Category Archives: Health

Financial Planning in the Age of Coronavirus

Like many of you, I’ve been trying to stay afloat–mentally–under stressors that appeared practically overnight. With the economy humming along somewhere through a very long bull market, it was clear the upward tick to the markets wouldn’t last forever. However, I don’t think anyone thought it would end so jarringly.

I sit here from my “shelter in place” apartment in one of the worst hit counties in California. My company went a little early in moving to WFH and I’ve been adjusting, but the last weeks have been a bit of a blur. On the Saturday before my company decided to move to a WFH policy, I felt I was coming down with something. I don’t think I had a fever, I just had mild aches, and my chest immediately felt impacted. I went to work on Monday (if I had a fever I definitely wouldn’t have) and waited for my company to make the call. It wasn’t far into the day Monday when whispers of the company going fully remote made their way around the office, then an email formalizing that we would no longer be coming into the office for the next few weeks.

My lungs tight and heavy managed to breathe a sigh of relief. All I wanted was to get home and keep my family safe. At the time my 76-year-old father-in-law who provides childcare was still coming to our house via the train. It made no sense. I feared for his health and safety. In those 24 hours our worlds changed. Grandpa no longer would take the train to provide childcare. But my husband and I would still continue working, albeit with both of us WFH, with no childcare.

Over the next days my lungs felt like they had a cool liquid pouring into them, a slight burning sensation, and I felt winded after walking or picking up around the house. With no fever, I didn’t want to be a hypochondriac, but I emailed my doctor and she said normally she’d have me come in to check out my symptoms (as they were concerning) but with coronavirus going around she couldn’t, so she’d just treat me for pneumonia–just in case that’s what I have. Coronavirus testing was out of the question since I hadn’t been to another country recently and had no known contact with another person who tested positive. I was put on a course of powerful antibiotics and provided an inhaler to help me breathe.

The next day, our entire region went on full lockdown.

Two weeks later, my lungs still hurt. I’m not sure if the antibiotics did anything. I’m not convinced I have coronavirus, but I’m also not convinced that I don’t. My husband had what appeared to be a bad stomach bug with a low fever the same week I first felt ill, and now coronavirus reports say that sometimes it starts with gasterontestinal issues. He too felt some tightening in his chest. Neither of us were coughing, though–so what we have could be pretty much anything. If it’s coronavirus, we’ll never know outside of suspicion. I know whatever is happening to my lungs, this cold fluid sensation and the tightness in the center of my chest, is new to me. Could it be crippling anxiety? Sure. But the cold fluid sensation is strange and I continue to have mild respiratory symptoms.

I think I’m ok. Physically I’m just trying to take it easy. Mentally, I’m a mess. I know way more than I ever wanted to know about pandemics and how they exponentially spread. I’ve spent countless hours trying to convince my boomer mother, stuck in her snowbird condo in Florida, to take this seriously–especially given she’s in an area with a lot of older people mixed with young tourists where things will likely get bad.

Then, there’s my portfolio. Down something like $200k, give or take, prob give quite a bit more in the coming weeks. I’m a buy-and-holder, and got my start in investing right before the 2008 downturn, so I believe in the power of investing when everything is going haywire and how the recovery is when wealth is made. Downturns are good for the market and give us a time to buy on sale. But this whole situation is unprecedented and things can get a lot worse than they are. It’s unlikely–given its fatality rate–that the economy will fail to recover once a vaccine is tested and brought to market. But I don’t know how the economy can handle everything shutting down for a while, especially if this goes on (or on and off and on again) for 18+ months.

I’m using this opportunity to rebalance my accounts, but not to sell for no reason. I’ve been doing some unrelated research regarding asset allocation including real estate, as well as what one should really have in cash for a home purchase. I’ll write another post about that eventually, but I’ve basically determined that 30% of my net worth should be held in real estate. I’m looking at 30% of my net worth including a downpayment, closing costs, and a conservative 12 month emergency fund. In order to afford a $1.7M house, we need $500k cash in the bank.

My CFP who I hired for a year (who is no longer my CFP) recommended putting my downpayment into municipal bond funds for the tax advantages over the low interest-paying savings accounts. Well, that plan went to shit in the last two weeks. Apparently muni bonds funds are usually super stable. But after I put $200k into them, they decided to become volatile in a way they haven’t been since 1987. So far I pulled out the $200k (down to $192k) and put it into a short term bond fund, to take the loss in the intermediate state muni. That hurt a bit. Will probably just move everything to cash soon. It seems like this will be the year to buy–that is, if I can keep my job!

On top of all of this I’m not questioning the timing of trying for my next child. Due to infertility issues (at least with my first kid) plus now my “advanced maternal age” of 36, I really don’t want to wait. I also really don’t want to be pregnant–with the weakened immune system that comes with that–in the middle of a global pandemic. If I do get pregnant, we also have to move, which isn’t horrible since I do think this will be the year to buy. But if we’re on a year-long shelter-in-place, I don’t know how we’d move. We couldn’t even look at houses–or rentals for that matter. I think we could manage a year with two kids in a one bedroom (we’d save a ton that way) but legally you’re not allowed more than 2 adults and one kid per one bedroom, so we’d be in a bad situation… if it gets to the point where I’m pregnant and we aren’t allowed to leave our homes except to get groceries and medical supplies.

My overall thoughts right now is:

  1. Make sure we have our downpayment fund (ideally $500k) secure in cash or cash equivalents by fall (we have about $363k right now if I sold the bonds, and if I needed to I could make up for the rest selling stocks, but I’d prefer to not have to do that.) Be ready to buy when no one else is buying.
  2. Try my best to keep my job. I’ve actually been making progress on my coaching plan and things seemed to be turning around. Then Corona hit and–who knows. I’d be on the chopping block if there were layoffs, probably. I’m hoping we don’t have layoffs coming, but I have to assume they are with the state of the world. If I assume they are, then buying a house sooner than later makes sense (kind of, I mean not having a job won’t be great after buying a house, but that’s why I’m making sure we have a 12 month emergency fund.)
  3. Just try to get pregnant and see what happens. Worst case, I’ll be giving birth while incubated with a shared ventilator wrapped around my head, with my husband waiting from home to hear if I’ve survived childbirth and coronavirus and if the baby is ok. Ok, that’s a pretty horrible worst case, but it’s a possible one. More likely if I were to get pregnant I’d get a different standard of care as the doctors would try to keep me out of the office as much as possible. Given my infertility situation, it’s still unlikely I’ll get pregnant naturally. I do worry about being able to get infertility treatment in the next year, especially if we need something beyond the medication-based treatment protocol we did to conceive baby #1… The good news is that I conceived baby #1 right after a 3 month in-between job break where I focused on my health, travel, and relaxing. This isn’t exactly the same scenerio–I’m working and stressed–but I think over time with this WFH situation, if I can manage to keep my job and be as productive as I know I can be WFH, I can really focus on making the most out of every hour in the day to eat healthy, exercise, sleep, and do the things that set my body up for the healthiest possible pregnancy.

Things sure are crazy for everyone these days. I know I’m not alone. I’m trying to figure out how to balance being a mom and working from home with no childcare and getting to that level of health I want–I ordered some new running shoes and plan to use them, while staying six feet away from the other residents of my neighborhood, to disconnect from the panic sensation that fills me daily and reconnect with the sounds of nature and the taste of spring air. I hope things go somewhat according to plan, but not counting on it.

 

 

 

 

The Real Wealth: Fixing My Health

My weight has yo-yo’d from 120 to 180 (225 if you count pregnancy) for the last 15 years. A “healthy” weight for my height is 108-145lbs. I’m 170-ish right now.

Whenever I tell someone that I want to lose 50lbs they always say “you’ll be skin and bones” but I know that’s not true. I was a size 6 at 120lbs–thin, but not exactly skin and bones.

Now that I’m older and post baby, I’ve largely given up on the dreams of looking good in a bikini (for the record, I never did, and unless I splurge on major plastic surgery, I never will.) But — I’m extremely committed to getting back to a healthy weight (120-130 is my goal) and doing this in a healthy AND sustainable way.

I’ve recently found Intermittent Fasting and seeing the results of others truly inspires me. It feels like the kind of lifestyle change I can stick with–although it will be hard on my (non existent) social life to not drink after 8pm, with a 12-8pm eating and drinking period. But that’s probably for the better anyway–I can have a glass of wine with dinner, I don’t need to be binge drinking until the wee hours of the morning. I’m not 21 anymore and it seems every time I drink I do something stupid anyway. Not flattering on a 21 year old and certainly not flattering on a 36 year old.

It seems people are able to lose substantial amounts of weight on IF without majorly changing their diet or exercise routine. I’m going to do something a little different on IF — I’m going to make sure I’m eating ENOUGH calories. I want to eat 1800 calories a day of generally “clean” foods and go for walks and see what that does for January. I’d love to get under 160 by Feb 1. If I stick to IF, I feel like I can. Sticking to it will be a huge challenge, but y’all know me, I love a good seemingly impossible challenge…

Financially speaking, being healthy saves so much money over a lifetime! I’m still pissed that my life insurance costs and arm and a leg and both my butt cheeks because I have depression (fuck you insurance companies) but at least I can minimize the cost of medical treatments later in life if I get myself to a health weight (and I might even save on not having to pay for infertility treatments to have kid #2 — a goal for next year, post losing some weight and getting my mental health in order!)

The Ups and Downs of a Lifetime of Weight Battles

A month before my wedding, I couldn’t believe my eyes — my scale read out 140lbs (I think even 139lbs) at the very end of my diet bet… 6+ months of exercising with a personal trainer 3x a week, healthy eating, and making sure I stuck to it with the risk of losing $1000 if I didn’t hit my goal. That was the ONLY time in my life when I was consistent enough in my diet and exercise to crossover into healthy weight territory.

Three years and one baby later, I’m back up to around 180. While I give myself a little leeway for the whole having a baby thing, I’m now at the point where I had dropped to 175 after baby (215 being highest while pregnant) and then bumped back up again. It isn’t a surprise I gained the weight either… I’ve been living off a diet of, well, candy and junk from work and maybe a semi healthy dinner every once in a while that just has too many calories.

In addition to wanting to be healthy, feel better, live longer, yada yada, I’m also trying to get my weight down to get better rates on life insurance. I don’t want to wait too long to buy life insurance but at this point I’m in the obese category and that may disqualify me from getting life insurance to begin with (if my history of depression and anxiety doesn’t already keep me from being considered for a policy.)

So I’ve decided to bite the bullet and try a well-known diet program–weightwatchers, at the advice of my friend who recently lost 30 pounds in the last 5 months. I don’t love the idea of paying $20 a month for an app to keep me in check–but if it works, it’s worth that $240 a year. Sure, last time I lost weight using free calorie counting on myfitnesspal – but that was a pain in the ass and really I’m liking weightwatchers points system as it generally offers the same diet I was following but makes it somewhat easier to track everything. I also like not being so focused on calories and instead feeling rewarded for eating healthier food (ie foods with less sugars are lower points) while still being allowed to eat very small portions of non super healthy food (I’ve avoided that thus far since I know I’m a binge eater and I can’t stop at just one bite of a candy bar!)

Well, I’m less than a week into the program and I already had one major mess up day… July 4th… but I’m now back on track. My goal is to lose 50-60lbs by next July 1. I need to figure out a way to add exercise into my life. With work it’s hard to find the time but really I just need the motivation to go the gym and walk/run for 30 minutes for now. Once I get down to 160lbs then I need to start adding in more weights and such, but at the moment I just have to get my stamina back. It seems like a very very long uphill climb but at least I know I’ve done this before so it helps as a reminder I should be able to do it again.

I’m headed to the east coast to see family for a few weeks and I know this can go either way health wise. I’m going to try to cook food for myself and my mother for 3 weeks… it may be we can both lose 5lbs over those 3 weeks if we stick to my healthy cooking. That would be very exciting! I have no excuses on being healthy since I will be on break and have time to do things like cook and go for walks etc.

That 140lb mark was exciting a few years ago and then I totally blew it and was up to 170 before I got pregnant a year later. But it’s time to prove to myself that I CAN be healthy long term. Yes, I’d like to look good but also just feeling healthy makes everything else in life so much better and easier. And that’s definitely worth $240 a year for a silly app that helps me track what I’m eating.

To go to the doctor, or not go to the doctor – that is the question

High deductible health plans are great when you hit your deductible – except when they’re not. Specifically, they’re not great when over the course of the year you have to start over paying your deductible due to company health plan changes and/or changing companies. Thus, this leads me to move away from my former infatuation with the HSA-enabled HDHP.

In November, my $2600 deductible restarted. I figured I could survive until the end of the year without seeing a doctor. Then, I got pregnant. And then, I got sick. Sick with a cold / sore throat / lost voice that’s likely a virus that has no cure anyway… not worth a doctor’s visit and certainly not worth spending $300 on. I already made that mistake a few times this year when I didn’t realize my deductible had not only reset, but doubled (thanks to my former company who didn’t notify me that as of Aug 1 they switched plans and the $1500 deductible was now $2600 and reset *cough*bullshit*cough.*) Yes, that cost me $1000 in medical fees that I expected to be covered due to a series of “fuck I lost my job and I’m incredibly depressed” psychologist appointments (nothing like a surprise $1000 bill you fix your mental health!)

But now, I’m going back and forth on whether to go to the doctor. Being pregnant changes things. I’m five weeks, two days pregnant… and, 3 weeks, 6 days away from a brand new year of health insurance and deductibles. Since I’m switching to Kaiser, my medical costs are going to go way down next year (it’s a $1500 out of pocket max, no deductible,  no more surprise charges PPO BS. I hope I do not regret this decision.) Can’t I just stop talking for a few weeks (who needs a voice anyway) and hold out?

I do get to see my reproductive endocrinologist tomorrow – or at least the nurse – and perhaps they’ll be able to advise if I should do anything about this stupid cold. Luckily, my follow up appointments for my pregnancy at my RE are “free” (well, covered by my monthly $800 cycle fee) until I’m handed off to an ObGyn… so I’m hoping they can help at least provide some medical advice of what to do if I’m super sick and cannot talk.

The good news is I haven’t had a fever yet. I know fevers can be dangerous to baby and the second I get a high fever I’m paying that $300 and going to the doctor. For now, I think I just need to figure out how to get some rest and eat a lot of chicken soup.

Open Enrollment & Pregnant: Anthem or Kaiser? PPO, HDHP or HMO?

It’s quite the luxury to fall pregnant the month of open enrollment. This means hubby and I can (theoretically) make smart financial decisions when it comes to selecting health insurance for next year which covers both the birth of our first child and their first six months of medical care.

Even with this great fortune, it’s unclear which of our options is the right one. Luckily, my company provides relatively good insurance. Given how much health insurance costs in this country, the $200-$300 we’ll be paying a month as a couple (and $200 to $400 as a family) is nothing compared to what insurance on our own would cost. Still, I want to make a smart choice here.

It’s hard to make smart choices when the data is all hidden. Plus, not every decision in life should be based on financial impact alone. Delivering a baby is serious business, and having the option to choose my doctors (especially in case anything goes wrong) feels, to me, like a must have. My husband disagrees.

As a “Kaiser baby,” he speaks highly of the whole Kaiser health system (which also happens to be our lowest-cost option by far.) While some people report Kaiser is horrible, it seems to be that they have their shit together in California. Still, it makes me incredibly nervous to switch to a new health system now with its own style of care.

According to the calculator provided by the open enrollment system — with maternity care and other costs this year (for family of 2) our Kaiser total out of pocket costs would be $3000 or less for the year, whereas Anthem PPO (low deductible) would be around $5000-$6000 and Anthem HDHP would be $8000 (but also includes a $6900 contribution to HSA pre-tax, so that’s about a $3000 discount long term if we buy and hold.)

Financially-saavy me thinks — go for Kaiser — it’s clearly a lot cheaper and it’s not bad – just different. People who dislike Kaiser seem to have rare medical conditions that the organization doesn’t find fast enough since they have no incentive to spend more money on your health, and you have to advocate for yourself. Their maternity situation actually seems to be well regarded. It might not be a horrible idea to go to Kaiser and save $2000=$5000 next year. Lawrd knows we’ll need it for daycare* (more on that in another post.)

Before I was pregnant, I found an ObGyn who looks great (lots of 5 star reviews online) and she didn’t have an opening until January so I booked it a while ago. I planned to talk to her about infertility but now that I’m pregnant, it works out that it’s week 10 of my pregnancy and likely ok to be my first prenatal appointment (I’m assuming — especially since my Reproductive Endocrinologist provides ultrasounds and bloodwork until I’m turned over to the Ob.) I’m just not sure if that trade off is supposed to happen at 8 weeks or if 10 is ok… but I’ll find out.

So… I’m leaning towards Anthem… even though it’s a waste of money. If we start with Kaiser now, we’re stuck (I’ll have a pediatrician selected for my child through them, and unless that doctor is horrible, we’ll likely want to stay with that pediatrician for our child’s entire… childhood.)

Regarding the Anthem options – I’m torn between the HDHP and the PPO. The PPO is cheaper, according to the calculator, and for my husband it’s nice that it has a $250 deductible. The monthly cost is definitely higher and doesn’t include any company contribution, so that’s why it starts to even out. Then the HDHP has that HSA which I love so much, being able to invest nearly $7000 in pre-tax dollars in an account we can invest in and use for healthcare later in life. That $7000 invested over 10 years at 5% would be worth $9.4k – $2.4k back, plus the $3000 or so savings in taxes up front, which is $5.4k, which covers the cost of the difference between this plan and Kaiser.  And that’s with 5% growth and only over 10 years. So is Kaiser really cheaper? — That said, we’d have to pay $7000 up-front now out of our take-home income (though it would only feel like $3500 lost, comparable to the Kaiser costs, I think?)

Either way, I’m fortunate to have a job that pays well enough to be able to be able to decide on this. Keeping my job has never been this vital, and every day I step in the office I know I have to get my game face on and make this work. Somehow. I haven’t told my boss yet that I’m pregnant (one doesn’t do that until week 12 or so, apparently), but I’m nervous about sharing this news with him since I’m not covered by FLMA until 3 months after giving birth to my child. More on that, later…

I spent $2000 for a week at fat camp…

Did I really volunteer (pay $2000 to) work out 5+ hours a day and wake up at the crack of dawn six days in a row? I asked myself that quite a few times over the last week while I was doing my nth set of reps or sprints at the weightloss resort my friend and I had spur-of-the-moment booked a trip to — how could one week of health-based torture hurt?

I really wasn’t sure what I had signed up for — would it be military-style “yelling in your face” bootcamp, or something a bit more gentle? Would everyone there be morbidly obese – and I, just “barely” obese, would be the fittest in the bunch, outpacing the others and not pushing myself hard enough to get any value out of the program?

It turns out that the program we picked had quite the mix of people – from those who were really already quite fit seeking to lose a few pounds to people who were well over healthy weight. Many guests, to my surprise, were staying for multiple weeks — and quite a few were repeat visitors, which I saw both as a good thing (they liked the program enough to return) and a bad thing (they couldn’t stick to the healthy lifestyle on their own so they have to come back to the program again and again to lose weight.)

Even though I had quite a few qualms about the program, overall I think it was a very positive and worthwhile experience. My husband thought I was a nut to spend $2000 on a week weightloss program because you can’t actually significantly change your weight in a week. I know that. It took me six months to lose 40 pounds and six to put it all back on. But one can accomplish a lot in a week mentally. Sometimes you need to get out of your comfort zone to break through places you’re stuck.

While all the exercise was helpful in getting me from barely-able-to-move to sprinting for two minutes at a time again in a very short while, what really impacted me was the nutritional element of the program. We were fed breakfast, lunch and dinner every day, which amounted to about 1200 calories per day, and were provided with snacks (take as much as you want) which were limited to hardboiled eggs, almonds, fruit, and a few other protein items. We were supposed to be eating about 1500 calories per day.

When I lost 40 pounds last year, I did eat about 1500 calories per day on average, plus exercised 3 times a week for 1 hour (not 5 hours 6 days a week.) However, my diet was very unhealthy. I felt sluggish and hungry all the time. In this program, the chef made meals that were perfectly balanced so that we’d feel full and not hungry before our next meal, despite all the working out. I supplemented with two hardboiled eggs for breakfast and a fruit, and a serving of peanut butter before going to bed if my stomach was growling. We were also allowed unlimited access to the salad bar which was not so impressive but it did teach the lesson that one should fill up with salad before eating to help eat enough nutrients and feel full. Lunch always was a tasty soup around 75-95 calories and a main dish. Dinner included a main dish and a desert. Breakfast was a protein, a carb and a fruit, with one serving of fat – such as eggs, a piece of sprouted toast, small dab of butter, and a few pieces of melon.

For someone who typically eats NOTHING *or* Half-a-loaf-of-bread for breakfast (with half a stick of butter) — it was a new experience to be eating a healthy balanced meal every day at 9am, especially after already having worked out for two hours on a challenging (to me) hike.

By eating balanced, nutritious meals throughout the day, I rarely got hungry, and I also discovered my mood to be much improved. It may just be that I was on vacation, or that the endorphins from suddenly exercising five hours per day were making me loopy – but I could feel my blood sugar remaining balanced, which really helped me not experience the depression dips that I’m used to (and I went off my starter zoloft for the week because I didn’t think I needed it.)

At the end of the week I lost 3.5lbs (1.6% body fat) and about 2 inches in my waist. I still have a long way to go to be healthy (I wasn’t really healthy last year when I was 140 pounds, nor am I healthy now at 173.) But I’m going to try REALLY HARD to stick to this food lifestyle and eat 3 balanced meals per day. No more binging. No more wasting calories on sugar that mucks up my emotions. I really feel like I’ve experienced a substantial change and I’m ready to see this through – the rest of my life. I don’t want to be one of the people returning to the program year after year (nor can I afford it.) I want to be my own success story.

The Cost of Getting Healthy: Worth It

With my somewhat aggressive savings plan, my networth has eeked over the $480k mark, leaving “just” $20k left for the remainder of the year to hit my annual and “before giving birth*” goal of $500k. (*still not pregnant, so it’s looking more and more likely that I’ll hit this goal.)

While I’m far from frugal, I started doing some longer term calculations and realizing that perhaps I’m saving too much of my paycheck (is there such a thing?) I’m not a Mustachian — I have no desire to “retire early” — and maybe I don’t need $200k a year (after inflation) in actual retirement because I hope to always be able to work (albeit in a different, lower paid and more meaningful job once I’ve saved enough.) Continue reading The Cost of Getting Healthy: Worth It

The Slow March of Death: My Father’s Cancer and Necessary Denial of Mortality

Yesterday, I joked with my husband that it’s difficult to say “poor dad” in any scenario. My father, with his chronic narcissism, is quick to blame you with a massive guilt trip for any slight mistake, to debate your opinion to the ground telling you you’re flat out wrong, and to make thousands of careless mistakes only to get extremely angry at you if you dare to call him out on any of them. Yesterday was a day when “poor dad” would be the tinge of empathy I feel for him bubbles to the surface.

It has been nearly 10 years since the doctors told him that he has an aggressive form of late-stage prostate cancer and he had “two years” to live. He is 67, and with all his health issues – his obesity, his diabetes which he fails to keep in check, and the cancer which was supposed to take his life long ago, has surpassed the lifetime of Carrie Fisher and many others who have died too young. Still, there is never a good time to die, and despite his personality shortcomings we all want him to live as long as possible and as comfortably as possible. I had a bit of a breakdown years ago about his looming mortality, and then as time passed and the drug concoctions they put him on started to slow down the growth of his cancer we all just put the thoughts of death out of our minds. He briefly lost weight and seemed a bit happier. Then he returned his old habits – overeating, yelling horrible things at my mother, and being his typical anxious, narcissistic, grouchy self. Continue reading The Slow March of Death: My Father’s Cancer and Necessary Denial of Mortality

My Cousin Tried to Kill Herself

There is nothing harder to get through than adolescent depression. Not only are you dealing with the darkness that is a depressive episode, you are stuck in an environment where drama is amplified and your hormones are raging and you are trying to figure out where you belong in the world as you transition to adulthood. It’s really fucking hard.

Yesterday, my aunt texted to tell me that she was back in the ER with my 15-year-old cousin, I’ll call her Jen. I just visited Jen last week in a special group home for youth with various mental illness. I visited her twice in the 10 days she was in the home after previously giving her school counselor a note saying she had a plan to kill herself. The first visit went relatively well, but was short because I got there after work and they have an early curfew. Continue reading My Cousin Tried to Kill Herself