WEDNESDAY — Routine stuff

John tells me I need to update this from the June 21st visit to my cardiologist.

I’m still tired from yesterday and not feeling up to much updating, but I will try.

Good news today is that the puppies got moved tonight to their new digs, and they are happy, but Mama Annie is not yet sure she wants to go in the different place.  She got sort of attached to that back computer room pen.  I did manage to do their toenails (cut them) today before the move.

Best news of the day is that our house roof is finished.  It is beautiful.

Okay– back to yesterday.  I drove myself to Yakima Heart Center for a 10:55 (I originally was planning for 10:15) so I was up way too early and with a lousy night’s sleep Sunday night.  I got there 20 minutes early and then had a 25 minute wait to get in to see the nurse, and then the doctor.  However, once there, he spent a full hour with me, so I felt good about that.  First words out of his mouth; “Where’s your hubby?”  John had always been with me since our first visit last July 2009.  I explained that John was working on the roof, and that I could drive now, so I had driven myself down.  I didn’t tell him I used John’s car and I think the seat is not set for my back, so the driving an hour down and back was actually painful.

The cardiologist had briefly seen me when I was in the hospital June 1 for the defibrillator implant and he just happened to see my name on the ICU floor.  He dropped in to say hi.  That was very cool.  Previously, he hadn’t seen me since April 14th and we both agreed that seemed like ages ago.

We debriefed and he looked at all my recent lab blood draws.  He determined that I need to be back on a statin type drug, which I had gone off of over a month ago, because of joint pain when I exercised.  He wanted me to go on Lipitor, but I told him I doubted my insurance would pay for it, and they wouldn’t (well they wanted me to pay a co-pay of $60/month.  Yikes.  I had asked him if that happened, could I go back on Simvastatin, which I was on last fall.  He said yes.  So, I requested a refill on that, and thankfully, it is only 9.99/month.  A lot better for the pocketbook, eh?

He also looked at some test which made him decide to change me to a medication to help my kidneys balance the sodium/potassium components.  The new pill (Spironolact) is meant to help remove sodium and some water while keeping some of the potassium. Thus I can cut back on the intake of potassium.  I should be able to start that tonight.  I was taken off the huge dose / week of Vitamin D, and just have to have 1000 mg (or mE) each day.

Then he asked a bunch of questions about what I was doing, and what, if any symptoms I was having.  He examined me with a stethoscope and pronounced me in pretty good shape.  He also mentioned again that I was fortunate to be alive and what a challenge I was to the medical community.  Not news – that.

He wanted to know what would tire me and cause my heart rate to increase.  I said, “Well, if I ran up the driveway, which I have not tried to do.”  He says that later this summer he will fit me with a heart monitor for a week to see how my heart is responding to the various things I’m doing.

He also went over the meds and the lab tests he wants me to have before I go to my family physician and to do that in about 3 weeks.  Then come back and see him.  I wish it were not so far to visit Yakima but it does have a Costco store and we do buy things there.  I will have to go every 3 months for checking up on my ICD.  My family physician is only 30 miles away, but the driving time can be similar in the winter (bad roads).  Now it is fine and a pretty drive up the Yakima River Canyon to Cle Elum.

His report will be transcribed and I will get that transcription within a couple of weeks.

Then about 1:00 I was out of the office, and needing to eat lunch.  There was not time to make it up for my exercise class that starts at 1:30, and I also wanted to visit Costco for dog food and such.

I picked up a nice grilled chicken salad and ate it before going to shop.  Yum, and I was hungry.  Off to Costco, where I got a motorized cart and asked for help lifting the heavy dog food.  They were happy to help.  I then motored around to get the rest of my needed things, and then got help to put them into my car.  I filled John’s car with gas (his takes Regular, where mine doesn’t recommend it), and got it there at Costco for 2.85.  Sweet.  Then home.  I didn’t make it back home until 3:30 and I was VERY tired.  I might have slept for 1.5 hours– don’t really remember.

But, that’s the best I can do on updating you to my latest.  Nancy

SATURDAY Nancy’s 2+ week . . .

. . . report since the ICD implant happened

Well, it’s really 19 days since, but who’s counting.  We have been very busy with various chores, besides dealing with the healing process and follow-up doctor visits and lab work.  Will get to that in a minute, but for now I may tell you about something I left out of the device check write-up June 8th.   I did say that I will be part of a research study, but I didn’t mention the fancy name.   It is called GALAXY, and the acronym, (don’t we love those?) comes from this.  I’ll try to highlight BOLD and CAPS the letters in the following phrase about the GALAXY Registry (LonG-term EvALuAtion of the LinoX FamilY ICD Leads Registry).   How long do you suppose it took for someone to figure that out?  It’s really not any different from just going in every 3 months for a device check-up, but I had to agree and to sign paperwork to give them permission to put “my data” in a research study.  The purpose is to work toward improving the device technology for the future.  I guess it is pretty good now, but I figured I would participate.  Why not?  Doesn’t cost me anything and I have to go in for all the checks anyway.  I’m interested in participating in good things for the future of others needing the same help as I did.  I have been grateful for all the comments from so many of you about success stories on friends and family who have had defibrillators.  It’s amazing how many are out there and have reportedly been operative for some time.

I am going to visit my cardiologist this Monday, and will be driving myself down to Yakima.  John is staying behind to care for the mom and the puppies, and to help taking off the last of the shingles (old) on the roof of our house – the front part.   While there I will take a trip to Costco to pick up a few items.

So, there is not much new to report on my progress, except I seem to be a little stronger each day.  I have been doing a lot of music venues, and turns out my fiddle would normally be held and rested on the place where the defibrillator is implanted.  That wound is still there and still has on all its little Band-Aids (it has a fancier strip name, but I don’t know what it is).  They haven’t rolled off yet.  So, I moved over the fiddle to under my chin and lower down so I didn’t have to raise my left arm too high.  I still need to use it to finger and to hold the fiddle, so the past 3 days of fiddling have been tiring.  My right arm is getting more use too, so it aches some.  I’m doing all right with Acetaminophen, just more than twice a day.  People enjoy our music so much, and we enjoy providing it, that it all has a happy ending.

The puppies will be 4 weeks old this Monday, June 21st.  That means they are ready for mushy puppy chow and their own water.  This also means they are outgrowing their pen, so we will be moving them (probably Sunday) to new digs where they have more room.  While I was gone to town to play for a 94th birthday party gig at one of the nursing homes, where they also gave us lunch, John took them out to play in the grass.  One ventured away from the rest and into the raspberries.  Then another went and almost got lost under the Nanking Cherry trees.  Funny, but not so for John.  He gathered them up and put them in a box and brought them back in ASAP.

I have not gone back to Physical Therapy because I’m waiting to hear if my insurance will pick up the rest along with Group Health.  If it is costing me $25 for 45-minutes on a machine, and I’m already paying a couple hundred to have medical insurance each month, plus the cost of Medicare each month, it makes no sense.  I am going to the SAIL class (earlier mentioned in this blog), at the Adult Activity Center 3 times/week for an hour, for only $3 for 3 months.  That’s a fine deal.  We get lots of stretching, strengthening and balance exercises each session.  I cannot do anything with my left arm that causes it to be raised above my shoulder, but I still can do a lot of the exercises.

I have done a little bit of walking around our place.  A couple days ago I walked into the lower pasture with John to retrieve the 3 “new” horses.  They now return to their pen on command from John, off the high grass.  It’s amazing to me to see how responsive they have become to his wishes and commands.  They also had not been fed treats before in their life and it is great to see them coming over to him for a carrot.  The day I went, the youngest (4 years old), Breeze, came up to me for a carrot.  (He has not seen a lot of me, so that was a rewarding experience.)

One of our recent times this past week was having the farrier in to do trimming on some of the horses.  While John rounded up the new ones, I held Myst for her trimming.  That was nice to be back in the thick of things around the “ranch”.

Our roofing project is going well too.  The barn was done in time to load it with hay last Sunday.  Lucky for John our provider came with two large trailer loads and a person to help unload and pack into the barn, and a powered bale elevator/conveyor.  Had John had to do this alone as we have in the past, it would have required at least 10 trips in the truck and trailer, across the valley, and back, and also he would have to do all the lifting and packing into the barn.  This was great.  He had only to supervise, open gates (which he had just built) for access for the big tractor trailer truck, and open windows and doors on the barn, plus build fences and tarps to protect the hay in the runway from having the horses nibble and break into the bales.

Other chores around the yard have kept John busy as well as horse training.  This is a year when we have had more rain than usual and the grass is high everywhere.   He has shifted the horses in and out of the pasture (and our backyard) twice a day.  It also has been very windy.  The temperatures have been down, however, which has made the yard work and roof work bearable.  I have been able to join the two guys each day for lunch outside.

Another thing we’ve been able to do is go to lectures at school and in the community.  There was an interesting 6 lectures given in downtown Ellensburg by one of our former colleagues in the Geology Department.  We missed two unfortunately, when I had this recent procedure, but we made the last one, and that was special.  The topics have all been on Washington State geology.  It is totally fascinating.

I guess you must be tired of hearing all this unrelated to the heart procedures, but to know I’m back to doing some of this stuff is very positive.  I’m happy to be alive to enjoy my retirement.

I’m still attending yard sales when I can and picking up bargains.  I had to get a whole new wardrobe because of my weight loss, and while doing that I also have found a few items for John.  There are pretty nice shirts out there that are almost new and of a quality we probably wouldn’t have bought new.

Thanks for staying tuned, and thanks again for all your prayers and thoughts that got me this far.


[from John: I’ll add something medical but unrelated to Nancy’s heart.  In December, while Nancy was in the ICU, I developed a “floater” in my right eye.  This turned out to be something of a false floater called a Weiss Ring and of little consequence, especially for me as I am left-eyed.  My right eye is of little use (sort of a spare) that would wander off until a couple of muscle-relocations brought it into alignment.  However, my brain ignores the image that eye sends and so the “floaters” in it are not noticed. Yesterday the left eye developed its own Weiss Ring and this one is going to take a bit more getting used to.  I’ll have it inspected this coming week because occasionally a small retinal tear occurs during detachment and that could be serious.]

SATURDAY — on the hunt, again

Garage/yard sales are the order of the day.  It is 6:30, the sun is barely up, it is cold out, and the wind is still blowing.  About that wind – for about 3 weeks the sustained velocity has been above 25 mph, often in the low 30s, and gusts up to 50.  Yesterday was the first day in three weeks I didn’t do something outside – I fed and watered the horses.  I’m sure they were thrilled with their day of rest.  Sunday morning the forecast claims the blowing will be down to 10 mph.

I tagged along with Nancy Friday afternoon to a meeting of the Trustees of Central Washington University.  First order of business was to have someone say nice things about recent retirees from across the employment categories.  They don’t give out gold watches.  Maybe the deep thinkers finally realized that someone that is retiring really doesn’t have the need for a watch, gold or otherwise, that might have been useful while they had a job.

The Trustees are empowered to vote on bestowing titles on faculty and in the current situation have voted to name Nancy as an Emeritus Professor of Geography.  She got to say a few words of thanks to and appreciation of CWU and of her joy of working with students.  I took a couple of pictures that are not too bad considering the nasty lighting, and then we (all the various honorees and tag-alongs) hightailed it out of there before the trustees and CWU administrators got back to figuring out how to run the University in a period of declining State revenue.

In addition to the new title, Nancy will be given a continuing parking decal which, truthfully, will be more useful than the gold watch they didn’t give her. In her remarks, Nancy was dignified as is appropriate for one with such a high-falutin ’ phrase in front of one’s name.  She did manage to insert a comment about her under- appreciation of “departmental politics” and that created a moment of hilarity.

MONDAY — just thinking

We are at that time of the year when the daylight hours are increasing and the weather is more conducive to being outside – sort of.  Last week three days of 45 mph wind didn’t help and now it is cool and slightly wet.  I still have 7 Ponderosa Pines to plant and lots of other things to do outside.  I mention this because during the winter (when Nancy was in critical care) there wasn’t much I could do, and so I grasped at all the information about her condition and treatment, and using the internet, tried to figure out what was happening, and then shared it with any that cared to read about it here.  There was a daily immediacy to the events and I began very unaware of all the medical possibilities and it was a steep learning curve.  So, I put lots of details in my winter reports.

There is less now on a daily basis to report and while we are very busy with all sorts of things, many are not exciting, and none are life threatening unless you count driving on narrow roads with right-angled turns every little bit (a consequence of our square survey grid). My (and our) reports now are more abbreviated but I still hope that on the medical issues I provide a good summary and appropriate links and key words that if you want to explore the issues more fully you will find it easy to do so.

I chose not to open this thing up to comments initially knowing it would be difficult for me to deal with personal issues (talking on the phone was an even more wrenching experience).  In one respect allowing comments would have made it easier for us to learn about what has been going on in the lives of others had you wished to share publicly but e-mail does work and we are learning a lot.  We thank you for updating us and we find it somewhat appalling that we have failed to keep up with all the goings on in your lives.  There have been accidents, hip replacements, surgeries, deaths, and new partners, and new grand children and many other things.  Wow!   [ ]

During last Saturday morning’s swing through the garage sale circuit John bought a pair of work shoes and an 18 inch pipe wrench.  Nancy bought a tear-dropped shaped mountain dulcimer (4 strings with C or D fretting).  You can look it up – I have no idea.

Nancy writes:

I want to put this next part in, because in this new exercise class I’m in, is a woman who had BOTH hips replaced less than a year ago.  She is doing really well in the class.  Maybe that will be encouraging to those of you with hip problems or replacements.  There are also people in the class who have knee replacements and they are up on their feet doing well.  We heard yet another family member just had one of those.  I’m still having trouble lifting my own body from a sit to stand without using my hands, but I’m told I will be better and able to do that at the end of three months.  I’m ready for that.

The program I joined is called SAIL—not as Sailing with the wind, but is an acronym for Stay Active & Independent for Life.  I joined a SAIL class, at the Adult Activity Center in Ellensburg.  It is an exercise class, developed by two women in the State of Washington.  It meets 3 days / week MWF from 1:30 to 2:30 and costs $3.00 for 3 months.  It is low impact aerobic stretching, balance, and strengthening exercises sitting or standing behind your chair, or walking around the room of chairs… to music.  We have a certified leader.  Today (Monday)  there were 21 people in attendance.  The oldest is 93 years young, and she “runs” / “walks” circles around most of us.

I’m still sorting through the clothes I bought at an estate sale.  Some low cut blouses (because of my heart surgery scar I don’t want to show) I’m giving to my neighbor.  My older bigger clothes, I’m portioning out to friends who can wear them.  I will never be in 2X again; that I know for sure.  I even had a few 3X blouses.  Now they swallow me.

One night last week we went to an orchestra presentation at the new music building where the acoustics are lovely; almost perfect from every seat in the house, and the Symphonetti from Rexburg, ID gave a great performance for about 1.5 hrs.

While I went to my normal nursing home music venue on Thursday afternoon with the Kittitas Valley Fiddlers and Friends, (I fiddle and sing), John planted trees, and cut off a matted (too bad to separate) tail of one of the new horses (Cheyenne).  I also attended a thesis defense for one of the REM graduate students who was in my class last fall.  So while I have retired, I still can find time to support some of the student activities that are meaningful to them and their families.

John reported I bought a dulcimer that I now have to learn to play.  A year ago I got  mandolin – also used much in old time music.  John says when we win the lottery and build a mansion with a great-stone room with a fireplace we can hang all the musical instruments we don’t play on the wall next to a large window looking out on the horses we don’t ride. Until that day, we plan to both play and ride.

SUNDAY — Many faithful readers

Well, okay, one actually: It’s only been since last Wednesday we (John) wrote, but had a request today from one of you in Blog land, that it was time for an update.

Things have continued going well with Physical Therapy and with getting out to go places.  Nancy went today to an award ceremony (for a prior student) at CWU, and John went on a field trip to Umptanum Falls and to patterned ground up on top of Manastash Ridge just a few miles south of EBRG.  John has continued every afternoon,  until today, to do “ground” work with the horses in the round pen.

We hit a few more yard sales and got me more clothes for the thinner body.  Nice to get them at these prices and not at store prices.  Goodwill is a good source too, but about 4 times as expensive.  I am still excited about the shoe-style boots we found in Yakima Goodwill for John, and the work boots I found for him at a yard sale, for $3.  The strangest coincidence happen with this purchase.  An hour after I returned home with the boots we went out again to watch a young friend play baseball, and behold, there sitting on the end of the bleacher was the previous owner – there to watch his grandson.

We do have to go to a doctor this Wednesday to talk about a possible implant of a device to control my atrial fibrillation but then the next appointment – a follow-up with the cardiologist isn’t for nine weeks.  I’m not sure I wish to go back in the hospital again any time soon, especially with my complications with Heparin, the blood thinner.


WEDNESDAY — taking stock

Nancy and I went to Yakima today for a visit with the cardiologist.  He reviewed her history and records from the time she entered Yakima Regional Hospital with an on-going heart attack on the Friday morning after Thanksgiving.  This was interesting – his view – but it was not new material.  He reviewed all the medications and recent tests and suggested some adjustments and a substitution.  He also made a referral to another doctor in the practice, this one is an implantable device specialist.

One med problem is that the desired action of Coumadin (Warfarin) as an anticoagulant isn’t being maintained with the 2.5 unit dose and creeps up with the 5 unit dose.  Thus, until there is a 3 unit dose we are back to taking the larger dose about every third day.

He is recommending stopping the Lisinopril and substituting Telmisartan at its lowest dose.  These meds are to help maintain blood pressure in an appropriate range and one advantage of the new med is that it lasts longer in the body than the other.  Deciphering all the other differences of these types of drugs will involve more reading than I want to do tonight, so no more about them now.

The referral to the implantable device specialist is to get an opinion on whether or not one of the modern gadgets would work for Nancy in controlling heart functions.  There may be benefits with some implanted device but there is also the problem of her reaction to heparin such that any procedure would be more problematic.  That appointment (about 2 weeks off) has yet to be scheduled, so again, there is not much more to be said tonight.

EASTER — Celebrating; now where’s spring

We bought a rib roast and took it over to our neighbor so she could cook it in her new oven, thereby saving us the trouble of cooking, making gravy, and carrying a cumbersome and hot carton of things 300 yards down the road.  Nancy is supposed to take a stomach motivation pill about 30 minutes before she eats.  So we arrived a bit early and engaged in neighborhood news with the extended family members.  After a time Nancy rose out of her chair as though she had been poked with a sharp stick.  We were shocked – shocked, I tell you!  She had forgotten to take that pill and dinner time was fast approaching.  We were shocked that she would be so forgetful and threaten the timely serving of the food, for the rest of us would not have tasted a thing until her recalcitrant stomach was primed for the event.  Shame on her.

We haven’t written in a couple of days, but it’s because we have been busy, visiting doctors, physical therapy, and checking out some horses in the lower valley.  Nancy anticipates riding this summer and needs a calm and responsive horse.  We found a Tennessee Walking Horse mare 10 years old with experience around guns, dogs, people milling about, birds flying from under foot and so on. Namely, a birddog field trial horse.  She has a 6 yr. old half brother.   We will pick them up next weekend.

Nancy drove to town Friday – her first such activity since before Thanksgiving.  And also, except when we know she will want the attached seat, she leaves the 4-wheeled walker in the car.  All signs of progress.

John participated Saturday with our youngest horse in a workshop put on by our horseback trail riders club in the Kittitas Valley.  The weather outside was frightful.  Friday we had 3 to 4 inches of snow, and it snowed here a little Saturday.  I stayed home and was able to speak by phone with my maid of honor at my wedding… 40 years ago.  That was quite special.

Also, Saturday afternoon we went to a friend’s house and watched 4 kids color Easter eggs.  It’s much different from what I remember as a kid.   Then we ate a wonderful dinner and played around afterwards on the piano.

Monday starts another busy week.  One of the companies with Nancy’s retirement money gave us the wrong forms a few weeks ago so new ones have to be completed, signed and stamped by CWU’s benefits administrator, then resubmitted.  We have to turn in campus keys, go to physical therapy, go to the hospital lab for another blood draw for tests—never stops, and threatens to make me anemic again ! (ha ha )… not so funny.  Wednesday evening there is a presentation on the great ice age floods that swept across what is now eastern Washington State carrying blocks of ice, rocks, and all sorts of debris to the Pacific Ocean via the (now named) Columbia River Gorge.  This is a favorite topic of many retired earth science types we have known for years and, as such, we will see a lot of friends last seen months ago.

We know some readers are experiencing lovely spring-like weather.  And from the winter you had, you deserve a few nice days.  Not us.  We had a mild winter.  Here, this past week has been more winter-like than winter was.  With new horses coming, John has preparatory work to do.  Where’s spring?

FRIDAY — more

“More” is the word of the week.  More exercise.  More pills.  More paperwork.  More attention to details.

Nancy has been evaluated at the other physical therapy facility and we have scheduled two (45 min.) days a week.  There was paperwork to fill out and as she switches to Medicare as prime provider next Thursday this will continue – the paperwork, I mean.  We were encouraged to do lots more at home – exercise, not paperwork.  Once each hour – out of the chair and chase the chickens around the yard.  (I’ll have to round up some chickens – we haven’t had any for about 17 years.)

The diagnosis of gastroparesis, although based on Nancy’s history and occasional emptying of stomach contents, and not on the high tech test has resulted in an additional med, namely “metohkloepramide” (sounds as: metohKLOEpramide).  What’s one more, at this point!

We learned carbonated drinks encourage water retention.  Bad.  As does just about anything one eats or drinks – salt or sodium is hard to escape.  That will be the “attention to detail” part.  And all the labels just get more complicated and seemingly smaller print size every year.

Yesterday a letter came inviting me (John) to serve the community by appearing for jury duty in May.  Fill out the form and return in 5 days or less, they say.  What are they going to do?  Come and knock me around for 5 minutes or so?  I’ll have to see if they will postpone the request for a few months.  More paperwork.

WED. & THURSDAY — fine & otherwise

It is late Thursday evening, and I’m happy.  Why?  Well, tonight’s food – clam chowder and lemon meringue pie – went down easily and has stayed down.  We established contact with a personal representative, for us, from one of the big mutual fund companies where a third of my retirement funds have been invested and she helped us complete the forms to begin taking out money instead of making deposits.  And, the Kittitas Valley Fiddlers and Friends made some music this afternoon.

About the not so fine things:  Minor irritations with the insurer regarding approving physical therapy continued. On the phone I alternately got yes and no, then absolutely not, and today a letter came that seems to say yes.  Still, the month is about over – so what does it matter?  I haven’t heard a peep from the 4-wheeled walker company – another stain on the health care system.  Some of the issues are like weeds.

John and I had blood drawn on Thursday.  He had to fast for a cholesterol test so we went from the hospital directly to one of EBRG’s finest fast food establishments.  We brought burgers home and about 2/3 of the way through mine – it reappeared.  Enough, I said and called both the pharmacist and my doctor to ask about the meds I’m on and if something might be causing this rapid regurgitation.  We made some adjustments. One of the things I’m on is Amiodarone (used to correct abnormal rhythms of the heart) and is known to have side-effects and interactions with other drugs – with digoxin, for instance, and I’m taking that. (Just for reference I’ll have another blood draw for the digoxin level tomorrow.) Big doses of iron also can cause issues.  As reported above, tonight’s meal was not a problem but that was luck or circumstances.  For one thing, Amiodarone builds slowly and stays long in a person’s body so just deciding to reduce the dosage, and having not yet done so, shouldn’t have any effect.  Do you think?

The oddest thing that happened this week was that my phone at CWU mysteriously quit working.  The deal was to be that the number and messaging system would stay for some months as previous students might be calling and asking for references and such.  The paper work was very clear about this but someone saw my name and the word “retirement” and the dastardly deed was done.  It took several phone calls and some sleuthing by the head-phone-lady to track this down and fix it.

Speaking of sleuthing, John learned that Amiodarone is a drug that emergency medical personnel need to know about.  I’m in the process of ordering a medical-alert bracelet and, so, along with heparin that one will have to be listed too.

WEEKEND — keeping up, keeping track

By week end my 4-wheeled walker is still the borrowed one from the PT folks at the rehab facility.  There was no word from the approved provider that was going to see about one with 7.5 inch wheels. Likewise, there was no word on my request of a review of the “approved for a new PT place” so that too is still on hold. Timely apparently is not part of the concept of health care recovery.

Late-week mail brought two interesting items.

1. Back on Dec. 14 & 16 (Nancy is in the ICU) something was done by the cardiologists and described as “Subsequent Hospital” and billed for $120 each time.  A statement arrived dated Jan. 29 indicating the insurance would not pay for these two things and we should send $240.  John tried to call but got a phone-tree and so he wrote a letter stating his understanding of the insurer’s denial to pay for something “Subsequent Hospital” when the patient was still in the hospital.  Now we have a new statement.  This one seems to indicate that the bill was resubmitted to the insurer and they then paid $99.60 which settled the 12/14 debt of $120 but left the other untouched.  Again, there is no explanation of what these charges are for nor why if the insurer can get by with paying only $99.60 of $120 we still have to pay the full $120.  Also, were these things the same (the code of 99232 and description and cost is the same) and, if so, why didn’t the insurer pay both of them?  We are still left wondering what we are being asked to pay for and why.

2. In response to a self-serving survey form from the insurer about a Case Management nurse calling program (talk-talk-nurse program) John wrote a letter.  A couple of weeks ago we were called by a nurse from Spokane.  She was the expected replacement in October for a nurse that called occasionally from Kennewick who was booted out of the process by the insurer when she didn’t agree to move to Spokane. This new talk-talk-nurse, in a response to a question from John, referred us to our EOBS.  John slowed her down, stopped her, and had her back up and explain what our EOBS were.  When the company pays a bill, or doesn’t pay, they then send a printout to you with the title “Explanation of Benefits.”  This is an EOB. The talk-talk-nurse was surprised we didn’t have any EOBs.  Because we did not have any we had no idea about the cost of Nancy’s long hospital and rehabilitation stay.  The nurse promised to alert the company’s computers and have our EOBs printed and sent.  A packet of about 40 arrived on Saturday.   The $$ amounts are frightening.  We will summarize them for you later.  One item, the blood for the open heart surgery, exceeded $10,000.

Change of topic:  Saturday we did go to a retirement community and I walked in with John’s help, my pillow, and him with my violin .. and took a chair I could get up from.   We had a great turn-out and most everyone joined in singing many songs (the Irish ones, we provided words for).  We went home for an hour, and then off to the Children of Chernobyl fund raiser with a dinner, program and silent auction.  We got in at the front of the line with my walker and proceeded along the buffet with servers adding small dollops of things to my plate that was riding on the seat of the walker. I managed to eat a good meal, encountered many friends and enjoyed the program.

Now today, Sunday, is a non-event day.  We have been resting and doing computer email.  I was able to write a letter of recommendation for a former student from Thailand that I had in an Intro GIS (Geographic Information Systems) class two years ago.  He is applying to graduate school in Texas and California, and, via computer, I contacted both places today.  Until ex-students settle firmly into careers these sorts of chores crop up.

With no outings planned, after lunch we walked up the driveway and back, for my daily exercise. There were lots of small birds at the feeder including a small woodpecker, a Downy, we think. Tomorrow we’ll take the camera, walk farther, and see more.