Oh, my aching back

 

"There are more fools in the world than there are people."  -- Heinrich Heine

(This is an excerpt from an article that appeared on August 24, 2011, at the link found below this piece):

Is that MRI for back pain necessary?

Back surgery is one of the best documented examples of expensive medical treatments that drive up health care costs while not always helping patients, and sometimes even hurting them.

And the latest Medicare data show that doctors frequently order MRI back scans for patients who haven't tried recommended treatments such as physical therapy. An MRI often prompts surgery.

I saw this article when it first appeared, and just had to save it for the opportunity to add my commentary. I guess it has had ample opportunity to ‘age,’ so maybe it is time to add said commentary.

This is a rather strange factoid to see jump up as suddenly as it did, because the basic conclusion of the article is the exact same thing that I, and many other professionals, have been saying for many, many years! There is and has long been, a tendency to over-diagnose (as in, running too many expensive diagnostic scans and tests) and over-treat back complaints (as in, entirely too much unnecessary surgery, too soon).

The results of these two things are really frightening, if you look at the big picture. Too often, diagnostic scans are misread, misinterpreted, or outright ignored, and serious diagnoses are given to relatively benign conditions. A very wise Orthopedic Surgeon, who I knew many years ago, said that the wisest course of action with back complaints is to do nothing. When there is any need for something to be done, he said, the wisest course was to keep treatment simple and minimally invasive. Physical Therapy, along with some education in how to cope with back problems, in general, in his opinion, went farther, caused fewer problems, and cost less money. Time, he said, was the greatest healer of back problems.

And, you know what? I did not need this latest study to know that he was right. Anecdotally, I can tell you I have talked to many people over the years who reported back problems – hell, I’ve got a ‘bad’ back, myself. And, I have come to realize that they generally fall into one of two camps: those who did not receive much beyond PT, some rest, some education, maybe some muscle relaxants; and, those who underwent CT Scans, MRI’s, EMG’s (with Nerve Conduction Studies), and whose treatment all too often included surgeries.

Guess how many of those who had back surgery had bad outcomes, and guess how many of those who did not have surgery are still going strong. Worse, I remember an investigation I did some years ago into multiple complaints (not to mention multiple malpractice actions) against one particular back surgeon in Texas. Now, this was only one guy, in one city, and he was not even the worst of the bad guys. What I remember most clearly is that I obtained and studied the case histories of a good number of patients who not only had bad outcomes, but whose medical records totally lacked any objective diagnostic information to suggest any need for surgeries.

Worse, I remember a situation where a physician – who was not even an orthopedic surgeon, by the way – convinced a large number of patients, diagnosed with “Intractable Pain,” that they needed to let him place an electrical device into their spines, the purpose of which was to somehow stimulate the spine into ignoring their chronic pain. These patients were a mixed bag of “failed back surgery” and/or other types of pain patients whose reported pain could not be controlled by other, more conventional methods. Most of them happened to be individuals who had reportedly been injured at work, and had not been able to return to work due to their intractable pain.

At that time, orthopedic protocol required that patients undergo a full psychological workup prior to undergoing surgeries, or the placement of such implants, in an effort to provide some indication of whether they were suitable candidates for invasive procedures. Turned out that, while all of them were indeed referred to see a psychologist, the testing rendered, without much personal interaction between this psychologist and the patients, was mostly leaning towards identifying these people as poor candidates for this implant, because they were mostly identified as being chronic complainers of pain, regardless of what interventions were attempted (in short, very close to being outright malingerers).

The ‘Surgeon” went ahead anyway, at a cost of many thousands of dollars per patient, and none of them were ever able to return to anything resembling a normal life. Most were disabled for real, after months to years of questionable ‘care,’ that ultimately did affect their physical abilities. What can I say? The ‘Surgeon’ was a good salesman.

Ultimately, even though a good number of patients’ lives were irretrievably damaged, nothing was ever done to the physician, even though we made a great case against him. Part of the problem is that these patients allowed him to do what he did, willingly (for whatever motives), and they had to assume a portion of any blame.

My point? Obviously, never allow your doctor to go straight to MRI’s or other expensive diagnostic studies, until time has had a chance to work, along with mild therapy and treatment. Below is the link to the article that got my attention: http://www.npr.org/blogs/health/2011/08/24/139923555/hospitals-have-got-your-back-maybe-a-little-too-quickly?ft=1&f=1001

Price Reduced!

For Sale, Lease or Rent:  This Piece of Paradise

Sale Price Now Reduced!

This two year old 2 bed, 2 bath cement block home sits on a secluded plot (2166 sq meters, or about ½ acre) on a very quiet road that actually runs all the way down to the water’s edge of beautiful Lake Arenal.  (The water is just 500 meters from the front door).

This is the last house on the road down to the Lake.  There is a heavily wooded, deep gully on one side (the Ticos refer to this as a montaña, or a quebrada), with a little stream at the bottom.  This ensures a nearly constant, fresh breeze.  Water is paid once a year, and currently is only about $72.00 per year, with no meter.  The water is cold, and crystal clear, with nothing added.  There are two septic systems (aguas negras, for toilets, and gray water, for washer, showers, and sinks). The house is available with Kenmore washer and electric dryer, Whirlpool Gas Range,

Maytag refrigerator, and a 2005 Suzuki Grand Vitara, XL7, with current Marchamo and Riteve would be included with the sale (pictured below).  Also included will be one queen size bed, with frame and one King size bed, with frame.  Additional furnishings are negotiable, including wall-mounted Samsung Plasma TV, Sharp Surround Sound system, and small appliances, including Sharp Microwave.  

Part of the Living Area is pictured above.

Ceiling fans are installed in both bedrooms, and in the living area, plus two more are on the front porch, which is completely screened.  Also included on the front porch is a round concrete table, with three concrete benches, completely tiled.

Front of the house features a recently completed and oversized carport, and there is an enclosed (screen, metal, and wooden bars) garage cum workshop attached to the back of the house.  

This is the workshop/bodega, at the back of the house.

One dusk to dawn yard light is attached to the back garage, and motion sensors are mounted at opposite corners of the dwelling itself, plus another on the new carport.  The floors throughout the house, and also in the garage and on the front porch are ceramic tile.

Solid wood doors, and beautiful wooden kitchen cabinets are featured.  Windows are all protected with iron bars.  The ceilings throughout are high, with beautifully stained wooden beams. Reduced Price: $175,000.00. Monthly rent is negotiable, with renter being responsible for all utilities.

Walmart: A (quick) study in Love/Hate

“Everyone is entitled to be stupid, but some abuse the privilege”. - Unknown

Why are some folks so upset with Walmart?  You know, I get so tired of these whining idiots who make claims like, “Walmart has ruined many small towns,” or “Walmart is responsible for making China what it is today.” Where do they get these silly ideas? Are they totally ignorant of modern history? Where were they during the sixties, seventies, and eighties?

First, let’s keep in mind that each and every generation, from the beginning of time, has seen change of one kind or another, and pinned responsibility in the wrong places. More recently, while folks my age pretty much agree that growing up in the fifties was an idyllic period in history, we are just as wrong as all the generations that came before us (‘cause we all know that the ‘Good 0l’ Days’ only exist in the memories of us old folks). And, as for the death of small town America, that was written way back at the beginning of the Industrial Age, and anyone who continues to deny it today is simply foolish.

The death of small town America was starting to be obvious as early as the sixties, and the death of Downtown America was evident at the same time. But, what really caused this? You certainly cannot blame Walmart, because they were not only not the first store of this kind, but the first Walmart did not open until 1962, the same year as the first Kmart and the first Target. At the same time, we saw, across the country, the establishment of a myriad of similar stores – Govmart, Globe, Fedmart, Grants, Woolco, and many others. These stores took over the retail spot earlier occupied by variety stores, such as Woolworths, S. S. Kresges, and so forth.

Variety stores, also referred to as ten cent stores, ‘the five and dime,’ or simply ‘dime’ stores, got their popular name because most of the items for sale in them only cost five or ten cents. They had much more class than today’s ‘dollar’ stores, but their merchandise was much the same quality, and variety. If one wanted clothing, one went to J. C. Penney, or to the local department store (another dinosaur). Auto parts were found (at least in my part of the world) at Western Auto, a great chain, also an extinct species. Groceries were purchased at the local food store, or maybe at Safeway (wow, I think this chain still exists).

What killed off all those dinosaurs? Competition, plain and simple. And, it was not Walmart alone. Here’s how it happened, and how it keeps on happening:

As for Walmart selling nothing but stuff made in China, I’m not going to cite any facts or figures for you, but I am going to tell you this: (applying logic, here’s how it goes) – you, the American consumer, demand decent quality for a fair price, no? Walmart, as a purveyor of goods, for a profit, realizes that they need to be able to offer you what you demand, right? How the hell are they going to stay in business if they don’t show a profit? And, how are they going to show a profit if they cannot provide you, the consumer, with what you demand?

So, they search the world over, looking for good products at a fair price. Actually, for Walmart, they no longer have to do much searching, since most decent manufacturers now bring their product to Walmart, hoping that it will be acceptable to their buyers, who after all, are looking for whatever you demand.

Now, don’t try to tell me that you disagree with any of this, because you know this is how it works. It is most certainly not the fault of this particular retailer (or any other retailer, for that matter) if the best products, for the best prices, happen to come from China. If you must blame someone, blame the Republican Party, the GOP, and big business (as in the owners/stockholders of major brand names). They are the ones who decided, beginning way back in the sixties and the seventies to start exporting work, from first our heartland, to our southern states, and borders, and then, overseas, first to Mexico, and then, very quickly, to Asia. Read your history!

I remember this happening and watching it happening right in front of all of us. We lived in El Paso, Texas, from 1970, until 2004. First, in the late sixties and very early seventies, large American manufacturers began to relocate their factories to places where they could find cheaper labor than they had in Indianapolis, Sheboygan, St. Louis, Erie, Gary, Rolling Hills, or wherever plants used to be. They found cheaper labor, and all kinds of tax breaks and other incentives from communities and even States located along the U. S./Mexico border, and in many southern states. I remember the excitement as Hallicrafters (a major supplier of radio communications equipment during WWII) came to El Paso. (I actually worked in their factory for more than two years, as an electrical technician). Then, Tonka Toys, then many apparel manufacturers came to town to join those who were already there (Farah had one of the world’s largest manufacturing facilities right along I-10). Lee Jeans, Levis, Wrangler, and many others also set up shop.

But, a funny thing happened. Once these big names arrived along the border, it did not take long before they realized that even cheaper labor was right there across the border. So, one by one, those who were able to do so, began to move their manufacturing to Mexico, and today El Paso, once a major manufacturing center, is nothing more than a great big warehouse for all the finished goods that cross the border from Mexico every day. And, of course, once these big names set up shop in Mexico, it did not take long before they heard the call of even cheaper labor over there in Asia, and guess what? Mexico has a good number of empty factories, now also, just like we do.

Who is to blame for this? NOT Walmart, folks. They, and others like them, only try to make you, the consumer, happy. We can’t hope to successfully boycott them (and, frankly, the very idea of trying is absurd). Hell, they even have their own subculture today. Haven’t you heard of, and seen those pictures of ‘Walmartians?’ Of course you have.

Ramblings on turning 65

NOTE:  (I began writing this on June 25th, my birthday).

“Now some of you may encounter the Devil's Bargain, if you get that far.  Any old soul is worth saving, at least to a priest, but not every soul is worth buying.  So you can take the offer as a compliment. He tries the easy ones first.  You know like money, all the money there is.  But who wants to be the richest guy in some cemetary?  Money won't buy.  Not much left to spend it on, eh gramps?  Getting too old to cut the mustard. Well time hits the hardest blows.  Especially below the belt.  How's a young body grab you?  Like three card monte, like pea under the shell, Now you see it, now you don't.  Haven't you forgotten something, gramps?  In order to feel something, you've got to be there.  You have to be eighteen.  You're not eighteen.  You are [65] seventy-eight.  Old fool sold his soul for a strap-on.  Well they always try the easiest ones first.  How about an honorable bargain?  You always wanted to be a doctor, well now's your chance.  Why don't you become a great healer and benefit humanity?  What's wrong with that?  Just about everything.  Just about everything.  There are no honorable bargains involving exchange of qualitative merchandise like souls for quantitative merchandise like time and money.  So piss off Satan and don't take me for dumber than I look”.  - - - -  Wm. S. Burroughs

Well, today’s the day. I am now 65 years old. There were times when I did not expect to reach this point. There were times when I thought I’d be truly decrepit when I reached this point. There were fewer times when I naively thought today would be just like any other day. But, now it’s here, and I hardly know what to make of it.

On the one hand, I do not feel all that well. But, part of that (I hope) must have to do with the fact that the doctor put me on anti-hypertensive medication for the first time just one week ago, and I think I am still adjusting to what the medicine does to me. At any rate, I feel very sleepy most of the day. Hopefully, this will ease over time.

Meanwhile, today is very muggy, we’ve already had a pretty good rainfall, and I’ve been sweating, as I worked to prepare some ribs. That’s right. Honest to Gawd, an entire rack of Pork Spareribs. - - - And, of course, right there, we have a side issue. I paid ₡3,500.00 per Kilo for said ribs. That’s like $7.00/Kilo, or $3.50 per lb. I brought back some newspaper grocery ads from our recent trip to Texas, and HEB (one of the best supermarket chains in the world) featured Pork Spareribs at $1.57 lb. - - At any rate, I did a brine soak overnight, and then made up a rub, with those ingredients that I had on hand, which I applied just before I lit the fire.

Now, I know that many will argue as to the best way to get good ribs, but this is what I know: Using local charcoal, which is not very good, but adequate, I made a very hot fire (shop vac helped here). I seared the ribs to black, on both sides. Then, just like always, I banked the coals, all around the sides of the grill, and placed the rack in the middle, closed all vents and the lid, and walked away. I returned to the fire after two hours, and turned the ribs over, and left them again, for two more hours. They were good! Really, really good. We had friends over, plus sent a couple of plates up to another neighbor, who was feeling under the weather, and all that was left at the end of the day, were a couple of small pieces. - -

Where was I? Ah, yes, reflections…………

We are blessed this summer to have three of our grandchildren staying with us. Yes, we brought Tristen (13), Aislynn (9), and Bryan (18, and a brand new High School Graduate) back down with us from our trip to Texas. We did get to see most everybody while we were there, and Blanca and I got to experience some of those good things to eat that we never can find down here (Long John Silver’s Fish & Fries, Der Weinerschitzel’s Chili Dogs, Rudy’s BBQ, a couple of decent burgers, and, of course (and just for me), DQ.

We came back to find that the oven has not fixed itself, and we really have no clue where to find someone who might be able to get it working again. We ask everybody we encounter, but no one knows who can really work on a gas stove. I suppose we could call the people that came to look at it when it was under warranty, but I was not really impressed with what that guy did when he came. Plus, I shudder to think what they might cost for a house call that I have to pay for.

I did find a choke cable repair kit at an auto parts in Arlington, and brought that back with me. Bryan, our grandson, helped me to put that in, and then, I bought a new battery for the Torito, so it is back on the road, after months of not being able to use it.

Electrical consumption was minimal during our absence, but now, with three more bodies in the house, I know it is going to jump way up there. Even though I know we did pay for a lot more than we ever used in the past, I know that with the exorbitant rates ICE charges, our bill will soar again, and the difference this time is that it will be due, at least in part, to some actual use.

As to being older, inside me is that same skinny young kid who was drafted way back in 1965, but now, he finds it hard to push his way out, past all the accumulated poundage, not to mention the years of experience and the scars that the years have laid on this old body.

I wish I could say that I am wiser for it all, but I think the only outward appearance of wisdom is that sometimes (rarely) I do know enough to stay silent when an opinion is asked for by some family members. That would be situations where I know one or the other of my kids or grandkids is not going to listen to me anyway, or more likely, those situations where I know my wife is going to ignore me altogether.

This thing started out to be titled as ‘reflections,’ but I have wisely (I believe) decided to call it ‘ramblings,’ since there is no one topic, and little of what I have written so far really applies to achieving this new age. I certainly do not feel wiser. My wife will happily tell you that that is for sure.

Life does, apparently, go on. I am just trying to take it one day at a time. We have been working our way through some TV mini-series, and movie series, with the grandkids. We have watched things like “Band of Brothers,” “The Pacific,” the “Back To The Future” movies, “The Lord Of The Rings” trilogy, and are now most of the way through Harry Potter. Yes, we know that we cannot yet see the final Harry Potter movie, nor can we see the latest “Pirates of the Caribbean” yet. But, we struggle on.

We did get the oven fixed, and I am still mystified as to what was wrong with it in the first place. At the cost of about $110.00, a technician came to the house late Tuesday afternoon, with his wife and child in the car. He didn’t spend ten minutes here, and all he had to do was make an adjustment to a valve at the very bottom of the oven. He claimed that it likely gets clogged with grease (I can personally vouch for the fact that there is no grease anywhere near the oven itself), and that is why it needs to be adjusted. I haven’t a clue as to what it is, exactly, that he adjusted. I did get down there myself, but only saw the one main orifice, and the air vent that may be adjusted. So, now, I guess I need to find another valve (the tech said that there is a brass screw down there somewhere that can be adjusted), so that I can save the bucks next time around. The problem that I am having here is that we have had mostly gas ranges for all of our married life, and never, ever did we have any problems with one until we came here, and, bought this stove!

Here’s some food for thought. We have, as I said before, had the pleasure of our grandkids visiting this summer. I know that I have long groused about the poor quality of public school education in the U. S. But, I have been very pleasantly surprised to learn that our 18 year old grandson, the one who just graduated from high school, has a surprisingly large store of information packed away inside that late-teen-age head. He needs to work on his vocabulary and English language skills (too much texting?), but he is able to converse intelligently on a wide range of topics. So, maybe there is hope for the future, after all.

Our granddaughters, meanwhile, are as delightful as always, being very sweet young ladies, with inquiring minds. We now count less than a month until they all depart. Bryan will return to Texas for a sort of farewell tour, with plans to go to Austin and spend time with some of his uncles before he heads back to El Paso to report for active duty with the Army in early October. The girls, of course, are very anxious to get back to Arlington, where they will first meet their new baby brother, Julius, and then get ready for the start of another school year.

Grandma will stay in Arlington until at least November, to help out with that new baby, while I will stay here to hold the fort down. Meanwhile, our property is for sale, if you’re interested…….oh, and, uh………I have reduced the asking price.

Quick update:  as of today, Nov. 30, 2011, I am in Texas myself, along with Blanca and the grandkids.  I seem to have an eye problem which was being improperly treated by those stalwart Tico docs of the Caja, and am hoping to get it fixed while here.  We are set to return to Costa Rica on Jan. 9, and I feel time pressing in on me, since I got here on Nov. 8, and have had nearly three weeks wasted by a doctor here in Arlington.  I am to see another eye surgeon on Friday, the 2nd, and hopefully, he can get me on the right path.

GMO food, Organic Food, Ethically killed food, and the human condition….

"The surprising thing about young fools is how many survive to become old fools." -- Doug Larson

This thought recently occurred to me: Does it make any sense at all for any person who wants to sell me something to knowingly offer me something that, in the long or short run, is going to cause me serious harm? I mean, if I was in the business of producing anything that I wanted people to buy, wouldn’t I run out of customers if I deliberately killed them all? So, where do these ideas of Monsanto as an evil-empire-set-on-killing-us-all-with-their-genetically-modified-foods originate? The same applies to the ideas of a cattle or chicken rancher administering various antibiotics to animals raised for food, or other medications/chemicals designed to ensure their health and fast growth. If that is so harmful to the humans who consume these animals, wouldn’t he, the rancher, soon run out of customers?

Maybe it’s just me, but it seems like I keep running into very vocal people who insist that they will only eat “organic” food, and that the meat they eat must have been dealt with “ethically,” whatever that means. I mean, obviously, it is OK with these people that somebody else killed the chicken or the pig or the cow that they eat, but the killing must have been done ‘humanely.’ Give me a break. I can accept the idea of religious philosophies directing how food is raised, killed, or prepared, because believe it or not, many of those ideas have some ancient basis in reason. As a for instance, pork is indeed very deadly, if not raised carefully, and cooked thoroughly, so it makes sense for a religious leader to just say, “Hey! Don’t eat that pig. It’ll kill you!”

But, to try to tell me that the chicken that laid my morning egg has to be maintained in such and such a fashion, or that the meat on my plate had to come from a contented cow, raised only eating specific foods, not given certain types of medicine or supplements (all the while, relying on all kinds of phony supplements oneself) is just a bit too hypocritical for me.

I especially am put off by people who say such stupid things as “I want to eat the same things that my grandparents ate.” They really don’t seem to grasp a few basic facts of life, or of history, for that matter. Our grandparents did indeed seem to eat a lot more than we do, and everyone has seen Hollywood versions, and maybe even read written versions of stories that depict the family sitting down to a breakfast where there are platters heaped with fried eggs, huge, thick slices of fried ham, huge hot biscuits dripping with real butter (not to mention ham gravy), and all kinds of side dishes.

What we tend to overlook, however, are two very important differences between those folks, and us folks. One, they tended to live a shorter life than we do/will, and they went out and worked their butts off after consuming that huge meal. They did not go sit at a desk all day, peering at a computer screen. No, they went out and pitched hay, mended or built fences, tended to livestock of every stripe, built barns, planted crops, weeded crops, dug irrigations ditches by hand, and cut down monster trees with hand saws, and so on.

So, unless you’re prepared to go out and work off a huge meal, don’t try to emulate your grandparents by eating such meals. But, to get back to the idea that it is wrong to ‘genetically modify’ our food, or to infer that Monsanto and others are out to poison us is just plain absurd. For one thing, nobody complains when they see the development of hybrids (see Burpee seeds), or the result of years of selective breeding. What do you suppose those are if not genetic modification, of a simpler variety?

While I do think it is kind of crappy for Monsanto, or whoever, to have developed so many varieties of plants that cannot be reproduced (thus forcing the grower to go back to them for next year’s crop), at the same time, I have to admire the fact that they did develop such a thing. That’s truly ingenious. And, hey, isn’t that really the result of the demands from consumers for things like seedless watermelon, or seedless grapes? And, let’s not totally overlook the fact that those seeds generally have built in – as the result of years of research on the part of Monsanto, or whoever – a better resistance to certain outside influences that might threaten a crop.

All the farmer has to do is seek another source for his seed corn, or whatever. At the same time he can go back to what his ancestors did, and simply hold out a portion of this year’s crop as seed for next year’s crop. All of that having been said, we, as consumers, need to keep in mind that we are at least partly responsible for these developments. We all want more and more quantity of wheat, corn, veggies, or whatever foodstuffs are grown, for less and less effort or money. We demand it. Because of these demands, the family farmer is long gone. What we have now is the corporate farm, which has grown out of our ever increasing demands. What we have now are much larger crops coming from larger fields and farms, and using anything that will grow faster, healthier, and cheaper.

If the end result is a minority of people who turn their noses up at the produce of the American farm, then maybe we should advise them to follow Marie Antoinette’s directive, and just let them eat cake.

Now, I will freely admit that there does appear to be a very small minority of people who – for whatever reasons – cannot tolerate some of the additives found in either the hybrids, or genetically modified seeds, or even some of the things given to food animals during their raising. Those people, in another time, another place, likely would not have survived early infancy, or childhood because they would have succumbed to any one of a multitude of things that used to kill kids. But, thanks in large part to the same science that has given us genetically modified foods, and hybrids, they now do survive infancy only to then fall very ill with conditions like celiac disease and other food sensitivities. There are a number of options for those thus affected, most of which do involve the avoidance of foods that the majority of people can and do eat.

But, ultimately, since those with these problems are such a tiny minority, it is not logical, reasonable, or at all realistic for the majority of people to have to give up anything in order to handle these problems. So, when folks start crying about the food producers are evil because they have modified our food, they need to remember another thing about cake…………they say that you cannot have your cake and eat it, too.

Heads Up, Y'all

OK, I guess it is time to provide some sort of an update on happenings around us.

Don't know if I have mentioned this before, but I have been having problems with my left eye since shortly after we moved to Costa Rica. First, and this has been ongoing, I experienced a sensation of having something in my eye, like an eyelash. Nothing helped to alleviate this, and I tried everything I could think of – eye wash with a Boric acid solution, eye drops, and went to see an ophthalmologist in Liberia, who was recommended as the best in the entire province of Guanacaste.

He was not cheap, he did do a pretty thorough exam, but he said he could not find anything other than maybe the tear duct was clogged and inflamed. He said he cleared it, and he gave me eye drops, mostly steroids. I returned to see him, and all he offered was that maybe I had some sort of allergy, and he thought I should see an allergist, in San Jose.

I asked the doctor at our local clinic (the Caja) for a referral, and he gave me one. I ended up seeing the same specialist that I had seen as a private patient, and he had nothing better to offer me. He did prescribe some allergy drops (Patanol), but the Caja pharmacy hardly ever stocked it, and it was too costly to buy on my own (the one time I bought a little vial of this stuff it cost something like $64.00). Meanwhile, I have noticed over time that my vision in the left eye has deteriorated, to the point where I can no longer read, even with reading glasses.

Finally, I got the name of another specialist, this time in San Carlos, and saw this guy (a Dr. Vega) a week ago last Friday. He said that I have a corneal tear (not a good thing to have, but it explains that sensation of always having something in the eye) and also said that my diminished vision is due to a cataract.

Now, I can accept the possibility of a corneal tear, mostly because (after he mentioned it as a diagnosis) I do seem to remember the symptoms of this condition do seem a lot like what I have experienced. Regarding the possibility of a cataract, however, I have trouble accepting that as a possible diagnosis, because all I have noticed is diminished visual acuity, and no limiting of the visual field that I thought was the classic and most prominent feature of a cataract.

The doctor in San Carlos wrote me a detailed referral to see another specialist, in San Jose, and estimated that it should cost less than two million colones (about four thousand dollars in real money) for the two separate surgeries that he thinks I need. Of course that does not include the cost of travel to and from San Jose, and who knows what other expenses might arise.

So, I have concluded that I need to see a doctor in the states, especially since I am paying for Medicare already. I have therefore made reservations to go to Texas in early November, after making some calls to various doctors' offices and to Medicare. I have no idea how much time might be needed, but am giving myself two months to take care of this. I can only hope this will be adequate. Any questions, give me a holler, and I'll try to keep things up to date here, and on Facebook (for my faithful Facebook friends and followers).

Meanwhile, Blanca is still in Texas since she took the grandkids back in August, so she will just wait for me, and then we'll return home in early January.

Taking Care..............

"We Americans live in a nation where the medical-care system is second to none in the world, unless you count maybe 25 or 30 little scuzzball countries like Scotland that we could vaporize in seconds if we felt like it."  -- Dave Barry

Why is everyone so upset about this issue regarding Ron Paul’s attempt to say that it is not the job of government to provide free health care for all?  Where have all these people been since forever?  And, why do people make statements like this:  “My (brother, sister, husband, friend, relative, or whatever) died because he/she/they did not have insurance…..”?  A lack of insurance is NOT going to kill anyone.  I’m sorry, but it just ain’t gonna happen!

Now, don’t get me wrong, I do agree that a certain amount of government involvement in health care is a good idea, and the thought of truly universal access to health care is a very attractive, albeit lofty, ideal.  However, all you have to do is look at those nations that have attempted to achieve this, and/or are attempting to do so right now, and you might get an inkling of just what is entailed in pursuit of such a lofty goal.

First, do not throw the Constitution, the Bill Of Rights, or even the Declaration of Independence at me.  They do NOT address this issue.  Never did.  Second, remember the world of the folks who wrote those venerable documents.  Did any government, anywhere have any thoughts of addressing this issue?  No, I don’t think so.  It was indeed the responsibility of the individual, the family, and the community to care for those who needed it.  The only thought given to such an idea was to simply put it under the general heading of charity, and go on about other things.  Granted, a big part of this is simply that people didn’t generally live all that long, anyway, and when they sickened, they usually got better on their own, or died.  It was as simple as that.

Some of the people who might have needed assistance from their family or their community would have included widows, orphans, and those too ill or infirm (such as the aged) to work and support themselves.  There was no welfare office, no food stamp program, and no such thing as Medicaid.

Jump forward to the Twentieth Century.  By that time, government had grown (oh, how it had grown), and had indeed assumed too many of those responsibilities that rightfully should still belong to families, first, then the community at large (sans government entities).  This is part of what makes a nation strong, having a solid family support system.  We all know that, and we all acknowledge that.  Apparently, this has led to too many people who now believe that it is the government’s job to care for them, from cradle to grave.  That is not the way to build a strong nation, folks.  It might well lead to some kind of Orwellian horror, or even to a “Brave New World,” but those are not necessarily such good ideas!

Now, I grew up in the 50’s.  We did have some limited food programs, if you will, in the form of a county agency that dispensed surplus foods.  I recall peanut butter, butter, canned chicken, flour, generally items that would be considered to be mostly staples, and they were packaged in very generic containers.  And, I know that there were such governmental entities as County Health Departments that did things like give us our Polio Vaccination, when it was first developed and made available.*  When someone needed healthcare, first line of defense (and, offense, as well) was mom’s home remedies, that she had learned from her mom.  Then, in a small town, as a last resort, the ill person might be taken to the local doc, and he would be begged to provide some relief.  He was paid if possible, when possible, with whatever of value the people could scrape together.

Larger communities built county hospitals, supported by the tax payers, and yes, this is government involvement in health care.  As far as I know this system still exists in most cities across the nation.  People who are ill, and who do not have a doctor, or the means to pay a doctor, go to the county hospital!  So, where have we got this demand, and this belief that medical care is not available for those who can’t afford it?  Beyond the fact that these community hospitals do exist, and do provide care, we have organizations across the country such as the American Diabetes Association, the American Cancer Society, MDA, etc., etc., and on and on.  Those organizations do assist those who cannot pay in seeking appropriate care and treatment!

Very recently, I have seen a video online where a lady reports that her brother died of cancer because he was unemployed and did not have insurance, and she thinks Ron Paul and those others up on that stage with him, are just terrible, cruel, heartless people.  It makes me want to scream.  So what if he had no insurance?  So what if he was unemployed?  How did he let himself get into a position where he was not prepared to seek alternative employment when he lost his last job?  I know that I changed direction more than once during my career, changing jobs (because I got fired) at the age of 56 (older than her brother, by the way), then, again, at 58, and finally, accepting (I was actually recruited for this) my last job at the age of 57.  I then decided to retire at 62 mostly because I was laid off from that last job.  Ultimately, who is to blame for this lady’s brother not being prepared to go out into a new field at 55?  Not me, and certainly not the government!

I know people who were in their fifties at the time that they went to work as clerks in convenience stores after long careers in fields like IT.  My point is that I am well aware that it is hard to find work after about 50 years of age, but there is work out there, if one is willing to consider some alternatives to what one might have been accustomed to doing.  And, it is certainly not the government’s fault if a person lacked the education to pursue other avenues.  Keep in mind that very often, those people who took jobs like this still had no insurance, but they did know that if they were ill, there were free clinics, and there was the county hospital system where they could seek care.  There are always alternatives, and there is always a solution, so please don’t just blame the government, or worse, demand that the government take care of you, unless you’re also able to remember just who the government is!  (Hint:  We are the government.  Remember Junior High Civics?)

So, frankly, imho, Wolf Blitzer asked a loaded question deliberately, and phrased it in such a way as to throw it into the same category as that old one about, “do you still beat your wife?”  And, of course, the others on that stage said nothing, and that is because – even though they are Republicans, with whom I personally disagree – they are right.

Speaking as a Nurse, who has more than thirty years experience, I must say that there is another, and very significant, element important to proper health care.  That element rests with each and every one of us.  Whoever we are, whatever our health, whatever our socio-economic status, we must assume at least fifty per cent of the responsibility for our own care.  I mean that we must do what the doctor tells us to do.  We must share all pertinent medical information with the doctor and his/her staff.  We must strive to do at least minimal things to maintain a healthy condition, such as practice moderation, try to get exercise, try to eat sensibly, and so forth.  I say this because too many times I’ve seen too many people who want to blame the caregiver for a worsening of their condition when it was the patient himself who failed to do what he/she knew to do.

Lest I overlook another factor here, be advised that I am not a supporter of Ron Paul, or any other member of the GOP.  I support the President, first because he is the President, but also because I believe he wants to, and is trying to do the right thing.  My opinions, as expressed herein are strictly my opinions, and are not meant to suggest that they are a reflection of the views of anyone else, no matter what political stripe decorates their back.  I like to think that this is a logical position to take, and that it has nothing to do with politics, because ultimately our health is our responsibility, and caring for it should not require any assistance, interference, or direction from any government.

* County Health Departments did a lot more than that, and I know because I worked in Public Health for ten years, but their accomplishments are not my topic right now.