chrishansenhome: (Default)
I will turn 60 on November 8th. Big effing deal, one might say. Well, in the United Kingdom, it is usual that private pension funds "mature" on your 60th birthday. Any time after age 50, you can take your pension money and buy an annuity with 75% of it, and take as a lump-sum the other 25%, which is not taxable in the United Kingdom.

A few weeks ago my pension fund carriers noticed that I was about to turn 60. Therefore, I began to get material about it. However, the one time I clicked on a Facebook ad was for an outfit that shops around for the best deal with the money you have.

Briefly, the (gay) agent who spoke with me has gone through the entire process, and we have discovered that I will likely be able to take a lump-sum payout of a little less than £26,000. and buy an annuity that will provide me with around £430 per month. Those sums translate to a bit more than US$41,000 and around US$680 / month.

Now for the catch. While the lump-sum is not taxable in the UK, as I'm still a US citizen I will have to pay US taxes on it. My US tax accountant does not think it'll be excessive but I suspect that I'll lose up to 25% or so of that to Uncle Sam. Oh, how I wish I'd followed through and renounced my US citizenship a few years ago.

So, let's say that I'm left with around US$30,000 or around £19,000. What to do with that money? I have two ideas. The first is something that I've wanted to do for decades: take a trip to Australia. My health isn't getting any better, and if I don't do this now, I may never get to do it. I'm thinking March 2013. I would go to Sydney and Melbourne, with perhaps a trip to Ayres Rock on the way. I think this will cost somewhere around £4,000 for travel and lodging and mad money (just a wild guess). I would stop off in Singapore on the way there and the way back, of course.

But the other thing I would like to get is a gastric bypass. As the NHS is unwilling to pay for it, I would like to use the rest of the money for the operation and recovery. I think this will cost something around £13,000 in the UK. There is also the option of going abroad for it—Thailand and India specialise in this kind of operation for expats with ready cash and I suspect that it will be a bit cheaper there.

So after filling out the forms for actually getting the money, I will have to do some research on travel and health. In two years I will get my US Social Security (which I would have gotten even if I'd managed to renounce my US citizenship) and that will add another £600 or so to my monthly income. In five years, if I'm spared, I'll get my state pension here, which won't be a heck of a lot but will probably add a few bob to my total income.

I will continue to update here as I make my decisions.
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Forgot to mention that I went to the quack yesterday for a checkup. I had blood drawn (hi, [livejournal.com profile] momshapedbox!) and the results were back. My HbA1C was 6.6 (119 in American measurements), where the normal range is 5-7 and with insulin-dependent diabetics they will be happy up to 8. My cholesterol was 3.3, which translates to 127 in American measurements. Liver, kidneys, and thyroid all OK. BP was a bit high in the systolic, but OK in the diastolic. I got all my prescriptions filled, and we chatted about the Foot Clinic at Kings, as my doctor is part of a consortium in Southwark looking at the provision of medical care to diabetics.

So I'm good for another 4-6 months. Next time I will see if I can revive my application for gastric bypass surgery.

And, I guess, yay me! (for now)...
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The people I normally see at the Foot Clinic are podiatrists who specialise in diabetic foot treatment. They are all very nice and professional (although they do tend to raise their voices when they talk to patients, assuming we're all deaf—and many are, of course, but that's just an aside).

If I lived in Peterborough, I might have been treated by this guy, who seems to have let his Christianity get in the way of his professionalism. Of course, it doesn't seem to have gotten in the way of his taking on private patients without informing the National Health Service. Funny, that.
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For a change, it's not about my health, but about the struggle to keep one man alive after a diagnosis of kidney cancer—and how much it cost. I was in tears by the end.
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I have two appointments with quacks this morning. The second one is the usual foot appointment. I think I'm going to catch hell because my right foot became infected the day after my last appointment two weeks ago and I just started taking the antibiotics again that they had left me with the last time. This was two weeks ago, and I suspect they'll be annoyed. Tough. It seems to have worked as the right foot is OK again. I'll just ask for more antibiotics.

The first appointment is at St. Thomas's Hospital with the Fat Doctor—Bariatric Surgeon. I am presuming that this will be an initial evaluation to see whether they should pursue some kind of bariatric surgery on me, either a gastric band or a gastric resection. I'm in favour of the latter because of its effects on diabetes is patients who have had the operation. We shall see. I'm a bit nervous about the appointment so I hope it goes well. If he's anywhere near the attitude of the lipid nurse a month ago, I'm outta there.
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Apparently the American Medical Association has weighed in on the Government-run health care proposal:

The Allergists voted to scratch it, but the Dermatologists advised not to make any rash moves.
The Gastroenterologists had sort of a gut feeling about it but the Neurologists thought the Administration had a lot of nerve.
The Obstetricians felt they were all laboring under a misconception.
Ophthalmologists considered the idea shortsighted.
Pathologists yelled, "Over my dead body!" while the Pediatricians said, 'Oh, Grow up!'
The Psychiatrists thought the whole idea was madness, while the Radiologists could see right through it.
Surgeons decided to wash their hands of the whole thing.
The Internists thought it was a bitter pill to swallow, and the Plastic Surgeons said, "This puts a whole new face on the matter."
The Podiatrists thought it was a step forward, but the Urologists were pissed off at the whole idea.
The Anesthesiologists thought the whole idea was a gas and the Cardiologists didn't have the heart to say no.
The Ear, Nose, and Throat specialist swallowed his pride and wouldn't hear of it because he smelled a rat.
The Oncologist thought it was a cancer on the heart of American medicine, but the Sports Medicine specialist wanted to run with it.
The General Practitioner wanted to run it up the flagpole to see who saluted.
In the end, the Proctologists won out, leaving the entire decision up to the assholes in Washington.
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When I was living in New York I met Tom Duane a few times. He was then a City Councilperson, and the only openly-gay City officeholder (AFAIK). Nice guy, very active, also openly HIV-positive. Someone to look up to in our community.

Fast-forward 20 years. He's now a State Senator in New York—not a particularly well-thought-of category of person nowadays. Well, he made a speech in the State Senate about his bill to limit the amount of rent people with HIV and on public assistance must pay to 30% of their monthly income. It's 21 minutes of power, folks. You must watch this speech.



Oh, and at the end he got a standing ovation, and the bill passed. What a fighter he is! He should run for governor of New York.
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I really intensely dislike sharing a lift or other conveyance with someone who is a heavy smoker, especially if they've stubbed out their cigarette just before they get into said lift. The odour of stale smoke that pervades their hair, skin, and clothing is really, in ways, more disgusting than breathing their smoke.

Well, I never knew there was a term for this: it's third-hand smoke, and according to an article in the New York Times, it can be as carcinogenic to people other than the smoker as second- or first-hand smoke.

I don't know what can be done about this, though. The only way to avoid third-hand smoke is to require a complete change of clothing and a shower after each cigarette.
chrishansenhome: (Default)
When you come in with an infection of the sort I had, the hospital takes a swab of the area to see what kind of bacteria you're harbouring.

I got a call this afternoon from the Diabetic Foot Clinic. The woman asked me, "Are you still taking the antibiotics and having the injection we prescribed?" I replied, "Of course I am. Why do you ask?"

She said, "Oh, the swab turned up a pretty nasty bug and we wanted to make sure you were still on the antibiotics." I enquired, "Which bug was that?" She told me: "Group A strep."

When I hung up, I Googled "group A strep" and came up with some pretty sobering results. This particular bug is a prime cause of necrotising fasciitis, and is also known as "the flesh-eating bug".

So I guess I've had a narrow escape. When I changed the dressing this morning, the toe looked good, wasn't wet or macerated, and had stopped oozing.

Now I don't normally speak lolcat, but I thought this picture might be appropriate.

chrishansenhome: (Default)
I discovered an ulcer on my left little toe yesterday. I went to the emergency foot clinic this afternoon, and while they scraped away the bad bits they referred me to Kings College Hospital, where the last infection was treated. They told me just to go and they would call to confirm that I was on my way, but when I got there no call had been received. I cooled my heels for an hour and was finally seen. They scraped away more of the junk and, yet again, started me on four antibiotics, one of which is a daily injection. I didn't think the foot was half as bad as it was last time this happened, but they wouldn't be swayed.

I believe that I will have to have shoes specially made in order to assist in keeping further infections away (once this one is dealt with). Normally this is a very slow process on the NHS but I think I will speed it up through going private for the footwear. They think that I should wear some sort of "Scotch boot" device for a while after the infection has been treated, in order to take the pressure off the sole of my foot, perhaps while the shoes are being made.

All this is ick, ick, ick, and prayers that it will speedily recover and that I can get the footwear that I need to try to avoid all this in the future would be most welcome. No commercially-available shoes seem to be wide enough to give my feet a comfortable toe box.

I'm glad that I didn't go ahead and buy air tickets for Boston for today, or I'd have been right royally scr*wed.

In other news, our former flatmate Brett left on the next leg of his around the world tour this morning...we miss him already. This is his blog in case you want to see the lovely dinner we had last night, which he blogged about much more coherently than I could, not knowing anything about food or wine on that level.

Hay fever

Apr. 19th, 2008 11:48 am
chrishansenhome: (Default)
I have never before had hay fever. In the spring I blithely went out and frolicked around, secure in the knowledge that no pollen was a match for my respiratory system.

A few weeks ago my nose started running and this week I began sneezing quite a bit. I think that at the ripe age of 55, I have finally succumbed.

As if I had no other health worries!
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A sweet grandmother telephoned St. Joseph's Hospital. She timidly asked, 'Is it possible to speak to someone who can tell me how a patient is doing?'

The operator said, 'I'll be glad to help, dear. What's the name and room number?'

The grandmother in her weak tremulous voice said, 'Norma Findlay, Room 302.'

The operator replied, 'Let me place you on hold while I check with her nurse.'

After a few minutes the operator returned to the phone and said, 'Good news. Her nurse has told me that Norma is doing very well. Her blood pressure is fine. Her blood work just came back as normal and her Physician, Dr. Cohen, has scheduled her to be discharged Tuesday.'

The grandmother said, 'Thank you. That's wonderful! I was so worried! God bless you for the good news.'

The operator replied, 'You're more than welcome. Is Norma your daughter?'

The grandmother said, 'No, I'm Norma Findlay in 302. No one tells me shit.'
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I forgot all about the second anniversary of my heart attack on February 7th. I remain relatively without heart discomfort, but have been unable to lose weight and am very annoyed about that. Yoga is good, but I haven't been for a couple of weeks becuause of my trip to New York and my fall (which made it too painful to use my hands and knees like one has to in yoga).

The second anniversary is that of our Civil Partnership, today, February 14th, Valentine's Day. It is either our second or our tenth anniversary--we have been together for almost 10 years but only legal for two. HWMBO is in Singapore, so I'm all alone tonight. But we're together in spirit, anyway.
chrishansenhome: (Default)
...and hopefully I'll be released from their care to my GP. I've not had any chest pain since the heart attack, and I try to exercise regularly and eat more moderately. Good thoughts would be appreciated.

In order to bring my blood pressure down I'll have to lose lots of weight, as medications don't seem to be doing it. I'm going to go to a bariatric surgeon within the next few months and see about the duodenal resection operation which not only help you lose weight, it also helps control or even cure your diabetes. I'm going private, as the NHS would not be likely to approve it for me.
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I went to my fifth class last night. The leader was a bit down, for personal reasons, but the class itself was perky and very lively, as usual. He gave me lots of praise, saying that I had improved markedly since I started.

Of course, this makes me feel good, but, more importantly, I think it has changed my health a bit for the better. My feet feel better, I think I've lost some weight, and I feel perkier. There are some pains involved (especially a few days after the class) but that's to be expected in this quickly-elderly body of mine.

I will continue to go on Wednesdays, and try to get to the Saturday classes once or twice a month. Continuous updates as appropriate.
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Got up this morning and discovered that a blister on my right big toe had burst. I find it difficult to understand why I have such trouble with my feet when I am here. Could it be that the heat makes them swell and that chafes in the shoes which fit perfectly in the UK? Anyway, bought some special blister plasters and will try to get some proper dressings while I'm in Shanghai. I'm certain that someone will be able to assist. I shall keep it clean and as dry as possible. If it's still weeping when I get back, I shall see a doctor here and get some antibiotics as well as proper dressings.

Next time I come I shall take advice on good shoes to wear so that chafing will be kept to a minimum. I'll probably look like an old man on his last legs, but I don't care...I am so tired of my feet.

In other news: didn't do much today. I went to Bishan shopping centre and had a MosBurger. For those not familiar with Singapore, MosBurger is a Japanese burger chain. Their burgers are small compared to McD's and Burger King, but they are very tasty. I had that, small fries, and a diet Coke. Bought a book to read during lunch, and found it so riveting I came back home and finished it. The Interpretation of Murder by Jed Rubenfeld is a murder mystery set in 1909 New York, with Sigmund Freud, Carl Jung, and various other real people as part of the plot. Really good. [livejournal.com profile] spwebdesign, I'll try to bring it back as I think it might be something you would like (although not a serious book).

This evening I met [livejournal.com profile] kingbitch for dinner and a drink. He is so nice and sweet and funny that if I weren't married to HWMBO, I'd propose immediately. He will be a great catch for someone as he's not only good looking, but great company. We then went to Tantrics and I met [livejournal.com profile] nicekit for the first time. Also a sweetheart, and I'm so glad that I can meet all these people on my travels. Then home, packed, and now to bed.
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This has been a gawdawful day--I got through it only with HWMBO's help, so thanks and hugs go to him.

I woke up at 6:30 to get ready to go to the Chinese embassy to apply for my visa for Shanghai. I got showered, dressed, and then went to the kitchen to eat a bit and take my pills, which I had prepared last night. As I took the pills, I counted, and realised that there was one missing. I went back into the room and, sure enough, I had neglected to pack my beta-blocker. I blame a couple of things. First, the size, shape, and colour of the packages change every time I get a new batch of pills, due to the NHS buying its pills from the lowest bidder. So I may have mistaken them for another pill which I did pack. Second, I take so many pills now it's easy to forget one if you're not careful. Third, there were so many pills in the bag that it would be difficult to discern that this particular box of pills wasn't in the bag.

So, what to do? I went over to Bishan to meet HWMBO, whom I immediately told of my plight. He was sympathetic, but we needed to get to the embassy pronto, so we did that, I all the time wondering when my heart would suddenly conk out.

The embassy is not terribly forbidding; there was little or no security presence to speak of, set against the vehicle barrier and the several guards stationed at the British High Commission next door. We waited for 45 minutes on the steps until they opened the doors. We then "took a number", filled out the form, and waited a couple of minutes. Called to the window, the clerk took the papers and told me to come back tomorrow. I'll be paying the equivalent of GBP 25 for this, whereas in London I would have paid GBP 75.

After this, HWMBO and I went to breakfast, and tried to find a pharmacy, only to discover that bisoprolol is only given under a doctor's prescription so I'd have to visit a doctor. Back to Bishan we went, me in a real state. Our host took me to a clinic (they have 24-hour clinics here!) where the doctor took my blood pressure, sympathised with me about all the pills I have to take, and gave me 30 atenolol pills, which are functionally equivalent. All for the equivalent of GBP 8. We went to the local food stall for lunch, where I popped my pill with a Diet Coke.

Then back to the flat for a few hours of shut-eye and letting my diuretic pass out of my system before I moved away from the bathroom. We then took a bus downtown, on which I was embarrassed because my farecard was out of cash and the driver called me back to pay. I had to use coins to pay for the ride, and when we got to Chinatown, put Sg$50 on the card. That should keep me for a while. We wandered around Chinatown for a while, enjoying the ambiance..."You want to come for a massage?" "You want a suit made while you wait?", that kind of thing. HWMBO had some dumpling soup, and we then walked over to the new Temple of the Tooth, mentioned in a previous entry. Very nice and new, but I couldn't go in as I was wearing shorts. We walked down to Clarke Quay to find a restaurant, and after a lot of walking through a new shopping centre (they have so many shopping centres here it's not funny; why do they need a new one?? Tell me again??) finally found a restaurant. I decided on a burger (silly me, but I have a lot of hawker-style food at other times so occasionally I want something else). Back home, read email, and now to bed.

Other random observations:

  • The MRT is more and more crowded, it seems. I was standing holding on to a pillar this evening and a young gentleman who was holding onto an overhead bar with both hands then leaned on my hand clutching the pillar, with his armpit sticking right into my fingers. I resisted the temptation to tickle his armpit, but also realised that perhaps he didn't wash his shirt as often as he ought.

  • It's very nice to see Singapore overland by bus. The one we took today went right past the first place I stayed when I came here in 1995 to visit my ex. I now have a better idea of where everything is.

  • The old Singapore is fast disappearing. The stalls where people try to pull you in used to be ubiquitous. Now you really only see them in Chinatown. The shophouses of Chinatown are falling to the developers very very quickly indeed, as well. If you do like Old Asia, and are coming to Singapore, you won't see much of it in a few years' time. So hurry!



I do hope that the rest of the trip goes better than it has so far. Good thoughts and sympathetic murmurs would be most appreciated.
chrishansenhome: (Default)
We were asleep just now when the phone rang. It was my sister calling from Marblehead. She started out, "I'm OK, Uncle Dick's OK, Harold (my brother) had a heart attack." I would have liked the bad news first, I think.

He was working and he felt a tightness in his chest. He ignored it for a while, until he couldn't ignore it any more, so he went home, changed his clothes (can't go to the hospital unless your underwear's clean, can you?), and called 911. They did an angioplasty and put in a stent, and he's now "resting comfortably", as they say.

I just gave him a call at the hospital, and he answered the phone with "Miller Auto Service". When they asked him whether he'd ever been in the hospital, he answered, "Once, when I was born. I wanted to be close to my mother." (he's a Three Stooges fan...) At least he could still crack a joke.

So there you go. I told him "I guess you've joined the club." but I hope he recovers as well as I've seemed to. My sister said, "I suppose I ought to make an appointment at the hospital for an angioplasty now, rather than waiting." I think it would be better if all of us lost more weight and took more exercise.

Oh well, back to bed, and maybe to sleep.

Later note: He seems to be resting comfortably. However, upon reflection, I realised that I had my heart attack aged 53 years 3 months. He had his aged 53 years 2 months. I should tell my sister to book the angioplasty lab at the hospital in August 2011.
chrishansenhome: (Default)
As in every race or competition, there are people who finish first, and of course there is always a person who finishes last. The guy who came last in the Boston Marathon is a blogger, and his story of the race is here. He may surprise you, but for all the angst I expend over my own health problems I wish I had even the tiniest bit of the moxie Jacob has.
chrishansenhome: (Default)
MadPriest also draws our attention to the first sentence in the fourth paragraph...saying that it's probably a very good idea to discuss this subject with one's members.

New York City Plans to Promote Circumcision

By DONALD G. McNEIL Jr.
Published: April 5, 2007

New York City’s Department of Health and Mental Hygiene is planning a campaign to encourage men at high risk of AIDS to get circumcised in light of the World Health Organization’s endorsement of the procedure as an effective way to prevent the disease.

While the Centers for Disease Control and Prevention in Atlanta is just beginning to convene meetings and design studies to help it formulate a national policy, New York City is moving ahead on its own.

In the United States, “New York City remains the epicenter of the AIDS epidemic,” Dr. Thomas R. Frieden, the city’s health commissioner, said in an interview. Referring to H.I.V., he said, “In some subpopulations, you have 10 to 20 percent prevalence rates, just as they do in parts of Africa.”

His department has started asking some community groups and gay rights organizations to discuss circumcision with their members, and has asked the Health and Hospitals Corporation, which runs city hospitals and clinics, to perform the procedure at no charge for men without health insurance.

A spokeswoman for the corporation said it was “having conversations” with the health department but had not reached a decision.

“As you know, the research on this is pretty recent,” the spokeswoman, Ana Marengo, said.

In three recent clinical trials in Africa, circumcision was shown to lower a man’s risk of contracting the virus from heterosexual sex by about 60 percent. On March 28, the World Health Organization officially recommended that countries adopt the procedure as part of their AIDS prevention plans.

No spontaneous outcry for circumcision has arisen in New York, Dr. Frieden conceded.

“This is not something that has a lot of buzz,” he said.

But he added that even 1,000 circumcisions in the right subgroups might slow the spread of AIDS.

For example, in Manhattan, 20 percent of all black men between 40 and 50 are infected with the virus that causes AIDS. About 10 percent of all gay men in the city are infected, and the rate rises to as high as 25 percent in the Chelsea neighborhood.

Dr. Frieden said black, Hispanic and foreign-born men were less likely to be circumcised than white Americans, and the percentage is smaller among men with lower incomes.

(About 65 percent of all male babies in the United States are circumcised, according to the National Center for Health Statistics, compared with about 30 percent of men worldwide, by W.H.O. estimates.)

Among men seeking treatment at the city’s clinics for sexually transmitted diseases — another risk group for AIDS infection because of genital sores — a large proportion are uncircumcised, Dr. Frieden said.

There are clear limitations, however, on extrapolating data from Africa to New York.

The studies, done in Uganda, Kenya and South Africa, enrolled men who said they had sex with women, while New York’s highest-risk groups are men who have sex with men, men who inject drugs and people who have sex with those men.

Nonetheless, Dr. Frieden said, it is logical to assume that circumcision would offer protection in some types of gay sex.

A man’s risk from performing penetrative anal sex is about the same as his risk from vaginal sex, Dr. Frieden said, so circumcision would presumably confer the same protection as it did in the African trials.

The risk from receptive anal sex is five times higher, he said, and circumcision would obviously not protect those men. Oral sex is much less risky.

Also, cutting down infections among bisexual men — some of whom do not admit to female partners that they participate in gay sex — would protect women, he said.

Dr. Frieden said he thought health insurance companies might agree to pay for preventive circumcisions since they already covered them for infections and urinary blockage. City hospitals also offer the operation in those cases, Ms. Marengo said.

Peter Staley, a longtime AIDS activist and co-founder of ACT-UP New York, the Treatment Action Group and AIDSmeds.com, said he was “intrigued” by the idea of offering circumcisions but worried because those in the studies supporting it bore little relation to New York’s risk groups.

“Should we proceed when we don’t have hard data yet on the population here?” he asked. “On the other hand, if we wait the three years it would take to answer that question, how many will be infected in the meantime?”

Also, after reading many postings on gay Web sites about the Africa trials, he said he feared a backlash among black and Hispanic men to endorsements of circumcision from white public health officials or gay activists.

“I’m white, Frieden’s white,” he said. “It’s going to sound like white guys telling black and Hispanic guys to do something that would affect their manhood.”

Tokes Osubu, executive director of Gay Men of African Descent, a 21-year-old gay rights organization, agreed.

“There will always be conspiracy theorists,” he said. “That’s par for the course.”

He also said he thought circumcision was “not the answer to our problems” and doubted that it would lower infection rates.

Many black men who have sex with men, he said, already face discrimination, stigma and an inability to talk about their sex lives with family members and sometimes even with doctors.

“No amount of circumcision is going to change that,” he said.

Bric Bernas, manager of information and counseling for the Asian and Pacific Islander Coalition on H.I.V./AIDS, said his organization wanted to see studies done in the United States and among gay men before taking a position on the issue.

Circumcision is not common among Asian men, except those from Muslim countries and the Philippines, Mr. Bernas said, “and there might be cultural sensitivities around it.”

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