Thumping away

 Yesterday turned into a very unnerving evening and I was dressed and ready to go, and didn't.  I called the ER and the only doctor there was the same I had previously, and I was refused a brief chat with her about returning.  I understand they are not permitted to give medical advice but I had a question about the summary I received of her report.  From it, I gathered there is no urgency and she suggested I see my PCP, not a cardiologist.  After messaging my PCP to tell her of the visit and to request my fricking $600 pills, I received a reply - I called in your prescription.  No offer of an appt., no questions, no concern.  I've been with her for 20 years and was considering a change, which she knew.  So I guess her ego is more important than her patients.  We have some real buttheads around here for doctors.

 I was lucky that a cancellation occurred for Tuesday morning with a cardio I have seen before, affiliated with the hospital here.  The one that caused so many errors and failed procedures for Carole, but I will sit down with the Tuesday doctor and see what the plan will be and take it from there.  My hospital and doctors of choice have no openings until February.  Ativan has been a huge help in allowing me to sleep comfortably.  

As for the Eliquis cost, my Part D plan and most all of them for 2021 has moved a lot of generics and other drugs into Tier 3.  A deductible was added for any drugs in 3 or higher of $435.  Medicare patients are not eligible for coupons, co-pay cards, discounts, nothing.  You can use GoodRx, SingleCare and others, but without involving/using Part D coverage.  We do regularly because their drug costs are cheaper than through our paid insurance.  But only for generics.  It's a shame to be forced to purchase an insurance plan and find lower costs without it.  Example - Metrogel was $92 through our plan, and $32 through GoodRx.  The law is as follows and penalizes Medicare patients.

Under the federal anti-kickback law, it's illegal for drug manufacturers to offer any type of payment that might persuade a patient to purchase something that federal health care programs like Medicare and Medicaid might pay for.

Sorry you jackasses, but I need Eliquis to prevent a stroke, it's not like I'm being persuaded to buy a new mascara.  And I can't get Xiidra which helps my eyes.  If I purchase a plan through Express Scripts which I had when employed, aren't they paying for the drug?  Why would Medicare be paying?  If they are, why do we need all these companies begging us to buy their plan?   If they aren't, that fricking law doesn't apply.  I don't get it.  But it stinks.

Well that was a rant of sorts.

Here's an odd tidbit of info about Afib.  I noticed that at times during the palps, I was burping quite often, not normal for me.  This continued for days (I've had these since last Wednesday).  Guess what?  Burping can be an indication of AF episodes.  The vagus nerve is involved and I found this very interesting.

Both the heart and the digestive systems are strongly regulated by the vagus nerve. Stimulation of the vagus nerve is responsible for controlling gastrointestinal motility and can sometimes initiate episodes of AF. Because of this relationship, it is sometimes observed that cold drinks can trigger episodes of AF.

We have a friend who has been through ablation after ablation after ablation.  Twenty years of mutiple procedures and no help at all.  This article claims an ablation is not the treatment if the AF is caused by the nerve.  Could this be why he hasn't had relief?

https://www.richardbogle.com/blog/vagal-af-if-you-dont-consider-it-you-will-miss-it

My mother had permanent, my sister had paroxysmal now permanent, my brother has paroxysmal.  In all the ER and doctor visits, no one questioned the details of onset.  I'm sure none were/are the vagal type in our cases, but it's something to consider for athletes and younger patients because the drugs to treat are ineffective and a different avenue is taken.  Interesting!

Done with the boring, on to the stitching.

This is all the stitching I've accomplished, working to the right of the house, and the double outline of the border.   It depends on how shaky I feel, not as bad today.

I worked out a brick pattern and chose the threads, scanned this into the Paint program to visualize.  Did not care for it.  Who doesn't like a brick house?  I can't explain it, other than the familiarity of seeing this chart over the years and loving it as is.  I found a partial skein of GA Brandy and it may work, not much variegation, but may be too gold.  

Have a good day folks.  We're under a severe thunderstorm watch but so far so good.

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