Grrr...argh

I just went through six pharmacies to try to get one of my diabetes medicines. My regular pharmacy is very small, so some of the brand names are an issue in terms of getting reimbursed enough, so I was getting this one at the University of Kentucky. which you would think is pretty big, so they could get it. And it wasn't any trouble before. But, no, they couldn't this time.

One had it (Kroger) but it no longer takes my medication insurance (head's up to you all at Shriners, as I'm pretty sure Express Scripts is used for both of the main plans). I finally found some at Walmart and am working on getting it transferred, although they won't know the price or anything until they run it and can't guarantee they'll be able to get it from here on out. Everyone else just had it on backorder. So it will hopefully work out as I'm supposed to take my weekly dose (it's a once-a-week injectable) tomorrow.

It's Ozempic, which has really helped with my blood sugars, but as I'm sure you've heard, recently perfectly skinny TikTok influencers who want to lose weight have been going crazy over it, and according to my main pharmacist, doctors are apparently writing prescriptions even when it's not needed, and in some cases, insurances are paying for it. Or maybe these people are just making so much money on TikTok that they just have the money to pay $1500-$1600 a month for it without batting an eye. Kroger did say they could sell me theirs for their retail price ($1500) if I wanted to pay without running insurance.




UPDATE: I did get my medicine in time for the scheduled dose, mainly by calling around and finally getting it at Walmart, a store I stopped going to years ago except for runs to get items for a friend who was dying of cancer.

The pharmacist did take me aside and explained that given the shortage, I should call them about three weeks ahead to get a refill started. Mind you, the pen lasts for four weekly doses, so I need to call them next week. I speak with my doctor this week and will let her know what's going on.

Are you still a librarian if you don't work in a library?

 

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I'm not sure who did this, so I can't credit them, but it's brilliant.

It's been five years since I've worked in a library. In that time I have had one contract position and then four regular positions at the same company I was a librarian for 20 years.  I also have moved seven times in five years as they've tried to get the right mix of office layout.  For three floors, it's pretty mobile.

I was laid off for six weeks before they asked me to come back.  My library gig was always part-time, first at 35 hours a week, then 20, and I eventually got a data entry position entering medical charges that made $10 less an hour, but I was finally able to stop taking extra jobs such as working at the gas station (I did that for five years, standing for hours through tendinitis and plantar fasciitis issues and worrying about being robbed).  I was finally full-time for the first time in my life anywhere.  I'd worked for 10 years in a 'real' job to finally get that.  All because we started taking insurance to reduce the draw on our endowment.

But those charges weren't going to be needed once we were an outpatient medical centre rather than an inpatient hospital, and the library wasn't going. So I was laid off.

Six weeks later the manager of patient access called me asking if I'd come back as a consultant as their numbers were through the roof now that we were getting paediatric fractures follow-ups from the University of Kentucky and other referrals for orthopaedic issues in numbers we hadn't had before.  When I'd been a data entry clerk, I'd helped out with patient access when three women went on maternity leave at once.  So I didn't have to be trained as much as a temporary worker, and they'd have more faith in giving me access to the electronic medical record system (at that time it was Cerner; we recently went to Epic).  I did contract work from May 2017 to October and was hired on again in the job I was performing, check out.  The next spring I was hired as a specialist to do insurance authorisations of office visits and schedule offsite imaging such as ultrasounds and MRIs.  Two weeks later the lady training me's husband got the best job offer he'd ever had, one tailored and created for him in a very small niche area, and they had two weeks to go to another state.  So I wound up getting her job, which was basically the same, although authorising surgeries, as we have an ambulatory surgical centre as well as medical and rehabilitation clinics, although it was a higher grade.  Eventually, we wound up changing the positions so the coordinator (me) did all the pre-authorisations, and the specialist did both offsite scheduling and their authorisation.  That will become important, as this summer HQ took over all inside authorisations, i.e., what I was doing, but my boss (who is great) argued that they keep me on in another position that had opened up, back in checkout.  Although it is technically a lower grade, they kept it a lateral move so I wasn't demoted or taking a pay cut.  For which I'm grateful.  HR and my boss really went to bat for me.

I had a panic attack shortly before transitioning to the new position, because when I'd done it before I was largely alone, handling up to 200 patients some days, as well as the phones and e-mails.  We have a second person in checkout now and a scheduler who handles most of the rest, letting us focus on checking out and scheduling new appointments, getting calls when we can and acting as a backup when she's out.  So it's much better, and despite being an introvert, I've discovered I enjoy making a difference directly with patients and their families rather than doing it on the back end by wrestling with insurance companies.

But that isn't the point of this post.  It's that I have been doing other things outside of librarianship. Am I still a librarian? Yes, I'm trained, I have a piece of paper that says I am, and I worked 20 years in a professional position beyond work-study and graduate-assistant jobs.  I am still very interested in the library world and books, censorship, publishing, and other library-related topics.  Have I tried to get another library job lately? No. I did when I was laid off, and I did during my return at first, but I discovered three things (in addition to the long-known issue that I live in a city with a school of library and information science that puts out scores of new librarians three times a year, and you almost have to wait for someone to retire or die to get a library job).

1. I was a solo librarian all the time I was in my position. I did all aspects of library work.  That's great, right? But no one wants to give me an entry-level job because of my experience and won't give me a mid-career job because I've never supervised anyone except some students over the years.
2. Of the libraries in my area, most (except for the University of Kentucky and the Lexington Public Library) pay less for master's-level library salaries than I make at checkout at my current job.
3. No one I've seen has had the level of health coverage that I have. I have an HMO that doesn't require referrals, never have had problems with them covering any of the doctors I have across multiple systems, has a deductible of only $150 (which I've already met for this year) and an out-of-pocket maximum of $1500. That, along with a flexible spending account, means that I have money on January 1st to cover my out-of-pocket max that hits quickly with my medications (I'm diabetic, on insulin, among other things).  I usually put a little more on the card for contacts and maybe some dental work.  The money is taken out of my pay pre-tax in instalments over 26 paycheques.  Considering most of the places I've looked at have a minimum of $3000 deductibles, I can't beat that, really.  (Our workplace also offers a high-deductible plan for those who don't need the breadth of healthcare coverage I do, such as occasional trips to the doctor or maybe one or two medicines, that are lower in cost per paycheque). Although mine's not bad, either.  Essentially, I work mostly for my healthcare.

So my plan, if I can, is to retire from here. For one, I love my co-workers and what I do.  But I have twelve more years before I can retire fully.  Sixty-two isn't really an option, due to needing healthcare.  Sixty-five might be, so I could go on Medicare, and that's ten years away.  I'd make a little less for the rest of my life, but 1) my health is not the best, so I don't want to push it out too far so I can actually enjoy some of my retirement and 2) I have one of those rare things, nowadays, a pension, that could make up the shortfall.  I don't know if social security will even be a thing by then, but hopefully, it will.  Gods, it bothers me that I'm Gen X and I'm already looking at how my retirement will go.

Sometimes I regret not working in a library anymore. I derived a lot of validation in my identity as a librarian, and I found the work very rewarding. As a medical librarian, I helped with research, education, and clinical care that made a difference in evidence-based outcomes.  I was a member of various local, state, and national groups and served on committees, and chaired a couple, including a national awards jury. I was my state representative to the Midwest region of the National Network of Libraries of Medicine for five years, going annually to represent the Commonwealth in Chicago, except for the year I was laid up a few months due to being hit by a car right before the trip.  So I gained a lot of experience.  I published a book chapter, two chapters in a major medical collection development guide, spent over a decade working on Doody's collection development tool for Orthopaedics and Paediatric Nursing and wrote one article and numerous book reviews.  I think I have a total of 43 publications, all but one as a medical librarian (as an intern at the Kentucky state archives, I did a finding aid under my former name). It was a good run.

So, I will always be a librarian to the core, and the Rabid Librarian at that.

Pow! Pfft!

I went to Kroger this morning and this little boy saw my cane in the cart and thought it was a grappling hook. I think that makes me Batman.

Love this song

This song speaks to me, as I was once in a relationship where I was dying inside due to my partner.



Here's a version by the Brigham Young University women's a capella group, Noteworthy, that is beautiful. And I love what they did with the shirts.

I find it very sad that in all of 2022 I wrote exactly seven posts

I won't give you the standard 'I want to make 2023 better in terms of this blog'. You know the spiel. What I'm going to do instead is write. I am 55 years old. Mature, middle-aged even, but not really old. But I felt old this week due to finally making the decision to buy a cane. I have very bad knees (I have since high school, actually) and need a knee replacement but have about 50 more pounds to lose before they'll do it (I've lost 50 already since November 2021). But more importantly, my balance is really off. I've fallen three times in the past year, two on ice, so maybe they don't count, and once off a Lextran bus servicing the University of Kentucky. But a lot of the time I'll be standing on a completely solid, even surface, and if I turn my head at all or move a bit, or just stand completely still, I will start to fall over. Put me on an elevator and it's worse. So...I ordered a quad cane from Amazon using my flexible spending account. It's not aluminium, it's steel, all of two pounds, which several reviewers complained was too heavy (it took me a couple of days to get used to it, but I get that an older or less strong--and while I'm pathetic in terms of strength, I'm better than some). It can handle someone who's 500 lbs, which I'm not, of course, but I did need one above the standard ones that bear up to 200 or 250 lbs, as I'm about 30 lbs over. So I wanted to make sure it was sturdy enough.

Behold!



I've used it for a couple of days now. The first thing I did the night it came was to watch YouTube videos on adjusting, walking, and dealing with stairs while using a cane. The next day, I went to work with it and definitely made sure I took it to our physical therapy department to make sure all was well. I'd changed the height that morning, and gotten it right (it was a little too short). The cane should come up to your wrist. On a quad cane, there are four legs on the end, not one, and usually (as in mine) the inner ones are aligned narrower than the outer ones, so that shows the orientation that should be used, and if it has a curved section, it should face curving to the front, not towards you. You use it by the opposite leg from your weak one. My left knee is worse, for example, so I use it on my right, but bring it forward when I step forward with the left for greater stability. Lastly, you go upstairs with the good foot and downstairs with the bad one, and the PT secretary actually helped me remember this by saying, 'I always think of heaven and hell', so the good ones go up, the bad ones go down, and that mnemonic has done more for me than anything else.

What I have discovered is that it slows me down somewhat (I can walk smoothly with it, or at least did after I did a little experimenting), but that's good because I need to slow down due to my loss of balance, as I usually fall when I'm rushed.
One thing I discovered years ago when I broke my ankle after being hit by a car while crossing a busy street in a crosswalk (and with the light!) is that adaptive device like walkers, canes, and wheelchairs are a boon because they help maintain or increase mobility.  I initially felt bad about being on a walker and in a wheelchair then, but it helped so much.
This seems to be much the same thing.

Anyway, I'm going to try to embrace this and remind myself that people of all ages use canes, crutches, walkers, etc
This is a step up from my hiking poles, I guess.

But it will help me a lot in the long run.  I still feel a bit decrepit though, and I hate that feeling, but this will help me by preventing dangerous falls, I'm sure.

It also means that the bus drivers tend to remember to kneel the bus (the bus incident involved me coming down from a greater height on the step off the bus because the driver had not lowered that side of the bus, which they call kneeling), as they recognise I'm having some difficulty.
This, along with getting ADA [i.e., handicapped] parking this summer, including a general placard and a university hangtag, has really helped, along with riding the Lextran buses at UK, which kneel and are easier to navigate than the UK-run buses [almost all of which have stairs at the entry; the Lextran buses only have stairs if you go all the way to the back of the bus].

Also, the Lextran bus route takes me right across the street from the medical centre I work in, rather than being dropped off at the UK hospital employee entrance by the emergency department and walking all around the ambulance bays and the hospital itself, which is difficult for me. So it's a win. I park in the Blue 'K' lot near the stadium, and it takes me about 5-7 minutes to get from there to work once the bus comes.
The Orange buses that UK runs at the healthcare lot run more often, but they took about 10 minutes to do their route to my stop and then I took 7-10 more minutes to walk around the hospital slowly and get to my workplace.

I just wish I'd figured this out three years before when I struggled with those staired buses for all that time.

I love this song

Diabetes is no fun

I hate when my blood sugar goes south. If you've never had it happen, it's hard to explain. I get dizzy and unsteady, and I perspire but my hands and feet get cold and numb, and I just feel like my brain is mush and can barely function. Just now I had an episode where I was falling fast and got the special alarm that tells me on my monitor. It went down to 47, and after a banana, a pear, a frozen fruit pop, and glucose tablets, it's 78 and finally rising. Even once it levels off, I'll feel really hungover and unwell. It's so frustrating. I didn't take extra insulin, and I ate both breakfast and some lunch [and even skipped the short-acting insulin for lunch]. It happened yesterday at work, too, while I was at the sign-in desk, and I ate nearly an entire sleeve of glucose tablets to bring it up after 45 minutes. It should pop up in about 15 minutes. I'm going to dial back on my long-acting insulin some more. I think that will help.

Watch this

Cyndi Lauper - Sally's Pigeons Fly

I've taken the Back-to-School Reading Challenge to raise money for the Trevor Project

https://www.facebook.com/donate/402043688580684/

I'm taking on the 20 Minute Back To School Reading Challenge for The Trevor Project! Please support me as I raise funds by reading 20 minutes a day this September to help The Trevor Project achieve its amazing mission. Every donation, big or small, counts. Cheer me on in making a difference!

The Trevor Project is determined to end suicide among LGBTQ youth by providing life-saving and life-affirming resources including our nationwide, 24/7 crisis intervention lifeline, digital community and advocacy/educational programs that create a safe, supportive and positive environment for everyone.

Please consider donating at the link above.  Thanks!

Sigh

It's been a long while. I've posted almost 12,000 times on this blog for over 20 years, but I haven't felt like writing for some time. That makes me sad. I've gotten caught up with life and I'd been relying mostly on my phone for Internet interaction, and it was just harder to do that, for one.  I have a laptop though now AND I just got a folding table big enough to write, read, do crafts, etc., on, rather than having a computer on a stool and being uncomfortable in my chair because I had to put a leg on either side.

I do post a lot on Facebook, and that's for people I'm friends with, and almost all of them are people I know personally, with the exception of a few librarians.  I guess I feel safer there in some ways than over-sharing to the great world beyond.  I know, that hasn't stopped me in the past. But I'm 55 now and a little wiser than when I started.

So let's see...I think I last wrote in February.  We got a puppy then and she was so tiny at 8 weeks that she could go between the slats of the picket fence.  Now she's nine months old, and she's nearly 50 lbs.  She finally has a big girl bark, is very tall and long and lanky, and generally is getting very big.  My roommate thinks she's part Lab (that part is obvious, as she has webbed toes and Labrador waterproofing) and part Doberman, much like the dog he had when I first met him over 30 years ago.  I'm leaning towards part Great Dane with her build, but he is probably right.  She's a joy, very enthusiastic, loving, and a good companion to the other dog, who is a Lab/Pit cross and now much smaller than her.

Healthwise I'm dealing with ageing.  I've lost 50 lbs. since early November and 28 of that was from late December on.  (I was put on a different diuretic in November and I swear 20 lbs. came off because I am a sponge.)  I'm on medicine now called Ozempic for my diabetes, but it helps with weight loss and I'm doing pretty well on it, despite early side effects.  I just went up to the maintenance dose.

I do need to lose weight because I have chondromalacia, which is a loss of cartilage in the joint.  My knees are to the point of being bone-on-bone and I need a bilateral knee replacement, but I need to lose another 40 or so pounds.  They'd like my BMI to be under 40, but 45 is a hard stop and I'm 48 now.  So I need to work harder because I'm in a lot of pain and it's very difficult to walk very far.  I do have an ADA placard for out in the community.  I had one at the university but they only gave me a temporary one as they couldn't read my GP's handwriting. I had him redo it and resubmitted it, but they denied my request.  I have a couple of weeks to submit records, which I've requested, and perhaps I can get one on appeal.  You can't just park in a spot on campus without their specific hangtag, you see...my state-issued placard doesn't do a thing.  And they're pretty tough.  One of my former co-workers used a prosthetic leg and they made him send over records, and he finally got it. I've had it all summer, though, and it's been a godsend.  Without it I'm going to have to walk probably a quarter of a mile from my car to the bus stop and back, and that is very difficult and painful.

I'm also most likely going to have my gall bladder out soon. I go to a surgery consult the first week of September.  They'd found gallstones on an MRI of my liver but I was asymptomatic until I had fried fish and was in extreme distress for a week.  I'm a little leery of this. Even with the weight loss, I weigh about 280 lbs., so lots of visceral fat and higher mortality chances with any abdominal surgery.  Hopefully, it will be laparoscopic, as I don't want to miss much work.

Next week will mark the five-year anniversary since I moved in with my roommate.  All in all it's gone very well, surprisingly well, actually. Neither of us were particularly sure about the move and living together.

At work, headquarters took over my surgery and outpatient visit authorisations, leaving me without a position, but my boss (who's only been here a few months) really went to bat for me, and they did a lateral move into a position I've had before that is technically a few rungs down, but because of the way they did it, I didn't lose my pay, although I'm on the high end of the scale for this one.  I'm back in checkout.  One day before I moved I had a panic attack, because when I did it before, I was alone for the better part of a year, did the phone and e-mails, and generally had trouble keeping up.  Now there are two people at checkout (although my work buddy, who is very bubbly, is moving to registration, so they're trying to hire someone for the checkout position that's open), and one person who's job is to schedule phone and e-mail requests, letting me focus on the patients and families for the most part.  So it's actually been nice.  Not as much pressure and I get to interact with families and see the improvements in patients' lives. I do, being an introvert, get drained by too much interaction, but I also find it satisfying in this case.  So everything's going much better than it could have.

I've been working every day on a series of exercises to help keep my mind sharp.  There's Wordle and Latin Wordle, plus I'm studying languages on Duolingo.  I'm trying to brush up on my rusty Spanish, German, and Latin, plus I'm taking Irish and Welsh.  I was going to try to learn Modern Hebrew (I've studied Biblical Hebrew), but that wasn't going well, as the characters were very small, and it just wasn't clicking. I'm going to take my Biblical Hebrew and do some work on that instead and then go back to the modern after I get a grip on the ancient language.  But I'm getting through the ones I've studied before pretty quickly and understand more than I thought.  My grammar is actually still pretty good, it's just the vocabulary that I'm having to pick up again.  German is extremely easy, even though I haven't had it since 1985.  Latin is my most-studied language (5 semesters, including Mediaeval as well as the normal Classical, plus a little Humanist), so it's going well, although there are a lot of angry parrots in this one. (To be fair, Hebrew had a dove that liked warm wine--you can see why I was having trouble).  I've already used a little Spanish to check a person out at work without having to use the video interpreter, and I asked one of the in-person interpreters what the word for 'stickers' is and put it on my bulletin board because the kids love those.

Okay, I guess I'll sign off for now. I'm on vacation. No plans, not going anywhere, but I took the week off between now and Labor Day.  I'm hoping to get some rest and work on some new hobbies and actually do some reading.

And for some reason my neighbours are setting off fireworks for no discernable reason.