Feb 25 2014
16 Comments
Whine is Gluten-Free

Don’t waste my time! (On “patient autonomy” and health insurance)

If there’s one thing that makes my blood boil, it’s having my time wasted. I only have so much, and I waste enough of it myself that I really can’t afford to lose any to others’ incompetence.

Unfortunately, one of many frustrations that come with a chronic illness is wasted time. Managing celiac disease takes a fairly large toll on your time in the form of food research and preparation—though that’s, arguably, time valuably spent rather than wasted. Far more annoying, really, is dealing with doctors.

I, for example, have an HMO (health maintenance organization) insurance plan. The main difference between that and a PPO (preferred provider organization) plan is having to be referred by a primary care physician (PCP) in order to see a specialist. Even a specialist specializing in the chronic condition I will have for the rest of my life.

Researchers have actually felt the need—and gotten funding—to study the benefits of long-term follow-up care for celiac disease patients. Turns out (surprise!) it’s good for us. (See, e.g., this article in the Canada Journal of Gastroenterology.)

Judging from that, for the rest of my life, or at least the next few years, I should see a celiac disease specialist now and again. So can’t I just have a standing referral?

No.

Instead, before I can see my gastroenterologist to try to find out why I still feel crappy after over a year of being as carefully gluten-free as can be, I have to:

  1. call my PCP’s office
  2. wait on hold
  3. talk with a receptionist who seems determined not to understand what I’m asking for or help me to get it
  4. wait nearly a week for a return phone call
  5. follow up myself
  6. learn they need me to supply the doctor’s ID number (whether they were planning to ever, oh, call me for that information, or why they couldn’t ask me for it the first time I called, I do not know)
  7. tell them the ID number
  8. be advised to see my primary care doctor about whether I need to see the specialist
  9. snap that I have a chronic condition that my doctor already knows about
  10. feel bad for losing my temper
  11. agree to wait several days more for them to put through the referral
  12. and then and only then, finally, make the appointment with the specialist I already saw a year ago, who we all know I need to see.

I understand Oxford wants me to get referrals rather than run around willy-nilly to specialists and expect insurance to pay for it. They don’t trust me to know who to see, and why should they? Most people are idiots, and I haven’t proven to them that I’m not.

But wouldn’t it be nice if I could?

Look, I’ve been SAT tutoring for a while now, and if there’s one thing SAT tutoring will do, it’s turn everyone involved off of standardized tests. But some tests are necessary proving grounds or barriers to entry. No one wants people behind the wheel who haven’t passed a driving test, right?

So what if there were a test for basic medical common sense? Since “the prevailing ethical mantra in medicine” is supposedly patient autonomy (scoff), we could call it the PAT (Patient Autonomy Test). Those who passed could be trusted to refer themselves to specialists.

Insurance companies should be on board with this—after all, if I wind up needing to see a specialist, they lose money by making me see another doctor first to get the go-ahead. With the PAT, we all save money (and time).

Questions might include:

What kind of doctor should you see if you have a lifelong disease primarily affecting your gastrointestinal tract?

a) a gastroenterologist
b) a podiatrist
c) a cardiologist
d) none of the above

In your opinion, specialists and specialized medical tests and procedures are:

a) fun toys to enjoy at a whim
b) resources to turn to under specific, necessary circumstances
c) both

Are you:

a) a child
b) an adult capable of rational thought
c) a complete idiot
d) really struggling with these test questions

A quick reading comprehension portion on a passage describing recommended follow-up care for a specific condition could come next. And then a section on triangles, because—as my SAT students could tell you—that’s stuff we all really need to know.

bubbling an answer on standardized test with pencil

Don’t make any stray marks, now.
Photo © biologycorner | Flickr

What time wasters get your blood pressure up? And do you daydream about patient autonomy, too?

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Feb 19 2014
3 Comments
Gluten-Free Astrology

Gluten-Free Astrology: Pisces (born February 19 – March 20)

I can hardly believe it, but we’ve made it through an entire year of gluten-free astrology! We started with bold, optimistic, energetic GF Aries, and we end, of course, with depressive, lazy, self-immolating GF Pisces. Aw, just kidding, you’re only those things some of the time.

pisces fish

A cheery lot, you GF Pisces are.
Photo © Rromir Imami | Flickr

On the more positive side, if you’re a GF Pisces, you’re well known for your intuition: gluten-free pals turn to you for advice on whether to try that new restaurant that says it’s gluten-free-friendly, and a certain rumbling in your tummy can always tell you if they’re in for a glutening. Woe betide those who ignore your hunches, because there’s a decent chance they’re actually supernatural (if you believe in that sort of thing—which, being a Pisces, you probably do).

On the other hand, those friends who do wind up sick after an outing can count on you to be by their bedside, nursing them back to health with nothing but sympathy for their plight. You’re deeply compassionate and empathetic, not at all an “I told you so” type.

Most unfortunately, despite their keen powers of perception and willingness to care for others, GF Pisces often lack the self care skills necessary to keep themselves out of gluten’s way. You hate to say no and therefore often head out to eat at places you know aren’t safe for you. Your loyal and generous spirit might even lead you back again, tempted by managers’ assurance that they’ll make things right this time. Sometimes, they really do. Other times . . . well, I think you can fill in that ending yourself.

To compound the problem, you have a distinct tendency to overindulge in the good (and bad) stuff, which might mean you wake up not only glutened, but hungover to boot. Bummer.

A dreamer but not a schemer, the GF Pisces is unlikely to be an enterprising businessperson in the gluten-free zone. You could, however, probably write a lyrical chapbook or compelling novel about your celiac experience, if you could ever get up the energy to do it. Maybe this month is the right time; I don’t doubt we have a snow day or two left in store when you might find the time to pick up the pen. Of course, in your day-to-day life, you also do your part as a one-man support system for your gluten-free friends in need.

gluten-free Goldfish Puffs

A handful of your GF Piscean brethren?
Photo © theimpulsivebuy | Flickr

Your ruling planet, Neptune, is god of the sea, and your sign—mirror-image fishes tied together (makes it hard to swim)—and special colors (sea green and turquoise) link you even more to the water. So if you’d ever like to pamper yourself in a relatively healthy way for once, consider booking a spot on a gluten-free-friendly cruise. There’s a surprising number of them available, if the Internet can be believed. (If you book a ticket, take me with you!)

Extremely emotional and changeable, there’s a fair chance you suffer from mood swings or even full-on bipolar disorder as a result of your celiac disease. At the very least, you’ve been known to shed a tear outside of a pizzeria or cake shop . . . or even just at the thought of your old favorite. That’s when your active imagination isn’t much fun.

Speaking of the old imagination, many of your fellow Pisceans are artists and dreamers. Here are a few to be aware of:

Gabriel Garcia Marquez

Gabriel Garcia Márquez

 Gabriel Garcia Márquez, born March 6, 1927, is not, to my knowledge, gluten-free, but he does hail from Cartagena, Colombia originally. Any bread he ate there would likely have been made from masa arepa (corn flour), cassava (tapioca root), and sago. However, he’s definitely sympathetic to our plight, not only because he’s a Pisces but also because he is, self-reportedly, “on an eternal diet.” He told the NYT in 1988, “Half my life I couldn’t eat what I wanted because I couldn’t afford to, the other half because I have to diet.” Most GF people can’t even afford to eat the food we can eat on our diet, so Pisces or not, we can relate.

Johnny Cash (eating cake)

Johnny Cash (in a bush, eating a cake)

 Johnny Cash, born February 26, 1932, was certainly a Pisces: musical, somber, dark, and drugged out, drunk, and philandering. Sounds about right! But he was most certainly not gluten-free, because—from what I hear—no one, no matter how high, would want to eat an entire gluten-free strawberry cake made in the 70s by themselves.

As always, the “information,” such as it is, in this post has been largely ripped off from The Only Astrology Book You’ll Ever Need, by Joanna Martine Woolfolk, which is in fact the only astrology book you’ll ever need (need here being a relative term).

See also: Aries, Taurus, Gemini, Cancer, Leo, Virgo, Libra, Scorpio, Sagittarius, Capricorn, Aquarius

Well, folks, that’s everyone! I’m not sure whether I’ll be continuing this series in another form after this—maybe you want me to start in on romantic pairings (ooh la la)—but I hope you’ve enjoyed the tour through the cosmos as much as I have.

From now on, if you have further questions about the stars, you’d better direct them to your local GF Pisces. If that’s you, you can volunteer your services in the comments.

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Feb 13 2014
18 Comments
Breadcrumbs in the wilderness

Look at me! I’m a featured blogger.

Here’s a quick (and self-indulgent) post for you: Delight Gluten-Free Magazine chose me as their featured “gluten-free blogger of the week” this week!

In an interview on their blog, the Delight staff asked me some hard-hitting questions about mine, such as, “So, why don’t you post recipes?” You’ll have to read the interview to see my full response, but if you’ve read either of the two recipes I have posted (a classic easy weeknight meal, and an easy-meal-turned-way-overcomplicated), it’s probably obvious that I can’t take my recipe writing seriously enough to do it on the regular. Plus, um, food photography fail much?

Anyway, I’m . . . dare I say . . . delighted to have been featured, and I would be even more so if you checked out the interview. To show my gratitude, I’ll be sending the Delight team handwritten gluten-free Valentine’s Day notes (one for everyone, just like they taught me in preschool).* I know just the poems to include.

Check out the interview at Delight’s blog here, and please don’t be too annoyed with me for tooting my own horn.

tooting her own horn

Hey, it’s cute when she does it, right? Anyway, tooting someone else’s horn sounds unsanitary, and bound to lead to cross-contamination.
Photo © Dave Olsen | Flickr

*Just kidding; if I’m too lazy to write recipes, you can be darn sure I’m too lazy for valentines.

Feb 11 2014
6 Comments
Gluten-free prosody

Roses are red, gluten is blue (at least, that’s what it makes me, and probably you too)

Loyal readers will have noticed that I’ve been quieter than usual the last few weeks. There are a few reasons for that—some of which I’ll be talking about soon—but I do expect to get back to my twice-a-week schedule eventually.

In the meantime, it’s Valentine’s Week, and in case you’re worrying I don’t love you, I thought I’d reassure you with a poem. Then—because you deserve it, and “less is more” is a lie—I decided to reassure you with a bunch of poems.

This is a gift that keeps on giving, because it means this year you don’t have to confine yourself to blowing a kiss (air kisses are guaranteed gluten-free, even if hubby’s been cheating on you with cookies) or making one of those heart-shaped chocolatey things everyone’s been posting about since January. You can do your boo one better and make your card gluten-free, too!

Jot one of these puppies down in a lopsided heart for guaranteed romance:

Roses are red, violets are blue,
If I could eat gluten, I’d share it with you.

or

Roses are red, violets are blue,
I quit eating bread, but I’ll never quit you.

Or if you, like me, will instead be observing SAD (Singles Awareness Day), or if your taste in chocolate tends more to the bittersweet, I’ve still got you covered. Try this:

Roses are red, violets are blue,
I’d rather get glutened than make out with you.

or

Roses are red, violets are blue,
I’d go on a date, but I’m sick with the sprue.

violets are blue

. . . violets are blue . . .
Photo © M | Flickr

Then, for the descriptivist, there’s:

Roses are red, violets are blue,
Quinoa is white, and sorghum is too.

And, for dear old gluten:

Roses are red, violets are blue,
You hate my guts, and they sure hate you.

Normal small intestines mucosa

. . . and normal small intestine mucosa are pinkish-purple.
Photo © Ed Uthman | Flickr

If you enjoyed, spread the love! It is almost Valentine’s Day, after all.

Share your own gluten-free riffs on the classic in the comments (bonus points for using any rhyme other than “you”—it’s tricky!), and have a happy SAD week.

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