back into the moment by suddenly detecting an itch in my right ear canal. Then making me hyper aware that the muscles in my leg were clinched and I needed to relax. Then noticing that my pinkies were falling asleep from my crossing my fingers, which was how I was keeping my elbows from flopping around, so I couldn't really move them but I also couldn't forget about how much I wanted to move. However, when the machine beeped that it was over, I'd thought we were only at the halfway point. 

After the long scan, I had to go into a CAT scan machine still without moving because it had to line up with the previous images. The tech had to "stitch" the pictures, and I was trying not to say anything until there was a natural break, but by then I REALLY needed another visit to the restroom (one of the symptoms of the hypercalcemia caused by hyperparathyroidism is that my kidneys are always trying to jettison calcium, thus pulling moisture from my body and causing me to need to evacuate a minimum of hourly). Fortunately, she was able to let me go before we did the 3 final 5-minute scans.

Shortly after I got home, James had deja vu from last spring, when Indeed announced that it was laying off 8% of its work force. This time, James didn't keep his job, and he said he's mostly numb about it, but I think it will end up being a good thing. Morale has tanked since last year's down-sizing (the first mass layoffs Indeed had ever done), and he hasn't been happy for a while. 

Classes and extra-curriculars are shutting down for the summer. Mal has been out of Wednesday classes for two weeks. This Wednesday, we're going to to to the splash pad where we had his birthday party. I'm probably going to plan an activity every Wednesday that I can, just to avoid general malaise (although I love being home). Since Mal is enjoying public transit so much (we took the bus to Urban Air last week and had a great time), I'll see what I can find that is nearby convenient stops (we had to walk almost a mile between the stop and UA, but it was fun).

Thursday is Mal's last homeschool open gym until fall. And our Tuesday group is always lighter in the summer, with people traveling and dealing with summer custody arrangements.

But Mal's looking forward to YMCA movie-making camp in about a month! It'll be his first sleep-away camp, and I hope it's as magical as Camp Coral (a SpongeBob series), which is why I think he was interested in camp in the first place.

This last thing I'm going to tell you about... well, if you're squeamish or just don't like TMI, then stop reading and we'll see you next post. 

If you're still here, allow me to say: I'M TOO OLD FOR THIS! And by "this," I mean continuing my fertility. I, too, had deja vu today. We were in Montreal exactly a year ago (sigh) and the last full day we were in town, I took Mal to an indoor playground. We spent a LOT of time on public transit to get there. On the bus ride, I felt a kind of "swoosh" feeling that was weird. When we got to the playground, I went into the restroom and there was blood EVERYWHERE. I was wearing a menstrual cup (which I've used without leaks since 2010), AND period underwear. And still, my khaki slacks were absolutely drenched in blood.

I had a stain stick and pretty much used it up. It kind of diluted the visible blood, though it definitely looked like I'd peed myself. Oh well. I wasn't going to end the day early and travel an hour back to the hotel room just to change. I moved my stuff from a cloth seat to a leather chair and just dealt with it. It was fine; I didn't make a mess anywhere but on myself. Then Mal and I went to McD's before heading back several hours later.

(It's the next day).

Since then, I've had one overnight situation which hadn't happened since I stopped wearing pads in my early 20s. I determined to remember to change out IMMEDIATELY before bedtime from then on, and have done so.

But yesterday, as I used the restroom prior to my eternal scan situation, I realized I'd started my period. I'd gotten up in the dark so hadn't seen any clues at home. But by the time I made it to the radiology clinic, I suppose I'd been free-bleeding for about two hours. I didn't have on my period underwear (my periods are extremely irregular -- thanks, perimenopause! -- and I didn't get the usual two-day warning of hormone-induced stress this time. 

I had my cup with me as always, but had to do the whole procedure knowing that I'd bled straight through my jeans. Ehh. Got home, changed, was fine the rest of the day.

Then last night, I got the same feeling as on the bus a year ago. Got up and there was just blood EVERYWHERE. I don't understand what or how it is happening, but I'm over it. Cleaned up, went for a walk, could tell I was leaking. Had to change and clean up AGAIN when I got home.

Friends, I am almost 52 years old! This nonsense needs to stop. At least I will probably be at least mostly finished by next week. I don't want to have to do the pad/mesh underpants combo I discussed with the surgical nurse.

Parathyroid Update

Can't believe it was more than three weeks ago when I wrote that last entry! Time flies...

Since I posted that, we had a visitor for a couple of weeks (D's friend), Mal's school finished up, and temperatures are letting us know that summer is on its way.

I also did go see both my endocrinologist as well as the endocrinology surgeon. The endocrinologist was very empathetic about my frustration and said that she has concerns about medical care in Austin. There are just more people than there are doctors to meet the need. She said, "I'm here every day..." and then told me to come back in 4 months, but then the first available appointment was in 6 months. She did add to my notes that I was frustrated with how long this process is taking.

Then a bit later, I went to see the surgeon. She asked to ultrasound my neck, and immediately asked, "Has anyone told you that you have Hashimoto's disease?" I told her that I had not gotten that diagnosis, and she said that just based on what my thyroid looks like, she's pretty sure that I have it. She did an u/s on herself and showed me what a "normal" thyroid gland looks like compared to mine (it all looks like TV static to me, but I trusted her), and then she sent me off with lab orders to check some thyroid antibodies that would support her hypothesis.

I did the bloodwork and have a final different kind of scan scheduled for a week from today. The bloodwork came back... well, I have Hashimoto's.

I feel SO lucky. I know people who have Hashimoto's, and they often suffered for YEARS before getting a diagnosis. As far as I know, I'm asymptomatic, though the surgeon said that it was possible that I'd been having slow-onset symptoms and they're just normalized.

She did mention that I might feel better after surgery when my calcium level is corrected, and I might not feel any different at all. But that you get parathyroid surgery for the long-run, to avoid bigger problems down the road. So even if I don't feel magically more energetic, with no GERD, etc. that it's still the right move to avoid kidney damage and further bone loss.

My surgery is in two weeks, and I'm excited to get it over with!

Meanwhile, life goes on pretty normally...

Adventures in Medical Care (Parathyroid Madness!)

It's been a year, people.

Actually, it's been slightly longer, as bloodwork from January 2023 indicated that I have hyperparathyroidism (namely that my parathyroid hormone level is high while my blood calcium is also high; they're supposed to have an inverse relationship when all is working properly).

My calcium is just over the border of high, so I haven't needed any treatment for that, but we have realized since last fall that I do need surgery to remove whichever parathyroid gland(s) is(are) responsible for the misfiring.

During the past year, I've had further bloodwork, a couple of urine samples (including the 24-hour one I mentioned previously), a neck ultrasound, and two biopsies of an adenoma on my thyroid.

Everything keeps confirming hyperparathyroidism, and a bone density scan revealed that I have osteopenia, which is some loss of bone density but that can but isn't necessarily a precursor to osteoporosis. The problem is that the parathyroid is supposed to sense when your blood calcium is low, and it "tells" your bones to release some calcium to make up for it. Hyperparathyroidism is when your calcium is fine (or, in my case, borderline high), you're continually leeching calcium for no reason, thus putting your bones at risk.

Another risk is kidney disease, as the excess calcium can cause the kidneys to have to work harder to filter it out. My most recent urine sample revealed a lot of stuff that shouldn't be in this waste product: epithelial cells, protein, too-high ph... it's just a cloudy mess. 

SO... I was referred to an endocrinologist early last year and to an endocrinology surgeon months ago. I had an appointment schedule with the surgeon for March 25, but apparently the doctor ended up planning to be out of town and they rescheduled to June. 

This was an inconvenience but not a huge problem until recently. My first biopsy came back with no results, so we had to do it again. The second time, the endocrinologist took an extra sample to send off for DNA testing in case the "standard" assessment was inconclusive again.

It wasn't. It came back "suspicious as cancer" (of the thyroid; parathyroid cancer is extremely rare and you're not supposed to do fine-needle biopsy on the parathyroid as you risk "seeding" any cancer that might exist, since the gland is about the size of a grain of rice) and will likely result in my having to have half of my normally-functioning thyroid removed. That might fix the hyperparathyroidism, as it's right up against my left anterior parathyroid gland. But I'll find out more when I see a totally different endocrinology surgeon (one who is widely respected as an expert in this field) in TWO WEEKS (rather than two months; sorry, Baylor, Scott, and White... you just couldn't perform adequately this time).

It seems like during the surgery, they at least want to "visualize" all of the parathyroid glands just to make sure they're okay. Some people have more than 4; others have visualizations on only a few because one of them has moved into their chest somewhere. I don't think that's the case with me. I believe the ultrasound tech was able to find all of my glands.

Anyhoo, I have an appointment with my endocrinologist Wednesday and can't wait to tell her that I'm pretty disappointed in the care I've gotten so far. Much of what I've learned about my condition, best practices, and what is going to happen in the future has been from an online community. They're the ones who made it clear to me that I didn't understand what was happening, and who prodded me to read through the medical notes and imaging results to look for specific things. I feel like my doctor should have explained everything more clearly, since I know doctors don't love people consulting "Dr. Google."

In terms of symptoms, I'm not aware of any. I do experience GERD, and have for years before my numbers were wonky. Three weeks ago, I got off of omeprazole because it's not really for long-term use, and it runs the risk of both bone loss and kidney disease, and I figured my body did not need another threat to deal with. So far, I've been less-than-ideally comfortable, but I'm managing. I'm also hoping that maybe surgery will help a bit with that? Excess calcium triggers your stomach to produce more acid.

I might occasionally have fatigue and brain fog, but it's hard to know whether that's from perimenopause, having a 9-year-old as a middle-ager, or hyperparathyroidism.

What I'm saying is that I feel "normal," which is pretty darn good. But if I had surgery and felt even better, I would not be mad about it! I'm looking forward to getting it scheduled and over with, so I can fully recover before our trip to California for Mal's 10th birthday!

Asking for Help (dental version)

Apparently, April is the month of dental work here at Team Dave's.

D got taken care of last year, but this is THE time for the rest of us.

First, Mal has a couple of teeth coming in fully in his soft palate. He's had "shark teeth" before, but they were always right behind the baby tooth, which eventually fell out. One of these top teeth has been emerging (and is fully in) for months. Mal has been wiggling the baby tooth for probably a year (because it's infected and likely has been ever since he got dental work done when he was 4 and they capped it without getting all of the rot out, thanks so much, jerks) and it's just not budging. When the second tooth started coming in, that was all we needed to take him down to our awesome dentist in south Austin. It's a 45 minute drive but they're SO good with him.

In fact, Mal let them use the electric polisher to clean his teeth for the first time! In two weeks, he's scheduled for full anesthesia so they can pull these two baby teeth (one is so small that I'm afraid his gums are going to grow over it), fix his effed up caps from several years ago (thanks so much, jerks), fill one adult tooth cavity, and two baby teeth cavities. Whew. This boy brushes religiously twice a day, and he flosses at night. He's just going to have "those" teeth, I think.

As a child, D brushed only at night, never flossed, and never had a cavity. After not having ANY dental care for about 10 years, they only had two small cavities and everything else was fine after a good cleaning. Some of us just get easier teeth than others.

Meanwhile, James had mentioned that it felt like one of his fillings was falling out. He hasn't been to a dentist since 1995. So we had an appointment scheduled here in town, but then not only did his filling come out, but his whole tooth crumbled. We were able to find an emergency appointment at a slightly-less-nearby office, where he's been now several times. First, they got the tooth and a second one cleared out and fitted with temporary crowns. Then he had to go back in to have the permanent crowns put on. He went back for a deep cleaning, then the next day for the second half of that.

Although we have dental insurance, a pretty good amount of this is still out-of-pocket. In fact, we have to pay in full for Mal's anesthesia, then we'll submit a bill for reimbursement to our insurance a couple of weeks after the procedure.

This morning, I had an appointment to establish care with the same dentist James went to. It hasn't been as long as James, but I think the last time I went to the dentist, D was about 5 years old. So 16ish years. I can tell my mouth is aging, but I don't have any pain or complaints.

After a bunch of photos and gum evaluation, I need a few things: First, I need the two-appointment deep cleaning, as well. Some plaque has gotten down under my gums and it can result in bone loss (James has some; not sure about me) if you let it stay down there. Like they won't do a regular cleaning until we get all of that out. Also, four of my molars that have fillings (I got them when I was maybe 12 or 13) are cracked, and one of my other molars has a cavity. The dentist said that two of my existing fillings are the priority, as well as the cavity. But the other two, we can do later.

I explained to them that we've exhausted our dental budget for the year. James has literally run out of coverage just in the couple of weeks that he's had to have intense stuff done. Between all of this and our recent notice that our mortgage is going up $265 a month (don't get me started on property taxes in this state), we're just maxed out. I know I need this stuff done, but...

And here's the cool thing about being honest and open: The front office did some things: 1) They said I could make 4 payments instead of doing it all at once. 2) They will start billing in May, even though I'm having the two-part cleaning done this month. 3) They're taking $200 off of one of the fillings.

I know it's all messed up how expensive medical care is, and especially dentistry, which just isn't fully covered by any insurance I've ever had or seen. But they wouldn't have offered solutions if I hadn't asked. Most offices have a sign up that says "Payment in full is expected at time of service."

So that takes a little of the pressure off, which is cool.

In other news, I got a referral to an oral surgeon because of some differently-pigmented areas in my mouth. I get to get those biopsied soon, which will be covered by medical insurance but, bleh. 

Welp, That Sucked

Aaand, I think we're back.

We were all on the mend, but then last weekend, I CRASHED hard. I was nauseated, fatigued, and just felt "not right." I mean, it was worse than when I was actually sick.

Mal and I made it to church Sunday, but I had to cradle my head, and when I walked, I felt like my legs were melting out from under me. I was dizzy and exhausted, even though I'd "slept" almost 12 hours. I was sleeping most of the time, actually. I stumbled in the house after church, fell into bed, and slept all day. Mal took a little nap with me. Then we went to bed at like 8. And I never felt rested. Just gross and off and wrong and like I was going to die.

A little research and I think I figured it out: Steroid withdrawal. I was only on them for 5 days, which isn't supposed to require "tapering." But I think my body just stopped producing cortisol, and it took three good days for it to get back up and running. NEVER AGAIN.

So that's two things I'll never do again: 1) Flu "swab"/stab. 2) Oral steroids.

I've had a steroid shot before when I couldn't kick an asthma attack; that's still on the table. But, man, it was NOT worth it to take the pills. Big "no" on that. Do not recommend.

We've spent the week easing back into life. It's weird to have "lost" so much time. I don't like it. Plus, it was really overcast and the air pressure felt too high, though that might have just been a residual headache from the meds.

I think we're back to 100%. I hope so. I rarely get sick, and this was not a nice, quiet way to while away a quarter of a month.

Now I'm trying to get our taxes done so we can pay off our solar panels. The life of a home-owner is super glamorous (read: expensive).

The houses on both corners around us are almost complete, and I'm looking forward to it being quiet around here again. Also looking forward to the tax assessment this year, because so many vacant lots have sold in the past 12 months, we'll have a much easier case arguing that our lots are worth about 3/5 the amount the county has assessed the past two years.

More Adventures in Medicine

Friday while I was driving Mal around, I was feeling a bit of stomach unease, and I could tell that a cold sore was trying to crop up. I take acyclovir daily to prevent cold sores, so when one sneaks by, it's a big deal. In the entire year I've taken acyclovir, I haven't had a cold sore make it that far yet. I took a couple of extra doses, then some Lysine, and put Abreva on a few times, and ended up stopping it before it got all the way to the point of no return. And Saturday, I felt mostly normal.

Sunday afternoon, I was starting to think that I wasn't going to escape cedar fever this year, after all. By 8:30, I was beat. I went to bed by 9:30, and James mostly distracted Mal until he was wound down and "ready for bed."

One cool thing that James has been trying to tell you as he's worked on his blog entry about his and Mal's trip to San Antonio -- AT THE BEGINNING OF NOVEMBER -- is that, since they returned, James has been Mal's go-to for the nighttime tooth-brushing routine. It's super sweet, and, of course, I love being out of that loop.

However, after Mal brushes his teeth, he often watches videos for a while before he goes to sleep for the night. Usually, that's okay. But Sunday night, I felt like garbage. Mal kept saying, "I'm going to watch one more video, then I'm going to go to bed." "Okay." After the third round of this, I said, "Mal, you can watch as many videos as you want; I'm trying to sleep so you don't have to tell me."

When he DID go to bed, he managed to plug his iPad in himself, but when he laid down, he was frustrated because I had pulled back both of his blankets and his sheet, and he prefers just the top blanket. He was fussing about it, and kicking the superfluous sheet and blanket down to the foot of the bed, which he often does, even when it's absolutely freezing outside (and super cold inside because we live in a 13-year-old house with crappy insulation and crappier windows).

After he did THAT, he was still fussing, "Next time, the top blanket only! I'm so uncomfortable!" I asked how he was uncomfortable. He said, "I don't know," kick, kick, kick, "I'm just UNCOMFORTABLE!" And I LOST. IT. I sat up and started pulling his other blankets into the floor with way more force than was necessary. I said, "I JUST WANTED TO GO TO SLEEP EARLY BECAUSE I AM SO TIRED!" Then I announced that I was going to pee and left the room.

I guess I "said" this louder than I maybe meant, but probably about as intensely as I felt, because James was in Mal's room when I got back from the bathroom. He'd come in to see if Mal was okay, and I have to tell you... it feels like crap when your baby daddy has to check up on his kid because he's afraid you might have upset or hurt him. This has happened a couple of times since Mal was born, mostly when he was a baby and I was chronically sleep-deprived and on the edge.

Then, also, D asked me the next day, "What happened last night?" So I had to tell her that I had a temper tantrum because I was so exhausted and kept being awakened. By then, I had apologized to both James and Mal. But still. Geez.

Monday, I got up and took a shower with some eucalyptus sinus soothers. After that, I felt like I just needed to spend the day in bed. James is in his last week on his current team at work, and I didn't think asking him to stay home was a great idea (it looks like "senioritis"), so I decided I could make it. Mal got up, and fortunately was an absolute gem.

First, when he woke up, he called to me. I said, "I'm right here." He said, "It's not really you." I asked, "If it's not me, then who am I?" He said, "You just lost control, and then you got sick." I asked James if they'd talked about this, and he said they had not. I told Mal, "Aww, you're so sweet to me." He said, "You're sweet to me, too... And I'm a party blower so I can do anything." Kind AND weird. That's my kid.

I spent most of Monday in the master bedroom, because they were jack-hammering rock to try to make room for the septic tank across the street. In all, it's taken them about two weeks to dig that hole. I'm over it.

As I mentioned, Mal was amazing. He played Number Blocks and with his Sonic characters. I think he was just happy to have me not up and running around, but lying there with him, listening and interacting as much as I could all day. Then he'd run off to watch videos or play a game. I made him some food and tried to sit at the table with him, but needed to get back into bed after a few minutes.

I kept using my albuterol inhaler. Like a lot. And it wasn't working for more than 15 minutes. I have a nebulizer and used that once, also to little avail. I decided to make use of Teladoc, and after an hour or so had a prescription for several things: Tamiflu, an antibiotic, a steroid, and an inhaler than I learned would have cost $600 if I didn't have insurance.

Having kicked around in a stupor most of the day, I tried to get it together to take D to banjo lessons and to pick up my medicine. I was obviously not operating at full capacity, and D said, "We can stay home if you need to." But D missed a lot of classes after surgery, and then during the holidays, so I wanted to make sure we kept the routine up. And I neeeeeded meds.

We successfully made that trip, and I got the kids food from Sonic. I told James he'd need to pick up something on the way home, because I knew I couldn't cook dinner. As it got later, a couple of hours after I'd taken the first doses of everything, I started feeling worse. The uber-expensive inhaler was not helping me breathe. My head was killing me. I was exhausted. I was worried that I'd not be able to breathe during the night, and one thing the Teladoc had told me was that the flu wasn't likely to kill me, but that if I was gasping for air, I needed to get to the E/R.

I texted James and told him that when he got home, I wanted him to take me to the hospital, but within half an hour, I was on the verge of a panic attack, so D agreed to hang out with Mal while they waited for James to come home, and then I drove -- in James's car, which was recently pulled over for having a headlight out, which is why James had driven my car to work -- to the hospital.

I'd checked in online, but they were busy. It was quiet, but they didn't have any rooms, so kept sending me back to the waiting room after triage and then an EKG. When I arrived, my pulse/ox was 95, which isn't optimal, but not bad enough that I was going to beat anyone else out for a room. My pulse was 132, and my blood pressure was like 134/72, which is WAY HIGH for me. My temperature was 99.7, and my norm is around 97.5.

I guess the EKG was fine. I didn't see or hear anything about that.

Oh... when I was initially waiting, I felt so nauseated, I sped off to find a restroom. I got into the stall just in time... for a dry heave. I'd eaten a bag of chips, a box of Yoo-Hoo, an apple, and half a corn dog earlier in the day, but had nothing in my stomach at that time. I knew I was supposed to have taken the antibiotic with food, but was feeling so yucky that I could not. So I went to the vending machine and picked the only thing I felt my body could handle: a Snickers bar. Protein and chocolate and some calories. It's better than nothing, right?

Yes, I have a run in my sweats. But I LOVE these sweats and can't find them new anywhere.

So there I was, being triaged while putting away a candy bar. I'm sure the nurse was impressed with my overall health and wellness plan.

By the time I got into a room, my pulse/ox was shifting from as high as 98 to as low as 92. My pulse began to slow, and eventually dipped below 100. And my blood pressure was 168/64 by the time I was released.

The doctor was critical of the Teladoc who had both prescribed Tamiflu without a positive swab for influenza, and also prescribed antibiotics, as well, as they treat the same things. He also told me that Tamiflu reduces flu symptoms by approximately 18 hours, which is the kid of crap that is exactly why I stopped taking antibiotics for my chronic (and now absent for nearly 13 years) tonsillitis. He said that the reason I'd gotten sick in the waiting room is that, ya know, meds you don't need make you sick.

I did test negative for the flu, and I have to tell you: If I had the choice to get another flu swab OR go through the birthing process from when I had Mal but not end up with anything to show for it, I'd rather do birth. That flu "swab" (which would more rightly be called a "painful sinus stab") was easily the most painful medical thing I've ever had done to me. I mean, I will NEVER consent to one again, and I will NEVER EVER consent to Mal's having one. He would never leave the house again. We can just operate under the assumption that we do not have the flu because even if we do, I'm not taking useless meds when we'll just get over it anyway.

After three hours, a couple of chest x-rays, some blood work the results to which I guess I'll get later, spilling my Route 44 Diet Coke all under the E/R private room bed, and who knows how much out-of-pocket expenses, I was discharged with an "unspecified bug" (disappointingly referred to as an upper respiratory infection, AKA "the common cold" in my paperwork), and instructions to ditch the Tamiflu and antibiotic, but stick with the steroid.

I tried to clean up, but I was attached to machines, and throwing paper towels on the floor spiked my heart rate to 123!

I drove home with the hazard lights on the whole way, and kept the hospital bracelet on so that, if I got pulled over, I could tell the police, "I KNOW, but it was an emergency, and we're getting it fixed ASAP." It was also foggy and eerie, and I tend to turn on my hazards when visibility is that low sometimes.

By the time I got home, I felt a little better, but could still feel my heartbeat so noticeably for the next 16 hours or so. I slept mostly sitting up, and slept better than I had the night before.

I don't know what that was, but I have never felt as terrible as I did on Monday. Maybe the colitis or whatever I had as a teenager was worse, but then I had people to take care of me. I could stay home from school. I could pass out and someone would help me up.

I almost never get sick, and even when I do, it tends to be some low-grade mehh sickness that passes in a couple of days. Getting really sick made me feel, honestly, very alone. And resentful of that, even though there's really no one to be resentful of. But it just makes me aware that there's no back-up plan for me. Like, I don't "get" sick days. I guess most moms feel this way? Or I'm just a really bad patient.

Anyway, yesterday morning, my parents came down to play with Mal so I could get some more rest. I knew something was up when Dad offered to take Mal to McDonald's, and Mal said he didn't want to go.

About an hour into their visit, I called Mal back into the bedroom with me. I held him, and he was burning up. Five minutes later...

I sent my parents home (after they'd had some of the cheeseburger macaroni lunch I'd promised them), but they left me Lysol wipes and a loaf of fresh bread my dad had made.

Mal woke up after a bit, absolutely baking and inconsolable. He wanted to go sit at the table, drink some soda, and watch videos. He sat there for a minute, then said he needed to use the restroom. Half way there, he "threw up" in the floor, but he hadn't eaten anything so it was just stomach acid and caramel coloring. Sorry, folks. This is real life. Also the ugly part where one of the first things that ran through my head was, "Welp, glad I'm at 85% because someone has to clean this up and nurse Malcolm."

He immediately went back to sleep in the back bedroom, I got things cleaned up, and I was especially grateful that my mom had given me a pair of house shoes for Christmas because the ones I had been wearing needed to be washed, as well.

I followed Mal around with a barf bag all day, and he hated it, swearing he'd never throw up again. He was highly disappointed that this was "The first time I ever barfed when I was 5!"

Custom blanket by Grandma!

After Mal woke up from this nap, he was ready for a bath. He had refused one earlier, because he said, "I don't want to have the problem again!" His problem is when he is finished taking a bath, but doesn't want to get out. I told him that if he lets the water drain out of the tub, it's easier because you cool off gradually, and then there's nothing left to do but get a towel and get out when it's over. Since he'd been using a damp rag on his face all day to cool his "cheek burn," he decided that trying a bath to cool his fever might be okay.

He successfully bathed, we washed his hair, and I noticed that even in the water, he was covered in goose-bumps. He went straight from the bath back to bed.

Yes, this is the mermaid towel from D's childhood. They've both loved it.

James got home pretty early last night and, wouldn't you know it, looked like an absolute train wreck. James gets sick more often than I do (he's around more people more often, so this makes sense), but here's the deal: EVERY time I get sick, he follows me within a day or so. And this, of course, plays into my whole, "I'm the only hope" mentality, of which I am not proud.

James went straight to bed (Mal's bed, since Mal was in his), and except for moving back into his room because Aish both wanted to be in Mal's room with James, and out of Mal's room when I shut the door because who knows why cats want to do anything, but I guess 5 repetitions of this was plenty. He slept basically 12 hours and looked a lot better this morning. He's working from home today, though, as he scared himself driving home last night (I know the feeling!), and he doesn't want to taint his cow-orkers.

I washed Mal's bedding while he watched videos and napped on the trundle bed. Then he got into his bed and I brushed his teeth with training toothpaste, so he didn't have to spit it out. He did want to rinse with water, but didn't feel up to standing at the sink, so I finally got to use that barf bag!

I laid down with Mal at about 9:30 and then finally discovered something that stupid $600 inhaler is good for!

Often, I wheeze when I lie down. There's something in the back of my throat, or down my windpipe, that, even when my lungs feel open and clear, it makes cat sounds. After half an hour of that regardless of my sleep position, I decided to do my final dose of that otherwise useless inhaler... and there was silence! YAY!

I'm going to stop taking it four times a day, as prescribed, and use it instead only when I'm wheezy at bedtime. It worked all night, and I don't think I snored, either. There appear to be about 180 doses left, so it's conceivable that it could last me a year. Fingers crossed!

Mal had a restless night, waking up and saying things like, "Where's the lava?" and going to the restroom a couple of times, always burning with fever. He woke up at around 6 AM, asking, "Mommy, tomorrow can I have some canned oranges?" I figured he was starving after his Tuesday diet, which consisted of half a bowl of cereal, and apple, and one bag of fruit snacks, so asked if he wanted some right then. He ate about 1/4 of the can very ravenously, declared himself stuffed, and dropped right back off to sleep.

He woke up a little bit later and asked, "Why can I see things in here?" I told him it was because the sun was coming up. "But I'm still tired!" I assured him he could continue to sleep.

It's almost 2 PM on Wednesday. I'm pretty much 100%; I managed to vacuum today and that was something I could not have done yesterday. Mal has slept on and off, eating most of the rest of the oranges. He asked for some milk and an apple and is working on that. He keeps watching these LEGO Star Wars play-through videos, and dozing off. He's less hot than he was a few hours ago.

James is working and still coughing, but we kind of all are. Hopefully D missed out on it. I did go around and wipe down all of the appliance handles, light switches, door knobs, toilet handles, faucets, etc. with the Lysol wipes my parents left. Oh, and last night I managed to make dinner for D and me with the bread my dad made.

Sautéed mushroom, spinach, and garlic with Alfredo sauce and mozzarella cheese. Very good. D especially approved.

Looks like we're all on the mend.

I'm operating under a working theory that Mal is actually "teething." He had a hard time teething as a baby, and yesterday I noticed that his front top right tooth is visibly longer than the left tooth. The dentist who did the fillings did a very poor job, but the teeth were at least even. I think that one is trying to come out. This news, of course, upsets Mal, who does not desire change, especially one that is evocative of aging, which predicts eventual independence. He refuses to wiggle it around to see if it is loose. So I guess we just wait.

When Fatphobia Leads to False Conflations

Today, James and I had to have some vitals checked and do some blood work for a new life insurance policy.

First, the whole thing was kind of sketchy. They're a medical contractor that does the work for Mutual of Omaha, and they do offer to come to your house. I'm glad that James opted not to do that, because my allergies are worse at home than anywhere else, and that affects my heart rate at times, for sure.

Anyway, the address they gave us was a pretty spectacular glass office building that was way fancy.

Mal especially enjoyed this white noise indoor courtyard.

When I found the suite, I went in and told the guy we had a 9:30 appointment. He asked, "Do you know the name of the company? We have a lot of companies here." Well, actually, maybe? They didn't mention that they rent office share space, and that information would have been helpful.

Next, they'd instructed us to start drinking water before the appointment because we'd need to provide samples. I took this seriously, and when they hadn't called us in by 9:45 (we were already discussing how long to wait before we took off), I went to the bathroom. As I washed my hands, a lady opened the door and said, "Laura? Oh. We need a urine sample." I told her, "I held one for you for fifteen minutes." Sigh.

We went back into this office and I was ready. I am at a healthy headspacee, for the first time in 30 years, regarding my body. I eat and move and wear what and how I want, without thought to others' opinions, or without shaming myself, and it's so freeing. But I don't know how I'd react to having a number assigned to me (I don't really care what size I wear; that's never been an issue) and I don't want to risk obsessing or going down a dark tunnel over a stupid measurement of my body relative to the gravity of our planet.

So.

I said, "I need not to know what I weigh." The technician interrupted me with, "But no! You're beautiful." I said, "I know." (Seriously. Ask James.)

Just because I was performing self-care doesn't mean I think I'm ugly. On the contrary. Most of my life, I've felt pretty until outside sources "corrected" me. My not wanting to know my weight made her think I feel "too" fat and therefore ugly. There's a meme I just saw last week, and this recalled it.

From Body Positive Memes by Michelle Elman

So there's that. Anyway, because the whole office was carpeted, the scale didn't work, anyway, and so we both just provided weights out of the air. I said what I weighed when I first went in because I was pregnant with Mal. My body is definitely different now than then, but besides that pregnancy, I haven't weighed in 10 years, other than at the doctor's, and then I said the same thing: I can't know. It's not good for me.

Besides that, neither of the women who helped us had English as a first language, although one was fluent. The other was a lot more fluent in English than I am in any other language, but since we were talking about medical conditions and medication, sometimes had a difficult time understanding James and therefore writing down what he was saying. Never mind that EVERY SINGLE THING they asked us we'd already answered on our life insurance application.

Fortunately, the blood-letting was done quite adeptly and you can't even tell that I got jabbed today.

But also, the notes given to us before the appointment about what to expect were: "Blood and urine samples, body fat checks, basic questionnaires."

Sigh.

This is for life insurance, so I'm sure they have some rubric they use to determine risk, based on many factors. However, science is on the side of saying that "body fat" shouldn't be one of them. From a study a few years ago, researchers found "a U-shaped curve, with the bottom of the curve — the lowest risk of death — falling around 25 to 26 on the BMI chart, making the risk of early death lowest for those now labeled overweight. People considered 'mildly obese' had roughly the same risk of dying as those in the 'normal' category. Death rates went up for those on either end of the scale — underweight and severely obese — but not by much." (New York Post)

Anyway, I'm just glad that's over. Because ugh. And after fasting and not having caffeine, I treated myself to Krispy Kreme's Chips Ahoy doughnut and a soda. Because that, too, is self-care.

Follow-Up (Or How It All Ended... Almost)

This is a story all about how my life got flipped, turned upside down...

Not really. Just a continuation of the previous post about home and car repairs and whatnot and so forth.

The house: The water damage guy came back on Monday (President's Day) to find that D's room was mostly dry. All of the areas where we saw water leaching and leaking from the ceiling were fine. At the wall shared with our bathroom, though, it was still damp. He moved some stuff around, took one fan, put the dehumidifier in our bathroom, and left everything another day. By Tuesday, it was all dry, so D finally got to return to the isolation chamber.

Joking aside, that kid handled the stress of having basically zero privacy for four days amazingly. It made me very proud, and hopeful for the future, since the anxiety management was so effective.

The SUV, however, is another matter: I picked it up from the shop on Thursday morning, about a week ago, to find that the gas gauge didn't work anymore. It had worked before, and we'd already had the "the battery keeps dying" drama, and I wasn't ready to handle finding a ride home and keeping the vehicle there, so I put it off for a bit. I did call them and told them what had happened, and they said to let them know when I could bring it back in.

THEN the water thing happened, and there was no way I could handle the auto repairs while we were dealing with all of that.

Also, we'd agreed to donate our Cobalt to KUT, holding off about two weeks after our SUV purchase to make sure it would run okay, and we were getting close to that pick-up with no definite resolution on the new (to us) vehicle.

In the midst of this, Mal and I drove up to see my parents and spend a night just to get some people out of our house, which was down one bedroom and one bath. The Torrent drove beautifully, and was SO much more comfortable than the car. It gets pretty good mileage, too: 24 mpg for the first couple hundred miles we drove it.

Unfortunately, the "check engine" light was still on, so it wouldn't pass inspection, and we couldn't register it. The clock is ticking on that particular item, too, as half of the 30 days have now elapsed.

So yesterday, we took the SUV back to Klingemann. After we'd been there almost an hour, they said it would take at least another hour just to get the fuel tank out, and then they'd have to evaluate what was wrong. They kindly gave us a shuttle home; I'd intended to take a Lyft, which was $11, but after 11:30, the "busy lunch" rate kicked in and it was almost $30!

Last night, they called us and said they'd put a whole new (not after-market) fuel pump in and had had the same problem. He told me he'd call me back on Saturday.

I got two calls this morning.

The first call was from a lady whose brother bought the 1/3 acre lot right behind our back lot about a week ago. I had heard them looking at it last Friday, and James had met them on Saturday when Mal and I were in Temple.

The lady is interested in purchasing our "extra" lot so she can retire here. We spoke for a bit this morning, and I learned that Jonestown apparently adopted some building guidelines that would make it impossible for our house to be built today: Namely, that homes have to be at least 1000 square feet (check) and have to have a 2-car garage (nope). Anyway, we chatted for a bit and she made it clear that she wasn't interested in haggling, so for us to tell her what we'd take for it and get back to her.

Then Klingemann called. And they made me cry. This probably would have happened, regardless of the prognosis, but he said basically this: We put in a third fuel pump and had the exact same problem, so we put it in fluid and realized that the sender is bad. I have one on order from Houston. Had we caught it last week, and we should have, we could have told you that it would cost extra. Since we didn't, we're going to eat it. We'll have the part Monday and get your car back to you then.

So. Whew.

After this, James, Mal, and I went out to the back 40 to see exactly what we'd be selling off. Long story short, we had such a good time (well, all of us but Mal, who was scared and wanted to go to our "real" back yard) that we decided we couldn't part with the land until Mal has had a chance to get out there and explore and have adventures in a few years. Maybe when we get another dog.

This tree is LCRA property, but all of the stuff on the back of the grotto, in the background, is on our back lot.

Besides, 5 years from now, that property just might be worth double what it is now (the tax assessment went up 125% after we bought the property), and that's a lot better a return than we'd get if we sold it and put the proceeds into some investment.

I have high hopes now that I might be able to get the car titled and registered next week. The only possible hold-up will be that it's an out-of-state title and the seller has zero desire to go with me to the tax office (which they recommend), but I'm pretty charming and look legit, right?

One more kind of cool thing from today: We got out for a bit and when I came home and checked the mail, I was surprised to find two prepaid cards I knew *should* be coming, but one never knows...

A couple of months ago, I'd seen an offer for this credit card where you could get what is tantamount to a couple hundred dollars after you'd spent $500 during the first three months. Please! Our car repair and a couple of household bills, and we hit it on mine AND James's. And within a week, they sent us the cards! It was just a nice, encouraging way to approach the end of this whole set of circumstances.

AND, speaking of surprisingly quick action: I filed my taxes on February 11. They estimated that I'd have the refund by March 6, which wasn't in time to make our next mortgage payment and meant we'd have to pull MORE out of our dwindling savings. However, when I logged into my bank account on February 17, IT WAS THERE. So we paid EVERYTHING off that I'd been holding out on until the regular salary payments started back up, AND we have enough to make the mortgage payment with no further withdrawals.

Whoo! Getting back on track feels good.

And lest you think it's all fun and games, I realized this morning that we're 2 weeks out from Daylight Saving Time and if we keep our current schedule, Mal will be going to bed at 12:30 AM and sleeping until 11. Ugh. Let us all hope this story has a twist and as happy an ending as all of this other stuff.

Ridiculousness with medicine!

It's been a while since D has had a well checkup. 12.5 years, if you're counting, which I wasn't until the PA asked, and then I felt a little sheepish. Anyway, it seemed like the time was right (and ripe?) to get a full physical and blood panel, just to make sure everything is going well in adolescent land.

The physical was great, and we have an appointment to go back in three weeks to discuss the results of the many many blood tests.

I was really impressed with Austin Family Medicine, I have to say. The PA was great, we were in and out fast, and it was nice not to have to be around sick people just to get a physical, honestly.

I prepaid for all of the labs, most of which were in the $20-40 range. There was one that was closer to $500 that they said I could opt out of, and then I had to sign a paper that said I understood I was going to be billed for another test, but it would be $125 maximum. And that's where this gets interesting and stupid.

Today, I had a voice mail. If you ever call me, I'm sorry. My phone is usually silenced, and I almost never answer it. But I do return calls (or more likely text back), so when I saw this message, I listened. Here is what it said:

"This is Jake from Boston Heart Diagnostics, calling for Daphne. Please call me back at..."

I was actually in our complex clubhouse when I got the message. Mal wanted something, but I shushed him and opened my notes so I could write down the number and the reference. I called immediately, my imagination already going. The diagnostic center doesn't call you... unless it's something serious.

As it turns out, our friend Jake is from the billing department, a fact I feel he purposefully neglects to include because he thinks people wouldn't reach back. That's the first crappy thing.

Jake had apparently called to get my insurance information, which I don't have since we don't have insurance. I explained that I was cash pay and was trying to pull up my Google Wallet so I could pay off of the info on my phone, when Jake came on the line to inform me that the cash pay amount for the test was $2200.

I said, "I was told that the only other test would be $125, max."

He said, "Oh, yes, one of the tests is $125. But we ran all of them and here are your options: You can fill out a form and see if you qualify for assistance, based on your household income and the number of people in your home. You could qualify for 50% up to 100% of the cost paid for." (I guarantee we qualify for nothing.) "You can work out a payment plan, so you can pay a little bit a month. Or you don't have to pay, and we just won't send the results to the doctor."

Okay, so NOW I get it: This place ran more tests than they were authorized to run because they assumed I'd have insurance, so it'd be paid for, even though it wasn't ordered. Then when they find out I'm cash pay and realize I might not want to fork over $2200 when I'm worried absolutely zero about my daughter's cardiac health (not that I'm not concerned, but I have no reason to be worried that it's vulnerable), since they've already run these big expensive tests, they'll just hold on to the big expensive results. That's the second crappy thing.

Well, second and third. Second is running the unnecessary tests under the assumption that it'd be covered because what insurance company is going to question it? And third is basically trying to extort money out of me for results they already have and might as well just zip 'em over to the office. Jerks. Stupid, money-grubbing jerks.

I'm GLAD I don't have insurance and they won't be repaid for their time and effort and whatever they used in testing. I'm sorry someone else is probably paying for it through their own payments or insurance premiums or whatever. The whole thing is ridiculous.

This raises an ethical question: What if there were something amiss, like a congenital defect or something we didn't know about, that came up as a result of this testing? Are they liable for not mentioning it, even though I didn't pay to see the results?