Sunday, Nov 6
For Nov 5 CPAP. Reported figures. AHI= 0.16. Events: 1 H, 9 RERA. Time on 6 hrs 15 min with (max = 10 L/min). Oximetry: SpO2 one blip to low 86, only 1 other below 88 with avg., 91.8%.
Experienced a long day, mostly away from home. We took a field trip, conducted by Nick Zentner (CWU Geologist) to find the location of courses the Columbia River has taken in the past. It was a fascinating day.
We went to town early for gasoline for John’s car, and got to the leaving point on campus before the 10:00 departure time. We did not get home until almost dark.
Our first stop was south of Ellensburg, was to view rocks deposited by the Yakima River, with access from Ringer Loop.
John is visible in the top right of the left photo, with his light blue hat. The right photo has 3 of his small rounded found rocks at the top left. Most of the rocks are darkish and many are not very roundish. Such are typical of the Yakima River because of the closeness of the mountain source regions and types of rocks found there.
The second stop was past Moxee at Konnowac Pass, an old wind gap (a failed water gap).
I took both of these photos on my way slowly up the hill to join the crowd for Nick’s presentation. The trees are fruit orchards, still with leaves but most of the color is gone.
The next stop was likely my favorite of the trip. First, the view when we got out of the car is directly below.
To appreciate this, watch my very short movie of Emerald Road Cobbles, laid down by the old Columbia River.
Next is a collage of some close-ups of the river rock cobbles at that site.
Finally, from across the street overlooking the Yakima River is this collage:
Left Nick explains how the river rocks across the street were not deposited by the Yakima River behind him, but by the Columbia River during another route it took long ago. The middle photograph is to his left and focuses on Toppenish Ridge, with the Yakima River in the foreground, and below our position. The right photo is looking (northeast) at the many feet of cobbles, all very roundish and most orange-ish, unlike the rocks from the Yakima River (1st photo, above). The Columbia River begins near the Village of Canal Flats (Canada), but other big rivers also flow in the region, namely the Kootenay, Clark Fork and others near Missoula, MT. So the small rock he is holding has an unknown source, but it did not come from the drainage of the Yakima.
Story of Quartzite inside Cobble on Snipes Ridge near Sunnyside, WA pictured above, and videoed below.
Nick Zentner with cracked-open cobble explaining the Quartzite inside from the old Columbia River deposited rock along Emerald Road on Snipes Ridge near Sunnyside, WA on 11-6-16, Field Trip, “Chasing the Old Channel of the Columbia River.” It is Precambrian Quartzite, older than 500 million years. Brief intro here, 21 seconds, see above link.
Below is a further short video introduction (1 minute) to the old channel of the Columbia River that deposited this picturesque river rock feature.
Old Route of the Columbia River near Sunnyside, WA
Below are the rocks we carried away from our day in the field.
These (just on the board) are what John collected. Top 4 (whiteish) are from the current Columbia just downstream of Priest Rapids Dam. The large flattish orange one (and the others close by) are from the cobbled hillside (southwest side of Snipes Mtn., between Granger and Sunnyside. The new rocks will find a place among our other rock-garden treasures. Do you have anything that is 500 million years old?
Monday, Nov 7
For Nov 6 CPAP. Reported figures. AHI= 0.40. Events: 3 H, 15 RERA. Time on 7 hrs 34 min with (max = 19 L/min). Oximetry: SpO2 3 blips to 88, 0 < 88 with avg., 92.2%. (Probably low considering a spurious 83 which doesn't show on the graph I received & inexplicable considering the events below 88% is zero)
Much of my day was spent assembling my medical reports for tomorrow’s doctor appointment, filling in our voting ballots to drop off at the courthouse on election day, and reviewing more of the master’s thesis for which I’m on the committee (to be defended in a week) at the graduate program at CWU – Cultural & Natural Resource Management. I retired April 2010, but stayed on this committee. It is my last. Over the past several years, Terri Towner researched this thesis, entitled, “Everyday Farm Life in the Moxee Valley 1915-1950 Historical Ethnography.” We went through the Valley just before our 2nd stop on the Sunday field trip.
Tuesday, Nov 8
For Nov 7 CPAP. Reported figures. AHI= 0.29. Events: 2 H, 19 RERA. Time on 6 hrs 58 min with (max = 16 L/min). Oximetry: did not record properly.
We left for the start of our doctor appointments at 9:25 a.m. in
Cle Elum, 45 minutes away. We participated together. This was part one of our annual physicals. Part two is next Tuesday, same time. Today was primarily data gathering of vitals and a fasting blood draw. After the nurse collected information, we visited with our doctor, who will be retiring in May 2017. He was going to retire in December but a new Doc isn’t coming in time. Regardless, this will likely be our last appointment with Dr. Paul – started in 1988/89.
On the way home, we drove back through Ellensburg to Grocery Outlet for ice cream and cat food and dropped off our election ballots at the Courthouse drive-up box receptacle. Ballots are mailed to us and we drop them in a box, but could mail if we needed to. The car in front of us pulled away just before we got there, so no waiting. Our citizen-duty done, we talked with John’s sister Peggy (in Ohio) for the trip back home.
I returned home, changed clothes, and went to Bi-mart to check my number and bought two kinds of cough drops; luckily, one type was on sale for 50¢ off, a 25% larger package than I had recently bought.
I went to get my 3-month medical supplies (for CPAP machine, supplies and equipment), and found out starting Oct 13, I no longer get a break on prices for supplies and equipment paid for by Medicare. They have cut back 45% on payments for the stuff I have been getting without any $ crossing hands every 3 months. The medical costs are rising all around – not a surprise but not welcome either.
I picked up limited supplies today at Kittitas Medical Supply. Now it will cost me almost $185.00 every quarter. I did not get the mask, nosepieces, and short tubing, saving that money. I will just clean the mask I have and keep using it. At least they gave me the two filters, one foam and three paper ones. That is charged out at $48.00 to Medicare, and my supplier decided to take the loss on that, but not on the mask parts or both sections of tubing.
Here’s the scoop — especially if you depend in part on Medicare.
2016 is the year of Medicare’s Rural Payment cuts.
You can voice your concerns, in WA:
with Senators
Patty Murray 866-431-9186
Maria Cantwell 202-224-3441
Ask them to pass Senate Bill 2312 to roll back the rural Medicare cutbacks.
Congressman Dave Reichart 202-225-7761
needs to be requested to sponsor Bill 4185, which will do the rollback needed.
IF you have a specific Medicare complaint about the decline in your home healthcare services, call the Medicare Complaint Hotline (NOT AFFILIATED WITH MEDICARE). You will be asked to leave your name, phone number & complaint, and they will get back to you.
CALL 800-404-8702.
I did this, and if you follow below, you will see the interesting results.
I also went to Jazzercise class this afternoon for 45 minutes and it was too much considering I have not exercised in 3+ weeks.
I canceled my contribution playing and singing music at Hearthstone tonight because I am not up to it. It is with The Connections and is religious music, twice monthly.
Wednesday, Nov 9
For Nov 8 CPAP. Reported figures. AHI= 0.00. Events: 7 RERA. Time on 6 hrs 57 min with (max = 10 L/min). Oximetry: SpO2 one blips to low 87, all rest > 88 with avg., 91.5%. (Spurious blip to 78, probably from changing fingers on Oximeter).
I picked up Gloria and we went to the Food Bank to sing and eat, and to SAIL exercise. I was feeling much better today. I came home to more thesis chapter reviews.
Thursday, Nov 10
For Nov 9 CPAP. Reported figures. AHI= 0.64. Events: 5 H, 19 RERA. Time on 7 hrs 50 min with (max = 18 L/min). Oximetry: SpO2 blip to low 86, 5 < 88 with avg., 91.8%. A friend shared this interesting link with me. You may wish to check it out, especially if you want to voice your comment about the Medicare cutbacks. If you do not live in Washington State, there likely is something similar for other states. The information on all the elections we have voted in, since 2005 is informative. (No, nothing is revealed about your voting behavior. Just that you did.) weiapplets.sos.wa.gov/myvote/#/login
I went to Meadows Place today for music. I forewarned the activities director and the head as to the count for armless chairs, but they were not ready for us, having no chairs out, tables moved, or fireplace turned off. We had to set up ourselves. We only had 7 of us there to play because of scheduling conflicts with doctors, school functions, and other activities. We had an appreciative audience.
I filled the Forester’s tank with gas, so it was not a completely wasted day.
Most of any spare time left the past few days, even when I was feeling bad, I have been reviewing the thesis, for which the defense is Monday. I am on my third read of every chapter (of eight). I am the only committee member reading not only for content, but also for grammar, syntax, phrasing, details, spelling, margins, style, and anything else I see. To me, I have to get those problems out of the way to be able to digest the content. The committee consists of me, a geographer, the chair, an anthropologist, and the other member is an historian.
Friday, Nov 11
For Nov 10 CPAP. Reported figures. AHI= 0.13. Events: 1 CSR, 1 H, 14 RERA. Time on 7 hrs 57 min with (max = 13 L/min). Oximetry: 0 events < 88 with avg., 92.0%. (Spurious blip to 79 probably from changing fingers on Oximeter).
I am downloading the first 7 chapters’ final copies of the thesis, with all the edits I have noted over the past couple of weeks, corrected. Her defense is Monday from 1:00 – 4:00 p.m. This is my last ever thesis committee! Having been retired since April 2010, it is about time I quit doing professorial work, don’t you think? This is all volunteer time. I no longer have any salary or a phone, or access to previous student / class information from being a full-time faculty member since 1988. However, I do still receive mail at CWU and maintain my old email account there, have a permanent (free) parking sticker, and access to the James Brooks Library (including an excellent Music Library with access to Inter-library loan), so I have a few benefits left. I also continue to get requests for letters of recommendation for former students for jobs for which they are applying. I know few of the students any more, except through my continued work on a Google Groups job announcement list with almost 800 members, NW Geography Jobs. Via it, I actually publish daily job opportunities in many disciplines besides geography (biology, environmental sciences, geology, economics, political, forest service, government jobs (DNR, DFW, DOT) graduate school opportunities, faculty jobs, and techniques such as GIS, mapmaking, geospatial, & engineering.
Regardless of your voting preference, this link is a HOOT!
Donald Trump meets Barack Obama – five awkward photos
Today, I received a phone call from the research group collecting information on my Medicare Complaint Hotline call earlier this week.
They requested my “story” – and here it is below. I plan to submit it via email so they will receive on Monday morning, Nov. 14. This was my letter to the research team examining nationwide Medicare Complaints Hotline. Skip to the next photo if the text doesn’t interest you.
Nancy’s Complaints Regarding Medicare cutbacks proposed for 2016 of 45% in Pap, wheelchairs, oxygen and other healthcare equipment.
I called the Medicare Complaint Hotline at 800-404-8702 on 11/10/16 and had a return call on 11/11/16, Veterans’ Day. Luckily, I was home.
The first call came at 11:26 from an Iowa number: 319-274-7913, with the caller ID, V GM MGMT LTD. I let the answering machine catch it, and then when I realized what it was, I picked up the phone. I imagine we talked 20 minutes. After I told her my story and all the information she wanted (mostly my location and how I am affected by the monetary cuts), I mentioned I was going to search our recent garbage to look for my mask I threw away before realizing this week I could no longer replace it, as I had been doing every 3 months, since September of 2014. This mask was particularly dirty from in-taking dust from our dirty rural house. I SHOULD have kept it and washed it thoroughly–especially now that I know the cost, I will have to pay for a new one that is no longer covered 100% by Medicare reimbursements (and my supplemental Group Health insurance). It seemed worth the effort to search our garbage for the unit, now worth an outlay of $34.99 (reimbursement of $19.00 later) for the headgear straps, and the clincher, the connected Mask/nasal pillow with short tubing for an outlay of $129.99 (reimbursement of $61.02 later), reimbursements to come to the patient sometime in the future. It will be interesting to see the amount of time that elapses. Those figures mean my out of pocket cost for the head mask every three months will be $15.99 + $68.97 = $84.96. This time, I chose not to pay the cost for the head mask and accessories (tubing). I chose not to buy the longer tubing because I have a couple left I can use. And, I can wash them out as well. I did not check their replacement price. The filters cost total for one foam filter and two packs of 2 each of the paper filters which need to be changed every 2 weeks, or possibly more often in a dusty house as ours, are $48.00 total. Medicare used to cover the longer compressed air tubing and all filters, but now they will not. My medical supply provider, Kittitas Medical Supply, has decided to continue “giving” the filters to clients because their loss on them is not as drastic as the loss on the payback for the masks, headgear, and tubing. I am grateful for that perk and support. Therefore, on Tuesday this week, 11/8/16, I only walked away with the filters for replacement, and no money exchanged hands.
We started searching and an hour after the research team called, and she returned a call and asked me if I was willing to write my story for an on-line “article.” When she heard I was, she asked me to take pictures of the search and of my find. I told her I would. Sadly, I had to report that we did not find it. We both find it difficult to believe we missed it, but I know I put it in the garbage and we searched every bag clear back to May. We could not locate it, but I did take some photos of the effort.
I will try to answer the following questions the researcher asked me, on a returned email, and I have marked in bold.
How is medical equipment important to you?
Of the equipment affected by the cutbacks, I only am hurt by one, the PAP, or the CPAP machine’s supplies for operation nightly. The importance to me personally is not for sleep apnea, but for keeping my SpO2, blood oxygen saturation level above 90%, while I sleep. In my case, it is very necessary because of a heart valve (Mitral) replacement I had in Dec 2009. I bought myself an Oximeter (my cost, sadly not covered by insurance of any type), because it is necessary to measure my SpO2 while sleeping with the CPAP machine running. CPAP machines do NOT measure that parameter, or the actual pulse throughout the night. I have an implanted defibrillator that controls my pulse, if it goes below 50. I wear my oximeter now throughout the night so that it measures and records my pulse and my SpO2. Each morning I can read the data from the CPAP (on an SD card) and from the Oximeter, and merge the values via software, with the ability of displaying graphs of everything coordinated from the CPAP and the Oximeter. I have also kept my oximeter on, after turning off my CPAP machine, and recorded the data without the CPAP operating. I review that each morning, and I have printed graphs to share with my cardiologist and my sleep doctor to display my findings. It definitely makes a difference in the value of the SpO2 figures. One interesting thing (to me anyhow) is that the CPAP does not prevent all decreases below 88% SpO2, and that on occasion there is evidence that continuing the recording off the CPAP does not show a decrease in the SpO2.
I will add two graphs from the CPAP’s SleepyHead software comparing to the Oximetry, and another from the Oximetry’s SpO2 Review software showing the graph overnight of the pulse and SpO2 values, with and without the CPAP. You on the blog have previously seen those graphics, so I won’t include them here.
What do you use?
I have answered this question above. The only equipment I use is a CPAP machine with its associated needs for a mask, tubing, and filters.
How have Medicare’s funding cuts personally impacted you?
I have also addressed that above in the first question. I am hopeful that Senate Bill #2312 and House Bill #4185 will be passed in Congress, and the result will be to roll back the rural Medicare cutbacks. I have paid into the system, and I believe others and I should not be limited in our ability to get care and supplies. I realize that some other folks are more financially restricted than I am, but it should be helpful across the board. Yes, I certainly also understand the huge expenses of the medical system and Medicare’s need to adjust, and I am also aware of the large debt our country has incurred.
What medical equipment were you looking for in the trash bags?
I was looking for this part of my nightly garb attached to my machine’s main tubing (not shown) and using filters embodied in the CPAP machine. The ruler is in for scale.
CPAP Mask Head Gear (Nasal Pillow)
How we could have missed this is beyond me. However, we searched for an hour and a half.
We live 12 miles from the transfer station (dump), we compost as much garbage as possible, recycle newspaper, plastic, and glass, and we only drive a truckload in every several months. We started with the most recent garbage bags, sorted through and repacked mostly into new black bags, but we also used some dog food bags. We had 15 repackaged and checked when we stopped. We do not have any more bags in the house, garage, shed, or barn.
Here is Nancy, in yard clothes, frowning, standing in front of the searched and repackaged 15 garbage bags.
Here is another:
I have on my Washington Old Time Fiddlers hat which goes with my normal activities about town, playing Old Time Music with a group, visiting assisted living and retirement homes providing sing-along entertainment, with a mostly string band.
Just last Friday, in honor of Veterans’ Day, the Ellensburg Adult Activity Center (Senior Center) provided lunch and activities for 100 people. Our group provided a 1/2 hour of patriotic music.
That’s me on the right with my photo from a previous year there:
This year (above), we began with a color guard with two of our local veterans in military dress, the pledge of allegiance, then the patriotic songs, and we closed with the National Anthem, acapella, always a moving experience. After that, all the veterans present were brought to the front according to their branch of military service. Two of our players were honored.
I have the names and numbers of our WA senators and our representatives to share with everyone I can to request them to pass these two bills. I am trying to spread the news via email and by Facebook.
I will also give them your Medicare Complaint Hotline number so they can do what I did. Thank you for your service.
Sincerely,
Nancy Hultquist
Ellensburg, WA
~ ~ ~ ~ ~ ~ This above was in response to the following email:
Hello Nancy,
Thank you for sharing your story! If you could send me some photos of you looking for your equipment from the garbage (with you in it) that’d be good.
If you could email me back with the following information
How is medical equipment important to you?
What do you use?
How have Medicare’s funding cuts personally impacted you?
What medical equipment were you looking for in the trash bags?
Thank you!
Lalaina Rabary
Digital Content Strategist
VGM Marketing
Lalaina.rabary@vgm.com
866-544-7913
My mission: To make the internet a better place one word at a time
Saturday, Nov 12
For Nov 11 CPAP. Reported figures. AHI= 1.30. Events: 6 H, 8 RERA. Time on 4 hrs 38 min with (max = 13 L/min). Oximetry: SpO2 one (maybe spurious) blip to 82 , 25 < 88 with avg., 91.2%. Oximetry continued to 8 hours.
I spent the day doing a serious computer backup after problems last night and this morning with computer not restoring properly from an update/shutdown. Now we have to get to work again researching a new computer for me to replace this old worn-out laptop.
Details of my Seagate backup drive. Has 997 gig used and available, 865 Gb as of 11-12-16.
Intermingled was working on the thesis review comments and going around our rural block for a long overdue haircut.
Hope your week was fine.
Nancy and John
Still on the Naneum Fan