My father and father-in-law each had a leg amputated, quite some time ago. Months later, well after the amputations healed, both complained of severe pain in their foot. But neither had a foot. The pain was called “referred pain” and my wife and I dismissed it as being “in their head.” In fact, the pain was a result of the nerves that headed down that way being stimulated quite unpleasantly and was very, very real. Excruciatingly real. But I didn’t really know that then.
I know it now having just experienced it myself, thankfully not as a result of losing a leg. I had an injection in the facet of my cervical spine at level C2. The doc inserted the needle, fairly painlessly, and then administered the steroid. The pressure I felt at the injection area was expected and uncomfortable. But it was tolerable. What got me, and what freaked me out, was the real pain I felt about 6 inches higher than the injection site, at the side of my head above my ear. I was scared. I wondered if my brain was being affected. I called out to the doc, informing her of this pain. Informing might not express the fear I had. It felt as if she was pressing her thumb against the side of my head. But this doc was super. She immediately calmed me down, reminding me to breathe into the pain, and mostly easing my concern by stating emphatically that it was referred pain. I can’t tell you how weird it felt. Here I was lying on a table with a needle in my spine, with real, sharp pain coming from the side of my head. And then it went away, just like the doc told me it would.
A few minutes later she was injecting level C5, and this time I felt a sharp stabbing in the middle of my back and under my shoulder blade. Again I informed my doc, but this time with considerably less affect. I knew, and she assured me again that this was referred pain.
Many caregivers deal with people who either have lost legs or arms, often a result of diabetes, or have nerve-related disorders. Nerves are complicated things in many ways. You may have a sore leg or foot, but the root of the pain is in your back. Pressing strategic spots along the route of the nerve often has the feeling of easing the pain, even more than pressing the spot in your back where the nerve root exits the spine. Maybe that’s how acupuncture works. I don’t know. But I do know that I’ve pressed on places and the pain I felt elsewhere eased. So there’s something to this.
I hope you never have to experience it yourself. And the next time you are with someone complaining about pain you absolutely know is not coming from that spot, understand that it’s referred pain. And be sympathetic and empathetic. It’s very real, a very odd sensation, and very painful.
As the election draws nearer, I would be remiss if I didn’t blog about how the presidential candidates’ positions might affect elder care, health issues (including health care and health insurance), and quality of life concerns of older folks. Because of the magnitude of this issue, I will have separate installments on the topic.
I begin with Obamacare.
First let me say that while the President doesn’t mind that the Affordable Health Care Act is referred to as Obamacare, I mind. I think it’s a total misnomer. The Act does not have that much to do with health CARE. It has to do mostly with health INSURANCE. I think the President and the supporters of the Act did a great disservice to all of us by suggesting it was about healthcare. It riled people. It scared them. All of a sudden people were feeling that there would be something – in particular, government – between them and their doctors.
But when you look at the Act, it doesn’t have anything between them and their doctors. It does create a Board that can suggest, recommend, and maybe even ultimately insist (if legislation followed) that certain things be done to streamline healthcare or that costs of drugs and medical care be reduced. But there’s nothing that will prevent an individual doctor from recommending a particular procedure for a patient. In fact, it’s not any different than what exists now under most health insurance plans. Many plans require preauthorization for certain procedures – things like MRI’s, PET scans, etc.. That won’t change under the new law. And if it did, it would be universal, not specific to one plan. Right now individual companies contract with health insurance companies to provide coverage for their employees. The companies negotiate rates and terms and companies try to get as much coverage – and more important, as much flexibility in the plan – for the money. A lot of what we used to have has changed, mostly increased in cost. But not all. Here’s an example of a way that a company improved the options for employees.
A company I’m familiar with offered 2 health insurance plans: one for just an individual employee and another for an employee and his/her family. The rates reflected the difference. But the family plan was geared for families with children, who are notoriously more sick and injured than adults. The organization negotiated with the insurance company to provide a third plan: employee and spouse/partner. Because the plan covered only two people, the rates were far lower for this couple than for an entire family.
Since the new Affordable Healthcare Act has many good provisions (e.g. covering kids ‘til they’re 26, no elimination based on preexisting condition), what’s the downside? That now everyone has to be a part of it? Hello? Is there something wrong with that? It’s just good policy for a country. The only way it can be affordable is with healthy people participating. Ergo, the individual mandate. For me, the Act protects everyone, not just those who have employers that provide health insurance. I never saw the logic in tying insurance to employment. Insurance, in particular health insurance, is about individuals and families, not about employers.
So back to the political arena. Since I believe this is a good law, and since the only candidate agreeing with me, my support goes to President Obama. Seniors, juniors, and everyone in between should be for this new law. Now if Governor Romney changes his mind (again) and decides that he really is for this law, I’d gladly revisit this endorsement. The whole law, after all, is one that he endorsed when he was governor of Massachusetts. But it’s not likely Mr. Romney will agree to be labeled with “I was for it before I was against it.”
Bottom line regarding health insurance and whether i: Obama. Stay tuned for my next political blog.
Please excuse the absence of a new blog. I've been working on my latest book and just didn't have the time to write anything else.
The new book will be out in February and it's a joint project between my publisher, John Wiley & Sons, and AARP. I'm very excited to do this book because I think it addresses something that many of us face, particularly those of us in the sandwich generation. Although my parents and in-laws are all gone now, it wasn't that long ago that we were dealing with their crises. The new book's title is long so as to maximize search engine optimization – you try to hit as many key words as possible so Google searches bring up your book. The title is AARP Roadmap for the Rest of Your Life with a subtitle of Smart Choices about Money, Work, Insurance, Lifestyle... and Pursuing Your Dreams. Whew, quite a handle. About the only thing we missed was sex. So maybe we should have called it the AARP Fifty Shades of Gray.
Anyway, as it implies, it's about living the rest of your life. We have our families to deal with, our kids and parents. We have our careers, perhaps winding down. We face retirement concerns that include money, leisure time, and choices. We have our insurance issues with many of us on or about to be on Medicare. And we have the concerns about aging and health.
The whole project began when I participated in a panel discussion sponsored by AARP. The author Gail Sheehy talked about how she and her husband had faced serious health problems and, in fact, signed up for palliative care. The doctor came to them and asked her husband, who clearly had significant mobility limitations and other health problems, "What are your goals for this stage in life?" I thought, "Wow, what a great question." I didn't have an answer for that and I'm not facing end of life issues.
So the book also addresses goals, role models, and questions we are now or will be asking ourselves as we get older. It deals with the very practical areas we have to face as we age, including our finances and signing up for Social Security and Medicare. I guess the most important message I relate in the book is to not judge aging. We are who we are and getting older is not something to fight or shy away from. As the old joke says about getting older, "it sure beats the alternative."
In the book I create a Level of Activity scale, something that you can use to help guide you (or your aging parents). Where you are on the scale, much more than your chronological age, will likely have more influence on your choices than anything else.
So please watch for my new book and watch this space where I will continue to blog about important issues.
Thanks for reading and please post your comments and questions.