Tuesday, March 30, 2010

In Search of a Cure

As you can tell from our blog, the lifestyle we have chosen keeps us on the move. We have RVing friends who wouldn't dream of roaming about as much as we do and others who can't imagine staying in one place for as long as two or three weeks at a time. Time constraints can dictate the pace of travel for many, and favorite places and a "been there, done that" feeling dominate the travel plans for others. For us, it's the lure of places unseen and  experiences (and foods) unsampled. It's a wonderful freedom that we have enjoyed as often as possible through 15 years on the water and 4 1/2 years on the open road. All that's required is a surprisingly modest income, the willingness (and freedom) to be away from family, and good health. And so we get to the business of this blog entry...

For at least the last ten years, I have had a progressively worsening case of congestion and cough. A distaste for doctor visits (and a lack of health insurance) led to years of self-neglect and -accommodation until conditions became bad enough (and Medicare kicked in) that we finally sought help. When that decision is finally made, it has the effect of slowing down the travel. Setting up appointments, getting tests run, and waiting around for results...

The winter of '07/'08 we spent in central Arizona, near Sedona. We stayed long enough to have my symptoms checked out (as well as cataract surgery for Jan) and in the meantime enjoyed a great time in Red Rock country. The initial diagnosis was either allergies or asthma. Testing ruled out asthma, but did confirm a significant (maybe 25%) loss in lung function. My penchant for self-diagnosis (Doctor Dave, here...) pretty much ruled out allergies, too. After all, the only persistent symptoms that seemed to fit was the cough and congestion. No itchy or watery eyes, no sneezing, etc, etc , etc. And besides, it was time to get on the road.

The winter of '08/'09 we spent in the south Texas Rio Grande Valley. (Loved the company of thousands of fellow RVers from all over North America and the fun times in Mexico, but the scenery and weather...not so much.) But the three month travel freeze led to more thorough (and better???) diagnoses. More tests, many of which were repeats from the previous winter (there's that built-in waste generator of fee-for-service) led to the confirmation of COPD, a malady unheard-of ten years ago, but which is now all the rage (the better to sell Advair and Spiriva and Symbacort and Omnaris and ...) A low oxygen level even put me on 24-hour oxygen for about two weeks, lugging a tank around, and sleeping with those funny little tubes going up the nostrils - imagine what a happy camper I was. So anyway, I was now on Advair and Spiriva and occassionally Albuterol and eventually Omnaris, and oh yes, Mr Walton, part of your problem, Mr. Walton, could be gerds so start taking four Prilosec a day for the next six months (WHAT??!!) We started keeping a close eye on the impending "donut hole" in drug coverage that was going to cost us around $4000. And I used to think that Excedrin was my only drug of choice.

But now it was time to go again, and surely all these meds would provide the answer and improve the condition. So we started on the part of our journey that you've been following for the past year. By mid-summer, the frustration of continuing and even worsening symptoms was forcing us to seek out more medical attention. But our Humana Medicare Advantage coverage had no in-network doctors (especially the "urgent care" variety) outside of the major metro areas of the Northwest. And with Humana, if you stray out-of-network for care, instead of the 80% coverage you'd get from Medicare, you get 70% coverage from Medicare Advantage. So we kept postponing. By the time we found a doc, I had a significant sinus infection, and what was termed an "exacerbation" of an upper respiratory infection from the COPD. Over the next six weeks, a series of courses of antibiotics and Prednisome finally put me in much improved health.

HOWEVER! These latest exams revealed problems with my heart. (WHAT??!!) An irregular heartbeat checked out by an ekg and they were urging us to see a cardiac specialist ASAP. Six weeks later, we finally found a cardio clinic to use for further testing - ekg, 24-hour monitor, echocariogram, stress test, nuclear stress test. The most likely cause???? - the COPD meds that I'd been taking for the last six months!

So here's the deal - nothing wrong with my heart (although I'm now on the same bp medications as Jan,) I probably don't have COPD so no more of those meds, I likely have severe allergies - "Wasn't that the original diagnosis?" you ask - which I need to address with an allergist when we slow down again later in the year. Spirits are MUCH improved and I'm feeling much, much better. The chronic cough has all but disappeared and the chest congestion is improving day by day (as long as I stay away from high mold situations.)

Whew! Getting old ain't for sissies.

Tuesday, March 2, 2010

A New Home Base

Travel is and will continue to be our lifestyle for the foreseeable. We have new things to see and familiar places to revisit and friends and family we love to spend time with. But we know that at some point we'll need to consider reducing the miles - we can do that without really "slowing down" if we can find the right combination of activities, friends, nearby places to go and things to do - for part of the year.

When we quit our jobs for good and began cruising fulltime, our daughter Shannon was a terrific mail-forwarder, sending whatever we had received by post to wherever we dropped the hook. When we "swallowed the anchor" and began RVing, we turned to an organization of fulltime travellers called Escapees (or SKPs) which offers an array of activities and services from providing a "home address" for insurance, voter registration, and the like to an excellent mail service to membership RV parks to annual gatherings for fellowship and continuing education (called Escapades), and many other perks. The costs are very reasonable and we highly recommend them to our full-timing friends. There are over 15,000 members and they even have some political clout.

Among their membership parks (about two dozen around the country) they have traditional facilities with pools and spas and sports courts and meeting/activity centers for stays of a day or a week or a month or more, and others which offer RV-sized lots for purchase or sites for longterm lease. One of the great benefits of the organization is that any investment for a purchase or lease is protected by a long waiting list of members who want the same thing. The long list is a disadvantage when you're looking to commit, though. With some of the parks, it can take four to five years for your name to percolate to the top. Our travels have given us the opportunity to visit many of these lease parks, and this winter, we have found the one we would love to use for that base of operations.

It's called Jojoba Hills. It's a gated community of 230 RV sites in the Palomar mountains near Temecula, CA with great amenities, tons of activities, and lots of friendly residents. Temecula has just about everything we could want for shopping and dining and gaming, and the ocean is only 35 miles away, and San Diego and LA are about 75 miles.

And, the wait is only two years. We'll see how things go, but for now, we're on the list.