BillyD

Ditto.

BillyD

... and that’s just the north 40, right?

LAJ

Sad.

Velo Vol 

It's raining.

I shall not be riding.

datlas 

Happy Easter to those who celebrate it.

I have two items to share/comment on this morning. One is COVID19 related and the other is cycling-related (fake miles but still cycling).

One of my partners (who works in a different office from mine) developed CLASSIC covid19 symptoms. Fevers 101-102. Achey all over. Swollen joints. Said his head felt like a bad hangover. Since he is a physician and has access to the hospital, he was able to get the rapid COVID19 test done at our hospital's microbiology lab. This is a 45 minute turn-around-time test which I am told is a PCR like the usual tests, but it's only for inpatients and hospital staff. They only have a limited number of kits or reagents or whatever.

The rapid test was NEGATIVE. Of course he is a sharp physician who knows that clinical judgement is more important sometimes than a test, so he has been isolating himself at home. He is slowly getting better.

His send-out swab came back positive, of course. It makes me wonder how reliable all these fancy tests will be. I know this is NOT data but an n of 1. Still, food for thought.

Next topic:

I wanted to do a recovery to Zone 2 ride today, so I signed up for a fake group ride on Zwift. Those who know Zwift and have done non-race group rides know that there is a feature called the "fence" and the fence is leader-set several seconds ahead of the leader. If any riders go past the fence, a warning pops up and if you don't drop back within 60 seconds, you are kicked off the group ride. I LOVE it! It's a great way to keep wanna-be racers off the ride an allows the pace to be what the leader wants.

Sadly, just as we started to deal with COVID and are riding indoors more, the fence feature has been down. It has not been working for about a month. Today's ride ended up being a ****-show with half the riders going off the front and never seen again. Sad!

I find it hard to believe that with all the resources and $$$$ Zwift is getting, they can't fix this feature which worked great the previous several months.

Velo Vol 

No surprise, but a century ride I held out some hope of attempting was moved from June to "late August or early September."

More time to get in shape; we'll see if the joints cooperate.

WhyFi

Well, that's encouraging.

datlas 

I am going to get on my high horse. JUST for a minute.

One of the reasons why I am close to walking away from medicine is the vast majority of patients want/need/like TESTS. They do NOT trust the doctor's judgment. It's incredibly frustrating for me, but this is my age showing.

Classic example:

A newly turned 50 year old male comes in to see me. Says he wants to get his heart "checked" including an EKG and a stress test, since he has friends that have had heart attacks and stents etc. I ask him about any symptoms? No, doc, I just ran a 10K and did really well. His heart and lung exam are fine. His BP is normal, he is a nonsmoker and cholesterol numbers are not ideal but acceptable.

He does NOT need a stress test. OR an EKG even. However, if I tell him this, he will be very angry. Even if I explain that tests like these will NOT predict who will have a heart attack in the future. He KNOWS he needs to get this done.

His identical twin brother goes to a NP, not a doctor. Asks for the same thing, of course the noctor says "yes" because nurses care more than doctors. Guy goes to cardiologist, gets EKG, heart monitor test, echocardiogram, and nuclear treadmill test. Oh, and to be safe a check on his carotid arteries. The whole pricetag for this workup is about $8,000, but it's covered by insurance. Everything looks ok.

The twin is very happy and satisfied that he got a 100% clear bill of health from the cardiologist. He thinks his brother needs to stop seeing me and see his NP instead.

Everyone is happy. The cardiologist made a lot of $$$, the patient was reassured, and the NP saw the patient in 5 minutes, while I spent 30 minutes trying to explain to the patient why he does not need all the testing etc.

This is part (only part) of why our healthcare system is really good and a terrible rip-off when it comes to value.

/end rant

big john

Stupid work. In about a week it will be one year since I retired which is how I was able to start doing group rides during the week. The last 2+ years at the job I was so exhausted all of the time I didn't ride after work at all and Saturday I would start the group ride so tired I started getting dropped earlier and more often than ever.

Not going to work is the greatest thing ever.

big john

"Noctor" love it.

Velo Vol 

Oh?

In witch doctory there are no (diagnostic) tests that patients are going to get hung up on.

Just sayin'

LAJ

Just plug the "machine" into it, and it'll tell you what's wrong.

ls01

pity

Pirkaus

Connect to the diagnostic port, and download the DTCs. Follow troubleshooting tree, and repair defect. Come on this ain't rocket surgery.

datlas 

Kudos. We are such savers and so thrifty that I am considering early retirement. Wanna know the main obstacle?

Wait for it...

Cost of health insurance! May have to wait for Medicare which is 10 years away.

datlas 

Wrong-o.

Lots of noctors (and doctors) are ordering a blood test called ANA. Anti-nuclear antibodies. This test is frequently positive (although typically in a low titer) which most often means NOTHING but in the correct context could signal Lupus or another mixed connective tissue disorder. I expect that one of the biggest headaches rheumatologists have is explaining that in spite of some aches and pains and fatigue, the “abnormal” ANA blood test is not significant.

datlas 

Yes. Contraction of Not a Doctor. Pejorative term for NP or PA.

WhyFi

Ugh. I can understand the frustration.

Also, I'm surprised that insurance is willing to cover these kinds of elevated tests without evidence of concern.

WhyFi

Or rather, evidence that there should be no concern.

LesterOfPuppets

Neighbor's yard is all gravel, ain't gonna be mowing that !

big john

I had planned (I use the term loosely) to retire at 62 and figured I would just buy insurance or do without. Then we got evicted so they could sell the house and Mrs John got fired from her job. 3 more years! Now that my employer knew I would be leaving at some point I lost a bit of clout so they stopped all efforts to help me and then came the hardest years.
The 2 young guys they hired to make me redundant weren't up to the task, one of them eventually quit. One of the managers said he could body-snatch a guy from another dealer and so they made that guy a huge offer rumored to be more than anyone else at our dealer. So they knew they didn't need me.
The week before i retired the guy bailed, said he wouldn't leave his other job. Then they finally called me into the office to ask "what will it take" to keep me there?
I wanted to tell them the whole story about how they jerked me around for 3 years but instead I just said I wouldn't consider staying until I had at least several months off. So I didn't burn the bridge and they actually let me work on my own car there since I left.

Velo Vol 

What I meant is they're probably not facing patients demanding to have an ANA test, or CRP, or anti-CCP tests. Or at least I didn't.

I could be wrong.

That said, a couple doctors ago I did ask the guy to explain the basis of his diagnosis.

He got bent out of shape and said something along the lines of, "If you think this f'ing Lyme Disease, you can go see another doctor."

So I did, not because I thought I had Lyme Disease, but because I thought there had to be a better doctor nearby.

LesterOfPuppets

RIP!

Once upon a time I was seeing this girl and she took me over to her Mom's place for a shindig. They introduced me to her little brother "...and this is Sterling." and I said oh, after Stirling Miss.

At that moment, I instantly became part of the family.

Bah Humbug

The testing situation is why I think, if I came down with symptoms, I would just assume positive and quarantine until recovered (or in need of hospital). The testing situation gives no confidence.

And the more I hear about Zwift, the happier I am with Rouvy.

BillyD

Me neither.