Earhart_Light's recent activity
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Comment on Supercritical CO2 is used to extract caffeine from coffee, but this strange phase of carbon dioxide is really weird in ~science
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Comment on McDonald’s is losing its low-income customers in ~food
Earhart_Light LinkThe thing with fast food is that it was cheap and fast. It's no longer cheap, and it's also no longer fast. If I have to pay $20 and wait 20 minutes for a meal, I'll go to a fast casual place instead.The thing with fast food is that it was cheap and fast. It's no longer cheap, and it's also no longer fast. If I have to pay $20 and wait 20 minutes for a meal, I'll go to a fast casual place instead.
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Comment on Cell phone advice in ~tech
Earhart_Light LinkIt doesn't cover every phone, but I'd suggest starting with versus to help narrow down your list.It doesn't cover every phone, but I'd suggest starting with versus to help narrow down your list.
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Comment on Cataloging your home library in ~books
Earhart_Light LinkCalibre.Calibre.
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Comment on Experiences with united healthcare in ~health
Earhart_Light (edited )LinkMy cousin had United in New Jersey. The good: she did find a PCP in her area, and the PCP did have appointments regularly available. The bad: she could never get a comprehensive appointment with...My cousin had United in New Jersey. The good: she did find a PCP in her area, and the PCP did have appointments regularly available.
The bad: she could never get a comprehensive appointment with him; each appointment dealt only with a single issue, with no real consideration of other factors. Like, she could see him about her allergies, but if she also wanted to go over her thyroid problem, that had to be a separate appointment, that kind of thing. It very much felt like the doctor was maximizing whatever they were paying him. He was decent about continuing to prescribe existing meds (not sure if she got put on any new meds) and giving referrals to specialists.
Specialist referral was where everything went wrong. UHC had a massive book of all the doctors "in their network". Her PCP would give her a referral for something - let's say an annual obgyn exam. If he recommended a specific doctor, she'd call them, only to find out that they no longer accepted her coverage, so she'd start calling the doctors listed in the book, only to find that almost none of the "in network" doctors accepted her plan. The very small handful that did still accept it weren't accepting new patients.
She called UHC customer service to find more doctors who were in-network and accepting patients; absolutely the only thing they did was read her names and addresses from their book, despite her repeatedly telling them that those doctors no longer accepted her plan or weren't accepting new patients. UHC just told her to keep calling the doctors listed in the book.
She called literally every obgyn listed in the book for New Jersey, trying to get an appointment. It took her hours and hours, over a period of days. There were only two obgyns that were still in-network and still accepting new patients - and they were literally three hours away at the other end of the state - like she lives in Cape May county and the doctors were in Sussex county. Plus they wanted her to make two separate visits to the office, at least a week apart, and they insisted that any bloodwork or mammograms be done locally to them. And I think one of them didn't have appointments available anytime in the next six months?
Every referral was like that: no one took her insurance (despite being listed the The Book and despite customer service saying that they were) or they weren't accepting new patients. She had to do everything herself, manually. It took a lot of time and a lot of effort, day after day spent on the phone. She moved off UHC as soon as she could.
I dunno, dude. Maybe it's different in Pennsy, maybe things have changed, maybe it's a different kind of plan. But you might try calling up some of those doctors listed in the book and see if they're actually accepting whatever your insurance will be - and also accepting new patients, and when y'all might be able to get an appointment with them. My cousin was in tears with me because she kept bleeding and couldn't find an obgyn to take her for months, and it was literally at the other end of the state.
She's with Horizon BC/BS now, and much much happier.
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Comment on Travel essentials: eight items to pack for your next trip – and what to leave at home in ~travel
Earhart_Light Link ParentI bring my own water bottle because it fits perfectly into my fanny-pack carrier slot. I pack it with my medications so the space isn't wasted during the travel portion. Sometimes I bring books,...I bring my own water bottle because it fits perfectly into my fanny-pack carrier slot. I pack it with my medications so the space isn't wasted during the travel portion.
Sometimes I bring books, mostly I bring magazines. I usually have a stack of magazines that I want to read, and I'll discard them in waiting rooms and lobbies as I finish them, for other travelers to read while they're waiting. The books are never ones I really want to keep, and a lot of the hotels I stay at have a little book of left-behind books where you can drop off the one you've just finished or pick up a new one if you've run short and want something to read
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Comment on Travel essentials: eight items to pack for your next trip – and what to leave at home in ~travel
Earhart_Light Link ParentLaundry depends on how long and varied my trip will be, and what I plan on doing. I've been known to just head out with a spare shirt and pair of socks, quick-washing everything at night; and I've...Laundry depends on how long and varied my trip will be, and what I plan on doing. I've been known to just head out with a spare shirt and pair of socks, quick-washing everything at night; and I've also been known to pack a full suitcase, and mail my dirty clothes home to make way for books I've found.
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Comment on Grape glut: Too much wine across the world leaves tons of US grapes rotting this crush season in ~food
Earhart_Light Link ParentSo, growing the vines takes time, and wine grapes aren't eating grapes. But could you graft eating grapes onto wine grape rootstock and convert that way?So, growing the vines takes time, and wine grapes aren't eating grapes. But could you graft eating grapes onto wine grape rootstock and convert that way?
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Comment on New Jersey theme park puts animatronic dinosaurs on Facebook Marketplace as it shuts down in ~tech
Earhart_Light LinkThey should sell them to Edelman.They should sell them to Edelman.
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Comment on Looking for some cat advice in ~life.pets
Earhart_Light Link ParentNo, I understand. And thank you for taking the time for this conversation, and for all the care you're giving your cats.No, I understand. And thank you for taking the time for this conversation, and for all the care you're giving your cats.
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Comment on Looking for some cat advice in ~life.pets
Earhart_Light Link ParentNo, that's all understandable, this is all so overwhelming and I completely understand - I went through all of this as well (except the dry food thing). Last question, I guess: does she like...No, that's all understandable, this is all so overwhelming and I completely understand - I went through all of this as well (except the dry food thing). Last question, I guess: does she like Churu's? I don't know if they'd be at all useful, either in getting her to eat wet food, as a way to disguise pills or other meds, or simply as a higher fat thing to maybe help check her appetite?
Also, I want to say that I think you're admirable for trying to handle all this - it *is overwhelming, even with none of the other major issues in your life.
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Comment on Looking for some cat advice in ~life.pets
Earhart_Light (edited )Link ParentI used an intermediate-duration insulin that's no longer on the market, so my experience isn't going to be applicable to anyone using long-duration insulins like Lantus or Levemir (or whatever...I don't know when to test her compared to food and insulin
I used an intermediate-duration insulin that's no longer on the market, so my experience isn't going to be applicable to anyone using long-duration insulins like Lantus or Levemir (or whatever their generic names are - glargine and sitting else?). I think the L&L folks were testing six hours before giving the shots, but I may be misremembering. The idea was to see what that number was, and calculate how much you needed to give. People would post their bg test numbers to the forums and would get advice on how much insulin to give.
haven't figured out how I'm getting her to tolerate that on top of the shots
Have you tried a rice sock? It's a small sock with a bit of rice in it, warmed a little in the microwave. It gives you something to press against, the warmth helps the blood move easier. Also, massage the ear a little bit before you prick: again, it helps get the blood moving, and it may help relax the cat They may have newer tricks now as well.
Oh! When I was there, there was also a little list for things to gather together for an emergency kit in case of a hypoglycemia incident. Ours was just a small box; I forget most of what was in it, except it had a small jar of honey (or corn syrup), to quickly raise BG levels if needed, a couple syringes, spare test strips and prickers. There was some other stuff as well - I can see the box in my mind, I just can't remember what was in it. Edit: oh, I had a little kitty blinder mask in there too. She never fought me but I was afraid if she hypo'd and was confused, I'd spend time struggling with her instead of fighting the hypo.
I also sat through several vigils, where members came in because their cat was hypo, and we talked them through initial treatment. About 2/3's of the time they managed to avoid going to the middle-of-the-night emergency vet.
Is there any way to switch her to canned food, or at least supplement with canned? Especially if she's this hungry. Some of the Fancy Feast canned foods are surprisingly diabetic friendly.
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Comment on Looking for some cat advice in ~life.pets
Earhart_Light (edited )LinkI had a diabetic cat for five years. A fair number of cats can eventually get off the juice (no shots) with dietary changes. My suggestions are to sign up to the forums at the feline diabetes...I had a diabetic cat for five years. A fair number of cats can eventually get off the juice (no shots) with dietary changes. My suggestions are to sign up to the forums at the feline diabetes message board, where you'll find lots of people who have been in your situation and who can help you while you get your cat stabilized and on the lowest possible insulin dose (which ideally is 'none').
And head over to Tanya's feline chronic kidney disease page to look at her food charts. There's also Dr Lisa Pierson's charts. [With much love to Janet and Binky, who started the charts.] I think Tanya's charts are more recent, but Dr Lisa's charts may have information for other foods. [If you're not in the US, the FDMB has links to charts for other countries.]
Your ideal food is something that's less than 10% carbs (or as close to that as possible), that accommodates any other health issues your cats may have, that your cat will eat, that's available in your area, and that's cheap enough for you to afford. There are a lot of options, including things like cans of Fancy Feast.
You'll want to switch their food at a point where you're comfortable getting BG readings, so you don't accidentally send her into a hypo.
I don't know your situation; did your vet check with you about either Bexacat and Senvelgo? They're pills that were approved to treat feline diabetes, but I'm not sure under what situations their use is recommended for or against.
What food is she getting now? You want something low carb, and if she's constantly fighting hunger, you'll probably want something with a higher fat content as well.
There's probably more information I should mention, but it's late and my brain wants to sleep.
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Comment on Capital One US settlement: Here's who's eligible for $425 million payout in ~finance
Earhart_Light Link ParentI make it a point to submit my claims, regardless of how little I expect it to be. I want the companies to lose these suits, and I want it recognized that there are people who have been hurt by...I make it a point to submit my claims, regardless of how little I expect it to be. I want the companies to lose these suits, and I want it recognized that there are people who have been hurt by their actions. If nobody bothers to file in the class action suits, it becomes performative legal work between corporations and lawyers.
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Comment on Navigating differences in risk tolerance regarding health in ~health
Earhart_Light LinkI can't help with your produce dilemma, but I'm struck by this comment: Have you run into this 'she keeps changing her mind issue' before? Because I'm struck by something my sociology professor...I can't help with your produce dilemma, but I'm struck by this comment:
I'm trying to find a reasonable middle ground or a bellwether indicator we can use as a go/no-go, but every time I think we've agreed on one it feels like the goal posts have been moved.
Have you run into this 'she keeps changing her mind issue' before? Because I'm struck by something my sociology professor said years ago: in conversations, there's a tendency for women to give "I'm listening" feedback by nodding their heads, making little "mm-hmm" noises, etc; and there's a tendency for men to not do those things.
She said that gendered miscommunication of this type was partly what fed into two of the 'classic' gendered communication stereotypes: the wife who complains her husband never listens to her (because he never gives her the "I'm listening" feedback that she gives him); and the husband who complains that his wife is always changing her mind, because he interprets her "I'm listening" feedback to mean "I agree with you".
I'm not saying that's the case here, and I think the suggestion that this is an emotional issue and not a logical one is excellent, but I wanted to bring this up in case one of the contributing issues to your disagreement is a basic difference in communication styles.
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Comment on How can I make life easier on my child who has to (temporarily) use crutches? in ~health
Earhart_Light LinkDepending on the location and type of injury, would a medical knee scooter be an option? They're much less tiring than either crutches or a wheelchair, and they're less unwieldy as well. I...Depending on the location and type of injury, would a medical knee scooter be an option? They're much less tiring than either crutches or a wheelchair, and they're less unwieldy as well. I actually kinda had fun with mine!
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Comment on When The Wind Blows: The darkest movie you haven't seen in ~movies
Earhart_Light LinkOh, wow. I wonder if that was the inspiration for Eric Bogle's When the Wind Blows. https://m.youtube.com/watch?v=Ovrp5iqPA7AOh, wow. I wonder if that was the inspiration for Eric Bogle's When the Wind Blows.
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Comment on Supercentenarian and remarkable age records exhibit patterns indicative of clerical errors and pension fraud in ~health
Earhart_Light LinkCould we please just wait until stuff that's been posted to biorxiv has actually been peer-reviewed before spreading it around the internet like it's gospel? The *rxiv servers are for papers...Could we please just wait until stuff that's been posted to biorxiv has actually been peer-reviewed before spreading it around the internet like it's gospel? The *rxiv servers are for papers waiting peer-review and publication; there's stuff that never makes it out of there and some stuff that's pretty flawed. One of the things I hate most about the pandemic is that the media and the general public have discovered the *rxiv servers and uncritically take stuff that's there as entirely sound.
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Comment on How best to get a thorough inspection after avoiding doctors for a decade? in ~health
Earhart_Light Link Parent[cont.] For the stuff that you do need prior authorization for: go through the process to get the prior authorization. The exact details will vary depending on a lot of factors. I personally found...[cont.]
For the stuff that you do need prior authorization for: go through the process to get the prior authorization. The exact details will vary depending on a lot of factors. I personally found it significantly easier once my PCP was part of a hospital's care network. I hate that I'm part of a corporate group, but getting and managing appointments was so much easier going through their network. The following is my process for handling a referral with my current insurance and hospital care network; yours will likely differ somehow, but I'd suggest writing down your process, plus whatever tips you find for making your life easier, so that Later!You has something you can refer to when you need to. My process:
- See or call PCP, describe problem, get referral.
- Call the place I was referred to, ask if they accept my insurance.
2a. If they do not, call hospital care network and ask for a referral to an in-network doctor. [With my old insurance, this was a nightmare step, calling each office individually, trying to find someone in-network.] - Once I have a referral to someplace in-network, call and make an appointment.
- Confirm with them whether I need prior authorization. If I don't, make the appointment and I'm done.
- If I need prior authorization, ask the appointment person for the doctor's NPI number.
- Call my PCP and ask for the referral department. Tell them I need prior authorization for the referral to this doctor, and give them the NPI number. They'll process it and give me a prior authorization number over the phone. Write that down on the referral sheet. [This was the other nightmare step under my old insurance.]
- Call the place I was referred to, give them the prior authorization number and make the appointment.
Repeat steps 1-7 (or whatever your local process is) for every referral you have.
I'm going to be honest: I was in a similar situation as you a number of years ago, and making and getting to all the follow-up appointments is both exhausting and time-consuming. I do as much follow-up as I have time and energy for (trying to really hit the more critical issues), then I usually give up and leave the more minor items for the following year. It took a few years, but now most of my stuff is under control and we only go over the status of things at my yearly check-up.
One side note, as well: be prepared that a significant percentage of your appointments, especially here in the beginning, will spawn follow-up appointments. You're having a foot issue, the doctor sends you out for X-rays, you have a follow-up appointment to go over the results - suddenly one appointment spawned into three! Like I said, it gets exhausting and time-consuming. Focus on the most important items first, and be able to accept that you may not follow up on everything.
When you go in for a referral to a specialist: get a notepad and write down all relevant medical history, then write down your symptoms and your questions. Keep the notepad for a couple weeks, adding in symptoms and questions as they occur to you. Organize those, type them up (include the date and the doctor at the top of the page!), and bring two copies to your appointment, one for your doctor and one for you. Take notes, and take a couple minutes at the end of the appointment to repeat back to the doctor what you think they've said to you.
For any follow-up appointments: I take my notes for the original doctor's appointment and update them as follows:
- These were my symptoms. You diagnosed <X> and told me to do <Y> and <Z>.
- I have done <Y>. I have not done / had trouble doing <Z> [I include this so their records are accurate] because of <reason> [this is useful because there may be alternative treatments].
- My issue is better in this way. I am still having problems in this other way.
- These are new problems that may possibly be related to earlier issues.
- These are new problems that I do not believe are related to my earlier issues, but which fall within your area of expertise.
I bring in two copies to the doctor, etc, etc. I keep copies of all my notes and test results in a file; and I have a separate file for each calendar year. The files provide me with a detailed set of notes for any issues I may be having, including when things started, how things got better or worse over time, when things changed for the better or worse, and what things we did that helped or hindered.
I acknowledge this is all tedious, but I can't rely on someone who sees me for half an hour once or twice a year to spot every little thing. The files give me a baseline to work with, to help manage my own health.
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Comment on How best to get a thorough inspection after avoiding doctors for a decade? in ~health
Earhart_Light LinkOkay, so: some Medicaid plans are offered by better companies than others. I had United Healthcare, and they made everything a massive hassle; I moved to a different plan the next open season and...Okay, so: some Medicaid plans are offered by better companies than others. I had United Healthcare, and they made everything a massive hassle; I moved to a different plan the next open season and have been delighted. So, if your current Medicaid plan isn't working for you this year, do some investigation and see if there are any better ones for your area. (A lot will depend on your state, and how close you are to doctors.)
When you call to make your appointment, tell them that you haven't seen a doctor in the last ten years and that you need a new patient appointment for an annual physical. The next available appointment will probably be a few months away (it's okay, you can use the time to your advantage), though you can ask to be put on a waiting list on case of cancellations. The new patient appointment is important because it's a larger time frame for a more detailed history.
Ask them if they would like any lab tests (such as bloodwork) done before the exam. If so, ask them to send you the paperwork for the lab work. Call your insurance company and confirm that the lab work is covered under your policy, and that it doesn't require prior authorization. [Standard lab work should not require prior authorization, but I'm paranoid about checking these things first.] Whenever you contact your insurance company, keep a piece of paper with you. Write down the date and time, the name of the representative you're taking with, why you called, and what their answers were (again, my paranoia).
Call the lab and schedule an appointment for 2-3 weeks before your doctor's appointment. That gives the lab plenty of time to run the tests and get the results to your doctor, and also makes sure that the test results are 'fresh' enough to still be relevant. For this and any other tests you ever have run, always ask the lab to send copies of the test results to you as well; I like having copies on hand in case I end up needing them for another doctor or if I want to look for patterns.
If the doctor's office doesn't offer, ask them to mail/email you the new patient history forms to fill out. When they arrive, make a copy so that you're not working off the only original. Fill it out in as much detail as possible, ask relatives about family medical (and mental health) history for possible genetic risks. Thoroughly review the paper several times over the course of a couple weeks to make sure it's as complete as possible. You're deliberately making the list over a period of time (and on a 'test' copy of the form), because there will be things you think of or find out after you've initially filled it out. When you're finally done, re-write everything onto a fresh copy of the form, and make a copy of it for your records before you send it back to them.
As you fill out your medical history form, and as you ask your family about the family history, keep a separate notepad available. As you go through the forms and history, write down every physical issue you've had in the last year, or any untreated major issues you've had since the last time you saw a doctor. Keep the notepad around for a couple weeks or a month and, every time you run into a new issue or remember an old issue, add it to the list.
When you're done with the list, sit down with it and put it in some kind of order. I try to order the list with what I think are the most important issues at the top, with decreasing severity as you get farther down. This is so that, if there isn't enough time in the appointment to get through the entire list, the most important things are addressed first. Where appropriate, you can group issues together if you think they may be related in some way; like if you think a pair of symptoms are related to the same problem, or if you're having multiple problems with the same organ.
Print out two copies of this record, one for you and one for your doctor, and bring them to your appointment. As you work your way down the list, write down any notes or comments on the paper; do not trust your memory.
At the end of the appointment, I like to take a couple minutes to quickly read my notes back to the doctor. That gives them the chance to correct anything I may have misunderstood, and also the chance for them to offer further information on what they're suggesting and why.
Your PCP will do basic care, and will likely refer up to specialists for everything else You are likely to leave the doctor's office with a bunch of referrals, for other tests and to see said specialists. Call your insurance company ask them what their process is for you to get prior authorization. Write their answer down so you have it for future reference. Then go over the list of referrals with them, and find out which ones require prior authorization. For each referral, you'll also want to ask them if the suggested doctor is in-network; if the doctor isn't, ask them for names of doctors with that specialty that are in-network and are in your area. [Most of this comment assumes that your referrals are to people and places that are in-network, but different doctors' offices and different insurance plans are better at making sure your referrals are actually made to in-network providers.]
For the stuff that you don't need prior authorization for: call them up, confirm that they accept your insurance, confirm that they're accepting new patients, confirm that you do not need prior authorization, and make an appointment. [cont.]
I haven't watched the video yet (at work), but I went on a tour of a coffee plantation in Costa Rica years ago. They said they shipped the beans to Germany to be decaffeinated, and the beans were placed in boiling water, then steam was injected into the water to extract the caffeine.
To me, the most interesting thing was that the purpose of this process was not to major decaffeinated coffee - The purpose was to remove the caffeine so that it could be added to Coca-Cola. Decaffeinated coffee was just a byproduct that they realized they could sell.