Rudynate

Your post from a few months ago: - Stop complaining.

You should be thanking me. I'm the only one who expressed any sympathy for your plight.

I smell confirmation bias.

I read the whole thing. The bulk of your post was a melodramatic description of your recent ER experience with you screaming in agony and the docs ignoring you, which made it difficult to tease out your larger message.

So you were venting your lingering frustration over a negative ER experience. That's unfortunate. My experience with ER visits is that that is how they used to be but they have vastly improved. Even 20 years ago, I went into the ER with a clot that turned out to extend from the back of my knee almost to my liver in my vena cava. My right leg was twice its normal size and looked like a salami. They jumped on it and wasted no time. The ER doc glanced at it and ordered a venogram, which he said was the first one he had ever ordered. OTOH, the inpatient care was pathetic.

My husband went through a bad patch a few years ago - he was hospitalized several times for bad UTI's. The care he got in the ER was amazing. The first time, we walked in, they took a look at him, got him into a room and were hanging antibiotics within minutes, literally.

Rivaroxiban is Xarelto. Eliquis is apixaban. There is a single antidote that works for both. Why wouldn't an ER doc know how to use them? I would think they of all people would know.

I have my share of complaints about Kaiser, but I'm definitely not going anywhere. I had a surgery a few weeks ago that cost me $400.00. I don't even want to say what the bill was.

I was getting my Eliquis through Kaiser, but even the co-pay was expensive - $300.00 for a 90-day supply. I got it offshore for 300.00 for a one-year supply. The full retail for Eliquis in the US is about $600 for a 30-day supply.

That's interesting. So often Canadians say "There's nothing wrong with Canadian healthcare. Americans just like to criticize it because healthcare in the US is so expensive." It is true that the American system of healthcare financing is totally screwed, but healthcare itself is top-notch. I belonged to a Facebook support group for people with autoimmune problems and the Canadians and Brits had a lot of scary stories about needing to wait for a year or more for an appointment with a rheumatologist. The first time I saw a rheumatologist at Kaiser, I had an appointment in a couple of weeks.

The usual instructions when on a blood thinner are to not take NSAIDs, such as aspirin. I am on Eliquis and I definitely do not take NSAIDs. I learned from personal experience that it's a very bad idea. I have been on blood thinning medication for more than 20 years. Before we had modern drugs like Pradaxa, Xarelto and Eliquis, the only alternative was warfarin, a very difficult drug to take. When I was taking warfarin, I once took some ibuprofen, even though I knew better. I told myself "Oh, what can it hurt?" The next morning, I woke with a huge purple bruise on my side - and I was convinced. The newer drugs are a piece of cake compared to warfarin. When I finally got off warfarin onto Pradaxa, I felt like I had just got out of jail.

The guidance for that baby asprin regimen was very unclear. They said that people who were already on the regimen should stay on it. But nobody else should start it. I suppose that means that the data hadn't shown there was any benefit from taking baby aspirin. But also that there was no significant risk from taking a baby aspirin every day, so that if you wanted to keep taking your baby aspirin every day, it wasn't going to do anything for you, but it wasn't going to kill you either. I had a surgery not long ago and the surgeon wanted me off of the blood thinner for 6 days total. I told him I was uncomortable with interrupting the blood thinner for that long, so we compromised by agreeing that they would start aspirin immediately after the procedure. Of course, that was kind of silly because an anti-platelet agent is not effective against venous clots. But, I lived through it.

It seems your treatment was careless. And that's the weird thing about blood clots - a lot of primary care docs just sort of blow you off and treat you like some sort of malingerer and they don't seem to appreciate that they are dealing with a potentially life threatenting condition. They tell you - if you even suspect it's a blood clot, get to the hospital pronto, better to be safe than sorry, etc. etc. But then, if you do, they treat you like a hypochondriac. One time, I went in to see my PCP in San Francisco because of some soreness and swelling in one of my legs. My PCP was almost contemtptuous as he declined to order an ultrasound. That was back before Kaiser's records were all digitized. He had to order my imaging from a facility in the East Bay and it took a couple days to get it. When he saw the reports he called me back and asked me to come in right away for an ultasound. Fortunately, that time was a false alarm. Another time, I was having clear-cut symptoms so I want into the Santa Rosa Kaiser - this was deep in the pandemic. They did an ultrasound which came out negative and sent me on my way, in spite of my symptoms. I wasn't satisfied - and my symptoms only got worse, so I went in to the San Franciso Kaiser when I got home and asked for a repeat scan - and I told them I didn't think the technologist in Santa Rose had imaged the correct veins. They got very surly, the radiologist said that the scan from Santa Rosa was "perfect!!" But another radiologist who wanted to placate me had the technologist image some superficial veins - sure enough, there was a sizeable clot right at the junction of a superficial vein and a deep vein. Your treatment clearly sounds careless - I'm sorry that happened. Was the d-dimer elevated? There are other things that can cause an elevated d-dimer. But an elevated d-dimer in the presence of symptoms is a whole other thing.

How would they follow up blood clots? Either you have them or you don't. Usually, after your first clotting episode, they do tests for clotting problems, but what else would they do? I have a diagosed clotting problem. I've had a pulmonary embolus and more DVT's than I care to think about. I'm on lifelong anticoagulation. I know my hematologist very well. If I even have a colonoscopy, they take special precautions. To me, that's the followup for blood clots. You don't want it if you don't need it.

As a little kid, I used to do errands and chores for the neighbors for pocket money. When I got 75 cents, I used to love to go downtown to Newberry's and get an order of french fries and a ginger ale at the lunch counter. The waitresses were all middle-aged ladies in waitress uniforms with white nurse shoes

That sounds terrific - next time I will use that recipe

When you are curing the salmon, you can add some booze - not too much. I have always used gin or vodka but I've seen recipes that call for brandy or bourbon, even scotch. So I decided to try cognac and it was excellent.

What kind of booze do you cure it with? The last time I made it, I used cognac and it was just great. Now I want to try bourbon. Two of our oldest friends love smoked salmon - with them it's a food group. I served the gravlax cured with cognac and it knocked their socks off - they couldn't stop eating it. I had also invested in a nice slicer so I was able to cut it in paper-thin slices.

I like to make gravlax and serve it in small portions with a sweet mustard sauce, capers and red onion and thin-sliced pumperickel or black bread.

Not long ago, I had one screw me. He wasn't a pro - more like a guy who is monetizing his sex life. He hit me up on IG, saying right up front that he was a sex worker. I never met him in person, so I don't know if his pics were real, but it they were he was very much my kind of guy - Latin, muscles, hairy chest, beard. He wanted payment upfront, which I have never encountered, but I thought, "why not?" His fee was only going to be 200.00 for an open-ended session. First he wanted me to use cashapp to pay him. My bank won't accept charges from offshore payment processors, so that was a no go. Then he suggested Paypal and I said "great," and sent him 200.00. He kept telling me that he hadnt received the money. I called Paypal and they said "no, the money was deposited into his account." I was beginning to tire of the whole thing, so I told him he would have to work it out at his end because the money had already been paid from my account and I was done. I told him to email me if he located the funds and we could schedule a date. So that's it - not very dramatic.

I see them on menus. I'm tempted to order them but haven't taken the plunge. I don't like lamb that tastes like lamb. Every now and again, I encounter lamb that doesn't have that obnoxious lamb taste - it's tender and sweet wthout THAT taste. When I encounter it, I think "Why can't all lamb taste like this?"

When I was in college - I bought packages of chicken backs. They had enough meat on them so they were good stewed and then I used the bones for soup. I also bought beef shanks - now they're pretty costly, but back then, they were considered not quite carbage. They were excellent stewed.

"insulted" is too strong a word. I just thought he needed to learn something about providing a good experience. For me, it's part of the experience - that payment is just assumed and not talked about. It reminds me of sexy movies I have seen involving gigolos.

Once, I had someone do that. I had laid the cash on a table and he counted it in front of me. I just thought "wow, how low-rent."

If you want it bad enough, you’ll find a way to pay for it-tap your retirement account, get a second mortgage. And lots of people just have the coin for it. I remember a trans woman who was a waitress at the lunch counter at Woolworth’s. I always wondered how she had managed to finance her transition, but there she was.