A little rant about health care, mammograms, paranoia and unfounded faith in technology

When someone blames Obamacare for their high  health insurance premiums, I want to scream.

It’s not politics that increased my health insurance premium by $78.37 in the middle of the year (yeah, I didn’t know they could do that either, but my monthly premium  — for the exact same plan that covers me alone — went up 34% in July, the equivalent of nearly $1,000 a year).

At least, it’s not only politics. It’s wiz-bang innovations that patients demand and/or doctors recommend for no reason other they sound good.

Image by Prevention magazine

Image by Prevention magazine

Need an example? How about computer-aided-detection, aka CAD, for mammography. Computers do everything better, right?


CAD for mammography, which aims to double-check radiologists’ screening results, didn’t improve accuracy by any measure, according to the largest study to date of the controversial tool, published Sept. 28 in the journal JAMA Internal Medicine. I’ve been seething about the report shared in the Star Tribune ever since.

The JAMA Internal Medicine report found that CAD for mammograms added at least $400 million to the nation’s annual health care tab. Someone is paying that $400 million, people, and if you think it’s not you, you don’t know how insurance premiums are set. Insurance companies are out to make money, and they don’t pay for procedures out the goodness of their hearts — they pay for them out of your premiums.

You might be tempted to blow off that $400 million number, but think of it this way: There are about 35 million women in the U.S. between the ages of 50 and 74 (the age frame of women recommended to get mammograms). That $400 million means $11 every year for every middle-aged woman in the country. For just one unnecessary type of procedure among dozens, if not hundreds.

Not only does CAD not improve a radiologist’s accuracy in finding cancers on mammograms, it actually reduces it, probably because they’re depending on the computer as a crutch. “Radiologists’ sensitivity, or the proportion of times they correctly identified cancer, was 83 percent when they used CAD — and nearly 90 percent without it,” reporter Jonel Aleccia wrote.

Aye yi yi.

I’ve been suspect of mammograms since my last one three years ago, preformed after I found a lump in my breast (it was more of a bump, actually). It turned out to be a harmless bruise, but I paid $517 for an unnecessary ultrasound that discovered nothing except peace of mind (read that outrage here). In most cases — not all, I get it — but in most cases, a woman or her partner finds the lump first and the mammogram just confirms and pinpoints it. It’s one of the reasons breast cancer screening guidelines changed a couple of years ago from beginning routine screening (i.e. mammograms) for women of average risk at age 40 to age 50 and from being performed annually to every two years. Mammograms simply aren’t the be-all, end-all of breast cancer detection.

Some women are still insisting they want mammograms more often than the guidelines. The science just doesn’t back it up for healthy women (i.e., no family history, not taking hormone therapy, not at high-risk of carrying the BRCA gene, etc.). News flash: If you want a mammogram before age 50 or more often than every other year, you can still get one — pay for it yourself! Why should my insurance premium bear the cost of your paranoia?

So what can a logical woman do about health care procedures that do nothing to actually improve her health? Well, for starters, we can take control of our health care by being informed. Ask how much a procedure is going to cost before going ahead with something just because you’ve met your deductible for the year. As for CAD for mammograms, you  have a right to ask for a CAD-free mammogram, which is not only good for the community bottom line, it’s good for you because it encourages the radiologist to be more careful.

And the next time you’re tempted to blame politics for the cost of your health care, look in the mirror. I’ve seen the enemy, and it is us.

Taking to water like a couple of ducks

It’s not secret I’m a big fan of water. I mean there’s the whole hydration aspect of it, and you can’t beat it for getting you clean.

But I was born in the land of sky-blue waters (hello! Minnesota has been the Land of 10,000 Lakes on its license plates as long as Missouri has been the Show-Me State), and I spent many-an afternoon as a junior high schooler getting pruney and water-logged at the Wadena pool.

Despite swimming the crawl at the speed of a crawl, I became a lifeguard and spent two summers teaching 5-year-olds how to swim (thanks, Shannon Whateveryournamewas for assigning me to the role no one else wanted but has served for excellent blog fodder in my golden years).

But as I’ve aged and gotten increasingly protective of my artificially colored hair, I’ve spent a lot less time in the chlorinated waters of a pool.

Until recently.

NOT me and my Beloved. But you get the picture.

NOT me and my Beloved. But you get the picture.

My Beloved and I joined a new gym (goodbye, Snap Fitness, you served me well), and I’ve spent a number of mornings getting my groove on in the pool during water aerobics classes.


Well, it’s not because I’m a fan of green hair (and I’m really hoping I can avoid the inevitability by keeping my ponytail dry — well, dryish).

My Beloved appreciates the lower impact exercise opportunities afforded by a pool of warm water, so I’ve been joining him and the grannies so we can exercise together.

Only here’s the thing: It’s not just grannies. And it’s not a bad workout.

I’ve been walking around all day today fully aware I worked out in the pool this morning. It’s not the same kind of sore as lifting bar bells that were too heavy, but I know I put my arms and legs and heart to work.

Another plus on the pro-and-con list: No one looks sweaty. We’re all just … wet.

Hey, today’s song list even had us underwater grapevining along to Michael Jackson’s “Thriller” and Ray Parker Jr.’s “Ghostbusters.” Oh, wait a minute. I suppose teenagers who were amazed by “Thriller” are grandparents now. But whatever. We weren’t dancing to the oldies. OK, the really old oldies.

It’s not like a summer run as the sun rises over the horizon, but water aerobics are pretty fun.

And splashing around the pool with my sweetie is better than icing on the cake. Because I’m burning calories instead of consuming them.

A movie worth seeing, even if you’re not into highly dangerous space travel

The protagonist in The Martian — the guy who survives against all odds for a year and a half on an isolated barren plant — is admirable and highly worthy of emulation.

But he is so not me.

I would cry my eyes out, lie down and give up.

Whenever I get caught up in a conversation with someone about doomsday and my survival comes down to protecting my tuna cans and bottled water in an armed battle against a marauding horde, it’s my Beloved who is aiming between the eyes. I’m the one huddled in the closet, crying while the zombies climb over the fence.

I guess I’m too willing to go with the flow, and when the flow is running uphill, I throw up my hands.

So if it was me trapped in a no-win scenario, I’d be the expendable red shirt in the Star Trek episode where someone dies before the opening credits.

However, Matt Damon as the never-say-die astronaut in The Martian is highly entertaining, and the movie was riveting for nearly three hours. 

Even if I can’t relate.

So count this as another endorsement for the movie. And maybe even worth springing for the 3D upgrade.

Because cleaning the camper and chili go together like a mop and a bucket

After a day of cleaning refrigerators (yes, two), a toilet and sweeping, vacuuming and mopping all available floors, I could use a nice pot of chili.

You understand, my Beloved and I were winterizing the camper (and yes, there’s one dorm fridge in the “basement” and one in the camper proper), and all the glamour of a year’s worth of camping goes out the window when you’re on your hands and knees trying to poke the vacuum cleaner attachment into the back of the closet. And driving around searching for a place to legally dump the shitter (because we’re not Cousin Eddie).

We also stripped the bed and removed the mattress because, Twister Sister fans, we’re not gonna take the old one anymore!

But that’s behind us now, the camper tucked snugly into its storage barn on the edge of town. It’s October, and it’s that time of year.

And now it’s time to think about supper. And because it’s that time of year, some spicy chili is just the stuff to soothe the savage RV cleaning beasts.

Where do I turn? But to my sister’s recipe which I love for its black-eyed peas. Instead of hamburger, I dug up some leftover steak in the freezer, and for spices, I mined the pantry for two kinds of chili powder, molasses and soy sauce (it’s umami, baby!). Sister shared this recipe on my blog a half dozen years ago now (oh, my gosh, how time flies). And it’s a post worth sharing again…

Beautiful chili is in the eye of the beholder

A good chili recipe is as personal as a particular brand and style of underwear. One size does not fit all.

I recently saw a recipe for “the world’s best” chili. It called for cubed tri-tip steak, brown sugar, cumin and paprika — among other basic ingredients — and that was a good start, but it had no chili powder and no beans! How can that be considered “the world’s best”?

Click here to read more. (You can find my sister’s recipe tucked in the comments.) 

Ah, the lure of restful slumber

Good sleep is a better blessing than almost anything else. A full stomach? Yes, good food is wonderful, especially when enjoyed with good friends. To be loved. Ah, the world would be lost for want of that. But one sleeps away one third of life. Poor sleep or not enough of it interferes with happy digestion and satisfactory relationships.

So to find the perfect place to lay one’s head for deep, dreamless sleep, that is better than a fine steak or a tantalizing kiss. I have found such a bed.

But I am away from it just now, and thinking of returning to it tempts me to chuck the rest of my road trip, just for a few extra nights of perfect slumber. Perhaps that is the definition of success — being able to afford a better bed for every night than one can enjoy when one’s on vacation.

For now, I will settle for something else.

A nap.

Boundaries make good neighbors

Suburbs have a multitude of boundaries, both physical and socioeconomic. Setting apart the obvious societal lines between inner cities and suburbs, let’s discuss those physical boundaries today in honor of the WordPress weekly photo challenge.

There are streets, of course. Then curb and gutter (two boundaries if we’re counting). Boulevards are nice, and for dog walkers like me and the adorable schnauzer, sidewalks are useful. 

Now we’re at the property line. We’ve got a nice, usually green buffer in the yard. An upscale suburban house certainly has landscaping around the house — bushes, usually, and maybe pretty flowers, as here in this tony Detroit suburb’s clear signage at the subdivision entrance (we’re visiting a friend here in Motor City). Don’t forget the rocks or mulch, and if you’re very particular, plastic edging between the mulch and the grass.

Finally, we get to such boundaries as siding, walls and doors.

Whew! After reading a novel set in 19th century London where the protagonist finds himself poverty-stricken and grateful to find a job that includes housing in the form of a cot with a blanket in a dormitory, I’m pretty grateful for modern boundaries. I’m glad I can’t hear my neighbor snoring.

Finishing this book releases me from the Bondage of an unfinished assignment

Thirty years ago, my Thematic Writing teacher — Mr. Mickelson, I think, but it might have been Miss Sharp — assigned me to read Of Human Bondage by W. Somerset Maugham.

I’m happy to report I’ve completed my assignment. On my Kindle, no less!

Of Human BondageAs part of my PopSugar 2015 Reading Challenge, one of the books I was to read was “a book you were supposed to read in school but didn’t.” I know I didn’t read Of Human Bondage because I dutifully reported it in my diary as “a book I was supposed to read for Thematic Writing.”

It’s the coming of age story of Philip Carey from the time of his birth the late 19th century in England until about age 30. An orphan with a club foot, he is brought up by his strict and religious aunt and uncle who hope he enters into a pastoral profession, but he yearns to travel the world freely.

Philip ends up studying in Germany, painting in Paris, hating accounting in London and, finally, taking up medicine. In the meantime, he meets all sorts of people who Maugham generally describes as homely and disgusting in some way. Most horrifying is Mildred, a bitchy waitress (and later, hooker) who repeatedly takes advantage of Philip’s adoration and kindness.

This book is written in formal English (no Valley Girl speak here) and it’s interminable. I can see why I didn’t finish it (or even bother to start it) 30 years ago. But it kind of grew on me. I didn’t care for the way Maugham chose to make his protagonist so indecisive: “He was afraid that Sally by speaking would break the spell, but she said never a word, and he wanted to hear the sound of her voice.” Did Philip want her to speak or not? And I absolutely hated Mildred and longed for Philip to hate her, too, but alas, it was not to be. But Maugham covers a lot of philosophical ground about faith, art, beauty, money and the meaning of life, so this book is a thinker (and believe me, only thinkers are the type to tackle a 30-year-old English assignment). And, I’m happy to report (because I actually got to the end), it has a happy ending (surprise!).

Remarkably, one of the characters commits suicide and twice, Philip seriously considers taking his own life. Also, there’s Mildred as a painted lady and brief references to venereal disease and teenage pregnancy. This is a book assigned to high schoolers to read? I mean, I would let my teenager read it (how impressive would that be!), but I can imagine some parents freaking out.

With Of Human Bondage, I’ve read 38 books this year, which puts me squarely nine books behind schedule to accomplish my goal of 63 books. With three months left in the year, it’s not looking good. But hey, I finished one of my high school reading assignments today, so I’m feeling totally, like, rad, um, ya know?