BROKEN DING-DONGS, HEARING AIDS, AND ONE MORE REASON TO HATE OUR GOVERNMENT

Hey everybody! It’s been a while. I thought it would be good to post again.

I’ve got a little time; I’m on a medical leave right now to take care of a sudden and troublesome condition. I’m hoping to return to work in January. So, I’m using the time for research and writing. Good time for a new post.

My time as a Medical Assistant has not been terribly long, but I have learned a few things. The world of healthcare is full of drama, intrigue, gossip, strong emotions, and downright assault. They didn’t exactly prepare me for that in school. But, many veterans of the industry are a bit burned out these days, so I joined the ranks just in time for the rampant profanity and frayed nerves. Good times!

But, all that’s for another time. Today, I’d like to write about broken male genitalia, hearing aids, and a federal government that just continues to annoy the crap out of me.

Okay, bear with me, because this is sort of round-about.

Older males can develop a condition called Peyronie’s Disease. Simply put, this a pronounced curvature of the ding-dong when it becomes ready for the old hoo-hoo cha cha with a nice lady. Many illnesses and conditions in medicine are eponymous; that is, they are named after the scientist or physician that first identified them. I have done no research, nor do I wish to, of who Peyronie was, and why he chose this area of study. Well, I suppose someone had to do it?

Anyway, this curvature of the little fella can be quite debilitating, preventing regular sexual intercourse. Please, please, please do not follow this link:

https://www.google.com/search?q=real+pictures+of+peyronie%27s+disease&tbm=isch&ved=2ahUKEwj6w5GU2v_zAhWLATQIHWN1AbAQ2-cCegQIABAA&oq=peyronie%27s+disease+pictures&gs_lcp=CgNpbWcQARgCMgcIIxDvAxAnMgQIABAeMgYIABAIEB4yBggAEAgQHjIGCAAQCBAeMgYIABAIEB4yBAgAEBhQAFgAYLQiaABwAHgAgAF0iAF0kgEDMC4xmAEAqgELZ3dzLXdpei1pbWfAAQE&sclient=img&ei=p1eEYbrUMYuD0PEP4-qFgAs&bih=757&biw=1600&rlz=1C1CHBF_enUS897US897

I warned you. Anyhoo, Peyronie’s Disease is generally caused by a buildup of scar tissue and plaque in Mr. Johnson. This is typically due to a number of various medical conditions, but most often due to penile trauma. What happens is, the old timer really, really wants to do the bang-bang dance with the pretty lady friend. However, along with age can often come another unfortunate condition, erectile dysfunction. ED, as it’s known, can be varied in its severity. If it is not too bad, the gentleman will do his darnedest to guide the not-so-stiffy into the nice lady’s fun zone. This invariably does not work, and is probably not all that fun for the female partner. I’m guessing. But, this continued practice will cause physical trauma, damage, to Mr. Johnson. This often results in Peyronie’s Disease. Oh, the tragedies of man…

But wait! Hope abounds! Modern modern medicine triumphs! There is a medication known as Xiaflex (triumphant music sounds) that can cure this condition!

Xiaflex is a medication that breaks down the plaque buildup in a shlong with Peyronie’s Disease.

https://en.wikipedia.org/wiki/Collagenase_clostridium_histolyticum

It is injected directly into the affected area of the penis. You are reading that correctly. A needle, made of metal, is inserted right into a crooked penis. In my practice as a Medical Assistant, I have seen Peyronie’s Disease, and I have seen it corrected by an injection of Xiaflex into the affected area of the male member. It cannot be unseen. I am different now.

Xiaflex is not inexpensive. Depending on the severity of the Peyronie’s Disease, it can take up to 12 injections of the medication. Each administration of Xiaflex costs roughly $3000.

Okay, so my 87 year old mother, who I love dearly, is nearly deaf. I know that there was no segue there, but bear with me. This all comes around. Nevertheless, I hope my Mom is not reading this.

Charlsia Schall is still very sharp mentally, and I inherited her wicked sense of humor. Physically, she’s doing okay for someone who is 87, but she needs to use a walker and she desperately needs hearing aids.

You can still speak with her, but it is usually best to speak directly in front of her, in a louder, clearer voice. Being that her cognitive acumen is still strong, it is easy to carry on a conversation with her. At her age of 87, I am truly lucky. Not many people have such a luxury. Again, I hope you’re not reading this, but I love you, Mom.

My mother and late father, through living frugally and saving as much as they could, did okay for themselves. You know, living within your means and saving as much money as you can. Like you’re supposed to do. Sheesh. Old people, wise with their money… I tell you… Anyway, though she could definitely afford it, Mom is not keen on making large purchases. On some level, I don’t blame her at all. Hearing aids are profoundly expensive, with decent ones starting at at least 4-5 thousand dollars. As my Mother is not entirely deaf, this is an economic button she is just not comfortable pushing.

Social Security was signed into law by President Franklin D. Roosevelt in 1935. Again, I got no segue here, but trust me, this is all going to come together. Hopefully. If this is a good day. Anyway, Social Security was part of the rescue package intended to mitigate the Great Depression. Apparently, economies occasionally need medication and therapy as well. The Great Depression had ravaged the United States. A recap of history is not needed here.

The government, at all levels, has always taken a strong interest in the American healthcare system. This can be a good thing, as government oversight can ensure the safety of patients and the efficacy of treatments, strengthening out healthcare system. (How we go about paying for this masterpiece is another story entirely). Federal agencies exist to oversee healthcare at all levels, ostensibly to protect the American patient: the FDA, the CDC, the DEA, the Joint Commission, etc. Occasionally, these departments can become weaponized for political reasons, as we are human, all of us flawed, and humans run the government.

My education and professional experience is in medicine. I dislike talking politics, as people can easily get all yelly-shouty-pissy. I know only the basics of our political system, and I hold opinions based on what I see. There is a branch of philosophy (I have dabbled, but am not educated) known as epistemology. This school of thought seeks to differentiate between what is fact and what is opinion. In today’s era of social media, it is quite easy for anyone, from any ideological camp, to loudly shout an opinion, with scarce facts backing it up, until, in this era of blatantly partisan media, their opinions are reinforced enough to become, in their world, facts. A nice twist of logic. It is difficult to speak of politics these days, as we live in a largely binary political belief system, with inflexible, unyielding opinions (not facts), and people quickly get emotional and confrontational. You cannot have a rational discussion with someone in that state. Hence, I avoid politics.

Anyway: back to politics nonetheless, the federal government, and Social Security. Over the years, the government has changed, tweaked, and adjusted Social Security, but the basics of the original intention still stand. All taxpaying Americans pay into it, and our senior citizens can enjoy an easier way of life, as medical bills mount with age. Be that as it may, there are certain things Social Security still will not pay for.

My beloved mother could really use those hearing aids. Hearing aids are not covered by Social Security.

Xiaflex, the medication that treats Peyronie’s disease, is covered by Social Security.

Let that sink in for a moment.

Hearing aids? Up to $7,000 or $8,000 dollars.

Xiaflex? Up to $36,000 dollars.

Yup. No hearing aids, no new glasses, no covered dental work for my Mom.

Bent weener? No problem. Got you covered.

I was a little stunned when I heard about this. Surely, I thought, the powers that be in Congress would have rectified this by now. An RN I was working with at the time gave me his opinion:

RN: Andrick, who do you think makes the laws in the Senate?

Me: Uhh… Well, for the most part, mostly older white males.

RN: And who do you think they have staffing their offices?

Me: Usually insanely hot 35 year-old women.

RN: Okay then, do the math.

Me: Aw, crap!

Joe Biden and the slim majority of Democrats in Congress have recently tried to stabilize the country and give long-needed help to the working class. Again, I hate speaking politics, but two of his Republican predecessors did the same thing. But, because half the country believes Joe Biden lost (dude… people… really?), the opposition is suddenly concerned about all this money we’ve been throwing around.

Initially, Biden’s rather largish spending plan included adding hearing aids, vision, and dental to Social Security recipients. Sounds like the right thing to do. But people balked at it. Biden has scaled his ambitions back. Recently, Congress at least passed an infrastructure spending bill. There is more work to be done. Biden and the Democrats are still trying to pass legislation that would help the needy. After much yelling, the plan was scaled back, as far as Social Security benefits go. Vision and dental are out, but hearing aids would be included. At least my Mom could finally hear again.

However, the opposition is again balking at this one. Along with them are two Democratic obstructionist Senators. One is a cranky old man, with an 85 year old body and 500 year old face,a Republican dressed as a Democrat, who doesn’t like spending money at all. He wears sensible shoes. He represents the state of Virginia. I had to Google Virginia; evidently it’s a suburb of West Virginia or something. East Virginia was infamously destroyed by the Cloverfield monster. The other Democratic obstructionist Senator is a woman from Arizona, who’s really pulling off the naughty-behind-closed-doors school librarian look. I’ve been to Arizona. Head south to the deserts of SoCal, go east, and stop where all the retired people are. Anyway, this Senator is rather hard to read. She doesn’t seem to stand for anything, and dislikes speaking to reporters, her constituents, or the clerk who asks paper or plastic. Maybe she’s just there collecting a paycheck. She certainly does not need the Viaflex. So, there is a good chance that the aid package that includes hearing aids in Social Security will not pass.

So, there you have it. Penny-pinching senior citizens can’t rely on Social Security for hearing aids, but senior citizen males, no matter what their station, can afford Xiaflex to fix their bent ding-dongs. Makes perfect sense to me!

Well, until next time! Thank you for reading!

A NEW MEDICAL STUDENT KINDA GETS IT RIGHT

Back in early 2020, when the world began to unravel, when I had just finished my first quarter of school, the lock-downs across the country had begun. My parents, I had both at the time, were considered vulnerable (right… remember when it only infected elderly people or people with compromised immune systems? It’ll go away in April! Like a miracle! Drink bleach!) and they were living in an assisted living facility. In fact, it’s only recently that restrictions have been relaxed, and I’ve been able to regularly visit my mother.

Anyway, I was having such a great time in school; I was particularity blown away by anatomy and physiology. The human body is an amazing machine. When our instructor first started lecturing about the roles that the cardiovascular and pulmonary systems play together, I devoured his words, scribbling furiously in my notebook. I read through the relevant chapters in our massive textbook. I was fascinated.

I wanted to tell my parents what I had learned, but that’s hard to do over the phone. So, I scribbled together these following pages and mailed my attempt to understand the human body off to them. They got a real kick out of it!

Needless to say, I was a green student, and I got plenty of things wrong in my notes. I think I got the actions of the diaphragm mixed up. I left out the other semilunar valve, the aortic valve. I did my best with the white blood cells, but I’m no biochemist. I got the test tube of blood wrong; white blood cells and platelets are actually in the middle, in a thin layer called the Buffy coat (seriously). There are also plenty of spelling and grammatical errors, and a few pages have this evening’s PB&J on them. Sorry about that.

If you manage to make it through my mangled scribbles of a new student barely understanding, and get to the part where I talk about platelets, you might notice something interesting. Platelets, the cells in your blood that form a mesh to stop bleeding, use serotonin in this process. This is the same serotonin that rattles around in your brain, affecting your mood, and are the primary target of most antidepressant medications. Huh. The human body’s kinda weird like that… Anyway, enjoy!

Thanks for reading! Wash your hands!

THE FAILURE OF MENTAL HEALTH TREATMENT: THE DIVORCE OF PSYCHIATRY AND PSYCHOTHERAPY

There is a massive problem with the practice of psychiatry in today’s modern healthcare industry. There are several reasons for this, which I will address in a moment, but first, let’s get a few things out of the way.

Many people have a very reactionary, negative opinion of the field of psychiatry. They feel that it does more harm than good. In today’s healthcare environment, they may have a point, but I am speaking in general terms. Psychiatry, to many, is a dangerous science that can damage your brain. Of course; many medical procedures can damage you if administered improperly. That’s why I went to school. Many people feel that psychiatrists have very little clue as to what they are doing. While it is true that the study of the brain, which has remained a difficult and emerging science for a very long time, and will continue to be so, there are millions of Americans who have benefited from what psychiatry does know, and what treatments it can provide. And still others feel as though psychiatry, and indeed, any treatment of the mind or emotions, should be out of the realm of medicine, and kept in either the family or church. While it is very true, and studies have confirmed this, that those of faith, or at least some level of healthy optimism about life, tend to heal much quicker from whatever affliction they may have, that does not mean that medical intervention is sometimes required. Nor does it mean that atheists do not heal.

Plenty of people have a negative opinion of healthcare in general. That is unfortunate. Many millions of people have benefited from the proper treatment of an affliction, and go on to live healthy and productive lives, despite an illness that would have been a death sentence one hundred years ago. The human body is a machine, an amazing construction, the triumph of life on Earth (although the debate about that is for another time). Whether by evolution or design, you and I, and everyone else on Earth, are amazing creatures, composed of practically countless processes, organs, chemical and electrical reactions, and things still yet to be discovered. However, just like any other form of life, like any artificial machine, like any magnificent creation of geology, things can, quite simply put, break down. Sooner or later, it happens to all of us. Have you ever thrown your back out? Well, so have 65 million other Americans. We are wondrous creations, but not entirely perfect. Healthcare plays a role in our repair, and improving our quality of life.

But back to psychiatry. The negative connotations I mentioned above are not entirely unfounded. The history of psychiatry is replete with practices that today seem barbaric, and would never be considered as an option for treatment. What is worse, in modern history, authoritarian regimes have tortured and killed untold numbers under the guise of psychiatry: Nazi Germany, The Soviet Union; even the CIA is guilty of using psychiatry for nefarious purposes.

However, like all healthcare, psychiatry is an evolving field. Healthcare, in essence, is an applied science. That is, it is a scientific endeavor, used for practical means. Many constructive gains have been made. However, the application of these discoveries, when applied to the practice of modern American healthcare, has been severely misappropriated.

I can’t get into the tired debate of whether or not mental illness exists. Believe what you will. Many people, intelligent people, will claim that there is no definitive diagnostic test to prove whether or not a mental illness exists. It is true that nearly all mental illnesses, particularly the behavioral ones, are diagnosed by interview and observation, or that form you occasionally fill out at your annual exam where you check the corresponding box as to whether you are happy or sad. However, you can get out the fancy medical equipment and see it for yourself. In people with anxiety, a part of the brain called the amygdala is overactive. In cases of depression, insufficient monoamines are developed in the neurons of the brain. One could utilize these ludicrously expensive machines if you want to see the proof, but good luck getting insurance to pay for this.

Mental illness exists. I was once speaking to a friend of mine, who had a negative opinion of psychiatry, and said to just get that person with depression some dancing lessons, a cat, and an exercise program. Okay, Tom Cruise. You tell the guy with the gashes in his wrists who’s hanging from a noose to get some dancing lessons, B-vitamins, and some duct tape, and I’m sure he’ll be fine. Sheesh. But I needn’t be snide. Annually, roughly 49,000 Americans take their lives each year. Suicide is the 10th leading cause of death in the United States; however, it is the second leading cause of death for those between the ages of 15 to 34. There are, on average, 132 suicides per day. Perhaps worst of all, according to the Department of Veterans Affairs, 20 veterans die from suicide every day.

To be fair, engaging in activities that one enjoys that are healthy, socializing with others, becoming involved in a community art or political program; these are great ways to alleviate the symptoms of depression. So too with the natural remedies; regular exercise, a healthy lifestyle, artistic expression, prayer and faith, whatever you might like. But many people are too depressed to even get out of bed.

Besides depression, anxiety disorders are the most common psychiatric disorder in the United States. They affect 40 million people. Untreated, this illness will damage those around the afflicted, cost industry labor, and overburden the healthcare industry. People having panic attacks often end up in the emergency room. The number of those with anxiety disorders is no doubt growing, considering the trauma of the last year and a half.

And we’re not even talking about schizophrenia, ADHD, PTSD, bipolar disorder, panic disorder, and a host of others. Intelligent people with fancy degrees will argue that the DSM, the Diagnostic and Statistic Manual of Mental Disorders, is cluttered with debatable mental disorders. It contains nearly 300 diagnostic entries. It should be noted that the ICD, the International Classification of Diseases, contains about 80,000 entries.

But I am severely digressing. The main point I am getting at with this article is the unfortunate practice of psychiatry that one will often encounter when they visit their regular clinic or provider.

Somewhere along the way, a great disservice was done to the field of mental health. Psychiatry and psychology were divorced. This is profoundly wrong, and does not do nearly enough to heal the mentally and emotionally afflicted.

These two sciences, psychiatry and behavioral psychology, go hand in hand. They are deeply intertwined. You cannot simply address psychiatric needs while at the same time giving little consideration, or even downright ignoring, the psychology that goes along with psychiatric suffering. It is analogous to a physician simply giving a person with diabetes insulin, and telling them to monitor their blood sugar at home, while not counseling them on their dietary habits. So with psychiatry. You cannot simply throw pills at them, without addressing the psychology, usually damaged, that accompanies it. This makes no sense.

Unfortunately, that is the solution of much of modern healthcare: throw a pill at it. Also, due to the profit motive, patients are generally allotted 15 to 20 minutes for a visit with a healthcare provider. That is not enough time. The psychiatrist, or MD with a specialty in psychiatry, may ask them how they’re feeling, how’s the job, etc, but that is insufficient time to dig deep enough to treat the illness.

Psychotherapists exist, of course. However, they are harder to find, as insurance will still balk at their treatment, or they are booked far in advance due to the dire need, owing to the stressful times we live in.

Some clinics will not even have a dedicated psychiatrist. Your primary care physician will treat you. I’m sure that person cares about their patients, and has studied, at whatever length, both psychiatry and psychology, but they are much more likely to just throw pills at you, tell you to keep a journal or do some art or something, and come back and see them in a month.

I was diagnosed with a mental illness in my early 20’s. It should be noted that there is no ‘cure’ per se, but there are treatments to alleviate the symptoms, mental exercises to retrain your thinking, so to go on and live a healthy and happy life. I was able to do so. Despite a crippling depression, in a way, I was very fortunate. I was first treated by a seasoned psychiatrist, whom I called Dr. Dispensapill, who knew that psychiatry and psychology cannot be separated. He would see me for an hour. We would talk briefly about medications. Then we spend the bulk of the visit speaking about psychological challenges I might be facing. Then we would wrap it up with any medication or lifestyle changes to consider.

His is a disappearing style. You can still find psychiatrists like him, but they are rarely covered by insurance, and they are frequently booked far out.

Dr. Dispensapill, north of 80 years old, recently ceased being able to practice. It was difficult to find help for my mental health afterwards, but I have found a combination that works. I see, for 15 minutes at a time every few weeks, Dr. Deer In The Headlights, who knows little of psychotherapy, it seems, but knows all about the different medications and how they work. She got a 4.0 in advanced chemistry, I guess. I have also been able to find a very skilled psychotherapist, Dr. How Many PhD’s Does One Actually Need. She has been fantastic.

More than one of the providers that I work with have complained to their superiors that there is a woefully insufficient staff of human resources to refer psychiatric and deeply troubled psychological patients to. They will help the best they can, but they are there to treat skin rashes and broken bones.

This is a great problem in American healthcare. We have made a damaging mistake. The mentally ill are not getting the proper treatment that they so often need. The separation of psychiatry and psychology is, in my low-level practitioner opinion, the biggest systemic mistake modern American healthcare has made. You can’t treat one without treating the other, and vice versa.

Until we fix this problem, and there are other, massive problems with American healthcare, the treatment of the mentally ill will remain insufficient. Many more will take their lives. Millions will continue to be crippled with anxiety, living tortuous lives. And the dangerously mentally ill, with no options for treatment, will continue to commit violence.

I’m not sure why this happened. It shouldn’t have. Just my opinion.

Be good to each other.

National suicide hot-line: 800-273-8255

Medical Terminology (and the ancient Romans were kind of jerks)

Well, the third quarter is underway, and so far it’s going great! I’m taking 2 courses; one is Pharmacology and Medication Administration (this is what the chemical is, this is how I will inject you with it) and Administrative/Clinical review (this class is a lot of fun –  the instructor basically sets up exam rooms, and we practice on-boarding patients; the instructor, playing the MD, then gives us a procedure to carry out with the patient), which ties together everything I’ve learned so far. We are also studying medical terminology, and where it comes from. Not sure why that wasn’t covered in the first quarter; perhaps they just wanted us to get familiar with the jargon before we closely studied the etymology.

Everything in healthcare seems to have a needlessly fancy name, but there’s a good reason for that. Just about every bit of terminology a practitioner uses is either Greek or Latin in origin. There is also the occasional eponymous term, a word named after the person who discovered/invented it (Pap test, Alzheimer’s, Tommy John surgery). I’m oversimplifying the history a bit, but a long time ago, when Hippocrates and his colleagues figured out that illnesses and diseases were actually environmental and not divine punishment (although that unfortunate concept still exists today), and began to actually study the human body, the ‘English’ of the day was either Greek or Roman. Many people in the known world (which was much smaller then, than our own) spoke one of these two languages; much like a good portion of the known world speaks English today. This way, a physician in Rome could correspond with a physician in Roman occupied England, who perhaps spoke a local dialect, and they would know what they were talking about. The practice continues today.

The word ‘doctor’ comes from the Latin ‘docere,’ which means: to teach. It also shares its roots with the word ‘docile.’ The thinking here is that one cannot properly learn and absorb information if one’s mind is not calm and focused on the matter at hand.

But, as it turns out, the ancient Romans could be a little flippant. The word ‘hyster’ comes from the Latin ‘hystera,’ the word they used for uterus (think: hysterectomy). The Romans believed that women got moody and emotional because of their menstrual cycle; therefore, the word ”hystera’ shares a root with the word ‘hysteria.’ Well, that’s charming. Sure, some women do occasionally get a bit out of sorts on their menstrual cycle, but that is not a character flaw or an indication of a psychological or psychiatric disorder. A woman’s endocrine system is simply in overdrive, if you will, forcing an ovum into the uterus. So there you have it. The etymology of medical terminology is fascinating, but glib, dismissive opinions are nothing new.

Wash your hands!

3rd qtr so far