Monthly Archives: September 2009

Cats

Tangerine: April 1995 to September 2009

1 Comment

Tangerine: April 1995 to September 2009

Here’s all I can really say about Tangerine.

She was a beautiful cat. She really was my favorite. I bonded with her in a way I’d never bonded with another cat. We both had respiratory issues; I have asthma and allergies, and Tangerine was permanently sniffly due to some upper respiratory issues she had as a kitten. We described her funny little noises as “snorfles”, and we could always tell when she was coming by her snorfles and sniffs. She was not a stealhy cat. And every now and then she would seem to get “oversnorfed” and would end up in a sneezing and sniffing fit that we could hear all over the house. Because of her breathing problems, she had a very loud and squeaky purr that we could hear from just about everywhere in the house.

Most mornings after waking up I spend half an hour or so puttering around on my computer. Tangerine would often jump onto my lap when I was doing that, and sometimes she would crawl onto my chest and lay ther purring, which would prevent me from sitting upright or standing up; she was a great excuse for avoiding my morning chores. If she didn’t jump up on me, she’d rear up and put her front paws on my leg, or just wander around the office, making her silly snorfs and squacking noises. Feeling her settle in on my chest and curling up and purring was one of my favorite parts of the morning, and it never failed to cheer me up.

She wasn’t much for playing or overt affection; she liked being on me, but she wasn’t too keen on being carried around or held. She hated being on her back, but sometimes she liked being on her side. Let’s say she liked affection but it had to be on her own terms. And even though she came with Jennifer to our marriage, Tangerine and I really bonded to the point where it was clear that she was really my cat more than she was Jennifer’s.

When she had her first seizure on Tuesday morning, we both panicked. I called the vet and brought her in as soon as I could; it was an hour until they opened, and during the entire time I worried. I took the day off work so that I could take care of her when she came home, and check in with the vet for the half day that she was there. When I went to the vet, the vet informed me that Tangerine’s heart was enlarged and she had some fluid buildup in her lungs, as well as a significant heart murmur. But we thought maybe it was something that could be managed at home, so Tangerine came home with me.

That night, while Jennifer was at her class, Tangerine had another seizure. Panicked, I call an emergency veterinary hospital. I took Tangerine in and let the ER techs take care of her while a vet took a complete history (every vet who’s examined Tangerine needed assurance that her “snorfles” and sniffles were normal for her). We worried and waited all day Wednesday while the hospital staff examined her and tried to figure out what was wrong.

By the end of the day on Wednesday, we had an answer: endocarditis. Endocarditis is essentially a bacterial infection of the heart valves. Bacteria build up, and as the heart beats, bacteria can break off and enter the blood stream and end up establishing colonies elsewhere in the body. The best theory is that bacteria or a clot had entered Tangerine’s brain and was causing the seizures. They started giving her antibiotics and some other medications, but she showed no improvement. Despite two rounds in an oxygen tent and continued medications, Tangerine showed no improvement; in fact, she was declining pretty rapidly. And on Thursday morning I asked the vet what he would do if Tangerine were his cat; and he told me that he would honestly consider euthanasia. And I knew it was the right choice. Tangerine would not get better. And the time she had left would not be pleasant. So I asked the vet to just keep her comfortable until the evening when Jennifer and I could be there, and I spent almost the entire day in tears; I honestly don’t remember when the last time was that I cried so much in a single day.

Last night we went to the veterinary hospital. The vet let us have a few minutes with her before it was time. I held her on my chest the way she occasionally liked to be held. She didn’t purr. She couldn’t purr; it was too hard for her just to breathe. We stroked her and gave her pets and told her how much we loved her. The vet let me hold her on my lap while he gave her the injection, and it was almost like the mornings and evenings when she would sit on me and purr and accept friendly pets. We both gave her pets and strokes while the injection did its work, and I take some comfort knowing that she was being held and surrounded by people who loved her when it was time for her to go.

There’s so much more I wish I could write about Tangerine: the little games we played; the way she sat on a pillow in the middle of the couch, staring at the back of the couch for hours on end; the friendly way she engaged people whenever we had gatherings or parties by sitting on the coffee table in the middle of the room; the way that everyone who met her seemed to want to take her home; how proud she seemed to be of her very fluffy tail; and so on. But writing this so far has been painful enough.

So long, my snerky and snorfly fuzzy friend. You’ll always be my fuzzy buddy, and words can’t express how much I miss you.

Politics

Lungs O' Doom

1 Comment

“Can Primatene Mist contribute to airway remodeling?” I asked the nurse.

She looked horrified by my question. “You’re not using Primatene are you?” she asked.

I shook my head. There’s no need for me to use Primatene. I have pretty good health insurance through my employer, and I happen to live in California, where it is illegal for employer-provided health insurance to refrain from covering pre-existing conditions. And since I’ve had asthma since birth, it definitely counts as a pre-existing condition. So fortunately, my insurance will pay for me to use Proventil, an albuterol-based inhaler which is considered the front-line medication for asthma patients having serious attacks (though recently my co-pay increased from $10 to $20, a result of a new remix using more ozone-friendly propellant, meaning the drug no longer qualifies as a “generic”).

Primatene Mist, by contrast, is an over-the-counter inhaler meant to treat mild asthma attacks in patients whose asthma is pretty well under control without medical intervention. It is NOT recommended for people with diagnosed asthma, because in patients with moderate to severe asthma, it can just do much more harm than good. And while it doesn’t contribute to airway remodeling (a phenomenon where the airways in the lungs change permanently due to chronic asthma-induced inflammation, leading to decreased airflow and lung capacity, and often alarming physicians who take X-rays of my chest), Primatene can cause long-term damage in asthma patients. This is why the nurse told me in response to my question.

Years ago, though, there was a time when I relied on Primatene Mist. I’ve had asthma since birth, as I’ve mentioned, and when my student insurance ran out after I graduated from college, I had no way of treating myself. I couldn’t afford to go to a doctor. I went deep into debt for the occasional hospital visit due to severe attacks; at such visits, I’d get a prescription for an albuterol inhaler, but I wouldn’t get them filled because I simply couldn’t afford it. (Of course, because I was unable to pay for my ER visits, the costs simply carried over to other patients). So I used Primatene. It was available without a prescription, I could afford it, and it worked for short-term relief. It caused damage to my lungs, worsening my asthma in the long-term, but it’s all that was available to me at the time.

MediCal was recommended to me as a way to get medical coverage during this time. Unfortunately, I was earning too much money at the time to qualify for MediCal; I was working two part-time jobs, neither of which provided any insurance, but I needed the income to pay rent (even though I had two housemates to help cover the cost of rent and utilities). It was  a choice for me between MediCal and shelter. I suppose there would have been resources to help me keep a roof over my head while I sacrificed part of my income so that I could get proper treatment for my asthma, but I wasn’t too keen on going on welfare. And, of course, I could not afford private health insurance, since my asthma counted as a pre-existing condition that would have made my premiums prohibitively expensive (and yes, I did look into it).

Fortunately, after a life-endangering episode, I finally got in touch with Dr. G., a local allergist and pulmonologist, who agreed to see me for a minimal cost. Dr. G. gave me the sample medications that drug reps gave him when they came to visit, including an albuterol inhaler so that I no longer had to use Primatene. And because he knew my financial situation, he agreed to see me monthly for the absolute minimal cost that he could — $10 per visit. This meant he wasn’t charging me for any of the tests that he performed, the spirometry and blood pressure and other tests that he performed regularly to keep tabs on my asthma. It was, as I understood it, at least partially dodgy for him to do so since he had to account for all of these tests, but believe me, I appreciated it. Of course, my asthma was aggravated by severe allergies, and, of course, he couldn’t give me the immunotherapy (allergy shots) that I really required to keep my asthma under control; and the drugs he gave me were barely adequate. In short, my asthma was under control, but just barely, and any irritation was liable to cause a serious flare-up which might require a hospital visit.

When I finally got a full-time job that offered health insurance benefits (after years of working part-time for a newspaper where I was regularly exposed to particulate matter in the form of paper dust and ink mist), Dr. G. was thrilled because now I could get the top-of-the-line medications he wanted me to have, and start on immunotherapy. I was thrilled to, although with my employee contribution to health insurance and all of the co-pays I was now paying for office visits and prescriptions, I was earning just under what I’d been earning before with my two part-time jobs. Still, six years after I graduated from college, I finally had adequate health coverage.

All of which is just to point out that the health care system in our nation is a joke. It’s full of pitfalls and traps. You might be able to qualify for state-run health care, but you have to go on welfare to do so because the job you need to pay your rent simply pays too much, putting you at just above the poverty level. If you have children, you have a better chance of getting assistance from the state, though if your child has a major condition — such as asthma — then you’re in trouble (my mom was still paying off my childhood medical bills even when I was in high school). God forbid you have to go on private health insurance, especially if you have a pre-existing condition, which pretty much rules out any notion of self employment. And me, I’m pretty sure that I’ll be working all my life instead of retiring, since I’m sure my asthma and other conditions will simply be too expensive to treat under MediCare or Social Security, without supplemental income. That is, if these conditions don’t kill me before retirement age anyway.

And from what I can tell, I’ve been lucky. I’ve known people with worse medical conditions than mine who can’t get any coverage at all. 68% of bankruptcies in our nation are caused by astronomical health care costs. Of those, 70% of the people filing for bankruptcy have health insurance. 50 million Americans have no form of health care coverage at all, and the majority of those people are children. And children who are sick pose health threats to other children, to say nothing of people in low-wage jobs who have no insurance (or inadequate insurance), who must stay on their job anyway because they can’t afford to take any time off.

The health care debate in our country isn’t just an issue of poor people not having access to adequate health care, it’s a public health issue as well. Diseases spread. Untreated diseases spread further and more aggressively. Even if you have adequate coverage, exposure to someone who is uninsured and sick and still preparing your food or driving your bus will make you sick as well.

That’s why I am totally in favor of health care reform in our country, and why I favor a public option as well. Vague threats about “socialized medicine” don’t scare me at all (and, to be honest, I’m convinced that most people throwing around the boogeyman of “socialized medicine” don’t even know what the term means). I don’t give a tinker’s cuss about insurance companies that link health care to profit and deny previously-guaranteed coverage when an illness becomes too severe. Our “system” is not any sort of system; it’s a convoluted mess of half-assed measures, cracks, and loopholes for executives.

Thus, I support President Obama’s goal of reforming the US health insurance industry to provide affordable health care coverage for all Americans. I’m not a Communist or a Socialist (and again, I think most people who use these terms as perjoratives have no idea what they really mean), though neither am I a Libertarian or a hard-core capitalist. I’m simply an American who believes that when all other Americans have access to adequate health care coverage, the entire nation will benefit.