Category Archives: Health

$1000 a month on a psychologist?

I’ve written before on my concerns on over-spending on healthcare, particularly mental healthcare, as my income has ranged from $50k to $100k. Even though today I make more money than I did years ago, it still seems a bit unreasonable to spend $1000 a month on a psychologist. However, that’s how much qualified mental health costs in my neck of the woods. I just spoke with a local psychologist who sounds like he may be able to help me reduce stress and be more functional, yet he costs $235 a 45 minute session. Does it make sense to spend $1000 a month on mental health therapy when my rent is only $600?

You could argue in the long run I’ll make more money if I get appropriate mental health help. I may be able to keep my job longer… be more successful in my tasks… prove to management that I’m capable of sustained success and therefore worthy of a raise… etc. But it certainly won’t help my bottom line in the short term. And wouldn’t something like yoga (even at the really expensive studios around here) or straight-up personal training be cheaper and actually make me healthier in the long run?

Perhaps I’m just resistant to allowing therapy to work because I don’t want to believe I can pay for someone to tell me how to fix something that isn’t physically broken. That said, these days I’ve been about at my wit’s end and need help. I need help enough that I’ve started to call local psychologists. Yet, then I remember that they charge $200 a session, and that means $800-$1000 a month, or $12,000 a year. Even though my take-home pay is $4200 a month after 401k and taxes, that’s still a lot. How much should I spend on mental health?

The Hard Realities of Aging and Falling to Pieces

A recent article on “life before death” dementia and late-life illness struck a cord with me and my family. While I’ve always been fearful of death, the reality is that death isn’t just a one-time end. Even if you’re “lucky” to reach 100, for everyone, that means many years of degraded mental and physical health. It must be terrible to go through, but it’s equally as terrible for everyone else around you trying to help you progress slowly towards death.

My Grandmother, 83, has a gambling problem. In the last 10, mostly 5 years, she has gambled away her entire life savings of more than $300,000. Everyone knew she had a problem, but no one legally could intervene to help. Now, she’s broke, and at age 83, approaching the age of severe medical problems, even after leading a relatively healthy life (more thanks to good genetics than being healthy.) My mother and her sister’s had already been in uncomfortable discussions around what to do with her — as her social security did not provide enough money to pay for her two bedroom apartment in her Las Vegas retirement community, but she refused to move into a smaller space.

A few days ago, my grandmother fell down. She broke a bone in her neck, which was operable. On the scene of the fall, the paramedic asked her how old she was — she said 64. The doctor’s brought her to a rehab facility after she stopped being combative and arguing with them, and after one day there she told my mother via phone she had been there for weeks. The doctor diagnosed her with mild dementia. Now the question is not how she can afford the 2 bedroom apartment and a $2000 tax bill, but how to afford many years ahead of assisted living.

Meanwhile, her daughters — my mother, and her two sisters — are not in strong enough financial places to step in and help. My parents are concerned about their retirement savings as the stock market has not recovered, and they continue to spend like it is magically going to. I tell my mom over and over to not make the same mistakes her mother did, but she cannot see spending money on clothes and cleaning help as the same as her mother’s gambling away all her savings. In the end, the money will be gone, I tell her, so it’s the same. She ignores me.

For now, they need to figure out what to do with their mother as she gets increasingly senile. She’s always been a bit crazy, so adding real dementia to that crazy could get very bad, very fast. My mother is considering trying to get her to move out to New Jersey to be closer and find a lower cost place to stay, but all is up in the air right now. I don’t think my mother can really handle her mother at the moment, as my dad is in the later stages of terminal cancer and his cancer will likely get worse in the next few years or even months.

Overall, this is a very depressing situation, but so goes life.


Health vs. Savings

I’ll admit that since joining Mint shortly after I graduated college, I’ve become addicted to watching my networth go up. While the stock market has made that not always the case, in general my uncontrollable spending habits have taken a backseat to my savings addiction. While my increase in salary over the years has helped, I’ve gone from being the type of person who would throw money away to someone who carefully ensures she maxes out her IRA and 401k each year, with extra cash to “play” on certain stocks in taxable accounts. Overall, that’s great.

Where it hurts the most, though, is in my health. I’ve become so frugal that my brain tells me it makes more sense to put together a dinner of random snacks at the office versus coming home and cooking dinner (I’ll be too tired by the time I get home to do that anyway.) In one’s 20s, eating unhealthy and living unhealthy catches up to you. I’ve never been thin, but I definitely am noticing how as the years go on I put on weight much easier. Seeing the scale hit 180lbs was an eye opener. For years 155lbs was the number I’d hit if I were eating anything and not exercising. If i’m at 180 when I’m just 28, what will I be in my 30s?

Besides the number, the reality is that I’m already on my way to Type 2 Diabeties, I’m going to have tons of health problems later in life, I’m already so tired and lacking energy (I’ve been sleeping 9 hours per night and still feel exhausted each day), and what’s worse, it’s going to be incredibly difficult if not impossible to have children. There are so many reasons why getting healthy now is imperitive, yet each year goes by and I manage to come up with more excuses and find myself in a binge eating nightmare. It’s awful to admit, but I’m definitely a food and carb addict.

In 2 years or so, I’ll be getting married. There’s no ring on my finger yet, but we’ve already joked about the date, and we’ve been together six years(!) There’s a NY Times article about how brides will do anything to lose weight for their wedding day. I don’t want to lose weight just for my wedding day, but I do want to do it for my life. I’m even avoiding going home to see my family because I know they will make comments about how fat I am, one after another, with my dad, mom, grandparents, aunts and uncles all making some cruel comment about how I need to diet. Which is true. But nevertheless, it ruins an otherwise plesant conversation of how I’m doing well in my career and life otherwise (minus the depression and all that, but that’s easier to hide.) In the NY Times article, it calls out a bunch of popular fad diets that the brides were doing to lose weight. Most of them sounded absolutely ridiculous (a feeding tube through one’s noise and 800 calories per day? No thanks.) But one — the Dunkan Diet — sounded quite reasonable.

I’ve always been attracted to the idea of a low-carb diet because with PCOS and insulin resistance this actually is the healthy way for me to eat. My body is funny in that I don’t actually mensturate due to the PCOS, but the only times in life I’ve been able to actually have a natural period was by cutting out carbs and amping up on protein (mostly dairy.) I also briefly went gluten-free, which made my stomach flatten out quite a bit. I bet it had more to do with cutting out carbs versus the gluten, but it made a huge difference. So why is it so hard to just eat healthy and cut out carbs? It seems like if it’s clear this makes me feel better and healthier, I should just do it, right?

Part of it is the difficulties anyone has going on a diet. There’s fatty food EVERYWHERE. We have lunch at work and it always comes with a lot of high-carb sides. I tend to dislike the protein (how it’s cooked) and end up eating only bread, butter, and potatoes (plus junk food from our snack cabinet later in the day when I’m hungry again.) No wonder I’m fat.

Alcohol plays a huge role in my obesity. I don’t normally drink often, but lately my work culture is to go out to happy hour a few times per month, or to have beers at the office at the end of the day. While I can “not” drink (and I should not drink!) this is exceptionally difficult in my professional environment. For a few months after my DUI, I did stop drinking entirely, and it was awkward to order water when the team went out for beers. Yes, I could easily say I need to drive home, but so does everyone else and everyone else had at least one beer.

Finally, and this is a biggie, my lack of healthy eating goes back to not wanting to spend money. I’d love to have fresh produce and lean meats in my diet daily (especially fish!) but shopping for this brings my monthly grocery bill up by a few hundred dollars. I do end up spending a lot on dining out, but those costs are usually split between my boyfriend and myself. Worse, because we live separately, I often end up buying food and it going to waste because I’m always at his house and I’m never home. The worst is when you spend a lot on food and then it all spoils because you haven’t had time to eat it or prepare it.

Alright, enough with the excuses, right? I really want to commit to a diet for the next year and see how I can transform myself. I’d also like to start swimming in the mornings (there’s apparently a pool with practice in the ams before work near my office — it will be another relatively large monthly expense to join and hard to get myself there in the mornings for the workouts, but if I can do it than the cost will be worth it!).

I’m very interested in this Dunkan diet. It isn’t that new, but it’s gotten a lot of attention lately. It’s very similar to Atkins or South Beach, except it focuses on a healthier way of doing low carb (ie one cannot eat a lot of fat.) There are 100 foods that are allowed at all times and you can eat as much of them as needed until you’re full. Oat Bran is apparently an extremely important element of the diet as it fills you up. The diet starts with an “attack phase” where for 10? days all you eat is protein and oat bran. I’d be amazed at myself if I could get through that phase. It’s supposed to kick start your metabolism. Ultimately, though, what I like abut the diet is that it’s designed to set you up for a life of eating healthy and maintaining your ideal weight. They have a quiz on their site about what your ideal weight is, and although I’d really like to be 120lbs, my big-boned self will have to settle for 130lbs as a healthy person. Seriously, though, that’s 50lbs to lose and that’s still a lot. That said, if I were able to follow this diet and swim for an hour three days a week I know I’d be able to lose the weight. It WILL cost a lot, and I won’t be able to save as much, but ultimately who cares how much money you have if you’re a big, fat lethargic blob who is diabetic, depressed and cannot have children? I guess when I put it that way, it makes a lot of sense to invest in my health. If I don’t max out my 401k, the world isn’t going to end.

HSA, FSA, and the Cost of Being Healthy

There are a lot of different versions of health benefits available these days. Even when you are fortunate enough to have insurance through a company plan, it seems basic healthcare costs have skyrocketed over the last decade. For instance, my co-pay to visit any sort of specialist is $50 a visit. Assuming I ever need to go to a specialist for more than one visit, which is often the case if you need to see a specialist, that adds up fast.

My last company offered an HSA plan, where instead of paying for a more expensive plan, they’d put $100 per month into your account. The deductible was high, like with all HSA plans, requiring a $3000 spend per year before additional fees would be covered at all. So it was basically a high-risk plan, with an HSA savings account that, theoretically, would be beneficial as a separate retirement account if you were healthy and didn’t need to touch the money. You could either leave the funds inside it to gain basic money market interest, or you could open an investment account where you could put the money in a handful of mutual funds available.

The good news is with HSAs, even when you no longer have the insurance plan open with them, you can still use any money put inside there for medical costs in the future. Plus, the money that goes in is tax free and as long as you use it for a qualified medical expense the money that gets spent is tax free too. But there’s a catch… Continue reading

Facing Reality of Cancer as Autumn Leaves Burn to Umber

As I’ve written about previously, my father has cancer. He was diagnosed three years ago with advanced stage prostate cancer. If you’ve been reading my blog, you know I have an interesting relationship with my dad. I wouldn’t say we’re the closet father-daughter pairing in the world, but regardless he’s still my father and I’ve always imagined watching him grow old and having him around as the grandfather to my future children — he was always good with really little kids. I wanted him to meet my kids, and for them to have him as a grandfather. I’ve always known he’d be a much better grandfather then father.

But everyday that goes by, I know this is more and more unlikely of how life will pan out. With cancer, you can be fine one day and the next your conditions can deteriorate rapidly. Living far away, I try to visit often, but in between there is little conversation. He doesn’t like talking about his emotions or what he is going through, though lately he’s admit to being depressed. He won’t admit to being depressed about dying, per say, more so that the drugs they have given him have removed his testosterone and have “feminized” him. Really, though, I know he’s equally, if not more depressed because he’s terminally ill. But I don’t know how to deal with that. He doesn’t want to talk about it. I want to be a support for him, but I don’t know if I can handle it, even if he was willing to talk.

The day today on the east coast is cool and crisp, with a heavy grey sky, and bright yellow leaves on the trees falling off in the wind to dry and die on the ground. Another year has come and gone — and things are slowly changing. Everything is aging, myself included. I don’t like change, but I’m not resistant to it. I’m more in denial about it. That will all change the day my father’s condition gets worse — which is any day now. That will all change when I need to decide how important it is for me to be out here with him through his final days, however long they may be, or to maintain my life across the country, far from his inevitable deathbed. I don’t like to think about it, but it’s getting to a point where I’m going to have to. I don’t know if he would want me here, he hates being seen as weak. But I’d want to be here. It’s strange knowing that in the next year or two, this is something I will have to face. It’s part of life, but he’s still young at 60, and I’m not ready for him to go. I keep hoping that someone will discover a cure for prostate cancer, and everyday there’s a new treatment available, but never a cure.

Occupy Doctor’s Office & Health Insurance Agencies

They say the occupy movement is unfocused — it’s about all these various things we’re upset about — but a lot of the movement is about the lack of transparency in between bureaucracy and us common folk.

When I got home yesterday, I went through my mail and discovered a “explanation of benefits” mail from a recent “surgery” I had on two pilar cysts on my head. The doctor’s office never knows about costs — they don’t really care about how much you end up getting charged, as long as you pay it. Even with medical insurance from work, the two cysts removed cost me $550. Last time I had two cysts removed it was $300, so I was a little surprised that the cost went up $250. But I haven’t found a way to identify how much any medical interaction will cost in advance of the treatment… it always has to be a big surprise after the fact.

Another example… I went to a regular yearly gynecological exam a while back, which is covered by my insurance. Or is it? The gynecologist decided to do an ultrasound to check out my polycystic ovaries which — big surprise — still had cysts on them. That procedure wasn’t covered by the free annual checkup description, as it was considered diagnostic, and ended up costing me a few hundred bucks. Continue reading

Health, Diet, Life: A New Road to Thin

Many of us have issues with our bodies. Either that keeps us fit or causes us to slip off the diet deep end. I’ve struggled with my weight and eating all my life, even more than my money issues. They seem to be heavily connected.

For starters, I was raised with the notion that it’s the worst thing in the world to not finish all the food on your plate. Leftovers are ok, but my family always overate so leaving any food on the plate just seemed odd. So I grew up somehow assuming that restaurant portion sizes (and parental portion sizes) were what I should be eating. Of course I know better now, but it’s hard to change that mindset.

After spending a week at home with my father calling me fat about 20 times, it continued to upset me when he’d also comment on how I should have “half” of his dessert when we went out to eat. My father, morbidly obese throughout his adult life and now dying of cancer among other things, surely had good intentions — he doesn’t want me to be fat like him. But the way it comes out of his mouth always feels like an awkward jab, not to mention his constant oohing and ahhing over how “good” my sister’s figure looks (girl isn’t exactly healthy but she eats one meal a day, so she’s much thinner than I am.)

What hurts me the most is growing up with no idea why I was gaining so much weight – especially around my mid-section. Whether the PCOS caused my fat or my fat caused the PCOS is a chicken or egg discussion that’s null. The fact of hte matter is my father took me out every week for McDonald’s where he’d let me get two cheeseburgers, supersized fries and a supersized coke, he wouldn’t push me to exercise (“we just aren’t an athletic family”) and then he’d constantly make comments about my weight. It’s sad to think that although I knew my candy and fast-food eating ways weren’t the healthiest, I had no idea HOW unhealthy they were, or that a certain number of calories would make you gain weight. I don’t want to think about how many calories I was eating when I was 6-11 years old, the years I ate those supersized meals.

Regardless of all that, my challenge is facing my eating issues (just as I’ve faced my money issues) without letting my parent’s voices get in my head. Even if it feels like I’ll be losing the weight for them, it’s really for myself — I’m the one who, long after their gone, will be struggling with tons of health problems from all this built up, artery clogging visceral fat. This is really a change in my lifestyle that I needed to make years ago, but I think as I approach 28 (and the curves on my body start looking like they belong on The Biggest Loser) the change is not an option.

Luckily, my boyfriend – also overweight – is committed to getting healthy as well. He’s not going to play any games about it. If I ask him to run with me, he runs (unless it’s in the morning!) I also met a new workout buddy through Craigslist who is getting married in a year, which is great motivation for us to stick to our workouts (I have less than 4 months to lose 40lbs for my high school reunion.)

My commitment for the next month is as follows:

  • Walk/Run *at least* 2 miles 6 days a week
  • Aim for 4-6 miles a day 3 days / week
  • Basic muscle toning workouts 2-3 days / week
  • at any given meal, eat half what i’d normally eat. leftovers are my friend.
  • minimize gluten intake and cut out all sugars except limited whole grains
  • try to eat 5-6 small meals per day (really small)
  • drink 3-6 glasses of water per day

Who would I be today if I stayed on Ritalin since I was 8?

After being prescribed Adderall IR yesterday and subsequently taking a rather high dose in order to understand my brain chemistry and the effects on the weekend, I’ve been up and then down on one prolonged ride. In seeking more information, I’ve read countless stories of people with ADD who say how they’ve been on Ritalin or Adderall since they were very young… 6, 7, 8… and I think to myself, wow, that could be me. And although I have a sinking feeling that I might have made permanent honor roll with the help of the medicine, I’m so glad that I had the opportunity to be a little lost… to appreciate exactly why I’ve chosen to alter my brain chemistry now as an adult, instead of not knowing who I am sans medication as a child.

I don’t know how I have no recollection of the days… months(?) when I was on Ritalin as a kid. I was in 5th grade… I do recall the black and yellow pill, and how the nurse would open it up and put it in apple sauce for me to eat in the middle of the day. I liked the apple sauce, though the medicine texture was gross. I have no memory whatsoever of a chance in my ability to focus on the drug. Which is strange given how sensitive I am to meds, and the clear change I felt about 10 minutes after taking just 10mg of Adderall this morning. It  must have done something to me back then as well, but for whatever reason it didn’t turn me into an all star student, and I ended up stopping because it wasn’t helping… or maybe the dosage was never high enough, or I didn’t take it on a regular basis… I don’t recall.

But who would I be today had it worked? Who would I be if in 5th grade some pill worked like magic in saving me from my distractions and daydreaming? Maybe I would have ended up excelling in math and science, spent less time in art, instead dreaming of becoming a doctor or engineer… I’d have vivid memories of my life, as opposed to a film missing so many scenes.

And I’d also… never know who I am as an individual apart from the drugs. It’s sad that there are a lot of kids… and adults out there who had their parents keep them on the meds through the years. I’m excited to move on to this new phase of my life which will be medicated, just to see the person I become. I’m still very grateful to have had the chance to be the person that I’ve been… despite how messed up she is when she’s on her own.

Your Drug is My Love

This morning, I’ve achieved clarity, all with the help of two tiny blue pills.

I’m pausing to reflect — not because I feel a urge to stop being productive — but just to note my state of mind and then return to productivity.

For the past 27 years I have been a roller coaster of mood swings stemming from my lack of control. Control over my intentions and my actions. The fog which I live in. The way in which time seems to pass faster and faster as I daydream in a haze, terrified of tomorrow.

Today, a new life begins. Or so I hope. So I hope this isn’t only a sugar pill reaction. My mind convincing itself it can be saved. I don’t think it’s that. Too many people are helped by this drug. Too many Ivy Leaguers swear by its ability to help them focus for this to be created in my mind.

It was 10:48am 8 minutes ago. It is now 10:56. Yesterday, the same time would pass and it would be 12:30pm. I feel like seconds are seconds again. Minutes aren’t escaping to distraction, to anxiety, to a thousand thoughts in my head battling for attention, binge eating the clock until the sun goes down and it’s suddenly 4am.

What is this new life of mine? Can I really be this changed? Can I now face my fears of inadequacy from a level playing field? Only time will tell. Time that’s now mine.

The drug will wear off, I’ll grow numb, I won’t remember life without this clarity, or this new kind of fog. Somehow the anxiety is gone. Somehow I feel ok despite my mile-high to-do list.

And for years doctors have put me on anti-depressants, anxiety meds, all these things that just flung me further into the haze, made me feel like a tired zombie. “We have to combat the depression first,” they’d say. As if somehow my depression was caused by something other than my lack of attention. All these years… failing over and over again. And why? The clutter in my mind became the clutter in my life. A thousand songs playing at once.

Now, all I hear is the laundry machine, the birds chirping, the soft California winter air, and I’m only a tiny bit sad for all the lost years, now knowing what it’s like not to be lost. I can only hope this is real. I can only hope this feeling stays constant when it’s Monday, and I’m sitting at my office desk, with a thousand tasks and distractions, already so behind, in order to save my career, my life, and my mind.

Psychiatrist Visit + Meds = $380

How much should mental healthcare cost? I’ve been in and out of therapy for my entire life, though rarely on meds. Most psychiatrists have put me on anti-depressants because I’ve gone to them when I was at my wits end, unable to focus, feeling like a failure, and rather hopeless. Finally I got myself to a psychiatrist before I was at that point… and was able to talk about my real problem… my ADHD.

I was diagnosed with ADHD in 5th grade and it hasn’t gone away. In fact, my entire life has been a blur inside my head. I’ve never been able to focus long enough to take in information or to learn. How I’ve gotten this far is anyone’s guess. But after losing job after job, and always on the verge of yet another failure, I decided it’s time to do something about my problem. I didn’t realize just how much it was going to cost.

My 90-minute initial consultation with the psychiatrist (who has had a maid for the past 30 years — she mentioned this as we were discussing my problem keeping my room organized and my trouble putting away my clothes right after they are dry, instead throwing them on the floor to get messy again) cost $285. Follow up appointments (I only need one a month, thank goodness) will be $125 for 30 minutes.

When I went to fill my prescription for amphetamine salts (aka generic adderall) I was surprised that my 30 day supply cost a whopping $87. Aren’t generics supposed to be cheap? I didn’t get Adderall XR because there is no generic of that version… I have no idea how much that would cost. This is all without insurance, but it’s still tough to spend that much of my monthly income on my mind.

Then again, if these pills will help me keep my job… and be successful in my career… then even $400 a month is worth it. I just can’t imagine how anyone affords medicine, especially if they need more than one type of pill per month.