99497

99497
now if you are in the medical industry you might recognized
this as a code for a medical procedure
a code that has been approved by
medicare medicaid better known as cms
all the insurances
all the medical societies for all the different primary cares and specialists
medicare pays roughly $86 for this service

now when i was in practice i always kept up with coding
thats what the doctor marks for each thing they do
insurance accepts these codes
as do medicare medicaid champus etc
each entity then pays for the service according to a fixed schedule
usually but not always private insurance pays more
but not always
some pay less than medicare pays

so this 99497 is an approved code
reimbursable by insurance
if your doc provides the service
most insurance pays for it

ok
so what is the 99497 code
well
i call it the death panel code
remember all that death panel stuff from a few years ago
well
now its here
as it should be

as usual in politics they really exaggerate things
they gonna put those old folks out to pasture like
the indians use to do with their old folks
they knew apparently to just wonder off into the woods
so the story is told

the code covers the discussion of advance directives
let me just say
i have had one for 20 years
i plan to update it soon
it will say the same thing
if you put me on life sustaining mechanical machines
when there is  no hope for me
i will personally come back to this world
and send your soul to the devil

those who oppose this should be treated that way

now i did have some second thoughts about this
maybe i should have my wife she to keep me alive
no matter what
since
she will be a retired teacher and as such
will not qualify to get my social security when i die
like the rest of you will with your spouses
so i told her the other day
if they dont change the law maybe...

so these 99497 visits were what all the fuss was about
all i can say is thank you to whoever come up with this idea
its a discussion that we all need to have with our medical providers
our family
our friends
except
now medicare and insurances will pay for us to do it

you need a
living will
power of attorney for healthcare
power of attorney for finances
consider a no cpr maybe tatto it on your chest right where they
place their hands when they start cpr

now
looking at my family medical history and my personal history
statistically
i am going to die from either
heart disease
stroke
or
worse i guess
alzheimers disease

if its alzheimers disease
when i get to the point where i am not a functional human
mentally and physically
i want my wife she to bring out all my forms
they will say something like
my husband the organicgreendoctor being of sound mind and body
having utilized his 99497 visit to discuss this with his doc
now wants all this stuff put into service
there on all the forms it will say

let me sink or swim
dont you dare take me to no hospital
dont you dare push on my chest
dont you dare stick a tube down my throat
dont you dare put an iv in me
dont you dare put no feeding tube down my nose

its my time
let me please float away like the old timey folks use to

the organicgreen doctor

alzheimers news-common questions

ALZHEIMERS NEWS-COMMON QUESTIONS

each time i do my presentations on alzheimers disease

i get a lot of questions

well they never end those questions

once they start asking it seems this floodgate opens

all those questions that they cant find anyone to answer

starts flowing out 

like a flood running over a dam

i feel like i am a unique person to answer these questions

since

my family has been riddled with alzheimers disease

my mother and younger brother died with it

my father probably had it

my older brother probably has it now

i have mild cognitive impairment amnestic type the precursor

stage before alzheimers although my memory recently 

returned to normal levels

i am a family doctor who treated some patients with alzheimers disease

looking back i didnt do a good job so i know what some of these 

people are facing as they see their doctors

i am a research study subject in a large alzheimers study

i am awaiting new treatment studies that have promise

so they start asking questions i give answers based on my personal 

experiences and medical knowledge

i keep up with all thats going on in the alzheimers world

eg i read 10 articles on alzheimers this morning

someone always asks about aricept (donepezil)

i can guarantee that their doctors dont really know about its side effects

yes like me when i was in practice they can read about them

and have patients tell them about their side effects

but

i read about them and i personally experienced them myself

so i really understand them

most folks stop the medicine since they dont take it right

and because they dont understand that the side effects are worse

at the beginning but get better over a few weeks

its like taking chemo at the beginning of treatment

if you can get through it you will break through on the other side

with less side effects

patients just arent explained all this 

i try to go through each side effect with the audience

then someone always ask what do i do if i have memory issues

i always say

get evaluated

always

most folks dont have dementia or alzheimers they have some cause 

thats fully treatable

like

med side effects poor controlled blood pressure cholesterol diabetes

obesity sleep habits anxiety depression inactivity stress etc

a few will have abnormal labs like b12 folate vitamin d homocysteine

hormone levels

all fixable with replacements

then i tell them make an appointment for only memory loss and 

nothing else

go in prepared with list of symptoms

make sure a workup is done to include history and exam labs some

type of memory test maybe labs

if they are ignored go somewhere else

if the person may have dementia they should not go alone ever

do an online questionnaire on how they are doing

i always refer them to the 21 question alzheimers questionnaire online

fill it out and take it with you

is dementia alzheimers 

dementia is a general term 

alzheimers is one of the most common causes of dementia

others are vascular dementia lewy body dementia frontotemporal dementia

parkinsonism dementia etc

is there are cure

no i say 

not yet

but we are working on it

the best you can do to prevent it is 

100% take care of your health maximizing it all including 

diet and exercise

if diagnosed take initially aricept (donepezil)

it helps about 1/3, it doesnt help 1/3 they just get worse, 1/3 stay the same

consider entering a research study 

they need volunteers badly 

this is how we will  find a cure

there are treatment studies ongoing now and soon to start that show

promise in slowing down the disease and if we are lucky

they will stop the disease if treatment is started early enough

here is where i go

www.utsouthwestern.edu/adc

so those questions go on and on and on 

i stood and answered them for two hours before

people it seems are starving for answers

two things

i am always available to do question and answer sessions in this area

contact me via facebook via the link on this blog page

i also do a talk on clinical trials and on alzheimers disease and on 

my story

i will answer questions sent to me on facebook

and if appropriate on this blog

feel free to ask me

then 

we need money to help in the fight

each fall we do alzheimers texas walks in this area

come walk at a site convenient to you and donate what you can

www.txalz.org/walk

outside of central texas 

you can do the alzheimers association walk to end alzheimers

at

www.alz.org/walk

we need your help

the organicgreen doctor

country n news-first honey, firewheel

COUNTRY N NEWS-FIRST HONEY, FIREWHEEL

this week i told my wife she
its time

we got our topbar hive a year ago
filled it with a nuch of bees
and
waited

so this week i decided its time to check the bees
after donning my full bee suit
so the bees wouldnt get me
but i didnt have a suit for poor bouncer-see yesterdays blog

so i smoked them real good
that calms them down
although this time i think it just made them madder

as i was working through the different combs
i realized that they didnt have enough honey for me
to be robbing from them

now robbing isnt the right word
i provide them a safe place to live
for rent they are suppose to pay me in honey
a fair exchange i think
but
as a young hive they arent quite ready to pay up

but
as i was working my way through the hive
there was a small comb that they had built in front
of a bigger comb
it was about a fourth the size of the full comb

now in a topbar hive the comb isnt square like in a regular hive
its shaped like a horseshoe

so i needed to remove that extra one
lucky for me it was full of honey
so
i trimmed it off
brushed off the bees
laid it in a plastic container that my wife she was holding
placed the cover on it to keep the bees from trying to save
the honey
making my wife she a target for the bees
since she had the honey
didnt tell her that though
as
she walked away from the hive
she looked like the peanuts character pigpen
with all those bees flying around her

as she got 60 ft away she went through the gate
where mr bouncer was happily awaiting her arrival
thats when he got zapped
again read yesterdays blog

eventually the bees gave up on my wife she letting them have
their honey back
so she took it inside the house

now we havent harvested honey before
so i had went online to youtube to find a lot of videos
on how to get the honey out of the comb and processed

so i found a kiss method
keep it simply simple method
my approach to things in this life

so
i opened the plastic container
cut the comb into squares the size of a cracker
dropped them into a quart fruit jar
took a spoon and crushed the smithereens out of the comb
of course i took the spoon out and licked it real good
not wanting to waste any honey

then
i put some cheese cloth over the mouth of the jar
screwed on just the metal part of a canning lid
set that jar on top of another empty canning jar with a lid on it
then
being the duct tape person i am
i duct taped it together

then
i set them on the counter to wait
it looked like one of those sand timers that used to be used as a timer
i guess in the old days

it was exciting to see that honey as it slowly slowly slowly
dripped into the lower jar

we waited overnight
then the next day i set the complex duct taped jars in the sun
until they got warm

then
i poured the warmed honey into a small jar
for use to admire
take a taste of occasionally
treating it like a million dollar bottle of some special liqueur

ok so i dip my finger in there all the time just to get a taste
my wife she uses it on her breakfast each morning

heres hoping it lasts until we can get a bigger harvest
next month

dont you just love homesteading

this is a firewheel or indian blanket wildflower that is blanketing
our pastures right now

im sure some of their pollen is in this
country n honey

the organicgreen doctor