St. Marina protect me - 17 March 2025

I started passing a kidney stone in late February.  I know this because I felt severe abdominal pain that drove me to the ER (Emergency Room) on 28 Feb 2025.  A diagnostic CAT scan revealed the clear mark of a 7mm kidney stone that was partially descended (in the ureter and moving toward the bladder).  I got a bunch of numbers quoted at me as the visit progressed and the diagnosis became more clear, but I was basically looking at a 30% chance that the stone would pass unaided within the next two weeks.  So I went home to see what would come to pass (no apologies).  Another bout of significant abdominal pain took me back to the ER yesterday morning, 16 March.  This means that there has been progress but no expulsion of the stone.  I was able to visit a urologist this morning, 17 March, and she was pretty direct about the chances of passing a 7mm stone - 30% chance within the next two weeks (make note of that).

Now, kidney stones come with a lot of fireworks, mostly neural fireworks that we humans interpret as severe pain, often described as repeated, stabbing pain, with the added likelihood of tisssue damage as the stone moved thru the organic tube of the ureter.

The docs were all inclined to wait two weeks to see if the stone would pass unaided.  As the subject of the discussion, I looked at the numbers differently.  I saw a 70% chance of medical intervention over the next two weeks.   Also, that "within two weeks" was starting to sound like a familiar refrain; I had already gone two weeks without resolution.  I was disinclined to wait another two weeks to find out.  I decided to remove the uncertainty and push that to 100% chance of medical intervention sooner.  Medical intervention has other risks, but it removes two weeks of uncertainty; two more weeks during which I would be basically housebound and required to avoid all major physical activities. And it is likely (7:3 odds) that I will undergo a medical procedure anyway.

There are two primary medical interventions for large kidney stones, one ultrasonic (aka shockwave) and the other laser-based.  The urology doc said that the laser lithotripsy was more controllable and the fiber optics would allow a determination of removal with certainty.  It also seems the break-up of the stone is more controllable (meaning smaller pieces to remove; if the doc sees a big piece, just zap it again).  

And who can say "no" to frikkin lasers?

Because Saint virgin and martyr Marina (Margarita) of Antioch in Pisidia (255-270) is recognized as the patron saint of kidney sufferers and the protectress of nephrology, I will say that I presently live under the Sword of St. Marina.  Or, because of the way it feels, maybe I should say the Hammer of St. Marina. 

Medicare Part D choices for 2025 - 13 November 2024

I reviewed the new (2025) Medicare Plan D drug plan options a month or so ago, when the information first came out, and I just re-reviewed them all.  In 2024, I have a plan that is $3.30/month and the drugs I use are at no additional cost.  For 2025, that same plan goes up to $36/month and the drugs now come at an added cost for an annualized total of $908.  Yes, the plan goes from about $50/year to $900/year.  Naturally, I looked at other plans.  

I found two that are zero cost.  Yep, $0/month and $0 for the drugs.  It is worthy of onte that one has Costco as the preferred pharmacy and the other has Bartell as the preferred pharmacy; the drugs have cost at the non-preferred pharmacy, and both offer no-cost drugs by mail.  Finally, the third cheapest option is also $0/month but the drugs cost about $50/yr.  

I conclude that I am the product.

If the plan costs nothing and the drugs cost nothing, then my information is being collected to be bought and sold.  Yeah, there is HIPAA "to protect me" but I am sure they have clever ways to, uh, comply while still selling information.  

The nine plans available to me run between $0 and $2150 (annualized).  At that top end, there is no deductible, but it is about $600 more expensive than the next most expensive - and the deductible is about $600.  Strange, that.

I assume I will spend the rest of my life on this merry-go-round, chasing low-cost options each year, and getting "collected" by various insurance companies each time I switch.