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zoux
Apr 28, 2006

You guys are also leaving out how every president has a doctrine, and they all apply to wildly different spheres of government and policy.

https://twitter.com/JenniferJJacobs/status/1674122828835180550

I do not have sleep apnea (and in fact have been getting the best sleep of my life for the past few years) but people I know who have say this can be a lifechanging treatment. So it's good that the very old most powerful man in the world will be getting oxygen in his sleep - in this goon's opinion.

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Leon Trotsky 2012
Aug 27, 2009

YOU CAN TRUST ME!*


*Israeli Government-affiliated poster

zoux posted:

You guys are also leaving out how every president has a doctrine, and they all apply to wildly different spheres of government and policy.

https://twitter.com/JenniferJJacobs/status/1674122828835180550

I do not have sleep apnea (and in fact have been getting the best sleep of my life for the past few years) but people I know who have say this can be a lifechanging treatment. So it's good that the very old most powerful man in the world will be getting oxygen in his sleep - in this goon's opinion.

He's apparently had really tiny nasal passages for a while and got surgery for them. Kind of surprised that he had the surgery before trying a CPAP and didn't try the CPAP until after the surgeries and 15 years had passed.

Most people just get the CPAP first.

https://twitter.com/ABC/status/1674135502482558978

Byzantine
Sep 1, 2007

yronic heroism posted:

Another way to look at it is that while US population increased by something like 65% from 1972 to 2020, Biden vote total over McGovern is about a 180% increase. Those are more stark numbers than trying to quantify how enthusiastic everyone is.

I have to believe that that was driven by anti-Trump sentiment, because the alternative - that an overwhelming amount of this rotting country are actually enthusiastic over Joe "Nothing Will Fundamentally Change" Biden - is just... horrible.

FizFashizzle
Mar 30, 2005







Leon Trotsky 2012 posted:

He's apparently had really tiny nasal passages for a while and got surgery for them. Kind of surprised that he had the surgery before trying a CPAP and didn't try the CPAP until after the surgeries and 15 years had passed.

Most people just get the CPAP first.

https://twitter.com/ABC/status/1674135502482558978

People hate wearing their mask, no matter what I goddamn told them. I had patients who’d literally tell me the world looked brighter once they got on cpap and others who’d rather pass out a hundred times a day than wear their mask.

Very uncommon for nasal passages to get smaller with age; quite the opposite actually. I’m having a hard time believing he had his sinuses cleared out 15 years ago and one of the alternatives was to try cpap. That’s a fairly benign procedure. Also not really sure why he would have had that for the first time in his mid sixties. Most people need it done multiple times through their life (raises hand.)

On the other hand, just from public knowledge biden is contraindicated from ever going under general anesthesia for an elective procedure.

On the OTHER other hand, cpap use can be used off label in patients with mild cognitive impairment to improve cognitive functioning. The benefits are modest but when you’re the leader of the free world anything can be helpful. And biden is kinda struggling.

https://twitter.com/unusual_whales/status/1674088517280972802?s=46&t=JBd6ZXmGQ3LmWL-ineTnAA

People his age just don’t sleep well or on a good schedule generally. Sounds to me they’re just doing everything they can to get him through next November.

Everyone wear your CPAP! Wear it! Always put it on!

FizFashizzle fucked around with this message at 20:49 on Jun 28, 2023

Jaxyon
Mar 7, 2016
I’m just saying I would like to see a man beat a woman in a cage. Just to be sure.

zoux posted:

I do not have sleep apnea (and in fact have been getting the best sleep of my life for the past few years) but people I know who have say this can be a lifechanging treatment. So it's good that the very old most powerful man in the world will be getting oxygen in his sleep - in this goon's opinion.

I do have sleep apnea, because I'm currently a fatass, and yes it's a huge huge difference. Apnea can put a ton of strain on your heart and that matters if you're a shambling corpse-like lich, as most of our political leadership is.

Artist rendering of the presidential bedroom:

Leon Trotsky 2012
Aug 27, 2009

YOU CAN TRUST ME!*


*Israeli Government-affiliated poster
It's been a few months since Eric Adams did something weird in New York City at he just wanted to remind everyone that he is still the Mayor, still really into good vibes, and still a weird guy.

https://twitter.com/NYTMetro/status/1673869840665247745

quote:

‘Mindful Breathing’ Will Now Be Required in New York City Schools

“There’s a science to breathing,” Mayor Eric Adams said when announcing the initiative, which will begin next year as a way to improve student well-being.

Take a deep breath. Relax your body. And slowly exhale through your mouth.

Then, repeat six times.

In New York City, kindergartners to high school seniors will be required to do similar exercises during class next fall, after Mayor Eric Adams announced on Tuesday that all public schools would have to offer two to five minutes of mindful breathing work each day.

Mr. Adams, who has often preached the benefits of healthy eating, mindfulness and fitness in his own life, cast the plan as a simple, “low-hanging fruit” pathway to build students’ emotional skills and to address a youth mental health crisis exacerbated by the pandemic, pointing to research that shows breathing exercises can reduce stress and raise alertness.

“Thousands of years ago, other cultures were learning how to breathe,” Mr. Adams said at the announcement at P.S. 5 in Bedford-Stuyvesant, Brooklyn. But in today’s world, he said, “we have never been taught.”

“We think that it’s just, air goes through your nostrils and you move. No, there’s a science to breathing,” the mayor added, before closing his eyes and following a student-led breathing exercise.

The announcement on Tuesday came as some advocates and families have argued for a more robust local approach to youth mental health, and have criticized the proposed elimination in the city budget of funding for a program that connects high-need schools to mental health clinics and offers mobile response teams for students in crisis.

But Mr. Adams said the effort was just one common-sense, low-cost way to improve student well-being, and would help children learn the valuable but abandoned “principle of something that is one of the oldest things in humankind.”

The breathing exercise requirement in New York reflects the renewed focus that school districts across the nation have placed on student well-being in recent years, as they grapple with increased rates of anxiety, depression, self-harm and other mental health challenges in children and teenagers.

In Los Angeles County, for example, virtual mental health services will be made free for all K-12 students under a new plan earlier this year. And in Illinois, a new law allowing students to take up to five excused mental health days off school recently went into effect.

In the nation’s largest school system, Mr. Adams and the schools chancellor, David C. Banks, have said that all high school students would soon be able to obtain virtual mental health support for the first time through a new program, though full details have not yet been announced.

“I get asked a lot of questions about, ‘What are you doing? Kids are going through a lot. What are your mental health programs?’” Mr. Banks said. “There’s nothing more important that we could teach our kids than mindfulness, deliberative breathing.”

Still, some elected officials, teachers and families have called for a more comprehensive approach to addressing mental health needs, and of disadvantaged students in particular. The New York State comptroller, Thomas P. DiNapoli, found that during the 2020-21 academic year, city schools were underprepared to address the youth mental health crisis. Since then, education officials have made several changes, including giving every school access to a social worker or mental health clinic.

Dawn Yuster, the director of the School Justice Project at Advocates for Children, an education advocacy nonprofit, said she remained particularly worried over the administration’s proposed $5 million in cuts from a mental health initiative at about 50 high-need schools, where rates of police intervention for students in emotional crisis are disproportionately high.

The program gives students access to faster mental health care, linking schools with clinics and providing mobile crisis teams who can help with immediate issues. A mayoral spokeswoman did not immediately return a request for comment on the proposed cut.

Ms. Yuster said she appreciates that breathing exercises and mindfulness can have a “real impact” for students. But she added: “That’s certainly not a replacement for other really critical programs and services that are at risk of being discontinued.”

MixMasterMalaria
Jul 26, 2007

Kalit posted:

Yea, he seemed to be. One of my friend's dads who grew up in the Cleveland area despised Kucinich, despite aligning close to him politically. He had met him a handful of times and said he was just an rear end in a top hat of a person :shrug: I realize this is second hand, so if someone who's personally familiar with Kucinich wants to correct me, please do so.

Regardless, if I had this knowledge in 2008, I still wouldn't have changed my mind on supporting him.

Me and a documentary producer friend had drinks with Dennis and Elizabeth Kucinich in 2016 and my impression was that they were both really nice, funny people. Dennis had kind of a sarcastic self-effacing style but seemed disenchanted with the democratic party. They didn't say anything about vaccines or alternative health.

Willa Rogers
Mar 11, 2005

FizFashizzle posted:

On the other hand, just from public knowledge biden is contraindicated from ever going under general anesthesia for an elective procedure.

I thought he went under general anesthesia for his colonoscopy. What's the public knowledge that contradicates him? His age?

quote:

On the OTHER other hand, cpap use can be used off label in patients with mild cognitive impairment to improve cognitive functioning. The benefits are modest but when you’re the leader of the free world anything can be helpful. And biden is kinda struggling.

https://twitter.com/unusual_whales/status/1674088517280972802?s=46&t=JBd6ZXmGQ3LmWL-ineTnAA

That might explain this weirdly phrased sentence from the abcnews story about apnea:

"The issue appears not to have been noted by White House physician Dr. Kevin O'Connor in his summary after Biden's most recent physical in February."

Mellow Seas
Oct 9, 2012
Probation
Can't post for 10 years!

Willa Rogers posted:

It's brave of them to rely on economic branding with two out of every three people disapproving of his handling of the economy and three out of every four people perceiving the economy as poor.
If 3 out of 4 voters think the economy is bad when far more than 25% of people are happy with their financial situation, unemployment is under 4% and inflation has fallen below global (or Reagan-era) levels, and there’s an election in 16 months, isn’t it appropriate to start making the argument that people are underestimating the strength of the economy?

I’ve never heard a Republican president say “well shucks sorry guys we want to do better” they say “the economy is great, because of us,” and wow whoda thought, after 50 years of that people think Republicans are better on the economy despite the mountains of evidence to the contrary.

It’s okay to campaign.

Byzantine posted:

I have to believe that that was driven by anti-Trump sentiment, because the alternative - that an overwhelming amount of this rotting country are actually enthusiastic over Joe "Nothing Will Fundamentally Change" Biden - is just... horrible.
People were super excited about Trump and that got him millions less votes than it got his opponent. And Biden has also been far more effective in office than his “exciting” predecessor. So maybe a candidate being exciting isn’t what we should be looking for.

zoux posted:

So it's good that the very old most powerful man in the world will be getting oxygen in his sleep - in this goon's opinion.
Whoa whoa whoa, let’s not go crazy with these hot takes!

Mellow Seas fucked around with this message at 21:17 on Jun 28, 2023

Willa Rogers
Mar 11, 2005

57 percent of Americans are living paycheck to paycheck.

This is considered to be positive news because it used to be slightly more.

Velocity Raptor
Jul 27, 2007

I MADE A PROMISE
I'LL DO ANYTHING

Willa Rogers posted:

57 percent of Americans are living paycheck to paycheck.

This is considered to be positive news because it used to be slightly more.

I love* how at the end of the article talking about how people are living paycheck to paycheck and have no emergency savings, the financial analyst says "Just save 10% of your paycheck each month. Bing bong so simple." It's so tone deaf.


*i hate it, actually

Mellow Seas
Oct 9, 2012
Probation
Can't post for 10 years!
It’s not surprising few have noticed the recent statistical improvements. After all, prices aren’t ever going to fall (absent some catastrophe) so people still know they are paying elevated prices. Maybe they’re the same prices they were in February, or even October, but that’s not going to make people feel better overnight when their bills are still way bigger than in ‘21.

If the price trends continue through next year (which is not guaranteed, of course) people will probably have noticed. I think they would be less likely to notice without the Biden campaign and other Democrats pointing it out.

Mellow Seas fucked around with this message at 22:02 on Jun 28, 2023

Willa Rogers
Mar 11, 2005

Velocity Raptor posted:

I love* how at the end of the article talking about how people are living paycheck to paycheck and have no emergency savings, the financial analyst says "Just save 10% of your paycheck each month. Bing bong so simple." It's so tone deaf.


*i hate it, actually

Yeah, it's on up there with the conventional advice to have an emergency fund equal to six months of living expenses.

FizFashizzle
Mar 30, 2005







Willa Rogers posted:

I thought he went under general anesthesia for his colonoscopy. What's the public knowledge that contradicates him? His age?

Colonoscopy is just twilight. General would have been the whole kit and kaboodle.

Contraindications for a procedure like getting his sinuses reamed out would be age, declining cognition, history of aneurysm.

Main Paineframe
Oct 27, 2010

Byzantine posted:

I have to believe that that was driven by anti-Trump sentiment, because the alternative - that an overwhelming amount of this rotting country are actually enthusiastic over Joe "Nothing Will Fundamentally Change" Biden - is just... horrible.

Most people aren't enthusiastic about politics or politicians at all, except for the occasional highly charismatic media darling. Hardly anyone is showing up to the polls and shouting "I'm so loving pumped for the opportunity to vote for this guy for my state legislature".

Velocity Raptor posted:

I love* how at the end of the article talking about how people are living paycheck to paycheck and have no emergency savings, the financial analyst says "Just save 10% of your paycheck each month. Bing bong so simple." It's so tone deaf.


*i hate it, actually

It's not necessarily all that ridiculous as you'd think. While I can't find the original report, this site that quotes from it says that nearly half of people with six-figgie incomes are also living paycheck-to-paycheck. That suggests that there's more to this than sheer poverty.



In general, I find that financial journalism is typically aimed at exactly that group: six-figgie earners who have enough money to cover their basic expenses, but still end up in precarious positions because they didn't really make an effort to rein in their non-essential spending and instead live at the limit of their means. For those people, extremely basic tips like "save a portion of your paycheck" can make a substantial impact in their financial security, because they make enough money that they can afford to attain financial security, but they don't make so much money that they can afford to spend whatever they want whenever they want.

Professor Beetus
Apr 12, 2007

They can fight us
But they'll never Beetus
Yeah, particularly for people who have struggled for a long time (like me), keeping the financial wiggle room to save stays difficult because you start going "holy poo poo I can afford x y and z now, kickass" and then you're still not saving anything even though you are technically capable.

Kale
May 14, 2010

zoux posted:

https://twitter.com/TPM/status/1673699912096129030

I don't have much more to add than: this is extremely good news. Kavanaugh, ACB, and Roberts on the majority side. Alito dissented because he thought the case should've been dismissed, so just Gorsuch and Thomas wanted to end American democracy. Better than I thought!

Basically what I've learned of this Supreme Court is that unsurprisingly Thomas and Alito always make the shittiest possible decisions while ACB, Kavanaugh and Gorsuch usually make them buy every so often end up siding with Sotomayor, Jackson and Kagan. The two must ultra right wing judges were already part of the court before Trump was even elected.

AlternateNu
May 5, 2005

ドーナツダメ!

FizFashizzle posted:

People hate wearing their mask, no matter what I goddamn told them. I had patients who’d literally tell me the world looked brighter once they got on cpap and others who’d rather pass out a hundred times a day than wear their mask.

Very uncommon for nasal passages to get smaller with age; quite the opposite actually. I’m having a hard time believing he had his sinuses cleared out 15 years ago and one of the alternatives was to try cpap. That’s a fairly benign procedure. Also not really sure why he would have had that for the first time in his mid sixties. Most people need it done multiple times through their life (raises hand.)

On the other hand, just from public knowledge biden is contraindicated from ever going under general anesthesia for an elective procedure.

On the OTHER other hand, cpap use can be used off label in patients with mild cognitive impairment to improve cognitive functioning. The benefits are modest but when you’re the leader of the free world anything can be helpful. And biden is kinda struggling.

https://twitter.com/unusual_whales/status/1674088517280972802?s=46&t=JBd6ZXmGQ3LmWL-ineTnAA

People his age just don’t sleep well or on a good schedule generally. Sounds to me they’re just doing everything they can to get him through next November.

Everyone wear your CPAP! Wear it! Always put it on!

My dad thought his CPAP machine was a literal gift from on high. The first night he used it, he crashed for 13 hours straight without stirring. Same with the second night. And the third. That's how sleep deprived his body was. loving crazy.

I've never had to deal with that poo poo, and I'm goddamn thankful for it.

Willa Rogers
Mar 11, 2005

Reminder to encourage your elders to enroll in traditional Medicare gap plans rather than the misnomered "Medicare" "Advantage" (neither Medicare nor an advantage over traditional gap plans) lest your future inheritances are drained by your parents' private insurers.

I've bolded the cliffs rather than restating them.

quote:

Jenn Coffey was so tired of having her care denied by her Medicare Advantage insurer that she considered signing a do-not-resuscitate order. “There was no more hope,” she said. “There was nothing left for me to hope for.”

Coffey, a former EMT from Manchester, New Hampshire, went on Medicare, the government health insurance program for seniors and others with disabilities, after a breast cancer diagnosis left her unable to work. Like an increasing number of Medicare beneficiaries, she ended up on a for-profit Medicare Advantage plan; a marketer directed her to an option administered by UnitedHealth Group, a $450 billion insurer.

But instead of finding the program a relief, Coffey, 51, says UnitedHeath constantly rejected or second-guessed the care options her doctors suggested for her cancer recovery and for a rare and painful secondary disease that has no standard treatment plan. “There’s lots of ways that they deny stuff that you need,” she said. “So many times that I had the opportunity to try different treatments and medications, the response was, ‘They won’t cover.’”

UnitedHealth’s routine denials led Coffey to frequently end up in the emergency room, and she eventually became so sick of struggling through the system that she nearly waived her right to be resuscitated if her condition was irrecoverable. “Mentally, it was very destructive,” she said. “I have been an EMT and worked in a hospital, knew there were treatments, but never thought about not having access.”

Coffey’s experience with Medicare Advantage transformed her views. Coffey is a former two-term Republican state representative in New Hampshire who, like many GOP faithfuls, believed private insurers could solve the health care crisis if they were allowed to do things like sell policies across state lines.

“Now I’ve realized that you can’t fix or repair the system,” she said. “The insurance companies don’t offer anything. They serve as a roadblock… The only way forward is Medicare for All.”


Coffey is not alone. As the privatization of Medicare via insurer-owned Medicare Advantage plans expands to half of Medicare beneficiaries — 31 million people — care denials by Medicare Advantage insurers are threatening the foundational premise of the government’s health care safety net for seniors and people with disabilities: that people in Medicare should get the care that is recommended by a doctor.

A 2022 investigation by the Inspector General of the Department of Health and Human Services found that in 2019, 13 percent of the total prior authorization requests denied by Medicare Advantage plans would have been covered under traditional Medicare, leading to an estimated 85,000 additional care denials. That year, Medicare Advantage plans also wrongly denied 18 percent of payment claims — covering an estimated 1.5 million claims — reducing the likelihood that doctors will recommend the costliest yet often most effective care, for fear of not being paid.


In the subsequent two years, as total Medicare Advantage enrollment increased from 22 million to 27 million, such denials have reportedly skyrocketed. A February report from the Kaiser Family Foundation found that two million prior authorization requests had been denied by Medicare Advantage in 2021, more than triple the 640,000 prior authorization requests these plans denied in 2019, according to an estimate in the Inspector General’s report.

These care denials are helping to drive record insurer profits — Coffey’s insurer, UnitedHealth Group, made more than $14 billion in profits in 2022, and the other three largest for-profit Medicare Advantage insurers pulled in an additional $10 billion. But these denials have disastrous impacts for ordinary people’s lives, as detailed in numerous patient stories shared with The Lever. And the total instances of denied care are likely vastly understated.


Kip Sullivan, an independent health care policy analyst active in Medicare for All advocacy groups, told The Lever that denied care in Medicare Advantage was “a grossly understudied problem” and that many instances go entirely unnoticed.

“It’s a primary reason for why we should terminate the Medicare Advantage program,” said Sullivan. “There are just not enough cops with nursing degrees stationed in emergency rooms across the country to detect this kind of abuse.”

More at link.

Insurance agents are paid up to three times more by private health insurers to enroll seniors in "Advantage" plans than the government pays agents to enroll seniors in gap plans. Both Democrats & Republicans have expanded Advantage programs at the behest of private insurers, and Biden's Deputy Administrator and Director of the Center for Medicare and Medicaid Innovation, a former Blue Cross lobbyist who crafted the ACA legislation while serving as Baucus's chief of staff, has vowed to get rid of traditional Medicare gap plans by 2030.

Further, most unions (especially public unions) are now bucketing their retirees into "Advantage" programs, although the benefits tend to be more generous for union plans than for individual seniors, just as employer-provided health insurance tends to be more generous than individual Marketplace plans.

So the next time you hear Democrats bleating about how the GOP wants to destroy Medicare, keep in mind how little that Democrats have done to slow down the speed-run of "Advantage" enrollment. (A handful of Dems like Warren, Sanders & Merkley have fought, to naught, to rein in the program & its misleading practices, including using Medicare branding.)

And, for god's sake, please try to talk your parents into carrying traditional Medicare gap plans if they're nearing enrollment age.

dreffen
Dec 3, 2005

MEDIOCRE, MORSOV!

FizFashizzle posted:

Everyone wear your CPAP! Wear it! Always put it on!

Done, happily. I got diagnosed with sleep apnea last year age having slept like poo poo for years. Once I got the CPAP it was a night and day difference.

I had an AHI of 71 before and after it’s less than 1 every night. Mask doesn’t bother me in the slightest thankfully.

I didn’t even need any further adjustments. They got that poo poo right on the first go.

Jaxyon
Mar 7, 2016
I’m just saying I would like to see a man beat a woman in a cage. Just to be sure.

dreffen posted:

Done, happily. I got diagnosed with sleep apnea last year age having slept like poo poo for years. Once I got the CPAP it was a night and day difference.

I had an AHI of 71 before and after it’s less than 1 every night. Mask doesn’t bother me in the slightest thankfully.

I didn’t even need any further adjustments. They got that poo poo right on the first go.

My only issue is one of my nostrils is always plugged, and one is fine, every single night.

USCE Spring: CPAC chat and CPAP chat

FizFashizzle
Mar 30, 2005







Jaxyon posted:

My only issue is one of my nostrils is always plugged, and one is fine, every single night.

This is natural. The body sorta alternates bloodflow into the nostrils so that one has more blood than the other, then it switches. I can't remember the reason why for this, but increased blood flow means the vasculature swells and the soft tissues swells. It's also why if you sleep on the unclogged side you can feel your clogged side open up, then the other side shut down. biology!

this is actually an indication for sinus surgery!

or just like get hooked on afrin (don't do this)

Leon Trotsky 2012
Aug 27, 2009

YOU CAN TRUST ME!*


*Israeli Government-affiliated poster

Jaxyon posted:

USCE Spring: CPAC chat and CPAP chat

What kind of CPAP mask should Joseph Robinette Biden Jr. be wearing to get maximum quality sleep, but avoid those marks on his face?

FizFashizzle posted:

People his age just don’t sleep well or on a good schedule generally.

Is "getting old" actually a reason for a CPAP prescription? I had not heard that before. A CPAP doesn't enhance your sleeping by itself, it just fixes it if you have an obstructive apnea. I know older people can develop central sleep apnea, but that is brain-related and usually treated with things other than a CPAP, right?

the_steve
Nov 9, 2005

We're always hiring!

Leon Trotsky 2012 posted:

He's apparently had really tiny nasal passages for a while and got surgery for them. Kind of surprised that he had the surgery before trying a CPAP and didn't try the CPAP until after the surgeries and 15 years had passed.

Most people just get the CPAP first.

I can kinda get it.
I'm another CPAP goon, and it took me years to come around to actually using it. I hated the mask, I hated trying to set the thing up when I had to travel for work and there was just no good place in the worksite bedroom to really set it up properly. It was just an inconvenient pain in the rear end and I was (still am, if we're being honest) convinced that there's someone in the Coast Guard getting kickbacks from CPAP companies because drat near everybody in my field has been prescribed with one.

If it weren't for the compliance check when I had to renew my MMC, I'd probably have never used it at all, but now that I'm used to it, I can't sleep without it.

Leon Trotsky 2012 posted:

What kind of CPAP mask should Joseph Robinette Biden Jr. be wearing to get maximum quality sleep, but avoid those marks on his face?

All he'd have to do is loosen the straps. They don't need to be that tight to stay on your face while you sleep.

Zero_Grade
Mar 18, 2004

Darktider 🖤🌊

~Neck Angels~

Replacement plans aren't even good for the provider in my experience (disclaimer, I work in a very niche area of healthcare). Instead of having a single national insurer, there's a bunch of somewhat smaller private ones that you as a provider actively have to be in network with, and they'll often make you take a haircut off standard rates to do so. For example, we aren't providers for BCBS because we'd contractually have to accept charging ~40% off the Medicare fee schedule for any services. As a result, smaller providers have to pick and choose which private plans to be in network with. Combined with the reality that some people don't even realize they're not on straight Medicare and we sometimes get the very uncomfortable situation of a patient arriving in the office, realizing we're out of network, and either having to be sent to another provider entirely or being asked to pay out of pocket and maybe get reimbursed later. It's uncomfortable for everyone and it sucks!

In my field at least, Medicare generally has very rigid guidelines about pretty much everything. What particular device(s) can be supplied for a certain diagnosis, exact wording that has to be in the physician's notes, and detailed justifications for the work done. If any of the guidelines aren't met, tough you ain't getting paid. The thing is, if you can show that you did meet them, then you will get paid eventually. I've argued appeals cases before administrative law judges and won, because we had the documentation to support that our case met their guidelines. You can always go read Medicare's LCDs (Local Coverage Determinations) that lay out exactly what has to be done in order for an item or service to be covered. They're quite dry but specific. Comparing this with replacement plans, if you're out of network it's a crapshoot how much you as a provider will be paid (or how much you as a patient will have to pay!). Even if you're in network, you still have to wait for the company to authorize services, which can take weeks or more, and they can drag that out with appeals/audits after the fact anyway.

I guess this is kinda more rambly than I intended, but at least it's mostly on topic.

BiggerBoat
Sep 26, 2007

Don't you tell me my business again.
Nobody is enthusiastic about Joe Biden. Come the gently caress on.

He won because not enough of the population is enthusiastic about Donald Trump and would vote for anyone else besides him. And it was still closer than I'd like. Trump's support is absolutely manic, rabid and is a full on cult. Turns out that 35% of the population isn't enough to win an election but I've never seen anything quite like the rabid fan base he has.

In my entire lifetime, I've never seen anything approaching the level of fanaticism Trump has and no one I know points to Joe Biden's victory margin as a passionate of Joe loving Biden. He's just better than the fascist rear end in a top hat.

For now.

Kith
Sep 17, 2009

You never learn anything
by doing it right.


joe biden fuckin sucks for a hundred reasons but i'd rather have that than someone who is actively malicious and dangerous for a million reasons. this does not mean i am happy about joe biden or enthusiastic about joe biden, it means i am willing to accept the lesser evil

FizFashizzle
Mar 30, 2005







Leon Trotsky 2012 posted:

Is "getting old" actually a reason for a CPAP prescription? I had not heard that before. A CPAP doesn't enhance your sleeping by itself, it just fixes it if you have an obstructive apnea. I know older people can develop central sleep apnea, but that is brain-related and usually treated with things other than a CPAP, right?

Getting old itself is not a reason for a CPAP. Like I said, there is some data that off label use may modestly improve cognition for people suffering from Mild Cognitive Disorder due to whatever. As a matter of fact, there was a huge recall a couple years ago from one of the biggest CPAP makers and you literally cannot get one without a diagnostic polysomnogram. And CPAPs track usage and if you don't use yours they will take it and give it to someone that will.

Older people that gain weight can develop OSA, but that's not necessarily just getting old. Also older people tend to need sleeping medications that can also cause drug induce sleep apnea (think about taking a benzo, ambien, pain med whatever that relaxes your throat) but again that's not specifically due to age. anyone can eat too much lunesta or whatever.

idiopathic OSA does occur, but by their own words he had this diagnosis 15 years ago, and he decided....not to use a cpap? doesn't make a lot of sense. 2ry sleep apnea can be related to heart failure, but that progresses very quickly

in short, their story doesn't make sense, and if I had to guess it'd be that they're just doing what they can to keep him lucid. just from what I can see on interviews and what not, he does not look or sound good. I don't have definitive proof or anything; that's just my experience working with patients.

VideoGameVet
May 14, 2005

It is by caffeine alone I set my bike in motion. It is by the juice of Java that pedaling acquires speed, the teeth acquire stains, stains become a warning. It is by caffeine alone I set my bike in motion.

Main Paineframe posted:

Most people aren't enthusiastic about politics or politicians at all, except for the occasional highly charismatic media darling. Hardly anyone is showing up to the polls and shouting "I'm so loving pumped for the opportunity to vote for this guy for my state legislature".

It's not necessarily all that ridiculous as you'd think. While I can't find the original report, this site that quotes from it says that nearly half of people with six-figgie incomes are also living paycheck-to-paycheck. That suggests that there's more to this than sheer poverty.



In general, I find that financial journalism is typically aimed at exactly that group: six-figgie earners who have enough money to cover their basic expenses, but still end up in precarious positions because they didn't really make an effort to rein in their non-essential spending and instead live at the limit of their means. For those people, extremely basic tips like "save a portion of your paycheck" can make a substantial impact in their financial security, because they make enough money that they can afford to attain financial security, but they don't make so much money that they can afford to spend whatever they want whenever they want.

OR work in Silicon Valley and other extremely expensive places.

dreffen
Dec 3, 2005

MEDIOCRE, MORSOV!

Jaxyon posted:

My only issue is one of my nostrils is always plugged, and one is fine, every single night.

USCE Spring: CPAC chat and CPAP chat

:same:

FizFashizzle posted:

This is natural. The body sorta alternates bloodflow into the nostrils so that one has more blood than the other, then it switches. I can't remember the reason why for this, but increased blood flow means the vasculature swells and the soft tissues swells. It's also why if you sleep on the unclogged side you can feel your clogged side open up, then the other side shut down. biology!

this is actually an indication for sinus surgery!

or just like get hooked on afrin (don't do this)

Learn new things every day. That was very informative!

pencilhands
Aug 20, 2022

How do you get started on the process of looking into possible sleep apnea? I snore loudly, regularly get sleep paralysis and often wake up gasping for air so I feel like I should maybe look into it

Willa Rogers
Mar 11, 2005

FizFashizzle posted:

in short, their story doesn't make sense, and if I had to guess it'd be that they're just doing what they can to keep him lucid. just from what I can see on interviews and what not, he does not look or sound good. I don't have definitive proof or anything; that's just my experience working with patients.

Most voters agree with you, according to the recent NBC News polling.



It's a good thing that Democrats have branded Trump as the fashiest fashy who ever fashed bc I don't think they'd have a prayer of a chance running Biden for reelection otherwise.

VideoGameVet
May 14, 2005

It is by caffeine alone I set my bike in motion. It is by the juice of Java that pedaling acquires speed, the teeth acquire stains, stains become a warning. It is by caffeine alone I set my bike in motion.

pencilhands posted:

How do you get started on the process of looking into possible sleep apnea? I snore loudly, regularly get sleep paralysis and often wake up gasping for air so I feel like I should maybe look into it

My snoring was loud, but I never had the gasping for air.

So I started doing inspiration exercises (breathing thru a resistance device) and, crazy as it sounds, taping my mouth to stop mouth breathing. It helped.

Robviously
Aug 21, 2010

Genius. Billionaire. Playboy. Philanthropist.

pencilhands posted:

How do you get started on the process of looking into possible sleep apnea? I snore loudly, regularly get sleep paralysis and often wake up gasping for air so I feel like I should maybe look into it

Talk to your primary care doctor and relay the symptoms, asking for a test for sleep apnea. If possible, do one at an accredited sleep lab. I'm sure home tests are fine at this point but I have a personal grudge against them, so I never recommend them if your insurance will cover a stay over. That's the basics of how to go about it.

Boris Galerkin
Dec 17, 2011

I don't understand why I can't harass people online. Seriously, somebody please explain why I shouldn't be allowed to stalk others on social media!

pencilhands posted:

How do you get started on the process of looking into possible sleep apnea? I snore loudly, regularly get sleep paralysis and often wake up gasping for air so I feel like I should maybe look into it

I think this is something you should talk to your doctor about and get a recommendation or something?

Jaxyon
Mar 7, 2016
I’m just saying I would like to see a man beat a woman in a cage. Just to be sure.

Leon Trotsky 2012 posted:

What kind of CPAP mask should Joseph Robinette Biden Jr. be wearing to get maximum quality sleep, but avoid those marks on his face?

I use this:



But my pulmonologist recommends this, and I think it will help his face stuff:


I love the 1000 yard state on this guy...he has seen some poo poo, and now he wants some good sleep

Robviously posted:

Talk to your primary care doctor and relay the symptoms, asking for a test for sleep apnea. If possible, do one at an accredited sleep lab. I'm sure home tests are fine at this point but I have a personal grudge against them, so I never recommend them if your insurance will cover a stay over. That's the basics of how to go about it.

^^^ This. Sleep apnea is really pretty serious and your doctor will take it seriously. Provided you have one in the medical hellscape that is the USA.

Jaxyon fucked around with this message at 03:07 on Jun 29, 2023

Scrotum Modem
Sep 12, 2014

pencilhands posted:

How do you get started on the process of looking into possible sleep apnea? I snore loudly, regularly get sleep paralysis and often wake up gasping for air so I feel like I should maybe look into it

You bring this up to your Primary Care doctor. They should refer you to a sleep specialist. You see them (typically at a hospital) and they schedule you for a sleep study where you spend the night at the hospital and hook you up to determine how many times an hour you stop breathing while you sleep for 10 seconds or more (usually referred to as "events"), along with monitoring heart rate etc.

Based on the results they diagnose you and connect you with the CPAP equipment company they have a deal with and go from there. All forms of insurance seem to cover most of the cost of the equipment and replacement parts, like the tubing, mask and more. I use Medicare and they cover all costs.

Modern CPAP breathing machines make a cellular connection to report usage data back to the company which is then sent to your insurance company for them to determine if you're actually using it and if they'll keep covering the costs for it. They even make apps for smartphones that you can use based on that collected data to monitor your sleeping activity, how many Events per hour you have, if your mask is secure, etc. It's pretty nice.

I'm not obese but have had snoring issues since I was a skinny-rear end child due to my tight nasal cavity. It took until my 30s to really notice the effects of sleep apnea including rapid heart rates when waking up and feeling sleep deprived during the day. During the sleep study I found out I would stop breathing for an extended amount of time (10 seconds or more) 52 times an hour on average. With the CPAP machine it's now usually between 2 and 5 times an hour.

CPAP breathing machines suck but they also allow me to have restful sleep now. So I'm glad I have it. They're a far cheaper solution than surgery on my nasal cavity, at least from the health insurance cost analysis perspective so it makes sense why your healthcare wants you to try using them as the first solution.

Gotta clean your mask and hose but otherwise it's not bad. The machines are quiet - the generate essentially white noise.

Scrotum Modem fucked around with this message at 03:49 on Jun 29, 2023

Main Paineframe
Oct 27, 2010

VideoGameVet posted:

OR work in Silicon Valley and other extremely expensive places.

Even in Silicon Valley, six figgies is enough for rent and food as long as you don't expect to own a McMansion, have kids, drive a luxury car, or buy all the videogames and take-out you want every month. The high cost of living in the biggest urban areas means someone making $100k won't be living a luxurious lifestyle, but they're not gonna be broke either.

Eric Cantonese
Dec 21, 2004

You should hear my accent.
I was told that surgery would be painful and wouldn't necessarily fix my sleep apnea issue so I just went for life with the machine. I wish I had known about my disorder before, but I wonder how bad CPAP machines back in the 1990s were...

I know many people don't like the idea of having to cart around a machine everywhere they go, especially when you're dealing with a child with that problem, but I don't see the point of surgery unless it's absolutely going to work.

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FizFashizzle
Mar 30, 2005







pencilhands posted:

How do you get started on the process of looking into possible sleep apnea? I snore loudly, regularly get sleep paralysis and often wake up gasping for air so I feel like I should maybe look into it

Get a referral to neurology/sleep from your PCP.

Then you'll do a polysomnogram which is essentially a sleep study. don't half rear end it and do the home version because if that is positive you have to go into a facility and get a proper one anyway.

polysomnogram involves sleeping somewhere with an EEG, a pulse ox, and a camera on you. Generally you only need to sleep for like 3-6 hours for them to get the info.

Then you go back to you provider and they go over the report with you. If you qualify, sometimes you can just get one but other times you need to go back for a cpap titration test (also sometimes they'll just go ahead and do this at your polysomnogram). The point of this test is just to figure out your settings. Not everyone needs the same amount of resistance.

Then you have a 2-3 month grace period where you get used to wearing it. Honestly the best thing is just to keep it on when you're watching tv or whatever. some doctors will give you klonopin at the beginning but that's bullshit dont do that.

Then you start wearing it and you have more energy and you think more clearly and you join a gym and you start working out and you can plan meals and you get on a diet program and you start losing weight which improves your sleep and exercise and people at work notice and you get a promotion and you get a whole new wardrobe and you feel more confident in yourself and you start making friends and you get invited to go out and you meet some cutie and you start joking with one another and it turns out she has a cpap too and you two bond over it and you fall in love and you get married and you start a family and you have children and you have success in work and life and decades from now, as you look back on everything you have accomplished and you watch the sun set and you hold your wife in your arms and you listen to the laughter of your grandchildren in the distance you remember this thread and you say out loud, softly, more to yourself than anyone else, "thank you fizfashizzle."

Eric Cantonese posted:

I was told that surgery would be painful and wouldn't necessarily fix my sleep apnea issue so I just went for life with the machine. I wish I had known about my disorder before, but I wonder how bad CPAP machines back in the 1990s were...

I know many people don't like the idea of having to cart around a machine everywhere they go, especially when you're dealing with a child with that problem, but I don't see the point of surgery unless it's absolutely going to work.

none of the surgeries work they're bullshit

the machine is the size of a casette player. there's a billion masks. get a CPAP.

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