Some Statins, Stat!

Earlier this week, I wrote about my wife’s summer-long ordeal with her bored general practictioner, who spent his COVID Vacation searching through her medical file to find shit to tamper with. I also touched on tipping your servers and hookers. Well, not tipping your hooker, but the economics of prostitution. Although you should probably tip your hooker. And no, not “just the tip.”

Regardless, after living through Wife’s own medical-solution-in-search-or-a-problem, I probably should’ve been more on guard when my own doctor asked to set up a phone call. To be fair, although I’d like to be a writer, a chronicler of the human condition, I’ve never claimed to be all that observant.

Doc wanted to talk to me about cholesterol medicine. Doc’s been wanting to talk to me about cholesterol medicine for quite some time. A few years ago, I went in for something, probably gout, and he pulled a “Hey, I don’t give a flying fuck about what you came to me for, your cholesterol’s a smidge high, so let’s randomly prescribe you some statins.” 

Sure. Why not? He sent me over to the pharmacy and I left with the drugs that very day. On the way home, Wife told me I miiiiight want to look up some of the side effects of statins. Umm, okay. I’m sure I’m not the only person who approaches the medical profession with confused acquiescence. 

Okay, here’s what my robot overlord, Google, tells me are some statin side effects:

They might spike blood sugar. Hmm, I’ve been prediabetic for five years.

Liver damage. Hmm, I’m a borderline alcoholic.

Kidney problems. Well, at least it won’t make my gout worse.

At least I’m at Kaiser. One of the reasons I chose the Kaiser, aside from my love of old-tyme handlebar mustaches and pickelhaube helmets, is that you can see your test results online. Back when I was on a different plan, my doctor would tell me something in my blood was “a little elevated,” which could mean just about anything. 

“So it turns out there’s some extra lead in your system.” 

“Yeah, Doc, I came to you for a gunshot wound.”

But at Kaiser, I can see precisely where I am and, even better, what the standard range. When I got home from the “quick, take these drugs before you ask your wife about it” appointment, I looked more closely at my last blood test. The standard range for cholesterol is listed as anything under 239. My horrible, sky-high cholesterol that needed drugs right the fuck now was a whopping… 219. 

Except, you see, it’s not just a matter of overall cholesterol. You’ve got to look at the good cholesterol versus the bad. Your HDL, or good cholesterol has to be over 40 or else you’re unhealthy, and mine was only at a measly 52. Oh, and that LDL, it’s the bad cholesterol and we should really look for a way to get it under 159. So maybe some drugs will improve my reading of… 150.

I’m not saying I’m the picture of health. But if all of my cholesterol readings are within the range that’s deemed “normal,” it doesn’t seem to be something I should be pumping my body full of side effects for. Sorry, Kaiser Wilhelm, if you don’t want me making uninformed decisions, then maybe you need to not let me see the information.

Why are they giving me pills to fix something that ain’t broke, especially if there’s a good chance it’ll break something else? I mean, if I take these pills to drop my cholesterol from an “on the high end” 219 down to an, I don’t know, 200? While at the same time spiking my blood sugar and losing both my vision and my feet to diabetes, I wouldn’t necessarily call that a “win-win.”

So I came home with the prescription but never used it. That worked for a while. Doctor got his kickback from the pharmaceutical company and I kept my liver. Actually, the next two times I got tested, my cholesterol went down, first to 199 then to 189, despite never touching the statins. Maybe I’m so magical that just convincing myself I needed to lower my cholesterol was enough to do it. It’s some Jedi magic. 

Or else maybe my cholesterol fluctuates inside the normal range. There’s a reason it’s called a range, right?

But eventually they caught onto my duplicity. Not because my cholesterol changed, but because I never refilled the prescription for something I’m supposed to be taking every day. Or maybe they were onto me because my blood sugar didn’t spike enough. “People who take our drugs can’t be as healthy as you are.”

After a year or so, doctor sent me a nastigram that I better take my fucking medicine like a good fucking boy. I ignored him, so he referred me to the big boss. I started getting emails from some random dude, inside Kaiser, listed as “Pharm.” That might stand for pharmacist, but I assume he works for Big Pharm, which is where this entire push must be coming from. My doctor needs to get a new Porsche or something, and the gout medicine people just ain’t willing to cup his balls the way he likes on the reach-around. I mean, if there ain’t kickback going all the way up the wazoo, then why the hell are we not only prescribing cholesterol medicine to people who don’t need it, but actually following up to ensure that said individual is taking said unnecessary drugs. 

By contrast, I also have asthma (hurray, mid-forties!) but I’m really bad about using my inhaler. Not the emergency inhaler. I use that one often. But there’s an inhaler I’m supposed to use every day that will prevent the need for the emergency inhaler. Problem is that when I’m breathing fine, I forget. So that’s another prescription I’m supposed to fill every six months or so but regularly go two years between refills. And not a single email from doctor nor pharmacist nor Pfizer lobbyist. Because if you can’t breathe, meh. But if your cholesterol is normal, well then that’s a problem we need to solve! 

So there I was, foolishly accepting the call from a doctor with way too much time on his hands, knowing full well that he had some drug kingpin breathing down his neck to make sure he gets all his little cretins hooked, and wouldn’t you know it, he doesn’t want to ask me how my breathing’s going with all of the fires going on, like the snazzy new “Glass Fire,” proving that I’m a fucking Nostradamus who nobody heeds. Nope, what he really wants to talk to me about is how important it is that I get my normal cholesterol under control.

This time, however, I was prepared for the statin conversation. I asked for clarification, like why the fuck am I supposed to risk making some of my medical conditions worse in order to fix a problem I don’t have. It turns out that cholesterol medicine ain’t got shit to do with controlling cholesterol. Studies have shown that prescribing statins to people who don’t need them severely lessens the likelihood of, I don’t know, heart attacks and stroke and scurvy or something. 

Honestly! Why, the drug company who has the patent for this drug has run bazillions of tests and, wouldn’t you know it, they all came back proving that their product rivals only the flush toilet and electricity in the advancement of the human race. And the proof is that, when they prescribed it to people who didn’t need it, those people ended up STILL not needing it. It’s kind of like saying that stitches help people who’ve been stabbed by a sword, but our tests show that unstabbed people who were given stitches ALSO didn’t exhibit signs of sword punctures. Stitches greatly reduce your chances of bleeding out in a medieval dungeon.

My doctor assures me that the DHS has signed off on this whole cholesterol-medicine-for-non-cholesterol-purposes thing. And boy howdy, if COVID has taught us anything, it’s that government agencies devoted to our health always know what they’re talking about.  Like when the virus was airborne for, like, an hour before the CDC took it off their website because the president complained. A week later, it was airborne again. Hopefully you weren’t breathing in deeply for that week that the virus was noncommittal. 

And yeah, I know that the Department of Health Services ain’t the same as the Center for Disease Control, but the only reason we’re focused on the latter is because they’ve kept us hostage all year and we’re suffering from Stockholm Syndrome. Even if the DHS whims can’t keep me chained to my refrigerator for the next fortnight, my eyebrow’s still rising over them suggesting what we really need in this world is more random, never-ending prescriptions. Those bacteria ain’t gonna develop antibiotic immunity by themselves, y’all! For all I know, the Orange One has a bunch of stock in the statin company and that’s why they’re now suggested for everything from hemorrhoids to gunshot wounds.

Then again, I’m just now realizing that the DHS is the British single-payer system. Shit, is my doctor running my blood tests in metric? Maybe that’s why my numbers don’t match what he’s saying.

Or maybe he’s talking about the other DHS, the American one that likes to look at your browser history. In which case I better get me some statins, because unlike some mamby-pamby doctors and pharmacists, you DEFINITELY don’t want to ignore the suggestions of the water-boarders. 

Then again, if it’s the Department of Homeland Security, then they need to update their sales pitch.

Lower your cholesterol! Avoid heart attacks! Now with fewer anal probes at the airport!!!

Sold!

Pandemic Pill Pushers

I worry about all the professions who are suffering during COVID, workers who can’t go through their normal day-to-day routines.

We hear a ton about the Uber and cab drivers, although I’m sure they’re all getting bonus shifts with Doordash. What about those retail cashiers, the restaurant servers? Am I the only one who struggles with what to tip for takeout orders? Look, I waited tables for most of my twenties. I know those servers get paid shit and rely on their tips to survive. My standard tip is 20-25% and you have to be phenomenally shitty to get less than 15%, but the most “serving” you’re doing on takeout is grabbing the bag, already prepped by the line chef or expediter, neither of whom are likely to a sniff of whatever tip I left. Is that worth 15%? I didn’t get my iced tea refilled once!

I still tip, but only as a nod to solidarity. And taxes. Did you know your server has to pay taxes based on what the government thinks you should’ve tipped him? If the bill is $100, the government is adding $15 to his W-2. Think about the next time you stiff a server – he actually lost money by serving you. 

But for takeout? I don’t know, man. I usually err towards 10%, enough to cover the stiffers and the IRS, but not enough to work as a dialogue about quality of service. Yeah, I feel a tinge of guilt, but I figure I’m not taking up one of his tables for an hour. He should be able to burn through 30 or 40 orders in an hour, as opposed to five. 

But then the restaurants are going to twist that little guilt knife by only giving me “pre-filled” options of 15%, 18%, and 20%. So now I have to write in my 10% number, making me go out of my way to stiff my server. Who isn’t really serving me. Shit, I bought donuts the other day, and she did that thing where they swivel the tablet around so I can select the tip, but then I had to tell her what the tip was and she would select it, so the customers don’t have to touch the screen. What the fuck am I supposed to say? “Write in 10% for yourself” or “No, I don’t think you deserve a tip”? So I told her to select 15%, the lowest option and now I just tipped more than I tip for takeout to a lady who only put six donuts in a goddamn box!

Donut-shop swindlers notwithstanding, making people write in any number below 15% probably results in more people paying zero.
“Skip” is just as easy to hit as “20%.”

I’m not here to talk about the servers though. At least they’re on most people’s radars. Some of them were probably laid off and reaping the rewards of the bonus unemployment before Congress yanked it away after a heartfelt and impassioned debate about the long-term consequences and short-term tradeoffs associated with paying people more to not work than they would make working. Ha ha, just kidding, politicians never articulate arguments for or against their actions, preferring the more nuanced “nan-nah, boo-boo.” Democrats wanted a $3 trillion bailout, which Republicans wanted $1 trillion, so they settled it like adults and made it zero. Maybe somebody should’ve given them a “$2 trillion” button.

So the Uber drivers are probably thriving and the servers will find a way to muster through. But what about the prostitutes? 

Meh, the prostitutes are probably fine. At least the illegal ones. For once, they’re economically better off than their legal counterparts in Nevada. I assume the brothels are shut down, but the place of business behind that dumpster on Broadway remains just as accessible as ever. It’s always on Broadway, right? Doesn’t matter which city, the whores hang out on Broadway. 

Plus, it’s not like their johns are overly concerned with health and cleanliness. I have a friend who’s a deputy DA, and one of the hookers she used to prosecute on a regular basis charged extra for sex without a condom. So I can have sex for twenty bucks, or I can have sex AND chlamydia for forty? What a bargain!

 Plus, you’re not allowed to kiss a hooker, right? So might as well keep that mask on.

So maybe the prostitutes are okay. But what about the drug dealers?

And before you tell me that pill pushers should be in the same boat as hookers (that ain’t a boat, it’s a yacht, baby!), let me clarify that I’m not talking about the same dealers you’re thinking of. The guys pushing meth and heroin are probably fine. I’m talking about doctors and Big Pharm.

You would think that primary care physicians would be overworked and malnourished during a medical emergency like we’ve faced the last six months, but it might turn out to be the exact opposite. Sure, those ICU Units are filled to the rafters, but the guy or gal you go to for the sniffles or tennis elbow is stuck twiddling their respective thumbs. After all, we’ve been told that all non-emergency situations don’t matter and are wasting the medical community’s valuable time. I went three months without allergy shots, and I don’t think my allergy doc was being drafted into front-line duty. So sorry about your pancreatic cancer, Grandma, but Aiden once drank a Corona, so you need to give your hospital bed up to him.

So now none of us are calling those doctors who normally take Grandma’s temperature long enough to refer her to seventeen other “specialists,” thereby maximizing insurance premiums whilst minimizing efficiency. Now those general practitioners are bored, and the news is doing their job for them, cause ain’t nobody questioning that 20% increase in insurance premiums this year. And just like a teacher who decides that the only time to clean the house is the day before grades are due, when doctors are bored, they find shit to meddle with. And since they’re probably not allowed in the Admiral’s Lounge with all the cool ICU doctors and patients, they fill their time consulting those nanobots they placed in our bloodstream the last time we peed in a cup.

What? There isn’t supposed to be blood in my urine? And I’m not supposed to put it back in my body when I’m done?

My wife got hit with BDS (Bored Doctor Syndrome) first. Her blood has always tested positive for a clotting risk. But her “askew numbers” have pretty much stayed consistent since her early twenties and she’s never had blood clots. It was certainly something we kept an eye on during her pregnancy, but if anything, overreacting to her bleeding risk is probably what caused them to radiate her after delivery, subjecting her to seven hospital trips over the first six months of Daughter’s life. So maybe sometimes we shouldn’t tinker with phantom ailments. 

I run into this all the time while I’m curling. We time the delivery to determine where the rock should end up and whether or not we need to sweep it. But you still have to watch the rock, walk alongside it. Sometimes the ice is frostier on one route than another. You gotta be ready to start or stop sweeping as the reality on the ice amends what your stopwatch told you. You can’t just say that it’s blood platelets was 3.6 seconds so the diabetes will end up right on the button.

Sorry, mixed my metaphors there, but you get what I mean. And in normal times, the doctors understand this, and don’t go out of their way to fix problems that only exist in the data.

For the most part, Wife’s blood issues are like a birthmark – always there with no discernable affect on her life. If the numbers had gone up as she got older, or if she ever experienced any of the many symptoms listed in the brochures, we would’ve done something. The health issues she does have, like some lactose intolerance that leads to some nasty IBS after a Starbucks trip, has nothing to do with blood clots. But obviously they aren’t concerned with that, because IBS isn’t covered by most insurance plans. Somehow that’s considered a “quality of life” issue like a boob job. Unlike boners, which are TOTALLY covered by insurance. Because, I suppose, senators have trouble getting it up. But let me tell you, needing to visit the toilet every five minutes is every bit as destructive to the libido as a little flaccidity amongst friends.

But somewhere in her medical file bored doctors were thumbing through, it said that Wife has clotting potential. So they called her up and told her that, you know, what with all this COVID stuff… 

I didn’t really see the connection, seeing as The ‘Rona attacks the lungs, not the blood. But you’ve heard the media reports. Everyone who dies is either old or had a pre-existing condition. What they don’t report, however, is whether that pre-existing conditionis in any way related to COVID. Hey, did you hear about that 25-year-old who died two days after catching the ‘Rona? Yeah, but he broke his arm as a teenager. And that teenager who got it? Her orthodontist said she had braces.

So whatever. Wife decides to play along with their blood-thinning regimen. But then she sliced her foot on a boat prop, so she had to wait a week. Seems a pretty big loophole there. All she has to do is cut herself once a week and she won’t have to go on blood thinners. Then again, if the shit they’re about to give her is going to turn her into a hemophiliac, maybe it ain’t worth it. Unless we get some medieval duchy out of it.

Instead of following my advice and becoming a cutter, Wife finally goes on the blood thinners. In addition to pills, she must give herself shots in the stomach. What the fuck kinda home remedy is that shit? I get allergy shots every few weeks and never once have I been expected to plunge that shit in myself. Aren’t there trained professionals who can give shots? Or are they too busy going through old medical boxes next to the Ark of the Covenant to sell Nefertiti on some meds?

Every few days, she gets her blood tested again. Fortunately they don’t make her take it out herself. On her first test, she overshot her mark. The number that used to be too low is now too high. This could be a great time for them to step back, realize Wife knew what she was talking about, that these were phantom numbers to begin with, an anomaly that remained consistent with no symptoms for twenty years, and that they were trying to fix a problem that didn’t exist, quite possibly creating a new problem, whereby my otherwise healthy wife now has to steer clear of a wall corner lest it break her skin and cause her to bleed out on the floor with nary a Russian orthodox month in sight to cure her.

Or, you know, they could just cut her down to one shot a day, then test again on Thursday.

So for the last month or so, Wife’s been heading to the lab to get her blood taken every three days. They adjust her dosage, rinse, and repeat. The good news is she doesn’t have to give herself shots anymore. The bad news is she’s never gotten down into the “healthy” range. Again, they’ve made her less healthy. Or maybe they’ve just made her equally as unhealthy, but on the other side. She’s gone from having slightly viscous to slightly runny blood. No big deal.

Except that all of those blood tests have her bruised up like a heroin junkie. She’s always had this problem where the technicians can’t find her veins. Sometimes they need to stick her three or four times before they get the good stuff. Add to that the fact that they won’t go in where the earlier bruises are and it wasn’t too long before they had to take blood out of the back of her hand! I’m a blood-giving pro. I don’t give two shits about getting shots, but holy hell, that sounds excruciating. Especially if it isn’t doing jack diddly to improve her health or quality of life. And since they haven’t done anything about her IBF, she still has to wipe with those hands!

So I should’ve been on guard, a couple weeks after Wife’s regimen started, when my doctor wanted to set up a phone call. 

Check here to hear about my own frivolity. At least I won’t bruise ya!